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Long-Term Outcomes of Nonalcoholic Fatty Liver Disease

  • Fatty Liver Disease (SA Harrison and J George, Section Editors)
  • Published:
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Abstract

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.

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Abbreviations

CI:

Confidence interval

HCV:

Hepatitis C virus

HCC:

Hepatocellular carcinoma

HR:

Hazard ratio

NAFLD:

Nonalcoholic fatty liver disease

NASH:

Nonalcoholic steatohepatitis

NFS:

Nonalcoholic fatty liver disease fibrosis score

OR:

Odds ratio

US:

Ultrasonography

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

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

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  1. Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, 39FL., Gangnam Finance Center 737, Yeoksam-Dong, Gangnam-Gu, Seoul, 135-984, South Korea

    Min-Sun Kwak & Donghee Kim

  2. Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 300 Pasteur Drive, Always Bldg Room M211, Stanford, CA, 94305, USA

    Donghee Kim

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  1. Min-Sun Kwak
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Correspondence to Donghee Kim.

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This article is part of the Topical Collection on Fatty Liver Disease

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Kwak, MS., Kim, D. Long-Term Outcomes of Nonalcoholic Fatty Liver Disease. Curr Hepatology Rep 14, 69–76 (2015). https://doi.org/10.1007/s11901-015-0258-6

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