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Association between noninvasive fibrosis markers and mortality among adults with nonalcoholic fatty liver disease in the United States
Open accessAbstract
UNLABELLED: The clinical and public health significance of nonalcoholic fatty liver disease (NAFLD) is not well established. We investigated the long-term effect of NAFLD on mortality. This analysis utilized the National Health and Nutrition Examination Survey conducted in 1988-1994 and subsequent follow-up data for mortality through December 31, 2006. NAFLD was defined by ultrasonographic detection of hepatic steatosis in the absence of other known liver diseases. The presence and severity of hepatic fibrosis in subjects with NAFLD was determined by the NAFLD fibrosis score (NFS), the aspartate aminotransferase to platelet ratio index (APRI), and FIB-4 score. Of 11,154 participants, 34.0% had NAFLD--the majority (71.7%) had NFS consistent with lack of significant fibrosis (NFS <-1.455), whereas 3.2% had a score indicative of advanced fibrosis (NFS >0.676). After a median follow-up of 14.5 years, NAFLD was not associated with higher mortality (age- and sex-adjusted hazard ratio [HR]: 1.05; 95% confidence interval [CI]: 0.93-1.19). In contrast, there was a progressive increase in mortality with advancing fibrosis scores. Compared to subjects without fibrosis, those with a high probability of advanced fibrosis had a 69% increase in mortality (for NFS: HR, 1.69, 95% CI: 1.09-2.63; for APRI: HR, 1.85, 95% CI: 1.02-3.37; for FIB-4: HR, 1.66, 95% CI: 0.98-2.82) after adjustment for other known predictors of mortality. These increases in mortality were almost entirely from cardiovascular causes (for NFS: HR, 3.46, 95% CI: 1.91-6.25; for APRI: HR, 2.53, 95% CI: 1.33-4.83; for FIB-4: HR, 2.68, 95% CI: 1.44-4.99). CONCLUSIONS: Ultrasonography-diagnosed NAFLD is not associated with increased mortality. However, advanced fibrosis, as determined by noninvasive fibrosis marker panels, is a significant predictor of mortality, mainly from cardiovascular causes, independent of other known factors.
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“NFS predicted cardiovascular mortality in the NHANES cohort. 180”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [180]
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Cites
Design and validation of a histological scoring system for nonalcoholic fatty liver disease†
Kleiner, D. E., Brunt, E. M., Van Natta, M., Behling, C., Contos, M. J., Cummings, O. W., Ferrell, L. D., Liu, Y., Torbenson, M. S., Unalp‐Arida, A., et al. (2005) · Hepatology · doi:10.1002/hep.20701 · Cited by 10,791
Sterling, R. K., Lissen, E., Clumeck, N., Sola, R., Correa, M. C., Montaner, J., S. Sulkowski, M., Torriani, F. J., Dieterich, D. T., Thomas, D. L., et al. (2006) · Hepatology · doi:10.1002/hep.21178 · Cited by 5,021
Wai, C.-T., Greenson, J. K., Fontana, R. J., Kalbfleisch, J. D., Marrero, J. A., Conjeevaram, H. S., & Lok, A. S.-F. (2003) · Hepatology · doi:10.1053/jhep.2003.50346 · Cited by 4,406
Chalasani, N., Younossi, Z. M., Lavine, J. E., Diehl, A. M., Brunt, E. M., Cusi, K. J., Charlton, M., & Sanyal, A. J. (2012) · Hepatology · doi:10.1002/hep.25762 · Cited by 3,854
Prevalence of Hepatic Steatosis in An Urban Population in the United States: Impact of Ethnicity
Browning, J. D., Szczepaniak, L. S., Dobbins, R., Nuremberg, P., Horton, J. D., Cohen, J. C., Grundy, S. M., & Hobbs, H. H. (2004) · Hepatology · doi:10.1002/hep.20466 · Cited by 3,664
Angulo, P., Hui, J. M., Marchesini, G., Bugianesi, E., George, J., Farrell, G. C., Enders, F., Saksena, S., Burt, A. D., Bida, J. P., et al. (2007) · Hepatology · doi:10.1002/hep.21496 · Cited by 3,244
