non alcoholic cirrhosis life expectancy

The most common causes of cirrhosis of the liver are: Alcohol use disorder (alcohol-related liver disease) caused by long-term [chronic] use of alcohol. It is more often seen in people with obesity, metabolic syndrome, insulin resistance, or type 2 diabetes. In the current study more severe lobular inflammation was found in the AFLD group compared to the NAFLD group and a significantly higher number of patients in the AFLD group had steatohepatitis compared to the NAFLD group. Anemia is commonly found in people with cirrhosis. If you are a Mayo Clinic patient, this could Median follow-up time for the non-alcoholic group was 9.9years (range 0.2-26 years) and 9.2years (0.2-25 years) for the alcoholic group. Each time your liver is injured whether by excessive alcohol consumption or another cause, such as infection it tries to repair itself. Patients with NAFLD have been shown to have increased cardiovascular mortality compared to the general population [6, 7]. The remaining study group of 245 patients had no signs of viral hepatitis in the index liver biopsy and did not receive any medication known to be associated with the development of steatosis. Major risk factors include infections with the hepatitis B virus (HBV) or hepatitis C virus (HCV) and alcohol-related cirrhosis. 2014;14(1):166. doi:10.1186/1471-230x-14-166, Wong RJ, Singal AK. Get the facts on the treatments, outlook, and, Beer, liquor, and wine have different effects on your cholesterol levels. Population based studies have shown increased risk of women developing alcohol-induced cirrhosis [2326]. Google Scholar. If you've been diagnosed with any fatty liver disease, let your health care providerknow if you have any symptoms that mean the disease is getting worse. Non-Alcoholic Fatty Liver Disease; Nutritional and Metabolic Liver Diseases; . 3: Bridging fibrosis. 2006, 44: 865-873. Non alcoholic fatty liver disease (NAFLD) is a group of conditions including mild hepatic steatosis and non alcoholic steatohepatitis. Could be decades but if signs of liver failure could be much shorter. Even if your cirrhosis isn't related to alcohol, it's best to abstain because alcohol can damage your liver, especially if it's already damaged. Some medications are being studied as possible treatments for NASH. 5) age under eighteen years at the time of index liver biopsy. Bruha R, et al. In the alcoholic group 35 (37%) patients had borderline ASH (NS) and 22 (23%) did not have ASH (NS). Dr. Brett Kalmowitz answered. Health care providers dont know the exact cause of fatty liver disease. Limit salt . But NASH occurs in people who don't abuse alcohol. What Are the Subtypes of Type 2 Diabetes? Alcohol liver disease. (2018). The most common cause of death in the NAFLD group was of cardiovascular disease 20/42 (48%), followed by malignancy 6/42 (14%) and other chronic medical conditions 4/42 (9.5%). 2: Perisinusoidal, portal/periportal. bloated abdomen due to fluid accumulation ( ascites) swollen legs. Fatty liver disease is sometimes called a silent liver disease. Dig Dis. Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. New masking guidelines are in effect starting April 24. Grade 0 steatosis was defined as < 5% fat and thus not compatible with fatty liver disease. The symptoms, diagnosis and treatment. Among patients developing cirrhosis in the follow-up period the histological diagnosis at baseline was as follow: one patient had no fibrosis (in the NAFLD group), three patients had stage 1A fibrosis (all three in the AFLD group), one patient had portal fibrosis (in the NAFLD group) and six patients bridging fibrosis (four in the AFLD group and two in the NAFLD group). When talking about life expectancy, its important to remember that its an estimate. Cirrhosis is a serious condition that causes scarring and permanent damage to the liver. https://www.uptodate.com/contents/search. Alcoholic hepatitis versus non-alcoholic steatohepatitis: levels of expression of some proteins involved in tumorigenesis. What can you do to reverse nonalcoholic cirrhosis of the liver? 7% of deaths were liver-related in the NAFLD group, no man in the NAFLD group died of liver-related disease whereas three women had a liver-related death. If you are overweight or obese, losing 3% to 10% of your total body weight can reverse type 2 diabetes or insulin resistance in some people, although weight loss has positive health benefits in all people. Overall, 58 (62%) of the patients in the AFLD group had undergone alcohol addiction therapy according to computerized database of patients in the National Centre of Addiction Medicine, whereas 2 (1%) in the NAFLD group had undergone an addiction therapy, not due to alcohol but due to abuse of sedatives and due to a gambling addiction. In the current study women were in the majority in the NAFLD group but the high proportion of women with fatty liver compared to men may reflect a higher disease burden in women. 