Causes and risk profiles of mortality among individuals with nonalcoholic fatty liver disease

• Published in: Clinical and molecular hepatology Vol. 29; no. Suppl; pp. S43 - S57
• Main Authors: Konyn, Peter, Ahmed, Aijaz, Kim, Donghee
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Association for the Study of the Liver 01.02.2023; The Korean Association for the Study of the Liver
• Subjects: Age; Alcohol; Biopsy; Body mass index; Cardiovascular disease; Cholesterol; Cohort analysis; Comorbidity; death; Diabetes; Diabetes Mellitus, Type 2 - complications; Ethnicity; Fatty liver; Hepatitis; High density lipoprotein; Humans; Hyperlipidemia; Hypertension; Liver cancer; Liver cirrhosis; Liver Cirrhosis - complications; Liver diseases; Metabolic syndrome; Mortality; nash; Non-alcoholic Fatty Liver Disease - complications; Non-alcoholic Fatty Liver Disease - metabolism; non-alcoholic fatty liver disease and fatty liver; Obesity; outcome; Review; risk factor; Risk Factors; Sedentary behavior; Smoking; Trends; Ultrasonic imaging; United States > US; Death; Non-alcoholic fatty liver disease and fatty liver; NASH; Outcome; Risk factor
• ISSN: 2287-2728; 2287-285X; 2287-285X
• DOI: 10.3350/cmh.2022.0351

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the United States and worldwide. Though nonalcoholic fatty liver per se may not be independently associated with an increased risk for all-cause mortality, it is associated with a number of harmful metabolic risk factors, such as type 2 diabetes mellitus, hyperlipidemia, obesity, a sedentary lifestyle, and an unhealthy diet. The fibrosis stage is a predictor of all-cause mortality in NAFLD. Mortality in individuals with NAFLD has been steadily increasing, and the most common cause-specific mortality for NAFLD is cardiovascular disease, followed by extra-hepatic cancer, liver-related mortality, and diabetes. High-risk profiles for mortality in NAFLD include PNPLA3 I148M polymorphism, low thyroid function and hypothyroidism, and sarcopenia. Achieving weight loss through adherence to a high-quality diet and sufficient physical activity is the most important predictor of improvement in NAFLD severity and the benefit of survival. Given the increasing health burden of NAFLD, future studies with more long-term mortality data may demonstrate an independent association between NAFLD and mortality.