The Natural History of Nonalcoholic Fatty Liver Disease: A Population-Based Cohort Study

Adams, Leon A.; Lymp, James; Sauver, Jennifer L. St.; Sanderson, Schuyler O.; Lindor, Keith D.; Feldstein, Ariel E.; Angulo, Paul

doi:10.1053/j.gastro.2005.04.014

Cited by 2,618 publications

(2,119 citation statements)

References 29 publications

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“…Our findings showed more patients developed end‐stage liver disease compared to what has been reported (1.2%‐5.4%) 7, 8, 13, 33. Angulo et al13 showed 4.2% of all patients developed end‐stage liver disease.…”

Section: Discussionsupporting

confidence: 47%

“…In our previous report of this cohort, 5.4% had developed end‐stage liver disease after a follow‐up of 13.7 years,8 which is in line with Angulo et al who reported almost equal frequency after 12.6 years of follow‐up. In addition, Adams et al7 showed an end‐stage liver disease frequency of 3% after 7.8 years. In the long‐term follow‐up by Dam‐Larsen et al,33 only 1.2% developed end‐stage liver disease after 20.4 years of follow‐up.…”

Section: Discussionmentioning

confidence: 99%

“…Some patients with NAFLD develop progressive fibrosis and subsequent cirrhosis with an increased risk of hepatocellular carcinoma 6. The prevalence of cirrhosis among patients with NAFLD is approximately 5%, and patients with NAFLD have an increased mortality compared to control populations 7, 8, 9. Today, NAFLD is the second leading etiology among adult patients awaiting liver transplant in the United States 10…”

Section: Introductionmentioning

confidence: 99%

“…There are few paired biopsy studies with approximately 520 patients in total,7, 8, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 and all but two studies have a median follow‐up time of less than 7 years (range, 3.0‐7.0 years). Albeit, some studies only include patients with NASH, the rate of fibrosis progression does not seem to be affected by the presence of steatohepatitis.…”

Section: Introductionmentioning

confidence: 99%

“…NAFLD is a slowly progressive disease,11 and most follow‐up studies have too short a follow‐up time to assess fibrosis progression 24. Fibrosis progression is seen in 27%‐52% of patients7, 8, 19, 21, 22, 24 over a mean of 3.0‐13.8 years of follow‐up, with the majority of patients with NAFLD having static or regressive fibrosis. Baseline variables predicting fibrosis progression have been hard to determine.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Natural history of nonalcoholic fatty liver disease: A prospective follow‐up study with serial biopsies

Nasr

Ignatova

Kechagias

et al. 2017

Hepatology Communications

128

104

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Nonalcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease in the world. The complete natural history of NAFLD is unknown because few high‐quality follow‐up studies have been conducted. Our aim was to find variables predicting disease severity through an extended follow‐up with serial biopsies. In a prospective cohort study, 129 patients who enrolled between 1988 and 1993 were asked to participate in a follow‐up study on two occasions; biochemical, clinical, and histologic data were documented. The mean time between biopsies was 13.7 (±1.7) and 9.3 (±1.0) years, respectively. At the end of the study period, 12 patients (9.3%) had developed end‐stage liver disease and 34% had advanced fibrosis. Out of the 113 patients with baseline low fibrosis (<3), 16% developed advanced fibrosis. Fibrosis progression did not differ among the different stages of baseline fibrosis (P = 0.374). Fifty‐six patients (43%) had isolated steatosis, of whom 9% developed advanced fibrosis (3 patients with biopsy‐proven fibrosis stage F3‐F4 and 2 patients with end‐stage liver disease). Fibrosis stage, ballooning, and diabetes were more common in patients who developed end‐stage liver disease; however, there were no baseline clinical, histologic, or biochemical variables that predicted clinical significant disease progression. Conclusion: NAFLD is a highly heterogeneous disease, and it is surprisingly hard to predict fibrosis progression. Given enough time, NAFLD seems to have a more dismal prognosis then previously reported, with 16% of patients with fibrosis stage <3 developing advanced fibrosis and 9.3% showing signs of end‐stage liver disease. (Hepatology Communications 2018;2:199–210)

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