Hepatocellular carcinoma is the most common liver-related complication in patients with histopathologically-confirmed NAFLD in Japan

被引：32
作者：
Akuta, Norio [1 ,2 ]
Kawamura, Yusuke [1 ,2 ]
Arase, Yasuji [1 ,2 ]
Saitoh, Satoshi [1 ,2 ]
Fujiyama, Shunichiro [1 ,2 ]
Sezaki, Hitomi [1 ,2 ]
Hosaka, Tetsuya [1 ,2 ]
Kobayashi, Masahiro [1 ,2 ]
Kobayashi, Mariko [3 ]
Suzuki, Yoshiyuki [1 ,2 ]
Suzuki, Fumitaka [1 ,2 ]
Ikeda, Kenji [1 ,2 ]
Kumada, Hiromitsu [1 ,2 ]
机构：
[1] Toranomon Gen Hosp, Dept Hepatol, Minato Ku, 2-2-2 Toranomon, Tokyo 1050001, Japan
[2] Okinaka Mem Inst Med Res, Minato Ku, 2-2-2 Toranomon, Tokyo 1050001, Japan
[3] Toranomon Gen Hosp, Liver Res Lab, Tokyo, Japan
来源：
BMC GASTROENTEROLOGY | 2018年 / 18卷
关键词：
Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis; Hepatocellular carcinoma; Liver-related events; Cardiovascular events; Type 2 diabetes mellitus; Malignancy; Mortality; Fibrosis stage; Hepatocyte steatosis; NONALCOHOLIC STEATOHEPATITIS; FIBROSIS STAGE; FOLLOW-UP; DISEASE; MORTALITY; BIOPSY; DIAGNOSIS; RISK;
D O I：
10.1186/s12876-018-0900-1
中图分类号：
R57 [消化系及腹部疾病];
学科分类号：
摘要：
BackgroundThe incidence of liver-related events, cardiovascular events and type 2 diabetes mellitus in patients with histopathologically confirmed NAFLD remains unclear.MethodsWe retrospectively investigated the incidence of liver events, cardiovascular events, malignancy, and type 2 diabetes mellitus in 402 Japanese patients with histopathologically confirmed NAFLD for a median follow-up of 4.2years. We also investigated predictors of the development of hepatocellular carcinoma and type 2 diabetes mellitus in these patients.ResultsThe rate of liver-related events per 1000 person years was 4.17 (hepatocellular carcinoma, 3.67; hepatic encephalopathy, 1.60; esophago-gastric varices, 2.43; ascites, 0.80; and jaundice, 0.40). The rate of cardiovascular events and type 2 diabetes mellitus was 5.73 and 9.95, respectively. Overall mortality was 3.33 (liver-related events, 1.25; cardiovascular events, 0.42; and malignancies other than hepatocellular carcinoma, 0.83), in patients free of previous or current malignancies. Multivariate analyses identified old age (70years) and advanced fibrosis stage 4 as significant determinants of hepatocellular carcinoma development, and hepatocyte steatosis (>33%), female sex, and serum ferritin (80g/l) as significant determinants of type 2 diabetes mellitus development in these patients.ConclusionsOur results highlighted the importance of cardiovascular and liver-related events in Japanese patients with histopathologically-confirmed NAFLD. Hepatocellular carcinoma was the most common liver-related event, and the incidence of hepatocellular carcinoma was more than half of that of cardiovascular events.
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页数：10
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