Commentary
Nonalcoholic steatohepatitis (NASH), the aggressive form of nonalcoholic fatty liver disease (NAFLD) is strongly associated with type 2 diabetes mellitus. Patients with both T2DM and NASH have increased risk for adverse clinical outcomes, leading to higher risk for mortality and morbidity. Using a Markov model with 1-year cycles and 20-year horizon ZM Younossi et al. tried to estimate the economic burden of NASH with T2DM in the U.S. This is the first study to assess the economic and clinical burden of NASH and NAFLD in patients with T2DM and their findings are staggering.
They estimated that there were 18.2 million people in the U.S. living with T2DM and NAFLD, of which 6.4 million had NASH. Twenty-year costs for NAFLD in these patients were $55.8 billion. Over the next 20 years, NASH with T2DM will account for 65,000 transplants, 1.37 million cardiovascular-related deaths, and 812,000 liver-related deaths. For the authors, this analysis suggests that the clinical and economic burden of NASH in patients with T2DM is currently substantial. As the prevalence of T2DM increases globally, this burden will continue to rise. However, it can be projected that interventions reducing morbidity and mortality in NASH patients with T2DM could potentially reduce this projected clinical and economic burden.
