Nonalcoholic fatty liver disease - A multisystem disease?

Table 1 Principal retrospective studies of cardiovascular diseases mortality and morbidity risk in patients with nonalcoholic fatty liver disease (published in the past 10 years)

Ref.	Study design	Study size	Diagnosis of NAFLD	Follow-up duration (yr)	Adjusted clinical variables	Major findings
Ekstedt et al[13]	Retrospective; Hospital-based	129	Histological	13.7	Matched for gender, age and country	NASH subjects (not those with simple steatosis) had higher rates of all-cause, CVD and liver-related mortality than the general population
Stepanova et al[15]	Retrospective; Population-based	289	Histological	6.25	No adjustments made	Higher risk of liver-related mortality in NASH than non-NASH. NAFLD and type II diabetes had the highest risk for overall and liver-related mortality
Ekstedt et al[14]	Retrospective; Community-based	229	Histological	26.4		NAFLD patients had increased risk of death, with a high risk of death from CVD and liver-related disease
						Fibrosis stage predicted all-cause, CVD and liver-related death
Rafiq et al[10]	Retrospective; Hospital-based	173	Histological	13	No adjustments made	Higher liver-related mortality but no difference in overall mortality (NASH vs simple steatosis)
Soderberg et al[11]	Retrospective; Hospital-based	118	Histological	18	Matched for gender, age and year	Increased total mortality in NAFLD was predominantly CV-related compared with matched reference population
Dunn et al[16]	Retrospective cohort	2343	Computed tomography	5		No significant association was found between NAFLD and risk of all-cause mortality and cause-specific
						(CVD, cancer and liver) mortality and morbidity. NAFLD patients
						(steatosis > 30% on imaging) averaged 8 yr younger than those without NAFLD

NAFLD: Nonalcoholic fatty liver disease; CVD: Cardiovascular diseases; NASH: Nonalcoholic steatohepatitis.