BACKGROUND AND AIMS: In non-alcoholic fatty liver disease (NAFLD), fibrosis is the strongest prognostic factor and can be assessed by non-invasive methods. We evaluated the ability of liver stiffness measurement (LSM) to predict overall survival and liver, cardiovascular and oncologic complications. METHODS: We prospectively collected data on 2251 consecutive NAFLD patients (mean age 59 years, male 53%, mean body mass index 28 kg/m2 ) in two centres. At inclusion, all patients had LSM, clinical and biological evaluation. During follow-up, we recorded cardiovascular events, cancers, liver complications, liver transplantation and death. The primary endpoint was overall survival. Survival curves according to LSM were first performed using Kaplan-Meier method for the primary endpoint, and Aalen-Johansen method for secondary outcomes to take into account competitive risks. In a second step, a Cox proportional hazard model analysis was done to identify independent predictors of overall survival. RESULTS: Median follow-up was 27 months [IQR: 25-38]. Fifty-five patients died and three patients had liver transplantation. Overall survival significantly decreased as baseline LSM increased. Twenty-one patients (0.9%) had a liver event, 142 (6.3%) developed cancer (excluding HCC) and 151 (6.7%) had a cardiovascular event during follow-up. By multivariable analysis, independent predictors of overall survival were as follows: baseline LSM (adjusted HR (aHR) = 2.85 [1.65-4.92], P = .0002), age (aHR = 1.11 [1.08-1.13], P < .0001) and male sex (aHR = 2.05 [1.17-3.57], P = .012). Patients with elevated LSM were also more likely to develop cardiovascular, and liver events but not other cancers. CONCLUSION: LSM can be used to predict survival, cardiovascular and liver complications in NAFLD patients.
BACKGROUND AND AIMS: In non-alcoholic fatty liver disease (NAFLD), fibrosis is the strongest prognostic factor and can be assessed by non-invasive methods. We evaluated the ability of liver stiffness measurement (LSM) to predict overall survival and liver, cardiovascular and oncologic complications. METHODS: We prospectively collected data on 2251 consecutive NAFLDpatients (mean age 59 years, male 53%, mean body mass index 28 kg/m2 ) in two centres. At inclusion, all patients had LSM, clinical and biological evaluation. During follow-up, we recorded cardiovascular events, cancers, liver complications, liver transplantation and death. The primary endpoint was overall survival. Survival curves according to LSM were first performed using Kaplan-Meier method for the primary endpoint, and Aalen-Johansen method for secondary outcomes to take into account competitive risks. In a second step, a Cox proportional hazard model analysis was done to identify independent predictors of overall survival. RESULTS: Median follow-up was 27 months [IQR: 25-38]. Fifty-five patients died and three patients had liver transplantation. Overall survival significantly decreased as baseline LSM increased. Twenty-one patients (0.9%) had a liver event, 142 (6.3%) developed cancer (excluding HCC) and 151 (6.7%) had a cardiovascular event during follow-up. By multivariable analysis, independent predictors of overall survival were as follows: baseline LSM (adjusted HR (aHR) = 2.85 [1.65-4.92], P = .0002), age (aHR = 1.11 [1.08-1.13], P < .0001) and male sex (aHR = 2.05 [1.17-3.57], P = .012). Patients with elevated LSM were also more likely to develop cardiovascular, and liver events but not other cancers. CONCLUSION:LSM can be used to predict survival, cardiovascular and liver complications in NAFLDpatients.
Authors: Laurens A van Kleef; Ibrahim Ayada; Louise J M Alferink; Qiuwei Pan; Robert J de Knegt Journal: Hepatology Date: 2021-12-13 Impact factor: 17.298
Authors: Alejandro Campos-Murguía; Astrid Ruiz-Margáin; José A González-Regueiro; Ricardo U Macías-Rodríguez Journal: World J Gastroenterol Date: 2020-10-21 Impact factor: 5.742
Authors: Jenny Lee; Yasaman Vali; Jerome Boursier; Rene Spijker; Quentin M Anstee; Patrick M Bossuyt; Mohammad H Zafarmand Journal: Liver Int Date: 2021-02 Impact factor: 5.828
Authors: Kara Wegermann; Catherine Howe; Ricardo Henao; Ying Wang; Cynthia D Guy; Manal F Abdelmalek; Anna Mae Diehl; Cynthia A Moylan Journal: Hepatol Commun Date: 2021-01-05