Non-alcoholic fatty liver disease natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
If left untreated non alcoholic fatty liver disease may progress to [[fibrosis]] and, later [[cirrhosis]]. Studies of serial [[liver biopsies]] estimate a 26-37% rate of [[hepatic]] [[fibrosis]] and 2-15% rate of [[cirrhosis]] in less than 6 years. | If left untreated non alcoholic fatty liver disease may progress to [[fibrosis]] and, later [[cirrhosis]]. Studies of serial [[liver biopsies]] estimate a 26-37% rate of [[hepatic]] [[fibrosis]] and 2-15% rate of [[cirrhosis]] in less than 6 years. Common complications of NAFLD include fibrosis, cirrhosis, internal bleeding, encepholopathy. The presence of [[fibrosis]] and [[cirrhosis]] associated with a particularly poor prognosis among patients with NAFLD. | ||
==Natural History, Complications and Prognosis== | ==Natural History, Complications and Prognosis== | ||
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**2) Patients with [[NASH]] has more liver-related mortality rate | **2) Patients with [[NASH]] has more liver-related mortality rate | ||
* If left untreated, patients with NAFLD may progress to develop hepato-cellular carcinoma ([[HCC]]). But it is directly propotional to the degree of [[fibrosis]] and advanced [[cirrhosis]] | * If left untreated, patients with NAFLD may progress to develop hepato-cellular carcinoma ([[HCC]]). But it is directly propotional to the degree of [[fibrosis]] and advanced [[cirrhosis]] | ||
* Children who are positive with NAFLD are also prone to short lifespan when compared to general population.<ref name="urlNonalcoholic Fatty Liver Disease">{{cite web |url=http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/nonalcoholic-fatty-liver-disease/ |title=Nonalcoholic Fatty Liver Disease |format= |work= |accessdate=}}</ref> <ref name="pmid27213358">{{cite journal| author=Calzadilla Bertot L, Adams LA| title=The Natural Course of Non-Alcoholic Fatty Liver Disease. | journal=Int J Mol Sci | year= 2016 | volume= 17 | issue= 5 | pages= | pmid=27213358 | doi=10.3390/ijms17050774 | pmc=4881593 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27213358 }} </ref> <ref name="pmid16012941">{{cite journal| author=Adams LA, Lymp JF, St Sauver J, Sanderson SO, Lindor KD, Feldstein A et al.| title=The natural history of nonalcoholic fatty liver disease: a population-based cohort study. | journal=Gastroenterology | year= 2005 | volume= 129 | issue= 1 | pages= 113-21 | pmid=16012941 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16012941 }} [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17213068 Review in: Evid Based Med. 2006 Feb;11(1):26] [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16388571 Review in: ACP J Club. 2006 Jan-Feb;144(1):22] </ref> <ref name="pmid27003142">{{cite journal| author=Goh GB, McCullough AJ| title=Natural History of Nonalcoholic Fatty Liver Disease. | journal=Dig Dis Sci | year= 2016 | volume= 61 | issue= 5 | pages= 1226-33 | pmid=27003142 | doi=10.1007/s10620-016-4095-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27003142 }} </ref> | * Children who are positive with NAFLD are also prone to short lifespan when compared to general population.<ref name="urlNonalcoholic Fatty Liver Disease">{{cite web |url=http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/nonalcoholic-fatty-liver-disease/ |title=Nonalcoholic Fatty Liver Disease |format= |work= |accessdate=}}</ref><ref name="pmid27213358">{{cite journal| author=Calzadilla Bertot L, Adams LA| title=The Natural Course of Non-Alcoholic Fatty Liver Disease. | journal=Int J Mol Sci | year= 2016 | volume= 17 | issue= 5 | pages= | pmid=27213358 | doi=10.3390/ijms17050774 | pmc=4881593 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27213358 }} </ref><ref name="pmid16012941">{{cite journal| author=Adams LA, Lymp JF, St Sauver J, Sanderson SO, Lindor KD, Feldstein A et al.| title=The natural history of nonalcoholic fatty liver disease: a population-based cohort study. | journal=Gastroenterology | year= 2005 | volume= 129 | issue= 1 | pages= 113-21 | pmid=16012941 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16012941 }} [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17213068 Review in: Evid Based Med. 2006 Feb;11(1):26] [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16388571 Review in: ACP J Club. 2006 Jan-Feb;144(1):22] </ref><ref name="pmid27003142">{{cite journal| author=Goh GB, McCullough AJ| title=Natural History of Nonalcoholic Fatty Liver Disease. | journal=Dig Dis Sci | year= 2016 | volume= 61 | issue= 5 | pages= 1226-33 | pmid=27003142 | doi=10.1007/s10620-016-4095-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27003142 }} </ref> | ||
===Complications=== | ===Complications=== | ||
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===Prognosis=== | ===Prognosis=== | ||
