Hospital admission with non-alcoholic fatty liver disease is associated with increased all-cause mortality independent of cardiovascular risk factors

MedRxiv : the Preprint Server for Health Sciences
Jake P MannR. Potluri


Background: Non-alcoholic fatty liver disease (NAFLD) is common and strongly associated with the metabolic syndrome. Though NAFLD may progress to end-stage liver disease, the top cause of mortality in NAFLD is cardiovascular disease (CVD). Most of the data on liver-related mortality in NAFLD derives from specialist liver centres. We aimed to assess mortality in NAFLD when adjusting for CVD in a real world cohort of inpatients. Methods: Retrospective study of hospitalised patients with 14-years follow-up. NAFL (non-alcoholic fatty liver), non-alcoholic steatohepatitis (NASH), and NAFLD-cirrhosis groups were defined by ICD-10 codes using ACALM methodology. Cases were age-/sex-matched 1:10 with non-NAFLD hospitalised patients from the ACALM registry. All-cause mortality was compared between groups using cox regression adjusted for CVD and metabolic syndrome risk factors. Results: We identified 1238 patients with NAFL, 105 with NASH and 1235 with NAFLD-cirrhosis. There was an increasing burden of cardiovascular disease with progression from NAFL to NASH to cirrhosis. After adjustment for demographics, metabolic syndrome components and cardiovascular disease, patients with NAFL, NASH, and cirrhosis all had increased all-cause mortal...Continue Reading

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