Metabolic syndrome, but not non-alcoholic fatty liver disease, increases 10-year mortality: A prospective, community-cohort study

被引:16
作者
Niriella, Madunil A. [1 ]
Kasturiratne, Anuradhani [1 ]
Beddage, Thulani U. [1 ]
Withanage, Shanthi A. [1 ]
Goonatilleke, Dilith C. [1 ]
Abeysinghe, Chathurika P. [1 ]
De Mel, Ruvini T. [1 ]
Balapitiya, Thilini L. [1 ]
De Silva, Shamila T. [1 ]
Dassanayake, Anuradha S. [1 ]
De Silva, Arjuna P. [1 ]
Pathmeswaran, Arunasalam [1 ]
Wickramasinghe, Ananda R. [1 ]
Kato, Nirihiro [2 ]
de Silva, Hithanadura J. [1 ]
机构
[1] Univ Kelaniya, Fac Med, Ragama, Sri Lanka
[2] Natl Ctr Global Hlth & Med, Toyama, Tokyo, Japan
关键词
fatty liver; metabolic syndrome; mortality; NAFLD; non-alcoholic fatty liver disease; LONG-TERM OUTCOMES; FIBROSIS STAGE; PREDICTS MORTALITY; ASSOCIATION; STEATOHEPATITIS; PREVALENCE; ADULTS; NAFLD; RISK;
D O I
10.1111/liv.14237
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background Data on outcomes of non-alcoholic fatty liver disease (NAFLD) from South Asia are lacking. We compared mortality, among those with- and without-NAFLD, after 10-years follow-up among urban, adult Sri Lankans. Method Participants (aged 35-64 years), selected by age-stratified random sampling, were screened by structured-interview in 2007. Anthropometric measurements, liver ultrasonography and biochemical/serological tests were done. NAFLD was diagnosed on ultrasound criteria, safe-alcohol consumption (Asian-standards) and absence of hepatitis B/C. Subjects without NAFLD were those without any ultrasound criteria of fatty liver, safe-alcohol consumption and absence of hepatitis B/C. The cohort was re-evaluated to assess mortality in 2017. Participants or their households were contacted by telephone/post, and deaths confirmed by home-visits and death certificate review. Cox-regression was used to determine predictors of all-cause mortality (ACM) and cardiovascular mortality (CVM) in those with- and without-NAFLD. Results 2724 (91.2%) of 2985 original participants were contacted (851-with NAFLD and 1072-without NAFLD). Overall there were 169 (6.2%) deaths [41-deaths among NAFLD (17-cardiovascular; 9-cancer-related; 4-liver-specific; 11-other) and 79-deaths among no-NAFLD (28-cardiovascular; 17-cancer-related; 1-liver-specific; 33-other)]. Metabolic syndrome (MetS), low-education level, higher age and male-gender independently predicted ACM. MetS, increasing age and male-gender independently predicted CVM. NAFLD did not predict either ACM or CVM. In those with NAFLD, MetS and age >55-years were independently associated with ACM, while MetS and male-gender were associated with CVM. Conclusion In this community-based study, increasing age, male-gender and MetS, but not NAFLD, predicted 10-year ACM and CVM. Among those with NAFLD, only those metabolically abnormal were at a higher risk for mortality.
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页码:101 / 106
页数:6
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