Incidence of liver-related morbidity and mortality in a population cohort of non-alcoholic fatty liver disease

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Männistö , V T , Salomaa , V , Färkkilä , M , Jula , A , Mannisto , S , Erlund , I , Sundvall , J , Lundqvist , A , Perola , M & Åberg , F 2021 , ' Incidence of liver-related morbidity and mortality in a population cohort of non-alcoholic fatty liver disease ' , Liver International , vol. 41 , no. 11 , pp. 2590-2600 . https://doi.org/10.1111/liv.15004

Title: Incidence of liver-related morbidity and mortality in a population cohort of non-alcoholic fatty liver disease
Author: Männistö, Ville T.; Salomaa, Veikko; Färkkilä, Martti; Jula, Antti; Mannisto, Satu; Erlund, Iris; Sundvall, Jouko; Lundqvist, Annamari; Perola, Markus; Åberg, Fredrik
Contributor organization: Centre of Excellence in Complex Disease Genetics
HUS Abdominal Center
Department of Medicine
Clinicum
Gastroenterologian yksikkö
IV kirurgian klinikka
Date: 2021-11
Language: eng
Number of pages: 11
Belongs to series: Liver International
ISSN: 1478-3223
DOI: https://doi.org/10.1111/liv.15004
URI: http://hdl.handle.net/10138/340500
Abstract: Background & Aims Non-alcoholic fatty liver disease (NAFLD) increases morbidity and mortality. However, patients in biopsy-based cohorts are highly selected and the absolute risks of liver- and non-liver outcomes in NAFLD in population remains undefined. We analysed both liver-related and non-liver-related outcomes in Finnish population cohorts of NAFLD. Methods We included 10 993 individuals (6707 men, mean age 53.3 +/- 12.6 years) with NAFLD (fatty liver index >= 60) from the Finnish population-based FINRISK and Health 2000 studies. Liver fibrosis was assessed by the dAAR score, and genetic risk by a recent polygenic risk score (PRS-5). Incident liver-related outcomes, cardiovascular disease (CVD), cancer and chronic kidney disease (CKD) were identified through linkage with national registries. Results Mean follow-up was 12.1 years (1128 069 person-years). The crude incidence rate of liver-related outcomes in NAFLD was 0.97/1000 person-years. The cumulative incidence increased with age, being respectively 2.4% and 1.5% at 20 years in men and women aged 60 years at baseline, while the relative risks for CVD and cancer were 9-16 times higher. The risk of CKD exceeded that of liver outcomes at a baseline age around 50 years. 20-year cumulative incidence of liver-related outcomes was 4.3% in the high, and 1.5% in the low PRS-5 group. The dAAR score associated with liver outcomes, but not with extra-hepatic outcomes. Conclusion The absolute risk of liver-related outcomes in NAFLD is low, with much higher risk of CVD and cancer, emphasizing the need for more individualized and holistic risk-stratification in NAFLD.
Subject: advanced liver disease
cirrhosis
non-alcoholic fatty liver disease
ALCOHOLIC STEATOHEPATITIS PATIENTS
HOSPITAL DISCHARGE REGISTER
LONG-TERM OUTCOMES
FIBROSIS STAGE
RISK
PROGRESSION
METAANALYSIS
CANCER
NAFLD
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: publishedVersion


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