Results from a large population-based cohort of almost a million people in the UK found that the chances of dying from non-alcoholic steatohepatitis (NASH), over a 14-year period, was approximately 50% higher than for those with non-alcoholic fatty liver disease (NAFLD).
The large study analysed the overall burden of cardiovascular disease and all-cause mortality across the spectrum of NAFLD. The four stages of NAFLD are steatosis (or simple fatty liver), non-alcoholic steatohepatitis (NASH), fibrosis and cirrhosis.
Data from over 900,000 patients in England was obtained from a local computerised hospital activity analysis register. Data was processed to identify patients with NAFLD, NASH and NAFLD cirrhosis throughout the study period. Cardiovascular comorbidities were coded and their prevalence were analysed over 14 years.
During the 14-year study period, 2,701 patients were diagnosed with NAFLD-spectrum conditions: 1,294 with NAFLD, 122 with NASH and 1,285 with cirrhosis. All-cause mortality was higher in people with NASH than NAFLD (22.1% vs 14.5%) and in those with cirrhosis than NAFLD (53.1% vs 14.5%). Congestive cardiac failure was less prevalent in NAFLD than NASH and cirrhosis.
Dr Jake Mann, University of Cambridge, UK, concluded: "Non-alcoholic fatty liver disease is recognised as a risk factor for cardiovascular disease. Our results suggest that non-alcoholic steatohepatitis conveys an even greater risk. This study provides important new insights into mortality and burden of cardiovascular disease in patients across the non-alcoholic fatty liver disease spectrum."
Dr Laurent Castera, vice-secretary, European Association for the Study of the Liver, commented: "In non-alcoholic fatty liver disease, fat builds up in the liver which can cause inflammation and, eventually, lead to permanent scarring. Non-alcoholic fatty liver disease has four stages and these findings clearly link the severity of the disease with the increased risk of cardiovascular disease and death. It is therefore imperative that we identify people in the early stages of non-alcoholic fatty liver disease so they can be treated through diet and lifestyle interventions before their condition becomes potentially deadly."