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Fatty liver disease is not associated with increased mortality in the elderly: A prospective cohort study.
van Kleef, Laurens A; Sonneveld, Milan J; Kavousi, Maryam; Ikram, M Arfan; de Man, Robert A; de Knegt, Robert J.
Afiliación
  • van Kleef LA; Department of Gastroenterology and Hepatology , Erasmus MC University Medical Centre , Rotterdam , The Netherlands.
  • Sonneveld MJ; Department of Gastroenterology and Hepatology , Erasmus MC University Medical Centre , Rotterdam , The Netherlands.
  • Kavousi M; Department of Cardiology , Erasmus MC University Medical Centre , Rotterdam , The Netherlands.
  • Ikram MA; Department of Epidemiology , Erasmus MC University Medical Centre , Rotterdam , The Netherlands.
  • de Man RA; Department of Gastroenterology and Hepatology , Erasmus MC University Medical Centre , Rotterdam , The Netherlands.
  • de Knegt RJ; Department of Gastroenterology and Hepatology , Erasmus MC University Medical Centre , Rotterdam , The Netherlands.
Hepatology ; 77(2): 585-593, 2023 02 01.
Article en En | MEDLINE | ID: mdl-35753042
BACKGROUND AND AIMS: Fatty liver disease (FLD) has been associated with excess mortality. Screening for hepatic steatosis (HS) in patients with metabolic dysfunction is therefore recommended by several guidelines, despite a paucity of evidence on the clinical relevance of FLD in this specific subgroup. APPROACH AND RESULTS: We studied participants of an ongoing prospective cohort (the Rotterdam Study). Persons ≥65 years old were enrolled from 2009 to 2014 and were followed through 2018. Steatosis was assessed by ultrasound and liver stiffness (LS) by transient elastography. The association between HS and LS with mortality was assessed using Cox regression analysis adjusted for age, sex, education, smoking, individual components of metabolic syndrome (MetS), heart failure, coronary heart disease, and stroke. We included 4093 elderly participants (74.4 ± 6.6 years old; 42.7% male); 36.8% had ultrasound-based steatosis. During the median follow-up of 6.9 years, 793 participants died (29.6 per 1000 person-years). In the overall population, steatosis was not associated with mortality in multivariable analysis (adjusted HR [aHR], 0.87; 95% CI, 0.73-1.03). Findings were consistent across a range of clinically relevant subgroups, including age categories, sex, MetS, elevated liver enzymes, and cardiac disease. Sensitivity analyses showed similar results for mortality beyond 5 years of follow-up and cancer-related and cerebro-cardiovascular mortality. Furthermore, among participants with steatosis, higher LS (aHR, 1.04 per kPa; 95% CI, 0.95-1.14) was not associated with mortality. CONCLUSIONS: Presence of FLD was not associated with mortality in this cohort nor in a range of subgroups. This indicates that screening for FLD and/or fibrosis is unlikely to improve outcomes among the elderly population.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome Metabólico / Enfermedad del Hígado Graso no Alcohólico Tipo de estudio: Etiology_studies / Guideline / Observational_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Hepatology Año: 2023 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome Metabólico / Enfermedad del Hígado Graso no Alcohólico Tipo de estudio: Etiology_studies / Guideline / Observational_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Hepatology Año: 2023 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos