Patient‐Reported Outcomes and the Economic Effects of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis: The Value Proposition

Younossi, Zobair M.

doi:10.1002/hep.30125

Cited by 46 publications

(42 citation statements)

References 60 publications

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“…Bariatric surgery and newer endoscopic procedures can only be considered for morbidly obese individuals who are candidates for these interventions. [118][119][120][121][122] In addition, we must also consider the social determinants of health when developing strategies to combat the development of NAFLD. In this context, social determinants are broadly defined as the external factors which can separate the health status of one area from another.…”

Section: Key Pointmentioning

confidence: 99%

Non-alcoholic fatty liver disease – A global public health perspective

Younossi

2019

Journal of Hepatology

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As the epidemics of obesity and type 2 diabetes mellitus increase worldwide, the prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing proportionately. The subtype of NAFLD which can be characterised as non-alcoholic steatohepatitis (NASH) is a potentially progressive liver disease that can lead to cirrhosis, hepatocellular carcinoma, liver transplantation, and death. NAFLD is also associated with extrahepatic manifestations such as chronic kidney disease, cardiovascular disease and sleep apnoea. NAFLD and NASH carry a large economic burden and create poor health-related quality of life. Despite this important burden, we are only beginning to understand its mechanisms of pathogenesis and the contribution of environmental and genetic factors to the risk of developing a progressive course of disease. Research is underway to identify appropriate non-invasive diagnostic methods and effective treatments. Although the risk of liver-related mortality is increased in patients with NAFLD and liver fibrosis stages F3 or F4, the leading cause of death is cardiovascular disease. Given the rapidly growing global burden of NAFLD and NASH, efforts must continue to find accurate non-invasive diagnostic and prognostic biomarkers, to develop effective treatments for individuals with advanced NASH and prevention methods for individuals at high risk of NAFLD and progressive liver disease.

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Section: Key Pointmentioning

confidence: 99%

Non-alcoholic fatty liver disease – A global public health perspective

Younossi

2019

Journal of Hepatology

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1,547

1,169

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“…Lifestyle and physical health in early life can be long-term determinants of a muscle strength decline [9]. Several previous reports highlighted the importance of improving QOL in patients with CLDs [10][11][12][13][14]. We previously demonstrated that grip strength (GS) was closely linked to health-related QOL as assessed by the 36-Item Short-Form Health Survey (SF36) in patients with CLDs [15].…”

Section: Introductionmentioning

confidence: 99%

Grip Strength: A Useful Marker for Composite Hepatic Events in Patients with Chronic Liver Diseases

et al. 2020

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Here we sought to clarify the prognostic impact of sarcopenia-related markers (grip strength (GS), muscle mass using bioimpedance analysis and patient quality of life as assessed by the 36-Item Short-Form Health Survey (SF36)) in patients with chronic liver diseases (CLDs, n = 411; 160 liver cirrhosis patients; median age, 64 years) on the incidence of composite hepatic events (CHEs). A GS decrease was defined as <26 kg in men and <18 kg in women, while a skeletal muscle mass index (SMI) decrease was defined as <7.0 kg/m2 in men and <5.7 kg/m2 in women based on the current guidelines. The physical and metal component summary scores on the SF36 were also included into the analysis. Sixty-two patients (15.1%) had the first incidence of CHEs. The three-year cumulative incidence rates of CHEs in patients with GS decrease or non-decrease were 24.51% and 12.44% (p = 0.0057). The three-year cumulative incidence rates of CHEs in patients with an SMI decrease or non-decrease were 19.65% and 12.99% (p = 0.0982). Multivariate analysis revealed that GS decrease (p = 0.0350) and prothrombin time (p = 0.0293) were significantly associated with the incidence of CHEs. In conclusion, GS can be an independent predictor for CHE development in patients with CLDs.

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“…The magnitude of the burden of NAFLD is also seen in economic modeling and population‐based studies . NAFLD‐associated costs over the next 10 years are projected to be an estimated $1.005 trillion in the United States and €334 billion in Europe .…”

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confidence: 99%

“…NAFLD‐associated costs over the next 10 years are projected to be an estimated $1.005 trillion in the United States and €334 billion in Europe . Patients with NAFLD also report a decrease in their health‐related quality of life, especially in the area of physical functioning, which affects their ability to work and perform activities of daily living . Despite the significant burden posed by NAFLD, fully validated noninvasive diagnostic tests are lacking and effective treatment for NASH is limited .…”

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confidence: 99%

Mortality Related to Nonalcoholic Fatty Liver Disease Is Increasing in the United States

et al. 2019

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Population‐level nonalcoholic fatty liver disease (NAFLD) death rate data are sparse. We described death rates for adults with NAFLD in the United States using mortality data from the National Vital Statistics System multiple‐cause mortality data (2007‐2016). Decedents who had NAFLD were identified by International Classification of Diseases (ICD) codes K75.81, K76.0, K74.0, K74.6, and K76.9. Among NAFLD decedents, cause‐specific deaths (e.g., cardiovascular disease [CVD], cirrhosis, hepatocellular carcinoma [HCC], non‐liver cancer, diabetes mellitus [DM]) were identified by underlying cause of death ICD‐10 codes. Trends were evaluated by average annual percentage change (AAPC) in age‐standardized death rate (ASDR) per 100,000 persons. Among the 25,129,960 decedents aged ≥20 years, 353,234 (1.4%) decedents had NAFLD (212,322 men; 260,765 non‐Hispanic whites, 32,868 non‐Hispanic blacks, 46,530 Hispanics, 5,025 non‐Hispanic American Indian or Alaska Natives [AIANs], 7,023 non‐Hispanic Asian or Pacific Islanders [APIs]), with a mean age at death of 64.47 ± 13.17 years. During the study period, the ASDR for NAFLD increased by 15% (12.94 to 14.90; AAPC, 1.98%; P < 0.001]), while women (AAPC, 2.99% vs. 1.16% men; P = 0.003), non‐Hispanic whites (AAPC, 2.48%), non‐Hispanic AIANs (AAPC, 2.31%), and Hispanics (AAPC, 0.74%) experienced the highest annual increases. Stable trends were noted for non‐Hispanic blacks and non‐Hispanic APIs. Among subgroups, Mexican (AAPC, 1.75%) and Asian Indians (AAPC, 6.94%) experienced annual increases. The top six underlying causes of death (155,894 cirrhosis, 38,444 CVD, 19,466 non‐liver cancer, 10,867 HCC, 8,113 DM, and 5,683 lung disease) accounted for 67.5% of NAFLD‐related deaths. For cause‐specific deaths, ASDR increased for HCC (AAPC, 3.82%), DM (AAPC, 2.23%), non‐liver cancer (AAPC, 2.14%), CVD (AAPC, 1.59%), and cirrhosis (AAPC, 0.96%). Conclusion: NAFLD‐related deaths in U.S. adults are increasing. Cirrhosis is the top cause‐specific death, followed by CVD. Women, non‐Hispanic whites, and non‐Hispanic AIANs (subgroups Mexicans and Asian Indians) experienced the highest increases in deaths. Policies addressing the societal burden of NAFLD are needed.

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Patient‐Reported Outcomes and the Economic Effects of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis: The Value Proposition

Cited by 46 publications

References 60 publications

Non-alcoholic fatty liver disease – A global public health perspective

Non-alcoholic fatty liver disease – A global public health perspective

Grip Strength: A Useful Marker for Composite Hepatic Events in Patients with Chronic Liver Diseases

Mortality Related to Nonalcoholic Fatty Liver Disease Is Increasing in the United States

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