Original ResearchFull Report: Clinical—LiverFibrosis Severity as a Determinant of Cause-Specific Mortality in Patients With Advanced Nonalcoholic Fatty Liver Disease: A Multi-National Cohort Study
Graphical abstract
Section snippets
Methods
The NAFLD Progression Consortium is an international initiative that includes tertiary academic centers with recognized experience and participation in studies related to the natural history of NAFLD. The main objective is to gather and analyse information of existing prospectively collected data of patients with biopsy-proven NAFLD.
Baseline Characteristics
Table 1 summarizes overall features of the study population. A total of 458 subjects were included, of which 159 (35%) and 299 (65%) had bridging fibrosis and cirrhosis, respectively. Most of cirrhotic patients were CTP-A5 (74%). The patients’ mean age was 55.9 years and 52% were women. There was a preponderance of white race (81%), mostly Hispanic (56%). The mean body mass index (BMI) was 33.2 kg/m2 and about two-thirds had type 2 diabetes (67%) or hypertension (61%). The mean Model for
Discussion
This study identifies new information on the clinical course of NAFLD patients with advanced fibrosis based on 3 stages of disease with distinctly different outcomes.
The current data show that among NAFLD patients with advanced fibrosis, those with cirrhosis are at a significantly greater risk for hepatic decompensation, HCC, and death or liver transplantation compared with those with bridging fibrosis. Among cirrhotic patients, hepatic decompensation (70%) was the most commonly identified
Acknowledgments
Our special thanks to Division of Gastroenterology and Hepatology, Department of Medicine, of Indiana University School of Medicine, as completing this study would not have been possible without its support. L.C.-B. has been awarded a scholarship from the Liver Foundation of Western Australia and is currently supported by an Australian Government Research Training Program Scholarship and a University Postgraduate Award at The University of Western Australia. Author contributions: Concept and
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Conflicts of interest The authors disclose no conflicts.
Funding This work was funded in part by PI 16/01842 Instituto de Salud Carlos III and Centro para la Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas from Spanish Ministry of Economy.
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Authors share co-first authorship.
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Authors share co-senior authorship.