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Cited by 221Liver Disease Diagnosis and TreatmentDiabetes, Cardiovascular Risks, and LipoproteinsAlcohol Consumption and Health Effects

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Components of metabolic syndrome increase the risk of mortality in nonalcoholic fatty liver disease (NAFLD)

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Golabi, Pegah, Otgonsuren, Munkhzul, de Avila, Leyla, Sayiner, Mehmet, Rafiq, Nila, Younossi, Zobair M.·2018·Medicine
DOI 10.1097/md.0000000000010214PMC PMC5895395
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Abstract

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the United States. Metabolic syndrome (MS) components are highly prevalent in NAFLD. Our aim is to assess the relationship of NAFLD and MS with long-term outcome of mortality.The Third National Health and Nutrition Examination Survey (NHANES) was utilized. NAFLD was diagnosed by ultrasound in the presence of hepatic steatosis and no other causes of chronic liver disease. History of MS and its components were obtained from self-reported NHANES questionnaires. Mortality was obtained from Mortality-Linkage File, through December 31, 2011. Chi-square test was used for categorical variables and Cox proportional models estimated hazard ratios with 95% confidence interval.NAFLD cohort (n = 3613) had a median age of 43 years, 73% white, and 50% male. NAFLD group with at least one MS condition was significantly older, had higher body mass index, more likely to have insulin resistance, and heart disease compared to NAFLD group without MS. Over 19-years of follow-up, 1039 people died. Compared to NAFLD patients without MS, presence of one MS component increased the risk of mortality at 8-year (2.6% vs 4.7%) and 16-year (6% vs 11.9%) (P < .001). After adjusting for socio-demographic factors, NAFLD with all MS components was associated with overall, cardiac and liver-mortality. Increased number of MS components was associated with lower survival (P < .0001).Patients with NAFLD and MS have higher mortality risk compared to NAFLD patients without MS. These NAFLD patients should be prioritized for the development of treatment regimens.

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Figure 1 Study flow, National Health and Nutrition Examination Survey (NHANES) III.
Figure 1 Study flow, National Health and Nutrition Examination Survey (NHANES) III.CC BY-SA · PubMed Central
Figure 2 Kaplan–Meier survival curves for 23-years follow-up (average = 19 years) of 3613 NAFLD participants, by MS conditions, NHANES III, 2011 public-use linked mortality files. MS = metabolic syndrome, NAFLD = nonalcoholic fatty liver disease, NHANES = National Health and Nutrition Examination Survey.
Figure 2 Kaplan–Meier survival curves for 23-years follow-up (average = 19 years) of 3613 NAFLD participants, by MS conditions, NHANES III, 2011 public-use linked mortality files. MS = metabolic syndrome, NAFLD = nonalcoholic fatty liver disease, NHANES = National Health and Nutrition Examination Survey.CC BY-SA · PubMed Central

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Metadata

Authors
Golabi, P., Otgonsuren, M., de Avila, L., Sayiner, M., Rafiq, N., & Younossi, Z. M.
Affiliations
Inova Health System (US)
Corresponding author
Younossi, Zobair M.
ORCID
Venue
Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2018-03
Volume
97
Issue
13
Pages
e0214
ISSN
0025-7974 (ISSN-L)
DOI
10.1097/md.0000000000010214
PMC
PMC5895395
OpenAlex
W2794816422
Cited by
221
References
46
Citations by year
2026: 16 · 2025: 20 · 2024: 32 · 2023: 25 · 2022: 33 · 2021: 36 · 2020: 24 · 2019: 24 · 2018: 9
FWCI
18.15
Type
journal article
Language
en
Open access
Licence
cc-by-sa
Locations
  • Medicine (publishedVersion, cc-by-sa)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-sa)
  • PubMed Central (publishedVersion, cc-by-sa)
  • PubMed (publishedVersion)
Funders
Centers for Disease Control and Prevention
Topics
  • Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Keywords
non-alcoholic fatty liver disease, metabolic syndrome, mortality risk, hepatic steatosis, insulin resistance, cardiovascular mortality, liver-related mortality, body mass index, long-term survival
MeSH terms
Adult, Cardiovascular Diseases, Female, Humans, Insulin Resistance, Male, Middle Aged, Nutrition Surveys, Risk Factors, United States, Comorbidity, Body Mass Index, Proportional Hazards Models, Age Distribution, Sex Distribution, Metabolic Syndrome, Non-alcoholic Fatty Liver Disease

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