Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults.

doi:10.1111/J.1365-2036.2011.04724.X

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Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults.

Journal Article•DOI•

Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults.

G. Vernon¹, G. Vernon², Ancha Baranova¹, Ancha Baranova³, Zobair M. Younossi¹, Zobair M. Younossi² - Show less +2 more•Institutions (3)

Inova Health System¹, Inova Fairfax Hospital², George Mason University³

01 Aug 2011-Alimentary Pharmacology & Therapeutics (Wiley/Blackwell (10.1111))-Vol. 34, Iss: 3, pp 274-285

TL;DR: Aliment Pharmacol Ther 2011; 34: 274–285

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Abstract: SUMMARY Background Non-alcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease, and its worldwide prevalence continues to increase with the growing obesity epidemic. This study assesses the epidemiology of NAFLD in adults based on clinical literature published over the past 30 years. Aim To review epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults based on clinical literature published over the past 30 years. Methods An in-depth search of PubMed (1980–2010) was based on five search terms: ‘nonalcoholic fatty liver disease’ OR ‘non-alcoholic steatohepatitis’ OR ‘fatty liver’ OR ‘steatosis’ AND ‘incidence’ [MeSH Terms] OR ‘prevalence’ [MeSH Terms] OR ‘natural history’. Studies of paediatric cohorts were excluded. Articles were categorised by topic and summarised, noting generalisations concerning their content.

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Journal Article•DOI•

Global epidemiology of nonalcoholic fatty liver disease—Meta‐analytic assessment of prevalence, incidence, and outcomes

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Zobair M. Younossi¹, Zobair M. Younossi², Aaron B. Koenig², Dinan Abdelatif², Yousef Fazel², Linda Henry, Mark Wymer², Mark Wymer¹ - Show less +4 more•Institutions (2)

Inova Fairfax Hospital¹, Inova Health System²

01 Jul 2016-Hepatology

TL;DR: As the global epidemic of obesity fuels metabolic conditions, the clinical and economic burden of NAFLD will become enormous, and random‐effects models were used to provide point estimates of prevalence, incidence, mortality and incidence rate ratios.

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6,746 citations

Cites background from "Systematic review: the epidemiology..."

...Clinically, NAFLD patients tend to be obese, with insulin resistance and/or type 2 diabetes, dyslipidemia, hypertriglyceridemia, and hypertension, which are all risk factors for cardiovascular diseases (CVDs).((10,11)) In fact, prevalence of NAFLD in patients with components of MetS is quite high....
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...The prevalence of NAFLD in the United States is reported to be between 10% and 30%, with similar rates reported from Europe and Asia.((10,19)) The variability of these rates is compounded by the technology used to establish the diagnosis of NAFLD and NASH....
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...In this context, NASH has been recognized as one of the leading causes of cirrhosis in adults in the United States,((1-11)) and NASHrelated cirrhosis is currently the second indication for liver transplants in the United States....
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...The pooled regional NAFLD prevalence estimates among patients diagnosed by blood test were 13.00% (95% CI: 4.44-32.47) for Europe, 12.89% (95% CI: 8.32-19.44) for North America, and 9.26% (95% CI: 7.07-12.05) for Asia....
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...(5-7) In this context, NASH has been recognized as one of the leading causes of cirrhosis in adults in the United States,(1-11) and NASHrelated cirrhosis is currently the second indication for liver transplants in the United States....
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Journal Article•DOI•

The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases.

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Naga Chalasani¹, Zobair M. Younossi², Joel E. Lavine³, Michael Charlton⁴, Kenneth Cusi⁵, Mary E. Rinella⁶, Stephen A. Harrison⁷, Elizabeth M. Brunt⁸, Arun J. Sanyal⁹ - Show less +5 more•Institutions (9)

Indiana University¹, Inova Fairfax Hospital², Columbia University³, University of Chicago⁴, University of Florida⁵, Northwestern University⁶, Pinnacle Financial Partners⁷, Washington University in St. Louis⁸, Virginia Commonwealth University⁹

01 Jan 2018-Hepatology

TL;DR: This guidance provides a data-supported approach to the diagnostic, therapeutic, and preventive aspects of NAFLD care.

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4,431 citations

Cites background from "Systematic review: the epidemiology..."

