Clinical-liver, pancreas, and biliary tractThe Natural History of Nonalcoholic Fatty Liver Disease: A Population-Based Cohort Study
Section snippets
Setting
The study population consisted of residents of Olmsted County, located in southeastern Minnesota. According to census data, the total population in the year 2000 was 124,000 people, with 81% of these living in urban areas and the remainder in rural farming areas.15 The proportion of whites in the population was 90.3%, compared with the general US population of 75.1%. The proportion of people with college education was 34.7%, compared with the general US population proportion of 24.4%.
Case Ascertainment
Patients
Patient Population
The 435 patients were predominantly middle-aged whites with an equal sex distribution (Table 1). Of the nonwhite patients, 20 (5%) were Asian, 6 (1%) Arabic, 5 (1%) Hispanic, and 2 (0.5%) African American. Features of metabolic syndrome were common. In particular, obesity was present in over two thirds of the population. IFG (glucose ≥110 mg/dL) was present in 159 (37%) patients, with 112 (26%) of these being diabetic.
The adjusted incidence rate of NAFLD diagnosis increased significantly over
Discussion
This study is the first to describe the natural history of NAFLD in a large cohort of community-based patients. Mortality was significantly increased among patients with NAFLD compared with the expected mortality of the general population of same age and sex and was predicted by presence of IFG/diabetes, cirrhosis, and older age. Death occurred in 12.6% of patients and was most commonly due to malignancy and ischemic heart disease, which are also the 2 most common causes of death in the
References (35)
- et al.
Expanding the natural history of nonalcoholic steatohepatitisfrom cryptogenic cirrhosis to heptocellular carcinoma
Gastroenterology
(2002) Nonalcoholic steatohepatitisa study of 49 patients
Hum Pathol
(1989)- et al.
The natural history of nonalcoholic fatty livera follow-up study
Hepatology
(1995) - et al.
Nonalcoholic fatty liver diseasea spectrum of clinical and pathological severity
Gastroenterology
(1999) History of the Rochester Epidemiology Project
Mayo Clin Proc
(1996)- et al.
The spectrum expandedcryptogenic cirrhosis and the natural history of non-alcoholic fatty liver disease
J Hepatol
(2004) - et al.
Nonalcoholic steatohepatitisa proposal for grading and staging the histological lesions
Am J Gastroenterol
(1999) - et al.
Nonalcoholic steatohepatitissummary of an AASLD Single Topic Conference
Hepatology
(2003) - et al.
Long term outcomes of cirrhosis in nonalcoholic steatohepatitis compared with hepatitis C
Hepatology
(2003) - et al.
Is obesity a risk factor for cirrhosis-related death or hospitalization? A population-based cohort study
Gastroenterology
(2003)
Diabetes increases the risk of chronic liver disease and hepatocellular carcinoma
Gastroenterology
Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001
JAMA
Prevalence of the metabolic syndrome among US adultsfindings from the third National Health and Nutrition Examination Survey
JAMA
Prevalence and trends in obesity among US adults, 1999–2000
JAMA
Prevalence of hepatic steatosis in an urban population in the United Statesimpact of ethnicity
Hepatology
Nonalcoholic fatty liver disease
N Engl J Med
Cryptogenic cirrhosisclinical characterization and risk factors for underlying disease
Hepatology
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L.A. was supported by an overseas medical scholarship from the Faculty of Medicine and Dentistry, The University of Western Australia.