11th ed. It is natural for you to think that the last thing you need is another health complication, but NASH doesnt always mean that you are in imminent danger. If you have NASH, no medication is available to reverse the fat buildup in your liver. Get regular screening tests for liver cancer if you already have cirrhosis. Only one patient died from hepatocellular cancer (HCC) in the total cohort and as mentioned above, from the AFLD group. Statistical testing was performed using R-software. Hepatic fibrosis 2022: Unmet needs and a blueprint for the future. Patient education: nonalcoholic fatty liver disease (NAFLD), including nonalcoholic steatohepatitis (NASH) (beyond the basics), The natural course of non-alcoholic fatty liver disease, Long term follow-up and liver-related death rate in patients with non-alcoholic and alcoholic related fatty liver disease, Trends in liver disease etiology among adults awaiting liver transplantation in the United States, 2014-2019, Alcoholic fatty liver disease, also called alcoholic steatohepatitis (ASH), Discomfort in the upper right side of your belly. Medical records from these patients were traced and the biopsies reviewed by experienced pathologists. The more severe form of NAFLD is called nonalcoholic . Cirrhosis is the common end stage of a number of chronic liver conditions and a significant cause of morbidity and mortality. We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. According to the NAS score overall 31/151 (21%) patients in the NAFLD group had NASH compared to 35/94 (37%) with ASH in the AFLD group (p=0.007). Make sure that none of your medications, herbs, and supplements are toxic to the liver. https://www.mayoclinic.org/diseases-conditions/nonalcoholic-fatty-liver-disease/symptoms-causes/syc-20354567, https://stanfordhealthcare.org/medical-conditions/liver-kidneys-and-urinary-system/nonalcoholic-steatohepatitis-nash.html, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1774026/, https://www.gastrojournal.org/article/0016-5085(95)90726-2/pdf, https://www.medscape.com/answers/175472-100864/what-is-the-prognosis-of-fatty-liver-disease. If you have cirrhosis, your doctor can give you a better idea of your outlook and what you can do to improve it. Besides, you may reverse your liver damage even during the initial stages of your nonalcoholic fatty liver disease. Since many medications can harm your liver, always let all your health care providers know about any medications you are taking. The index liver biopsies were formalin fixed and treated routinely in the pathology laboratory. The proportion of men was higher in the AFLD group, that is 67% (63/94) whereas the proportion of women was 31/94 (33%). For women, absence of or loss of periods not related to menopause. 2013, 145: 782-789. Exp Mol Pathol. About 16 million of these have more advanced inflammation and NASH nonalcoholic steatohepatitis a more aggressive form of the condition, often called a "silent killer" because it causes liver scarring and inflammation and can develop into cirrhosis. 1992, 117: 646-654. Oftentimes NASH presents with no symptoms, so you dont even know you have it. The first step involves insulin resistance and obesity, which results in high levels of fat infiltration into liver cells, called steatohepatitis. Between 10 and 20 percent of these cases will develop into liver cancer. Lifestyle Changes For Non-Alcoholic Fatty Liver Disease, Best Exercises/Activities For Non-Alcoholic Fatty Liver Disease. 2023 Healthline Media LLC. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. First, all patients had biopsy proven fatty liver disease and histology was re-evaluated based on validated scores. Can Nonalcoholic Fatty Liver Disease Go Away On Its Own & What Are Its Natural Remedies? Inherited disorders of sugar metabolism, such as galactosemia or glycogen storage disease. Neuschwander-Tetri BA, Clark JM, Bass NM, Van Natta M, Unalp-Arida A, Tonascia J, Zein CO, Brunt EM, Kleiner DE, McCullough AJ, Sanyal AJ, Diehl AM, Lavine JE, Chalasani N, Kowdley KV: Clinical, laboratory and histological associations in adults with nonalcoholic fatty liver disease. Thank you, {{form.email}}, for signing up. Advanced cirrhosis is life-threatening. The Child-Turcotte-Pugh (CTP) system awards points based on whether an individual has: With the CTP system, a persons score increases according to the number and severity of their symptoms. There is a problem with Control diabetes. The MELD system helps to determine the risk of death in people with end-stage liver disease. NASH is a type of nonalcoholic fatty liver disease. Trends in liver disease etiology among adults awaiting liver transplantation in the United States, 2014-2019. BMC Gastroenterol. Cirrhosis puts people at greater risk for: There are two stages in cirrhosis: compensated and decompensated. Mayo Clinic does not endorse companies or products. