Hepatocellular carcinoma is the most common liver-related complication in patients with histopathologically-confirmed NAFLD in Japan

BMC Gastroenterology

Hiromitsu Kumada¹  Yusuke Kawamura¹  Yoshiyuki Suzuki¹  Satoshi Saitoh¹  Masahiro Kobayashi¹  Kenji Ikeda¹  Yasuji Arase¹  Shunichiro Fujiyama¹  Tetsuya Hosaka¹  Fumitaka Suzuki¹  Norio Akuta¹  Hitomi Sezaki¹  Mariko Kobayashi² 

[1] Department of Hepatology, Toranomon Hospital and Okinaka Memorial Institute for Medical Research;Liver Research Laboratory, Toranomon Hospital;

关键词: Nonalcoholic fatty liver disease;    Nonalcoholic steatohepatitis;    Hepatocellular carcinoma;    Liver-related events;    Cardiovascular events;    Type 2 diabetes mellitus;   

DOI  :  10.1186/s12876-018-0900-1

来源: DOAJ

【 摘 要 】

Abstract Background The incidence of liver-related events, cardiovascular events and type 2 diabetes mellitus in patients with histopathologically confirmed NAFLD remains unclear. Methods We retrospectively investigated the incidence of liver events, cardiovascular events, malignancy, and type 2 diabetes mellitus in 402 Japanese patients with histopathologically confirmed NAFLD for a median follow-up of 4.2 years. We also investigated predictors of the development of hepatocellular carcinoma and type 2 diabetes mellitus in these patients. Results The rate of liver-related events per 1000 person years was 4.17 (hepatocellular carcinoma, 3.67; hepatic encephalopathy, 1.60; esophago-gastric varices, 2.43; ascites, 0.80; and jaundice, 0.40). The rate of cardiovascular events and type 2 diabetes mellitus was 5.73 and 9.95, respectively. Overall mortality was 3.33 (liver-related events, 1.25; cardiovascular events, 0.42; and malignancies other than hepatocellular carcinoma, 0.83), in patients free of previous or current malignancies. Multivariate analyses identified old age (≥70 years) and advanced fibrosis stage 4 as significant determinants of hepatocellular carcinoma development, and hepatocyte steatosis (> 33%), female sex, and serum ferritin (≤80 μg/l) as significant determinants of type 2 diabetes mellitus development in these patients. Conclusions Our results highlighted the importance of cardiovascular and liver-related events in Japanese patients with histopathologically-confirmed NAFLD. Hepatocellular carcinoma was the most common liver-related event, and the incidence of hepatocellular carcinoma was more than half of that of cardiovascular events.

【 授权许可】

Unknown