Clinical Outcomes in Biopsy-Proven Nonalcoholic Fatty Liver Disease Patients: A Multicenter Registry-based Cohort Study

被引：72

作者：

Fujii, Hideki ^{[1
,2
]}

Iwaki, Michihiro ^{[3
]}

Hayashi, Hideki ^{[4
]}

Toyoda, Hidenori ^{[5
]}

Oeda, Satoshi ^{[6
,7
]}

Hyogo, Hideyuki ^{[8
]}

Kawanaka, Miwa ^{[9
]}

Morishita, Asahiro ^{[10
]}

Munekage, Kensuke ^{[11
]}

Kawata, Kazuhito ^{[12
]}

Yamamura, Sakura ^{[13
]}

Sawada, Koji ^{[14
,15
]}

Maeshiro, Tatsuji ^{[16
]}

Tobita, Hiroshi ^{[17
]}

Yoshida, Yuichi ^{[18
]}

Naito, Masafumi ^{[18
]}

Araki, Asuka ^{[17
]}

Arakaki, Shingo ^{[16
]}

Kawaguchi, Takumi ^{[13
]}

Noritake, Hidenao ^{[12
]}

Ono, Masafumi ^{[19
]}

Masaki, Tsutomu ^{[10
]}

Yasuda, Satoshi ^{[5
]}

Tomita, Eiichi ^{[4
]}

Yoneda, Masato ^{[3
]}

Kawada, Norifumi ^{[2
]}

Tokushige, Akihiro ^{[20
]}

Kamada, Yoshihiro ^{[21
]}

Takahashi, Hirokazu ^{[6
]}

Ueda, Shinichiro ^{[22
]}

Aishima, Shinichi ^{[23
]}

Sumida, Yoshio ^{[24
]}

Nakajima, Atsushi ^{[3
]}

Okanoue, Takeshi ^{[25
]}

机构：

[1] Osaka City Univ, Grad Sch Med, Dept Premier Prevent Med, Osaka, Japan

[2] Osaka City Univ, Grad Sch Med, Dept Hepatol, Osaka, Japan

[3] Yokohama City Univ, Div Gastroenterol & Hepatol, Grad Sch Med, Yokohama, Japan

[4] Gifu Municipal Hosp, Dept Gastroenterol & Hepatol, Gifu, Japan

[5] Ogaki Municipal Hosp, Dept Gastroenterol, Ogaki, Japan

[6] Saga Univ Hosp, Liver Ctr, Saga, Japan

[7] Saga Univ Hosp, Dept Lab Med, Saga, Japan

[8] JA Hiroshima Kouseiren Gen Hosp, Dept Gastroenterol, Hatsukaichi, Hiroshima, Japan

[9] Kawasaki Med Sch, Kawasaki Med Ctr, Dept Gen Internal Med 2, Okayama, Japan

[10] Kagawa Univ, Fac Med, Dept Gastroenterol & Neurol, Takamatsu, Kagawa, Japan

[11] Kochi Med Sch, Dept Gastroenterol & Hepatol, Kochi, Japan

[12] Hamamatsu Univ, Dept Internal Med 2, Hepatol Div, Sch Med, Shizuoka, Japan

[13] Kurume Univ, Dept Med, Div Gastroenterol, Sch Med, Kurume, Japan

[14] Asahikawa Med Univ, Div Metab & Biosyst Sci Gastroenterol & Hematol O, Liver Dis Care Unit, Asahikawa, Japan

[15] Asahikawa Med Univ, Dept Med, Asahikawa, Japan

[16] Univ Ryukyus Hosp, Dept Internal Med 1, Nishihara, Okinawa, Japan

[17] Shimane Univ Hosp, Div Hepatol, Izumo, Shimane, Japan

[18] Suita Municipal Hosp, Dept Gastroenterol & Hepatol, Osaka, Japan

[19] Kagawa Univ, Fac Med, Div Innovat Med Hepatobiliary & Pancreatol, Takamatsu, Kagawa, Japan

[20] Kagoshima Univ, Dept Cardiovasc Med & Hypertens, Grad Sch Med & Dent Sci, Kagoshima, Japan

[21] Osaka Univ, Grad Sch Med, Dept Adv Metab Hepatol, Osaka, Japan

[22] Univ Ryukyus, Grad Sch Med, Dept Clin Pharmacol & Therapeut, Nishihara, Okinawa, Japan

[23] Saga Univ, Fac Med, Dept Pathol & Microbiol, Saga, Japan

[24] Aichi Med Univ, Dept Internal Med, Div Hepatol & Pancreatol, Aichi, Karimata, Japan

[25] Saiseikai Suita Hosp, Hepatol Ctr, Suita, Osaka, Japan

来源：

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY | 2023年 / 21卷 / 02期

关键词：

Asian; Cirrhosis; Fibrosis; Liver-related Mortality; FIBROSIS STAGE; LONG-TERM; CARDIOVASCULAR-DISEASE; FOLLOW-UP; STEATOHEPATITIS; MORTALITY; RISK; ASSOCIATION; VALIDATION; DIAGNOSIS;

D O I：

10.1016/j.cgh.2022.01.002

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

BACKGROUND & AIMS: There are no detailed reports of clinical outcomes in Asian patients with nonalcoholic fatty liver disease (NAFLD) who undergo liver biopsy. We aimed to investigate the clinical outcomes of a large cohort of Asian patients with biopsy-proven NAFLD and evaluate the specific effects of nonalcoholic steatohepatitis and fibrosis stage.METHODS: This multicenter registry-based retrospective cohort study, called the CLIONE (Clinical Outcome Nonalcoholic Fatty Liver Disease) in Asia, included 1398 patients.RESULTS: The median follow-up period was 4.6 years (range, 0.3-21.6 years), representing a total of 8874 person-years of follow-up. During that time, 47 patients died, and 1 patient underwent orthotopic liver transplantation. The leading cause of death was nonhepatic cancer (n = 10). The leading causes of liver-related death were liver failure (n = 9), hepatocellular carcinoma (HCC) (n = 8), and cholangiocellular carcinoma (n = 4). During follow-up, 37 patients developed HCC, 31 developed cardiovascular disease, and 68 developed nonhepatic cancer (mainly breast, stomach, and colon/rectum). Among our cohort of patients with NAFLD, liver-specific mortality was 2.34/1000 person-years (95% confidence interval [CI], 1.52-3.58), overall mortality was 5.34/1000 person-years (95% CI, 4.02-7.08), and HCC incidence was 4.17/1000 person-years (95% CI, 3.02-5.75). Liver fibrosis was independently associated with liver related events but not overall mortality.CONCLUSIONS: Liver-related mortality was the leading cause of mortality in Asian patients with biopsy confirmed NAFLD. Although fibrosis stage was independently associated with liver-related events, it was not associated with overall mortality after adjusting for confounders, such as histologic features of steatohepatitis.

引用

页码：370 / 379

页数：10

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