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. They were paraffin embedded and cut in 45 micrometer thick sections. Its critical to get immediate medical attention if you suspect you have it. In a study from Denmark, a significantly higher BMI was seen in NAFLD than in AFLD patients. Symptoms. In this retrospective study, all patients who underwent a liver biopsy 19842009 at the National University Hospital of Iceland were identified through a computerized pathological database with the code for fatty liver. And even in the most severe cases, liver transplants and new treatments provide those suffering from cirrhosis with hope. MELD scores help to determine three-month mortality rate. (2006). Diabetes and Liver Disease: What Is the Relationship? A total of 12 patients (18%) died of malignancy. Check your meds. Destruction of the bile ducts caused by primary biliary cholangitis. The mean liver-related death rate among the general population during the study period was 0.1% of all deaths. Learn more about cirrhosis from transplant hepatologist Sumera Ilyas, M.B.B.S. At the time of index liver biopsy 18 patients had cirrhosis, 6 patients in the NAFLD group and 12 in the AFLD group, respectively. For men, loss of sex drive, testicular shrinkage or breast enlargement, known as gynecomastia. Experts arent sure why some people get NASH and experience symptoms and others dont. In the nonalcoholic group 47 (31%) patients had borderline NASH and 68 patients (45%) did not have steatohepatitis. At the end of follow-up, ALT, AST and MCV were the only biochemical markers still significantly higher in the AFLD group compared to the NAFLD group (Table1). Keep reading to explore the life expectancy for cirrhosis by its stage, including diagnosis information and coping tips. Among patients diagnosed with cirrhosis a somewhat higher proportion developed ascites in the AFLD group, 11/19 (58%) vs. NAFLD, 3/10 (30%) (p=0.004). Measuring liver function enzyme levels is especially important because theycan help to diagnose NASH and differentiate NASH from alcoholic hepatitis. weight loss. The sections were stained with hematoxylin and eosin, periodic acid Schiff reagent (PAS) with diastase and for reticulin. Swelling in the legs, feet or ankles, called edema. Doctors may estimate the life expectancy of nonalcoholic fatty liver patients based on certain risk factors. Learn about metabolism and what to eat for a healthy liver. But in others, the disease continues to progress. If you have a type of scar tissue in your liver called fibrosis, you may be developing cirrhosis. As a result, NASH patients can remain unaware of their condition until the late stages of the disease. Limit or stop alcohol. Manage cookies/Do not sell my data we use in the preference centre. In rare cases, it may be reversed. Who is at risk for developing NAFLD and NASH? Am J Gastroenterol. Klatsky AL, Armstrong MA, Friedman GD: Alcohol and mortality. Long term follow-up and liver-related death rate in patients with non-alcoholic and alcoholic related fatty liver disease. You will receive the first liver transplant and decompensated cirrhosis email in your inbox shortly. Plus the Differences Between NASH and NAFLD. Although significantly higher in the AFLD group liver-related death in the NAFLD group was 7% of all deaths. Sumera I. Ilyas, M.B.B.S., Transplant Hepatologist, Mayo Clinic I'm Dr. Sumera Ilyas, a transplant hepatologist at Mayo Clinic. 2010, 52: 913-924. Most people are asymptomatic for a long time, and their daily life is unaffected, leading to difficulty in identifying and managing people who slowly progress to non-alcoholic . And when this happens, scar tissue forms. This is similar to our results showing liver-related to be the third most common cause of death amongst the NAFLD group. No medicines have been approved to treat NASH, so managing your underlying health conditions and leading a healthy lifestyle are the best treatment options. Overall, 11 patients developed cirrhosis during follow-up period, four patients in the NAFLD group and seven patients in the AFLD group. We believe we have included the vast majority of patients with biopsy-proven fatty liver disease in the whole population of Iceland during this period as at least 95% of the population lives in the catchment area of the National University Hospital. NASH is now a leading reason for liver transplants. Other ways to manage fatty liver disease include maintaining a healthy weight, eating a balanced diet, getting regular exercise, and continuing to avoid alcohol. Occationally