* Depending on the extent of the [[fibrosis]] and [[cirrhosis]] at the time of diagnosis, the prognosis may vary.<ref name="SumanKhullar2016">{{cite journal|last1=Suman|first1=A.|last2=Khullar|first2=V.|last3=Limaye|first3=A.|title=Complications of Non-Alcoholic Fatty Liver Disease|journal=Journal of Hepatology|volume=64|issue=2|year=2016|pages=S473|issn=01688278|doi=10.1016/S0168-8278(16)00798-4}}</ref> | * Depending on the extent of the [[fibrosis]] and [[cirrhosis]] at the time of diagnosis, the prognosis may vary.<ref name="SumanKhullar2016">{{cite journal|last1=Suman|first1=A.|last2=Khullar|first2=V.|last3=Limaye|first3=A.|title=Complications of Non-Alcoholic Fatty Liver Disease|journal=Journal of Hepatology|volume=64|issue=2|year=2016|pages=S473|issn=01688278|doi=10.1016/S0168-8278(16)00798-4}}</ref> | ||
* The presence of [[fibrosis]] and [[cirrhosis]] associated with a particularly poor prognosis among patients with NAFLD. <ref name="pmid22102440">{{cite journal| author=Jepsen P, Grønbæk H| title=Prognosis and staging of non-alcoholic fatty liver disease. | journal=BMJ | year= 2011 | volume= 343 | issue= | pages= d7302 | pmid=22102440 | doi=10.1136/bmj.d7302 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22102440 }} </ref> | * Histology is the most reliable means to grade the severity of the disease and thus estimate prognosis. | ||
* The presence of [[fibrosis]] and [[cirrhosis]] associated with a particularly poor prognosis among patients with NAFLD. <ref name="pmid22102440">{{cite journal| author=Jepsen P, Grønbæk H| title=Prognosis and staging of non-alcoholic fatty liver disease. | journal=BMJ | year= 2011 | volume= 343 | issue= | pages= d7302 | pmid=22102440 | doi=10.1136/bmj.d7302 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22102440 }} </ref><ref name="urlNonalcoholic Fatty Liver Disease">{{cite web |url=http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/nonalcoholic-fatty-liver-disease/ |title=Nonalcoholic Fatty Liver Disease |format= |work= |accessdate=}}</ref> | |||
==References== | ==References== |
Revision as of 20:33, 22 December 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]
Overview
If left untreated non alcoholic fatty liver disease may progress to fibrosis and, later cirrhosis. Studies of serial liver biopsies estimate a 26-37% rate of hepatic fibrosis and 2-15% rate of cirrhosis in less than 6 years. Common complications of NAFLD include fibrosis, cirrhosis, internal bleeding, encepholopathy. The presence of fibrosis and cirrhosis associated with a particularly poor prognosis among patients with NAFLD.
Natural History, Complications and Prognosis
Natural History
- The symptoms of NAFLD usually develop in the 40th decade of life, and usually asymptomatic at first.
- After following NAFLD patients for long-term the outcome of the disease is as follows [1]
- If left untreated, patients with NAFLD may progress to develop hepato-cellular carcinoma (HCC). But it is directly propotional to the degree of fibrosis and advanced cirrhosis
- Children who are positive with NAFLD are also prone to short lifespan when compared to general population.[2][3][4][5]
Complications
- Common complications of NAFLD include:[6][7][8][9]
- Fibrosis
- Cirrhosis
- Internal bleeding
- Encepholopathy
Prognosis
- Depending on the extent of the fibrosis and cirrhosis at the time of diagnosis, the prognosis may vary.[10]
- Histology is the most reliable means to grade the severity of the disease and thus estimate prognosis.
- The presence of fibrosis and cirrhosis associated with a particularly poor prognosis among patients with NAFLD. [11][2]
References
- ↑ "The Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology - Gastroenterology".
- ↑ 2.0 2.1 "Nonalcoholic Fatty Liver Disease".
- ↑ Calzadilla Bertot L, Adams LA (2016). "The Natural Course of Non-Alcoholic Fatty Liver Disease". Int J Mol Sci. 17 (5). doi:10.3390/ijms17050774. PMC 4881593. PMID 27213358.
- ↑ Adams LA, Lymp JF, St Sauver J, Sanderson SO, Lindor KD, Feldstein A; et al. (2005). "The natural history of nonalcoholic fatty liver disease: a population-based cohort study". Gastroenterology. 129 (1): 113–21. PMID 16012941. Review in: Evid Based Med. 2006 Feb;11(1):26 Review in: ACP J Club. 2006 Jan-Feb;144(1):22
- ↑ Goh GB, McCullough AJ (2016). "Natural History of Nonalcoholic Fatty Liver Disease". Dig Dis Sci. 61 (5): 1226–33. doi:10.1007/s10620-016-4095-4. PMID 27003142.
- ↑ "Nonalcoholic Fatty Liver Disease Symptoms, Causes, and More".
- ↑ Armstrong MJ, Adams LA, Canbay A, Syn WK (2014). "Extrahepatic complications of nonalcoholic fatty liver disease". Hepatology. 59 (3): 1174–97. doi:10.1002/hep.26717. PMID 24002776.
- ↑ Chacko KR, Reinus J (2016). "Extrahepatic Complications of Nonalcoholic Fatty Liver Disease". Clin Liver Dis. 20 (2): 387–401. doi:10.1016/j.cld.2015.10.004. PMID 27063276.
- ↑ Vanni E, Marengo A, Mezzabotta L, Bugianesi E (2015). "Systemic Complications of Nonalcoholic Fatty Liver Disease: When the Liver Is Not an Innocent Bystander". Semin Liver Dis. 35 (3): 236–49. doi:10.1055/s-0035-1562944. PMID 26378641.
- ↑ Suman, A.; Khullar, V.; Limaye, A. (2016). "Complications of Non-Alcoholic Fatty Liver Disease". Journal of Hepatology. 64 (2): S473. doi:10.1016/S0168-8278(16)00798-4. ISSN 0168-8278.
- ↑ Jepsen P, Grønbæk H (2011). "Prognosis and staging of non-alcoholic fatty liver disease". BMJ. 343: d7302. doi:10.1136/bmj.d7302. PMID 22102440.