Mixed
In patients with Non-Alcoholic Fatty Liver Disease (NAFLD), the presence and severity of liver fibrosis, rather than the presence of steatohepatitis (NASH) itself, is the primary predictor of liver-related and overall mortality.
If you have fatty liver, the specific type of liver damage (inflammation vs. simple fat) matters less for your long-term survival than the presence of scarring (fibrosis). You should prioritize getting assessed for fibrosis (e.g., via non-invasive scores like FIB-4 or APRI) rather than just focusing on liver enzymes or the presence of inflammation. Managing metabolic risk factors like diabetes and obesity is crucial to slowing fibrosis progression.
Emerging data suggests fibrosis, rather than NASH per se, to be the most important histological predictor of liver and non-liver related death.
Why this rating
Based on multiple prospective cohort studies with long-term follow-up (up to 26.4 years) and meta-analyses of paired liver biopsies.
Source
The Natural Course of Non-Alcoholic Fatty Liver Disease
Luis Calzadilla Bertot et al. · International Journal of Molecular Sciences · 2016
DOI 10.3390/ijms17050774
More from this paper
- Cardiovascular disease (CVD) is the leading cause of death in NAFLD patients with advanced fibrosis, independent of liver-related mortality.Good
- Genetic polymorphisms in PNPLA3 (rs738409) and TM6SF2 (rs58542926) are associated with an increased risk of advanced fibrosis in NAFLD patients, independent of metabolic variables.Good
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