Health and Economic Burden of Nonalcoholic Fatty Liver Disease in the United States and Its Impact on Veterans

Abstract

NAFLD is a leading cause of chronic liver disease and cirrhosis in the US and is associated with metabolic syndrome, type 2 diabetes, cardiovascular disease, and all-cause mortality.

FIGURE 1

Spectrum of NAFLD Abbreviations: NAFL, nonalcoholic fatty liver; NAFLD, nonalcoholic fatty liver disease; NASH, nonalcoholic steatohepatitis; HCC, hepatocellular carcinoma. ^aFibrosis staging level. Wide spectrum of NAFLD includes simple steatosis (NAFL), steatohepatitis (NASH), NASH-fibrosis which may advance to cirrhosis. Complications of cirrhosis include HCC and decompensated liver disease (liver failure). Recent studies suggest that HCC also can arise in those without cirrhosis.

FIGURE 2

Burden of NAFLD Abbreviations: NAFLD, nonalcoholic fatty liver disease; NASH, nonalcoholic steatohepatitis. NAFLD affects up to 24% to 26% of Americans, with the majority having simple steatosis, while 20% to 30% of those with NAFLD have NASH. About 4% to 6% of those with NASH have cirrhosis.

FIGURE 3

Metabolic Conditions and Complications Associated With NAFLD Abbreviations: CKD, chronic kidney disease; CVD, cardiovascular disease; HLD, hyperlipidemia; HTN, hypertension; NAFLD, nonalcoholic fatty liver disease; OSA, obstructive sleep apnea; PCOS, polycystic ovary syndrome; T2DM, type 2 diabetes mellitus.