Clinicopathological Profile and Outcome of a Large Cohort of Patients with Nonalcoholic Fatty Liver Disease from South Asia: Interim Results of the Indian Consortium on Nonalcoholic Fatty Liver Disease

• Published in: Metabolic syndrome and related disorders Vol. 20; no. 3; p. 166
• Main Authors: Duseja, Ajay, Singh, Shivaram P, Mehta, Manu, Shalimar, Venkataraman, Jayanthi, Mehta, Varun, Devadas, Krishnadas, Kar, Sanjib K, Goyal, Omesh, Nagral, Aabha, Saigal, Sanjiv, Nijhawan, Sandeep, Praharaj, Dibyalochan, Shukla, Akash, Sharma, Brij, Narayanasamy, Krishnasamy, Kumar, Pramod, Rao, Padaki Nagaraja, Arora, Anil, Mehta, Rajiv, Asati, Pankaj, Ranjan, Piyush, Koshy, Abraham, Alam, Seema, Mukewar, Shrikant, Mukewar, Saurabh, Mohan Prasad, Virukalpatti Gopalratnam, Rastogi, Mukul, Sanyal, Arun J
• Format: Journal Article
• Language: English
• Published: United States 01.04.2022
• Subjects: Adult; Aspartate Aminotransferases; Biopsy - adverse effects; Fibrosis; Humans; India - epidemiology; Liver - pathology; Liver Cirrhosis - complications; Liver Cirrhosis - diagnosis; Liver Cirrhosis - epidemiology; Male; Middle Aged; Non-alcoholic Fatty Liver Disease - complications; Non-alcoholic Fatty Liver Disease - diagnosis; Non-alcoholic Fatty Liver Disease - epidemiology; India; metabolic syndrome; nonalcoholic steatohepatitis; NAFLD; cryptogenic cirrhosis; metabolic dysfunction-associated fatty liver disease; fatty liver; NASH
• ISSN: 1557-8518
• DOI: 10.1089/met.2021.0104

Previous data from South Asia and India had shown that patients with nonalcoholic fatty liver disease (NAFLD) have mild liver disease severity. There are no data regarding long-term clinical outcomes in patients with NAFLD from South Asia. The aim of the study was to evaluate the clinicopathological profile, severity of NAFLD, and clinical outcomes in a large cohort of patients with NAFLD from South Asia. In an ongoing real-life study [Indian Consortium on nonalcoholic fatty liver disease (ICON-D)], interim data captured across 23 centers in India over 18 months was analyzed for clinicopathological profile, severity of NAFLD, and hepatic/extrahepatic events on follow-up. Of 4313 patients (mean age 45 ± 12.2 years, males 52%), data on metabolic risk factors in 3553 (82.3%) patients revealed that 378 (10.6%) were lean, 575 (16.2%) overweight, 2584 (72.7%) obese; metabolic syndrome in 1518 (42.7%) and at least one metabolic risk factor in 3292 (92.6%) patients. Evidence of significant or advanced fibrosis assessed with [aspartate transaminase to platelet ratio index (APRI),  = 3196 (74%)], [fibrosis-4 (FIB-4),  = 3554 (82.4%)], [NAFLD fibrosis score (NFS),  = 1924 (44.6%)], [Fibroscan,  = 2475, (57.3%)], and histology [  = 267 (6.2%)] was present in 682 (21.3%), 676 (19%), 397 (20.6%), 715 (29%), and 41 (15.4%) patients, respectively; 246 (10%) patients on Fibroscan and 22 (8.2%) on histology had evidence of cirrhosis. On a mean follow-up 43.5 months, hepatic and extrahepatic events recorded in 1353 (31.3%) patients showed that patients with compensated cirrhosis [71 (5.2%)] had more hepatic [26 (36.7%)] and extrahepatic events [8 (11.3%)] in comparison with those without cirrhosis (  < 0.0001). Around one fifth of patients with NAFLD in South Asia have significant liver disease. Both hepatic and extrahepatic events on follow-up are observed more commonly in patients with nonalcoholic steatohepatitis-related compensated cirrhosis.