the colours of the slides had faided somewhat. (2012). Correspondence to This includes medications that you are taking, your symptoms, and the health problems youve had. NASH can be diagnosed with blood tests and imaging. Thrombocytopenia is common in people with cirrhosis. Two of the key ones are Model for End-stage Liver Disease (MELD) and Child-Turcotte-Pugh (CTP) score. The damage done by cirrhosis typically cannot be undone. In addition all patients were linked to the database for the National Centre of Addiction Medicine in Iceland. (5), On the other side, if you make the doctors recommended lifestyle changes, such as regular physical exercise and following a balanced diet early, you will preserve your good health for many years. Progression of NAFLD has been found to be slow and seems to depend a great deal on the initial fibrosis stage [8, 14]. Feldman M, et al., eds. 2000, 132: 112-117. The mean liver-related death rate among the general population during the study period was 0.1% of all deaths [13]. Clubbing of the fingers, in which the fingertips spread out and become rounder than usual. Is Non-Alcoholic Fatty Liver Disease A Serious Condition & Can It Be Reversed? Inflammation can damage liver cells, causing fibrosis (scarring) of the liver. Khanna S (expert opinion). For someone with cirrhosis, a liver transplant can add years to their life expectancy. Previous Section Next Section. We and our partners use cookies to Store and/or access information on a device. Hepatology. A wide range of diseases and conditions can damage the liver and lead to cirrhosis. Google Scholar. The median survival was 24.2 (range 0.2-26.1) years in the NAFLD group and 19.5 (range 0.2-24.2) years in the AFLD group (p=0.0007). Furthermore, approximately 10percent to 25percent of nonalcoholic steatohepatitis develop the problem of cirrhosis within only 10years. However, when symptoms take place in any affected person, they include-, Nonalcoholic fatty liver may take place in two different types, which include the following-, In this case, you have fat deposition in the liver, but you do not experience any liver inflammation or liver cell damages. Int J Mol Sci. 2023 BioMed Central Ltd unless otherwise stated. Armand W. Fatty liver disease. Most patients live more than 10 years. Statistics Iceland: 2013, Available from: http://www.hagstofan.is/Hagtolur/Mannfjoldi/faeddir-og-danir. Angulo P, Bugianesi E, Bjrnsson E, Charatcharoenwitthaya P, Mills PR, Barrera F, Haflidadottir S, Day CS: Simple non-invasive systems predict long-term outcomes in patients with nonalcoholic fatty liver disease. NAFLD usually causes no signs and symptoms. Ann Intern Med. However, if more than 5% - 10% percent of the liver's weight is fat, then it is called a fatty liver (steatosis). This is a very valuable coding system for retrieving data and pathology reports from past years, like biopsies of the liver (T-56) showing fatty change (M-50080). It is quite common with up to 25% of people in the world having this condition. A liver biopsy can also provide information on the extent of your NASH disease. While there are no definite estimates on the progression of fatty liver to cirrhosis, studies have shown that lifestyle changes and avoiding alcohol can decrease the likelihood of developing cirrhosis and long-term liver complications. Clinical and biochemical data at the time of index liver biopsy in the 245 patients of the two study groups (Table1). Multiple types and stages of liver disease can lead to liver failure. (2018). DOI: Ying P, et al. In these conditions fat builds up in the liver. 1A: mild, zone 3, perisinusoidal. Dam-Larsen S, Becker U, Franzmann MB, Larsen K, Christoffersen P, Bendtsen F: Final results of long-term, clinical follow-up in fatty liver patients. information is beneficial, we may combine your email and website usage information with Doctors use someones CPT score to determine whether they have class A, B, or C cirrhosis. Class B cirrhosis is more moderate, while class C cirrhosis is severe. Medications and procedures to treat cirrhosis symptoms include: According to the VA, although cirrhosis is progressive, some people with the condition can move from decompensated, or symptomatic, back to the asymptomatic stage. Thus, even though NAFLD is potentially a serious condition well designed population based studies on its natural history are lacking. Patients in the AFLD group diagnosed with cirrhosis had a higher death rate compared to the NAFLD group; 10 patients (40%) in the AFLD group compared with 7 patients (17%) in the NAFLD group (NS). Lower your risk of cirrhosis by taking these steps to care for your liver: If you're concerned about your risk of liver cirrhosis, talk to your health care provider about ways you can reduce your risk. Besides, you will