Commentary
Our current understanding of the natural history of NAFLD is incomplete due to a limited knowledge of patient and clinical factors in addition to fibrosis stages that are associated with progression to advanced liver diseases and death.
Thus, the aims of the analysis by Ali Canbay et al. (Department of Internal Medicine, Ruhr-University, Bochum, Germany) were firstly, to evaluate the probability of all-cause mortality and determine the impact of liver disease severity, demographics and comorbidities on the risk of all-cause mortality and secondly, to evaluate the probability of liver disease progression in a large real-world cohort of NAFLD patients in Germany. Data from the German Institut für angewandte Gesundheitsforschung database between 2011 and 2016 were analyzed retrospectively.
The longitudinal probability of mortality for non-progressors, compensated cirrhosis, decompensated cirrhosis and HCC was 3.6%, 18.7%, 28.8% and 68%, respectively. Independent predictors of mortality included cardiovascular disease, type 2 diabetes mellitus, hypertension, obesity and renal impairment.
Early identification and effective management to halt or reverse fibrosis are essential to prevent progression.