...There is growing evidence that patients with histological NASH, especially those with some degree of fibrosis, are at higher risk for adverse outcomes such as cirrhosis and liver-related mortality.((1,18,19,41-52)) These studies have also shown the following:...
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...Over the past two decades, studies have reported the natural history of patients with NAFLD.((1,19,41-52)) There is growing evidence that patients with histological NASH, especially those with some degree of fibrosis, are at higher risk for adverse outcomes such as cirrhosis and liver-related mortality....
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Journal Article•DOI•

The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association

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Naga Chalasani¹, Zobair M. Younossi², Joel E. Lavine³, Anna Mae Diehl⁴, Elizabeth M. Brunt⁵, Kenneth Cusi⁶, Michael Charlton⁷, Arun J. Sanyal⁸ - Show less +4 more•Institutions (8)

Indiana University¹, Inova Fairfax Hospital², Columbia University³, Duke University⁴, Washington University in St. Louis⁵, University of Florida⁶, Mayo Clinic⁷, Virginia Commonwealth University⁸

01 Jun 2012-Hepatology

TL;DR: This is a practice guideline for clinicians rather than a review article and interested readers can refer to several comprehensive reviews published recently.

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3,212 citations

Journal Article•DOI•

EASL-EASD-EASO Clinical Practice Guidelines for the Management of Non-Alcoholic Fatty Liver Disease

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Giulio Marchesini, Christopher P. Day, Jean-François Dufour, Ali Canbay, Valerio Nobili, Vlad Ratziu, Herbert Tilg, Michael Roden, Amalia Gastaldelli, Hannele Yki-Järvinen, Fritz Schick, Roberto Vettor, Gema Frühbeck, Lisbeth Mathus-Vliegen - Show less +10 more

01 May 2016-Journal of Hepatology

TL;DR: The final purpose is to improve patient care and awareness of the importance of NAFLD, and to assist stakeholders in the decision-making process by providing evidence-based data, which also takes into consideration the burden of clinical management for the healthcare system.

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3,117 citations

Journal Article•DOI•

Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up.

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Mattias Ekstedt¹, Hannes Hagström, Patrik Nasr, Mats Fredrikson, Per Stål, Stergios Kechagias, Rolf Hultcrantz - Show less +3 more•Institutions (1)

Linköping University¹

01 May 2015-Hepatology

TL;DR: NAFLD patients have increased risk of death, with a high risk ofdeath from cardiovascular disease and liver‐related disease, and the NAS was not able to predict overall mortality, whereas fibrosis stage predicted both overall and disease‐specific mortality.

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1,621 citations

Cites result from "Systematic review: the epidemiology..."

...These data support those from previous studies showing a better prognosis for NAFLD patients without diabetes.(11) The increased risk of developing liver-related complication in the absence of diabetes is interesting....
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References

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Journal Article•DOI•

Prevalence of hepatic steatosis in an urban population in the United States: Impact of ethnicity

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Jeffrey D. Browning, Lidia S. Szczepaniak¹, Robert L. Dobbins, Pamela Nuremberg², Jay D. Horton, Jonathan Cohen, Scott M. Grundy³, Helen H. Hobbs⁴ - Show less +4 more•Institutions (4)

University of Texas Southwestern Medical Center¹, Texas Scottish Rite Hospital for Children², Veterans Health Administration³, Howard Hughes Medical Institute⁴

01 Dec 2004-Hepatology

TL;DR: The prevalence of hepatic steatosis was greater in men than women among whites, but not in blacks or Hispanics, and significant ethnic and sex differences in the prevalence may have a profound impact on susceptibility to Steatosis‐related liver disease.

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3,429 citations

"Systematic review: the epidemiology..." refers background in this paper

...by biopsy in 12% of the total cohort, or 30% of ultrasound positive patients.(15) Although less commonly appli-...
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Journal Article•DOI•

Nonalcoholic fatty liver disease: a spectrum of clinical and pathological severity.

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Christi A. Matteoni, Zobair M. Younossi¹, Terry Gramlich¹, Navdeep Boparai¹, Yao Chang Liu¹, Arthur J. McCullough - Show less +2 more•Institutions (1)

Cleveland Clinic¹

01 Jun 1999-Gastroenterology

TL;DR: The outcome of cirrhosis and liver-related death is not uniform across the spectrum of nonalcoholic fatty liver, and poor outcomes are more frequent in patients in whom biopsies show ballooning degeneration and Mallory hyaline or fibrosis.