Self-citationVernon, G. C., Baranova, A. V., & Younossi, Z. M. (2011) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2011.04724.x · Cited by 3,116
The Natural History of Nonalcoholic Fatty Liver Disease: A Population-Based Cohort Study
Adams, L. A., Lymp, J. F., St. Sauver, J., Sanderson, S. O., Lindor, K. D., Feldstein, A., & Angulo, P. (2005) · Gastroenterology · doi:10.1053/j.gastro.2005.04.014 · Cited by 2,890
Long-term follow-up of patients with NAFLD and elevated liver enzymes
Ekstedt, M., Franzén, L. E., Mathiesen, U. L., Thorelius, L., Holmqvist, M., Bodemar, G., & Kechagias, S. (2006) · Hepatology · doi:10.1002/hep.21327 · Cited by 2,302
Vallet‐Pichard, A., Mallet, V. O., Nalpas, B., Verkarre, V., Nalpas, A., Dhalluin-Venier, V., Fontaine, H., & Pol, S. (2007) · Hepatology · doi:10.1002/hep.21669 · Cited by 2,085
Risk of Cardiovascular Disease in Patients with Nonalcoholic Fatty Liver Disease
Targher, G., Day, C. P., & Bonora, E. (2010) · New England Journal of Medicine · doi:10.1056/nejmra0912063 · Cited by 1,907
Hernaez, R., Lazo, M., Bonekamp, S., Kamel, I., Brancati, F. L., Guallar, E., & Clark, J. M. (2011) · Hepatology · doi:10.1002/hep.24452 · Cited by 1,585
Comparison of Noninvasive Markers of Fibrosis in Patients With Nonalcoholic Fatty Liver Disease
Shah, A. G., Lydecker, A. D., Murray, K. F., Tetri, B., Contos, M. J., & Sanyal, A. J. (2009) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2009.05.033 · Cited by 1,561
Musso, G., Gambino, R., Cassader, M., & Pagano, G. (2010) · Annals of Medicine · doi:10.3109/07853890.2010.518623 · Cited by 1,304
McPherson, S., Stewart, S. F., Henderson, E., Burt, A. D., & Day, C. P. (2010) · Gut · doi:10.1136/gut.2010.216077 · Cited by 946
The natural history of nonalcoholic fatty liver: A follow-up study
Teli, M. R., James, O., Burt, A. D., Bennett, M. K., & Day, C. P. (1995) · Hepatology · doi:10.1002/hep.1840220616 · Cited by 913
Adams, L. A., Sanderson, S. O., Lindor, K. D., & Angulo, P. (2004) · Journal of Hepatology · doi:10.1016/j.jhep.2004.09.012 · Cited by 908
Prevalence and ethnic differences in gallbladder disease in the United States
Everhart, J. E., Khare, M., Hill, M. C., & Maurer, K. R. (1999) · Gastroenterology · doi:10.1016/s0016-5085(99)70456-7 · Cited by 845
Decreased Survival of Subjects With Elevated Liver Function Tests During A 28-Year Follow-Up
Söderberg, C., Stal, P. I., Askling, J., Glaumann, H., Lindberg, G., Marmur, J., & Hultcrantz, R. W. (2009) · Hepatology · doi:10.1002/hep.23314 · Cited by 755
Service, P. H. (1994) · PubMed · Cited by 740
Long-Term Follow-Up of Patients With Nonalcoholic Fatty Liver
Rafiq, N., Bai, C., Fang, Y. H., Srishord, M. K., McCullough, A. J., Gramlich, T., & Younossi, Z. M. (2008) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2008.11.005 · Cited by 729
Increased overall mortality and liver-related mortality in non-alcoholic fatty liver disease
Ong, J. P., Pitts, A., & Younossi, Z. M. (2008) · Journal of Hepatology · doi:10.1016/j.jhep.2008.06.018 · Cited by 636
Long term prognosis of fatty liver: risk of chronic liver disease and death
Dam‐Larsen, S., Franzmann, M., Andersen, I. B., Christoffersen, P., Jensen, L. B., Sørensen, T. I. A., Becker, U., & Bendtsen, F. (2004) · Gut · doi:10.1136/gut.2003.019984 · Cited by 505
Epidemiology and Natural History of NAFLD and NASH
Ong, J. P., & Younossi, Z. M. (2007) · Clinics in Liver Disease · doi:10.1016/j.cld.2007.02.009 · Cited by 459
Non-alcoholic fatty liver disease and mortality among US adults: prospective cohort study
Lazo, M., Hernáez, R., Bonekamp, S., Kamel, I. R., Brancati, F. L., Güallar, E., & Clark, J. M. (2011) · BMJ · doi:10.1136/bmj.d6891 · Cited by 395
GI Epidemiology: nonalcoholic fatty liver disease
Angulo, P. (2007) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2007.03246.x · Cited by 370
