Decreased survival with elevated liver function tests

The latest issue of Hepatology finds survival is decreased with elevated liver function tests during a 28-year follow-up.

The long-term survival of subjects with nonalcoholic fatty liver disease  in comparison with both individuals with elevated transaminases attributable to other causes and the general poulation is poorly characterized.

Dr Cecilia Söderberg and colleagues from Sweden determined the frequency of nonalcoholic fatty liver disease (NAFLD) in a cohort of subjects who underwent liver biopsy from 1980 to 1984 because of elevated liver enzymes.

In addition, the team assessed mortality among subjects with nonalcoholic fatty liver disease in comparison with the general Swedish population.

The 256 subjects had a mean age of 45 years at the inclusion.

Subjects with bland steatosis had a 55% increase in mortality

Hepatology

Liver biopsies were blindly scored for nonalcoholic fatty liver disease and nonalcoholic steatohepatitis.

The researchers ascertained causes of death from the national Swedish Cause of Death Registry.

Fatty liver was detected in 143 of the 256 subjects, including 10% with alcoholic fatty liver disease and 46% exhibiting nonalcoholic fatty liver disease.

Of those, 20% were classified as nonalcoholic steatohepatitis, and 26% as nonalcoholic bland steatosis.

Cirrhosis was present in 9% at inclusion.

During the follow-up period, the team found that 44% of the total population, and 40% of the 118 subjects diagnosed with nonalcoholic fatty liver disease  died.

Of the 113 deaths, 37 were of cardiovascular disease, and 16 of liver diseases

The research team compared with the total Swedish population, adjusted for sex, age, and calendar period, subjects with nonalcoholic fatty liver disease exhibited a 69% increased mortality.

Subjects with bland steatosis had a 55% increase in mortality, and subjects with nonalcoholic steatohepatitis had a 86% increase in mortality.

Dr Söderberg's team concluded, “Patients with nonalcoholic steatohepatitis are at increased risk of death compared with the general population.”

“Liver disease is the third most common cause of death among patients with nonalcoholic fatty liver disease.”