TY - JOUR
T1 - The natural history of nonalcoholic fatty liver disease
T2 - A population-based cohort study
AU - Adams, Leon A.
AU - Lymp, James F.
AU - St. Sauver, Jenny
AU - Sanderson, Schuyler O.
AU - Lindor, Keith D.
AU - Feldstein, Ariel
AU - Angulo, Paul
N1 - Funding Information:
The Rochester Epidemiology Project (REP) is a unique data linkage system funded by the National Institutes of Health to investigate disease in a population setting. The REP indexes all medical diagnoses made by health care providers in Olmsted County, Minnesota. 14 The 2 main providers of health care in Olmsted County (Mayo Clinic and Olmsted Medical Center) as well as local private physicians are indexed, allowing coverage of primary, secondary, and tertiary health care. Subsequently, all diagnoses made in outpatient office or clinic visits, hospitalizations, emergency room visits, nursing home care, surgical procedures, autopsies, and death certificates are recorded. Each year, 87% of the Olmsted County residents are seen at least once at Mayo or the Olmsted Medical Center, and, in any given 4-year period, at least 1 health encounter is recorded in over 95% of county residents. 14 This allows evaluation of the health status of what is effectively the entire county.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2005/7
Y1 - 2005/7
N2 - Background & Aims: The natural history of nonalcoholic fatty liver disease (NAFLD) in the community remains unknown. We sought to determine survival and liver-related morbidity among community-based NAFLD patients. Methods: Four hundred twenty patients diagnosed with NAFLD in Olmsted County, Minnesota, between 1980 and 2000 were identified using the resources of the Rochester Epidemiology Project. Medical records were reviewed to confirm diagnosis and determine outcomes up to 2003. Overall survival was compared with the general Minnesota population of the same age and sex. Results: Mean (SD) age at diagnosis was 49 (15) years; 231 (49%) were male. Mean follow-up was 7.6 (4.0) years (range, 0.1-23.5) culminating in 3192 person-years follow-up. Overall, 53 of 420 (12.6%) patients died. Survival was lower than the expected survival for the general population (standardized mortality ratio, 1.34; 95% CI, 1.003-1.76; P = .03). Higher mortality was associated with age (hazard ratio per decade, 2.2; 95% CI, 1.7-2.7), impaired fasting glucose (hazard ratio, 2.6; 95% CI, 1.3-5.2), and cirrhosis (hazard ratio, 3.1, 95% CI, 1.2-7.8). Liver disease was the third leading cause of death (as compared with the thirteenth leading cause of death in the general Minnesota population), occurring in 7 (1.7%) subjects. Twenty-one (5%) patients were diagnosed with cirrhosis, and 13 (3.1%) developed liver-related complications, including 1 requiring transplantation and 2 developing hepatocellular carcinoma. Conclusions: Mortality among community-diagnosed NAFLD patients is higher than the general population and is associated with older age, impaired fasting glucose, and cirrhosis. Liver-related death is a leading cause of mortality, although the absolute risk is low.
AB - Background & Aims: The natural history of nonalcoholic fatty liver disease (NAFLD) in the community remains unknown. We sought to determine survival and liver-related morbidity among community-based NAFLD patients. Methods: Four hundred twenty patients diagnosed with NAFLD in Olmsted County, Minnesota, between 1980 and 2000 were identified using the resources of the Rochester Epidemiology Project. Medical records were reviewed to confirm diagnosis and determine outcomes up to 2003. Overall survival was compared with the general Minnesota population of the same age and sex. Results: Mean (SD) age at diagnosis was 49 (15) years; 231 (49%) were male. Mean follow-up was 7.6 (4.0) years (range, 0.1-23.5) culminating in 3192 person-years follow-up. Overall, 53 of 420 (12.6%) patients died. Survival was lower than the expected survival for the general population (standardized mortality ratio, 1.34; 95% CI, 1.003-1.76; P = .03). Higher mortality was associated with age (hazard ratio per decade, 2.2; 95% CI, 1.7-2.7), impaired fasting glucose (hazard ratio, 2.6; 95% CI, 1.3-5.2), and cirrhosis (hazard ratio, 3.1, 95% CI, 1.2-7.8). Liver disease was the third leading cause of death (as compared with the thirteenth leading cause of death in the general Minnesota population), occurring in 7 (1.7%) subjects. Twenty-one (5%) patients were diagnosed with cirrhosis, and 13 (3.1%) developed liver-related complications, including 1 requiring transplantation and 2 developing hepatocellular carcinoma. Conclusions: Mortality among community-diagnosed NAFLD patients is higher than the general population and is associated with older age, impaired fasting glucose, and cirrhosis. Liver-related death is a leading cause of mortality, although the absolute risk is low.
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U2 - 10.1053/j.gastro.2005.04.014
DO - 10.1053/j.gastro.2005.04.014
M3 - Article
C2 - 16012941
AN - SCOPUS:22344452893
SN - 0016-5085
VL - 129
SP - 113
EP - 121
JO - Gastroenterology
JF - Gastroenterology
IS - 1
ER -