Ruhl, C. E., & Everhart, J. E. (2008) · Gastroenterology · doi:10.1053/j.gastro.2008.10.052 · Cited by 357
The Global Impact of Hepatic Fibrosis and End-Stage Liver Disease
Lim, Y., & Kim, W. R. (2008) · Clinics in Liver Disease · doi:10.1016/j.cld.2008.07.007 · Cited by 326
Suspected Nonalcoholic Fatty Liver Disease and Mortality Risk in a Population-Based Cohort Study
Dunn, W., Xu, R., Wingard, D. L., Rogers, C., Angulo, P., Younossi, Z. M., & Schwimmer, J. B. (2008) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2008.02034.x · Cited by 323
Dowman, J. K., Tomlinson, J., & Newsome, P. N. (2010) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2010.04556.x · Cited by 316
Nonalcoholic fatty liver disease is associated with coronary artery calcification
Kim, D., Choi, S., Park, E. H., Lee, W., Kang, J. H., Kim, W. K., Kim, Y. J., Yoon, J., Jeong, S., Lee, D. H., et al. (2012) · Hepatology · doi:10.1002/hep.25593 · Cited by 312
Self-citationComparison of blood tests for liver fibrosis specific or not to NAFLD
Calès, P., Lainé, F., Boursier, J., Deugnier, Y., Moal, V., Oberti, F., Hunault, G., Rousselet, M. C., Hubert, I., Laafi, J., et al. (2008) · Journal of Hepatology · doi:10.1016/j.jhep.2008.07.035 · Cited by 255
Angulo, P. (2010) · Hepatology · doi:10.1002/hep.23521 · Cited by 232
Gallstone Disease Is Associated With Increased Mortality in the United States
Ruhl, C. E., & Everhart, J. E. (2010) · Gastroenterology · doi:10.1053/j.gastro.2010.10.060 · Cited by 214
Choi, S.-Y., Kim, D., Kim, H. J., Kang, J. H., Chung, S. J., Park, M. J., Kim, Y. S., Kim, C. H., Choi, S. H., Kim, W. K., et al. (2009) · The American Journal of Gastroenterology · doi:10.1038/ajg.2009.238 · Cited by 125
Self-citationOng, J. P., Pitts, A., & Younossi, Z. M. (2008) · Journal of Hepatology · doi:10.1016/s0168-8278(08)60008-2 · Cited by 119
Klein, S. (2003) · Gastroenterology · doi:10.1053/j.gastro.2003.11.060 · Cited by 18
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Ekstedt, M., Hagström, H., Nasr, P., Fredrikson, M., Stål, P., Kechagias, S., & Hultcrantz, R. (2015) · Hepatology · doi:10.1002/hep.27368 · Cited by 2,287
The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis
Riazi, K., Azhari, H., Charette, J. H., Underwood, F. E., King, J. A., Afshar, E. E., Swain, M. G., Congly, S. E., Kaplan, G. G., & Shaheen, A.-A. (2022) · The Lancet Gastroenterology & Hepatology · doi:10.1016/s2468-1253(22)00165-0 · Cited by 2,246
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Metadata
- Authors
- Kim, D., Kim, R. W., Kim, H. J., & Therneau, T. M.
- Affiliations
- Mayo Clinic (US)
- Asan Medical Center (KR)
- Venue
- Hepatology
- Published
- 2013-04
- Volume
- 57
- Issue
- 4
- Pages
- 1357-1365
- ISSN
- 0270-9139 (ISSN-L)
- PMC
- PMC3622816
- OpenAlex
- W1987934823
- Cited by
- 772
- References
- 37
- Citations by year
- 2026: 27 · 2025: 35 · 2024: 51 · 2023: 74 · 2022: 77 · 2021: 80 · 2020: 92 · 2019: 74 · 2018: 52 · 2017: 70 · 2016: 43 · 2015: 46 · 2014: 33 · 2013: 18
- FWCI
- 23.23
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes, Digestive, and Kidney Disease (DK-34238)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Keywords
- non-alcoholic fatty liver disease, liver fibrosis, mortality, NAFLD fibrosis score, APRI, FIB-4, cardiovascular mortality, hepatic steatosis, non-invasive fibrosis markers, long-term follow-up, NHANES cohort, liver transplantation, liver cancer
- MeSH terms
- Adult, Aged, Aspartate Aminotransferases, Blood Platelets, Fatty Liver, Female, Follow-Up Studies, Humans, Liver, Liver Cirrhosis, Male, Middle Aged, Nutrition Surveys, Retrospective Studies, Risk Factors, Severity of Illness Index, Ultrasonography, United States, Prevalence, Survival Rate, Non-alcoholic Fatty Liver Disease
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