WEDNESDAY, May 6, 2020 (HealthDay News) — The clinical burden associated with nonalcoholic fatty liver disease (NAFLD) is high, according to a study published online May 5 in Alimentary Pharmacology and Therapeutics.

Rohit Loomba, M.D., from the University of California San Diego in La Jolla, and colleagues examined the impact of disease severity, demographics, and comorbidities on the risk for mortality and time to progression in a cohort of NAFLD patients from a Medicare representative sample. A total of 10,826,456 patients were assessed.

The researchers found that the prevalence of NAFLD was 5.7 percent. Among patients with NAFLD, 71.1 and 28.9 percent had NAFLD/nonalcoholic steatohepatitis (NASH) alone and NAFLD cirrhosis, respectively. Overall, 85.5, 84.1, 68.7, and 55.5 percent of patients had hypertension, dyslipidemia, cardiovascular disease, and diabetes, respectively. During eight years of follow-up, the cumulative risks for progression of NAFLD to cirrhosis and compensated cirrhosis to decompensated cirrhosis were 39 and 45 percent, respectively. Cardiovascular disease, renal impairment, dyslipidemia, and diabetes were independent predictors of progression. The cumulative risk for mortality was 12.6, 31.1, 51.4, and 76.2 percent for NAFLD, NAFLD cirrhosis, decompensated cirrhosis, and hepatocellular carcinoma, respectively.

“These findings of a high-risk of mortality and disease progression in diagnosed NAFLD/NASH patients reinforce the imperative for clinicians to identify patients who are at increased risk of NAFLD/NASH, highlight the urgent need for an algorithm to identify individuals at higher risk of NAFLD/NASH, and support the implementation of lifestyle and medical interventions with the potential to halt or delay disease progression,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry; the study was funded by Gilead Sciences.

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