Current Hepatology Reports

, Volume 14, Issue 2, pp 69–76 | Cite as

Long-Term Outcomes of Nonalcoholic Fatty Liver Disease

  • Min-Sun Kwak
  • Donghee Kim
Fatty Liver Disease (SA Harrison and J George, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Fatty Liver Disease


Nonalcoholic fatty liver disease (NAFLD) is a prevalent disease with 20–30 % of the population affected in many developed and developing countries. Studies assessing the prognosis of NAFLD have shown that simple steatosis has a benign long-term outcome without excess mortality compared to the general population but that patients with NASH or with fibrosis have increased long-term mortality with standardized mortality ratio of 1.34–2.6 and hazard ratio of 1.004–1.05. The excess mortality of NAFLD patients is mainly due to cardiovascular disease. Liver-related mortality is also elevated in patients with NAFLD, especially in those patients with NASH or advanced fibrosis. A simple noninvasive fibrosis marker such as the NAFLD fibrosis score might be useful for predicting overall mortality and cause-specific mortality in these patients. A proportion of NAFLD develop concomitant or subsequent NASH at a rate of 10–20 %, and about 10 % of NASH cases progress to cirrhosis. NAFLD can progress to HCC, especially in patients with cirrhosis or advanced liver fibrosis. In addition to these liver-related complications, metabolic complications can also occur. The incidence of newly developed diabetes is elevated in NAFLD patients, and nonfatal and fatal cardiovascular diseases occur more frequently in patients with NAFLD. Therefore, cardiovascular assessment and liver-related surveillance might be considered in patients with NAFLD. In summary, we should pay more attention to patients with NAFLD, especially those with advanced forms of the disease because these individuals have increased morbidity and mortality.


Nonalcoholic fatty liver disease Nonalcoholic steatohepatitis Survival Cirrhosis Hepatocellular carcinoma Diabetes 



Confidence interval


Hepatitis C virus


Hepatocellular carcinoma


Hazard ratio


Nonalcoholic fatty liver disease


Nonalcoholic steatohepatitis


Nonalcoholic fatty liver disease fibrosis score


Odds ratio




Compliance with Ethics Guidelines

Conflict of Interest

Min-Sun Kwak and Donghee Kim declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam CenterSeoul National University HospitalGangnam-GuSouth Korea
  2. 2.Division of Gastroenterology and HepatologyStanford University School of MedicineStanfordUSA

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