experience severe problems, which include-. How Does Nonalcoholic Fatty Liver Disease Affect The Body & What Triggers It? 8 patients were lost to follow-up. If you have cirrhosis, there are several tools your doctor can use to give you a better understanding of your outlook. Having high blood fat levels, either triglycerides or LDL (bad) cholesterol. All rights reserved. Health care providersdivide fatty liver disease into two types. Diabetes and Liver Cancer: What Is the Relationship? The Comfort of Home for Chronic Liver Disease, uptodate.com/contents/model-for-end-stage-liver-disease-meld, How to Follow a Liver Cirrhosis Diet: All You Need to Know. This content does not have an English version. volume14, Articlenumber:166 (2014) NAFLD is associated with insulin resistance, and has been considered to be the hepatic component of the metabolic syndrome [35]. NAFLD is sometimes called fatty liver disease because the presence of fat in the liver cells is the only characteristic of the condition. An example of data being processed may be a unique identifier stored in a cookie. Patients in the AFLD group had a higher liver-related mortality, but patients in the NAFLD group died more frequently from cardiovascular disease as already demonstrated in previous studies [6, 7, 14, 16]. Elsevier; 2020. https://www.clinicalkey.com. 3) use of drugs known to be associated with fatty liver disease such as methotrexate, amiodarone, tamoxifen and high doses of corticosteroids. Not only are those with NASH more likely to get infections, but they are more likely to progress to cirrhosis or complete liver failure if they get hepatitis A or B. The Nutritional Deficiency Theory (NDT) prevailed as the dominant aetiological understanding of cirrhosis for roughly three decades until it was challenged by a new set of new clinical and experimental studies in the 1960s and 70s. Chronic viral infections of the liver (hepatitis B and hepatitis C). But if caught early enough and depending on the cause, there is a chance of slowing it with treatment. This number could be even higher, as many people do not receive a diagnosis until they develop advanced symptoms. Sign up for free, and receive liver transplant and decompensated cirrhosis content, plus expertise on liver health. Potential treatments for thrombocytopenia in cirrhosis include medications, platelet transfusions. Accessed Jan. 6, 2023. Terms and Conditions, In the AFLD group, 4 died of breast cancer and one each of renal cancer, malignant brain tumor, colon cancer, nasopharyngeal cancer and pancreas cancer. As cirrhosis gets worse, more and more scar tissue forms, making it difficult for the liver to do its job. Lee GR: Nonalcoholic steatohepatitis: a study of 49 patients. Google Scholar. The measurements used to get a MELD score include bilirubin, serum sodium, and serum creatinine. severe form of liver scarring, which results in liver failure and later on, death. Fatty liver disease can happen without causing any symptoms. UpToDate. 2008, 49: 608-612. Patient with a reported alcohol problem or abuse or an alcohol-related diagnosis before or at the time of liver index biopsy were considered to have alcoholic fatty liver disease. Charles S. Lieber, a gastroenterologist based in New York, succeeded for the first time in producing cirrhosis in humans and animals by feeding them alcohol . Schuppan D, et al. There are several ways to help determine the potential life expectancy of someone with cirrhosis. We follow a strict editorial policy and we have a zero-tolerance policy regarding any level of plagiarism. (6), In most of the cases, the nonalcoholic fatty liver problem does not result in any sign or symptom. Review/update the Even if you do not experience any symptoms associated with liver scarring (further stage of the nonalcoholic fatty liver), you should start following a healthy lifestyle. Few studies have determined the natural history of biopsy-proven fatty liver disease and compared the long-term prognosis of these two major groups of fatty liver disease due to alcoholic and non-alcoholic fatty liver disease. The authors declare that they have no competing interests. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-230X/14/166/prepub. Population based studies have shown increased risk of women developing alcohol-induced cirrhosis [23 . When it does, they may include: Fatigue. The higher someones MELD score is, the more likely they are to die within three months. By using this website, you agree to our A total of 420 patients met the inclusion criteria and were divided into two groups, non-alcoholic and alcoholic group respectively (Figure1). See additional information. Your doctor may also do a liver biopsy to confirm NASH or rule out other causes of liver disease. 