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Is ‘fatty liver’ a disease?
▶ Musso G, Gambino R, Cassader M, et al. Meta-analysis: natural history of non-alcoholic fatty liver disease (NAFLD) and diagnostic accuracy of non-invasive tests for liver disease severity. Ann Med Published Online First: 2 Nov 2010. PMID: 21039302.
Although there is an acceptance that non-alcoholic fatty liver disease (NAFLD) is highly prevalent in the western population, there is still uncertainty regarding the natural history of NAFLD and its long-term clinical outcome. Consequently there are extreme views of its impact on public health.
Musso and colleagues performed a large scale literature review to identify 4185 articles of which 40 articles assessing the prognosis of NAFLD and its histological subtypes were included in the analysis. NAFLD was found to be associated with an increased pooled mortality compared to the general population (OR: 1.57, 95% CI 1.18 to 2.10), related to both liver and cardiovascular causes with a twofold increase in type 2 diabetes. Non-alcoholic steatohepatitis (NASH) had higher liver related mortality (OR 5.71, 2.31 to 14.13; OR NASH with advanced fibrosis: 10.06, 4.35 to 23.25) compared with simple steatosis, but cardiovascular mortality did not differ between steatosis and NASH. …
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