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3,167 citations

"Systematic review: the epidemiology..." refers background in this paper

...centres by Mateoni and colleagues assessed liver-related mortality in 132 biopsy-proven NAFLD patients.(105) After...
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Journal Article•DOI•

The Natural History of Nonalcoholic Fatty Liver Disease: A Population-Based Cohort Study

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Leon A. Adams¹, James F. Lymp¹, Jenny St. Sauver¹, Schuyler O. Sanderson¹, Keith D. Lindor¹, Ariel E. Feldstein¹, Paul Angulo¹ - Show less +3 more•Institutions (1)

Mayo Clinic¹

01 Jul 2005-Gastroenterology

TL;DR: Mortality among community-diagnosed NAFLD patients is higher than the general population and is associated with older age, impaired fasting glucose, and cirrhosis, although the absolute risk is low.

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2,681 citations

Journal Article•DOI•

Genetic variation in PNPLA3 confers susceptibility to nonalcoholic fatty liver disease

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Stefano Romeo¹, Julia Kozlitina², Julia Kozlitina¹, Chao Xing¹, Alexander Pertsemlidis¹, David Cox, Len A. Pennacchio³, Len A. Pennacchio⁴, Eric Boerwinkle⁵, Jonathan C. Cohen¹, Helen H. Hobbs¹ - Show less +7 more•Institutions (5)

University of Texas Southwestern Medical Center¹, Southern Methodist University², Lawrence Berkeley National Laboratory³, United States Department of Energy⁴, University of Texas Health Science Center at Houston⁵

25 Sep 2008-Nature Genetics

TL;DR: Variation in PNPLA3 contributes to ancestry-related and inter-individual differences in hepatic fat content and susceptibility to NAFLD.

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Abstract: Nonalcoholic fatty liver disease (NAFLD) is a burgeoning health problem of unknown etiology that varies in prevalence among ancestry groups. To identify genetic variants contributing to differences in hepatic fat content, we carried out a genome-wide association scan of nonsynonymous sequence variations (n = 9,229) in a population comprising Hispanic, African American and European American individuals. An allele in PNPLA3 (rs738409[G], encoding I148M) was strongly associated with increased hepatic fat levels (P = 5.9 x 10(-10)) and with hepatic inflammation (P = 3.7 x 10(-4)). The allele was most common in Hispanics, the group most susceptible to NAFLD; hepatic fat content was more than twofold higher in PNPLA3 rs738409[G] homozygotes than in noncarriers. Resequencing revealed another allele of PNPLA3 (rs6006460[T], encoding S453I) that was associated with lower hepatic fat content in African Americans, the group at lowest risk of NAFLD. Thus, variation in PNPLA3 contributes to ancestry-related and inter-individual differences in hepatic fat content and susceptibility to NAFLD.

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2,651 citations

"Systematic review: the epidemiology..." refers background in this paper

...A regression analysis indicates that these two sequence variations account for 72% of the observed ethnic differences in hepatic fat content in the study cohort.(71) In addition, resequencing of the PNPLA3 gene in individuals with abnor-...
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...72 In homozygous carriers of this allele, hepatic fat content is more than twofold higher than in noncarriers.(71) Notably, this allele is most prevalent in Hispanics (0....
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...mally high liver fat content revealed three cases of null mutations, which is consistent with the idea that a loss-offunction of PNPLA3 causes hepatic steatosis.(71)...
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Journal Article•

Nonalcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease.

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J Ludwig, T R Viggiano, D B McGill, B J Oh

01 Jul 1980-Mayo Clinic Proceedings

TL;DR: Findings in 20 patients with nonalcoholic steatohepatitis of unknown cause found the patients were moderately obese, and many had obesity-associated diseases, such as diabetes mellitus and cholelithiasis.

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2,484 citations

"Systematic review: the epidemiology..." refers background in this paper

...Non-Alcoholic Steatohepatitis and NAFLD are common causes of chronic liver disease world wide, and hepatic steatosis is the most common pathological feature.(1)...
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