Long term follow-up and liver-related death rate in patients with non-alcoholic and alcoholic related fatty liver disease

BMC Gastroenterology

Research Article

Svanhildur Haflidadottir¹  Einar S Björnsson²  Sylvia O Einarsdottir³  Jon G Jonasson⁴  Helga Norland⁵  Sigrun H Lund⁶  David E Kleiner⁷ 

[1] Department of Internal Medicine, Section of Gastroenterology and Hepatology, The National University Hospital of Iceland, Hringbraut 11D, 101, Reykjavik, Iceland;Department of Internal Medicine, Section of Gastroenterology and Hepatology, The National University Hospital of Iceland, Hringbraut 11D, 101, Reykjavik, Iceland;Faculty of Medicine, University of Iceland, Reykjavík, Iceland;Department of Pathology, The National University Hospital, Reykjavík, Iceland;Department of Pathology, The National University Hospital, Reykjavík, Iceland;Faculty of Medicine, University of Iceland, Reykjavík, Iceland;Faculty of Medicine, University of Iceland, Reykjavík, Iceland;Faculty of Medicine, University of Iceland, Reykjavík, Iceland;Centre of Public Health, University of Iceland, Reykjavík, Iceland;Laboratory of Pathology, NIH/NCI, Bethesda, MD, USA;

关键词: NAFLD;    AFLD;    Fibrosis;    Prognosis;    Mortality;   

DOI  :  10.1186/1471-230X-14-166

 received in 2014-07-03, accepted in 2014-09-23,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundFew studies have compared the prognosis and liver-related mortality in patients with NAFLD (nonalcoholic fatty liver disease) and AFLD (alcoholic fatty liver disease). We aimed to investigate the etiology and liver-related mortality of patients with liver biopsy verified fatty liver disease in a population based setting.MethodsIn this retrospective study, all patients who underwent a liver biopsy 1984–2009 at the National University Hospital of Iceland were identified through a computerized pathological database with the code for fatty liver. Only patients with NAFLD and AFLD were included and medical records reviewed. The patients were linked to the Hospital Discharge Register, the Causes of Death Registry and Centre for Addiction Medicine.ResultsA total of 151 had NAFLD and 94 AFLD with median survival of 24 years and 20 years, respectively (p = NS). A total of 10/151 (7%) patients developed cirrhosis in the NAFLD group and 19/94 (20%) in AFLD group (p = 0.03). The most common cause of death in the NAFLD group was cardiovascular disease (48%). Liver disease was the most common cause of death in the AFLD group (36%), whereas liver-related death occurred in 7% of the NAFLD group. The mean liver-related death rate among the general population during the study period was 0.1% of all deaths. There was a significantly worse survival for patients in the AFLD group compared to the NAFLD group after adjusting for gender, calendar year of diagnosis and age at diagnosis (HR 2.16, p = 0.009). The survival for patients with moderate to severe fibrosis was significantly worse than for patients with mild fibrosis after adjusting for gender, calendar year of diagnosis and age at diagnosis (HR 2.09, p = 0.01).ConclusionsPatients with fatty liver disease showed a markedly higher risk of developing liver-related death compared to the general population. The AFLD group had higher liver-related mortality and had a worse survival than the NAFLD group. Patients with more severe fibrosis at baseline showed a worse survival than patients with none or mild fibrosis at baseline.

【 授权许可】

Unknown   
© Haflidadottir et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.