2018;104(1):45-49. doi:10.1016/j.yexmp.2017.12.007, Kim KH, Lee M-S. Pathogenesis of nonalcoholic steatohepatitis and hormone-based therapeutic approaches. Tonon M, et al. Most people with NAFLD live with fat in their liver without developing liver damage. 1989, 20: 594-. Laboratory data included at baseline were: AST, ALT, bilirubin, albumin, alkaline phosphatase (ALP), prothrombin time (PT), glucose, platelets count (PLT), serum cholesterol, serum triglycerides (TG) and mean corpuscular volume (MCV). Fibrosis stage were defined as follow: 0: none. Cirrhosis puts both a persons liver and life at risk. The Creative Commons Public Domain Dedication waiver (https://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Dig Dis Sci. Infections; Hepatitis C; Alcohol consumption; Various factors can determine a cirrhosis patient's life expectancy. All histological slides were reviewed by experienced pathologists without knowledge of the clinical or biochemical data of the patients. In the process, scar tissue forms. What is it? Three pathologists (Jon G. Jonasson, David E. Kleiner and Sylvia O. Einarsdottir) divided the slides between them and reviewed all of the samples over a period of 2years. In the current context obesity was defined as BMI 30, 48/88 patients (55%) were obese in the NAFLD group compared to 22/50 patients (44%) in the AFLD group (NS). Accessed Jan. 5, 2023. Friedman SL, et al. 2002, 346: 1221-1231. The results were presented as medians, interquartile range and range and as number (%). Many things can eventually lead to cirrhosis, including: Cirrhosis is a progressive disease, meaning it gets worse over time. To provide you with the most relevant and helpful information, and understand which In the UK, the most common causes of cirrhosis are: drinking too much alcohol over many years; being infected with hepatitis for a long time, particularly hepatitis B or hepatitis C; a severe form of non-alcoholic fatty liver disease (NAFLD), called non-alcoholic steatohepatitis, where the liver becomes inflamed from a build-up of excess fat Cirrhosis is severe scarring of the liver. Hepatology. This content does not have an Arabic version. A total of 67 patients died during the follow-up period; 41 women (61%) and 26 men (39%). In cirrhosis (right), scar tissue replaces healthy liver tissue. Most recent studies on fatty liver disease have focused on NAFLD although AFLD is an important cause of fatty liver and only a few studies have compared the long term prognosis between NAFLD and AFLD [810]. If you have NAFLD without any other medical problems, you dont need any special treatment. If you have cirrhosis, you may be eligible for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. National Institute of Diabetes and Digestive and Kidney Diseases. Alagille syndrome, a genetic digestive disorder. Who is at risk for developing NAFLD and NASH? Levels of two liver enzymes, aspartate aminotransferase (AST) and alanine aminotransferase (ALT), are elevated in about 90% of people with NASH. If combined with weight loss and an improved diet, you can reverse fatty liver disease. Pain or discomfort in the upper right abdomen. confusion, slurred speech, or drowsiness ( hepatic encephalopathy) nausea and . Clinical and Molecular Hepatology. Cirrhosis. 1999, 94: 2467-2474. The fat causes inflammation and damage, which might lead to cirrhosis. Patients in the NAFLD had less severe lobular inflammation than the AFLD group (Table3). Maintaining a healthy blood sugar level via diet and medication decreases the likelihood of developing NASH symptoms. A liver biopsy involves getting a tissue sample of your liver with a needle. A higher number of patients in the AFLD group developing cirrhosis (20%) after approximately 12years of follow-up, is also in agreement with previous studies showing worse prognosis in patients with AFLD than NAFLD [8, 9, 18]. In this retrospective study, a search was undertaken in a computerized diagnoses database from 1984 (when the pathology registry commenced their electronic registration) to 2009, in the Department of Pathology at the National University Hospital (NUH) of Iceland and identified all liver biopsies analysed and registrated in the SNOMED coding-system, T-56000 and the M-50080 as having fatty change. Another limitation is the small number of hard endpoints with only four patients in the NAFLD group who developed cirrhosis over the follow-up period. Nonalcoholic fatty liver disease, a condition in which fat accumulates in the liver. People with alcoholic liver disease who stop drinking have a much better chance of long-term survival. The catchment area of the NUH covers >95% of the population in Iceland. Wilson R, et al. Bellantini S, Scaglioni F, Marino M, Bedogni G: Epidemiology of non-alcoholic fatty liver disease.

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