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In patients with non-alcoholic fatty liver disease, metabolically abnormal individuals are at a higher risk for mortality while metabolically normal individuals are not.
Metabolism. 2013 Mar; 62(3):352-60.M

Abstract

BACKGROUND AND AIM

Non-alcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease and is strongly associated with metabolic syndrome. The aim of this study is to compare the clinical profile and long-term outcome in NAFLD patients with or without metabolic syndrome.

METHODS

The initial cohort (N=6709) was identified from National Health and Nutrition Examination Survey-III (NHANES III, 1988-94) data. Laboratory profiles, body measurement examinations, and mortality data were linked to self-reported questionnaires of demographic and health risk information. NAFLD was defined as significant steatosis on hepatic ultrasound after exclusion of other chronic liver diseases (N=1448). NAFLD patients were classified according to presence or absence of metabolic syndrome. Mortality was determined through December 31, 2006. Cox models were used to estimate hazard ratios and 95% confidence intervals for all-cause, cardiovascular and liver-specific mortality differences between two sub-cohorts of NAFLD with and without metabolic syndrome.

RESULTS

NAFLD participants with metabolic syndrome were more likely to be Non-Hispanic white, older, and have higher aminotransferase levels. All-cause mortality (P<.001) and cardiovascular mortality (P<.001) were higher in NAFLD patients with metabolic syndrome. Furthermore, the presence of metabolic syndrome was independently associated with overall mortality, liver-specific mortality, and cardiovascular mortality. Age was an independent predictor of both all-cause and cardiovascular mortality. Elevated liver enzymes and obesity were two other independent predictors of liver-specific mortality. There were no differences in all-cause, liver-related, or cardiovascular mortality between groups of individuals without liver disease and individuals with NAFLD without metabolic syndrome (metabolically-normal).

CONCLUSIONS

Diagnosis of NAFLD with metabolic syndrome is an independent predictor of all-cause, liver-specific, and cardiovascular mortality. In contrast, mortality of metabolically-normal NAFLD patients is similar to the cohort without liver disease.

Authors+Show Affiliations

Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA. zobair.younossi@inova.orgNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22999011

Citation

Younossi, Zobair M., et al. "In Patients With Non-alcoholic Fatty Liver Disease, Metabolically Abnormal Individuals Are at a Higher Risk for Mortality While Metabolically Normal Individuals Are Not." Metabolism: Clinical and Experimental, vol. 62, no. 3, 2013, pp. 352-60.
Younossi ZM, Otgonsuren M, Venkatesan C, et al. In patients with non-alcoholic fatty liver disease, metabolically abnormal individuals are at a higher risk for mortality while metabolically normal individuals are not. Metabolism. 2013;62(3):352-60.
Younossi, Z. M., Otgonsuren, M., Venkatesan, C., & Mishra, A. (2013). In patients with non-alcoholic fatty liver disease, metabolically abnormal individuals are at a higher risk for mortality while metabolically normal individuals are not. Metabolism: Clinical and Experimental, 62(3), 352-60. https://doi.org/10.1016/j.metabol.2012.08.005
Younossi ZM, et al. In Patients With Non-alcoholic Fatty Liver Disease, Metabolically Abnormal Individuals Are at a Higher Risk for Mortality While Metabolically Normal Individuals Are Not. Metabolism. 2013;62(3):352-60. PubMed PMID: 22999011.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - In patients with non-alcoholic fatty liver disease, metabolically abnormal individuals are at a higher risk for mortality while metabolically normal individuals are not. AU - Younossi,Zobair M, AU - Otgonsuren,Munkhzul, AU - Venkatesan,Chapy, AU - Mishra,Alita, Y1 - 2012/09/19/ PY - 2012/06/07/received PY - 2012/08/01/revised PY - 2012/08/13/accepted PY - 2012/9/25/entrez PY - 2012/9/25/pubmed PY - 2013/7/3/medline SP - 352 EP - 60 JF - Metabolism: clinical and experimental JO - Metabolism VL - 62 IS - 3 N2 - BACKGROUND AND AIM: Non-alcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease and is strongly associated with metabolic syndrome. The aim of this study is to compare the clinical profile and long-term outcome in NAFLD patients with or without metabolic syndrome. METHODS: The initial cohort (N=6709) was identified from National Health and Nutrition Examination Survey-III (NHANES III, 1988-94) data. Laboratory profiles, body measurement examinations, and mortality data were linked to self-reported questionnaires of demographic and health risk information. NAFLD was defined as significant steatosis on hepatic ultrasound after exclusion of other chronic liver diseases (N=1448). NAFLD patients were classified according to presence or absence of metabolic syndrome. Mortality was determined through December 31, 2006. Cox models were used to estimate hazard ratios and 95% confidence intervals for all-cause, cardiovascular and liver-specific mortality differences between two sub-cohorts of NAFLD with and without metabolic syndrome. RESULTS: NAFLD participants with metabolic syndrome were more likely to be Non-Hispanic white, older, and have higher aminotransferase levels. All-cause mortality (P<.001) and cardiovascular mortality (P<.001) were higher in NAFLD patients with metabolic syndrome. Furthermore, the presence of metabolic syndrome was independently associated with overall mortality, liver-specific mortality, and cardiovascular mortality. Age was an independent predictor of both all-cause and cardiovascular mortality. Elevated liver enzymes and obesity were two other independent predictors of liver-specific mortality. There were no differences in all-cause, liver-related, or cardiovascular mortality between groups of individuals without liver disease and individuals with NAFLD without metabolic syndrome (metabolically-normal). CONCLUSIONS: Diagnosis of NAFLD with metabolic syndrome is an independent predictor of all-cause, liver-specific, and cardiovascular mortality. In contrast, mortality of metabolically-normal NAFLD patients is similar to the cohort without liver disease. SN - 1532-8600 UR - https://www.unboundmedicine.com/medline/citation/22999011/In_patients_with_non_alcoholic_fatty_liver_disease_metabolically_abnormal_individuals_are_at_a_higher_risk_for_mortality_while_metabolically_normal_individuals_are_not_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0026-0495(12)00309-5 DB - PRIME DP - Unbound Medicine ER -