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. 2018 Mar;97(13):e0214.
doi: 10.1097/MD.0000000000010214.

Components of metabolic syndrome increase the risk of mortality in nonalcoholic fatty liver disease (NAFLD)

Pegah Golabi  1 , Munkhzul Otgonsuren, Leyla de Avila, Mehmet Sayiner, Nila Rafiq, Zobair M Younossi
Affiliations

Components of metabolic syndrome increase the risk of mortality in nonalcoholic fatty liver disease (NAFLD)

Pegah Golabi et al. Medicine (Baltimore). 2018 Mar.

Abstract

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the United States. Metabolic syndrome (MS) components are highly prevalent in NAFLD. Our aim is to assess the relationship of NAFLD and MS with long-term outcome of mortality.The Third National Health and Nutrition Examination Survey (NHANES) was utilized. NAFLD was diagnosed by ultrasound in the presence of hepatic steatosis and no other causes of chronic liver disease. History of MS and its components were obtained from self-reported NHANES questionnaires. Mortality was obtained from Mortality-Linkage File, through December 31, 2011. Chi-square test was used for categorical variables and Cox proportional models estimated hazard ratios with 95% confidence interval.NAFLD cohort (n = 3613) had a median age of 43 years, 73% white, and 50% male. NAFLD group with at least one MS condition was significantly older, had higher body mass index, more likely to have insulin resistance, and heart disease compared to NAFLD group without MS. Over 19-years of follow-up, 1039 people died. Compared to NAFLD patients without MS, presence of one MS component increased the risk of mortality at 8-year (2.6% vs 4.7%) and 16-year (6% vs 11.9%) (P < .001). After adjusting for socio-demographic factors, NAFLD with all MS components was associated with overall, cardiac and liver-mortality. Increased number of MS components was associated with lower survival (P < .0001).Patients with NAFLD and MS have higher mortality risk compared to NAFLD patients without MS. These NAFLD patients should be prioritized for the development of treatment regimens.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Study flow, National Health and Nutrition Examination Survey (NHANES) III.
Figure 2
Figure 2
Kaplan–Meier survival curves for 23-years follow-up (average = 19 years) of 3613 NAFLD participants, by MS conditions, NHANES III, 2011 public-use linked mortality files. MS = metabolic syndrome, NAFLD = nonalcoholic fatty liver disease, NHANES = National Health and Nutrition Examination Survey.
See this image and copyright information in PMC

References

    1. Bellentani S. The epidemiology of non-alcoholic fatty liver disease. Liver Int 2017;37(Suppl 1):81–4. - PubMed
    1. Sayiner M, Koenig A, Henry L, et al. Epidemiology of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis in the United States and the rest of the world. Clin Liver Dis 2016;20:205–14. - PubMed
    1. Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology 2016;64:73–84. - PubMed
    1. Fazel Y, Koenig AB, Sayiner M, et al. Epidemiology and natural history of non-alcoholic fatty liver disease. Metabolism 2016;65:1017–25. - PubMed
    1. Goh GB, McCullough AJ. Natural history of nonalcoholic fatty liver disease. Dig Dis Sci 2016;61:1226–33. - PMC - PubMed