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Adverse Liver Outcomes Up With Diagnosis of NAFLD/NASH

Baseline diagnosis of diabetes independent predictor of advanced liver disease diagnosis

WEDNESDAY, May 22, 2019 (HealthDay News) — The risks for cirrhosis and hepatocellular carcinoma (HCC) are increased for patients with a recorded diagnosis of nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH), according to a study published online May 20 in BMC Medicine.

Myriam Alexander, Ph.D., from Real World Data at GlaxoSmithKline in Uxbridge, England, and colleagues extracted data from four European primary care databases and followed patients with a recorded diagnosis of NAFLD or NASH for incident cirrhosis or HCC diagnoses. Each NAFLD/NASH patient was matched with up to 100 non-NAFLD patients.

The researchers identified 136,703 patients with coded NAFLD/NASH out of 18,782,281 adults. Patients with coded NAFLD/NASH were more likely than controls to have diabetes, hypertension, and obesity. Compared with controls, patients had an increased risk for cirrhosis and HCC (hazard ratios, 4.73 and 3.51, respectively). For either outcome, hazard ratios were higher in patients with NASH and for those with high-risk Fib-4 scores. A baseline diagnosis of diabetes was the strongest independent predictor of a diagnosis of HCC or cirrhosis.

“Making an impact on advanced liver disease will need coordinated efforts to identify those with NAFLD, to stage their disease and target those at risk of progression,” the authors write.

Several authors disclosed financial ties to the biopharmaceutical industry.

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