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- Title
Hepatocellular carcinoma is the most common liver-related complication in patients with histopathologically-confirmed NAFLD in Japan.
- Authors
Akuta, Norio; Kawamura, Yusuke; Arase, Yasuji; Saitoh, Satoshi; Fujiyama, Shunichiro; Sezaki, Hitomi; Hosaka, Tetsuya; Kobayashi, Masahiro; Kobayashi, Mariko; Suzuki, Yoshiyuki; Suzuki, Fumitaka; Ikeda, Kenji; Kumada, Hiromitsu
- Abstract
<bold>Background: </bold>The incidence of liver-related events, cardiovascular events and type 2 diabetes mellitus in patients with histopathologically confirmed NAFLD remains unclear.<bold>Methods: </bold>We retrospectively investigated the incidence of liver events, cardiovascular events, malignancy, and type 2 diabetes mellitus in 402 Japanese patients with histopathologically confirmed NAFLD for a median follow-up of 4.2 years. We also investigated predictors of the development of hepatocellular carcinoma and type 2 diabetes mellitus in these patients.<bold>Results: </bold>The rate of liver-related events per 1000 person years was 4.17 (hepatocellular carcinoma, 3.67; hepatic encephalopathy, 1.60; esophago-gastric varices, 2.43; ascites, 0.80; and jaundice, 0.40). The rate of cardiovascular events and type 2 diabetes mellitus was 5.73 and 9.95, respectively. Overall mortality was 3.33 (liver-related events, 1.25; cardiovascular events, 0.42; and malignancies other than hepatocellular carcinoma, 0.83), in patients free of previous or current malignancies. Multivariate analyses identified old age (≥70 years) and advanced fibrosis stage 4 as significant determinants of hepatocellular carcinoma development, and hepatocyte steatosis (> 33%), female sex, and serum ferritin (≤80 μg/l) as significant determinants of type 2 diabetes mellitus development in these patients.<bold>Conclusions: </bold>Our results highlighted the importance of cardiovascular and liver-related events in Japanese patients with histopathologically-confirmed NAFLD. Hepatocellular carcinoma was the most common liver-related event, and the incidence of hepatocellular carcinoma was more than half of that of cardiovascular events.
- Subjects
LIVER cancer; HISTOPATHOLOGY; TYPE 2 diabetes; FERRITIN; FATTY liver
- Publication
BMC Gastroenterology, 2018, Vol 18, Issue 1, pN.PAG
- ISSN
1471-230X
- Publication type
journal article
- DOI
10.1186/s12876-018-0900-1