Increased overall mortality and liver-related mortality in non-alcoholic fatty liver disease

The diagnosis and management of non-alcoholic fatty liver disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association

“…[24][25][26][27][28] The likelihood of disease progression to advanced fibrosis or mortality increases in older patients with NAFLD. [29][30][31] Many recent studies have reported that male gender is a risk factor for fatty liver disease. 4 For example, in a study of 26,527 subjects undergoing medical checkups, the prevalence of NAFLD was 31% in men and 16% in women.…”

Non-alcoholic fatty liver disease: the hepatic consequence of obesity and the metabolic syndrome

“…Subsequently, three independent groups have analysed data from the US Third National Health and Nutrition Examination Survey for mortality risk among suspected cases of NAFLD based on elevated ALT levels (66)(67)(68) . While two groups have found NAFLD to be associated with an increase in overall mortality (66,67) , one of these two groups has found NAFLD to be associated with a very large increase in liver-associated mortality (66) , whereas the other group has reported a striking link between NAFLD among 45-54 year olds and CVD mortality (67) . Conversely, the third group has reported no association between elevated ALT levels and all-cause or CVD mortality but an association with liver-related mortality (68) .…”

Non-alcoholic Fatty Liver Disease: East Versus West

“…48 Similar results were obtained in another community-based study from the USA with important causes of death being cardiovascular disease (25%), neoplasms (24%), cerebrovascular disease (6%), and liver disease (6%). 119 Asian studies have also confirmed that patients with NAFLD have higher prevalence of diabetes, HTN, dyslipidemia and CRP, and higher cardiovascular risk by Framingham scoring compared with the general population, with NASH having higher risk than patients with simple steatosis. 75 Hazard ratios for cardiovascular events/mortality compared with controls were 1.6% and 1.8% in males and 2.9% and 5.3% of females with steatosis and NASH, respectively, in Korea.…”

“…However, even after adjusting for the presence of MS constituents, mortality remains higher in NAFLD patients with a hazard ratio of 9.22 for liver-related mortality and 1.12 for nonliverrelated mortality compared with general population. 119 Possible mechanisms include the presence of chronic inflammation, hypercoagulation, hypofibrinolysis, atherogenic dyslipidemia, IR, and oxidative stress associated with NAFLD. 121 We found that patients with NAFLD have increased atherosclerosis (as studied by the carotid intima media thickness and flow-mediated vasodilatation) and increased risk for cardiovascular disease (as studied by PROCAM score), but increased atherosclerosis and cardiovascular risk in these patients was dependent on the presence of MS (unpublished data).…”