Fatty liver and mortality

a cohort population study in South Italy

Maria Gabriella Caruso, Nicola Veronese, Maria Notarnicola, Anna Maria Cisternino, Rosa Reddavide, Rosa Inguaggiato, Vito Guerra, Rossella Donghia, Antonio Logroscino, Ornella Rotolo, Marisa Chiloiro, Gioacchino Leandro, Giampiero De Leonardis, Valeria Tutino, G Misciagna, Caterina Bonfiglio, Rocco Guerra, Alberto Osella

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Alcoholic fatty liver (AFLD) and non-alcoholic fatty liver (NAFLD) are two common conditions. However, if they can increase the risk of death is poorly explored. We therefore aimed to investigate the potential association between the presence and severity of liver steatosis and mortality in a large sample of older people.

DESIGN: Prospective.

SETTING: Community.

PARTICIPANTS: Women and men randomly sampled from the electoral rolls of the population of Castellana Grotte, a town in Southern Italy (Apulia region) between 2005 and 2006. Among 1942 initially contacted, 1708 (=87.9%) participated to the baseline survey (Multicentrica Colelitiasi III (MICOL III)). This specific study included 1445 older participants (mean age=65.2 years, females=44.2%).

EXPOSURE: NAFLD or AFLD.

PRIMARY AND SECONDARY OUTCOMES: Mortality (all-cause and specific-cause).

RESULTS: After a median of 12 years, 312 participants (=21.6%) died. After adjusting for nine potential confounders, the presence of steatosis was not associated with any increased risk of death in both NAFLD and AFLD. The severity of liver steatosis was not associated with any increased risk of mortality in NAFLD, while in AFLD, the presence of moderate steatosis significantly increased the risk of overall (HR=2.16; 95% CI 1.19 to 3.91) and cancer-specific (HR=3.54; 95% CI 1.16 to 10.87) death.

CONCLUSIONS: Liver steatosis is not associated with any increased risk of death in NAFLD, while moderate steatosis could be a risk factor for mortality (particularly due to cancer) in people affected by AFLD.

Original languageEnglish
Pages (from-to)e027379
Number of pages7
JournalBMJ Open
Volume9
Issue number6
DOIs
Publication statusPublished - Jun 20 2019

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Fatty Liver
Italy
Cohort Studies
Mortality
Population
Alcoholic Fatty Liver
Neoplasms
Non-alcoholic Fatty Liver Disease

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Fatty liver and mortality : a cohort population study in South Italy. / Caruso, Maria Gabriella; Veronese, Nicola; Notarnicola, Maria; Cisternino, Anna Maria; Reddavide, Rosa; Inguaggiato, Rosa; Guerra, Vito; Donghia, Rossella; Logroscino, Antonio; Rotolo, Ornella; Chiloiro, Marisa; Leandro, Gioacchino; De Leonardis, Giampiero; Tutino, Valeria; Misciagna, G; Bonfiglio, Caterina; Guerra, Rocco; Osella, Alberto.

In: BMJ Open, Vol. 9, No. 6, 20.06.2019, p. e027379.

Research output: Contribution to journalArticle

Caruso, MG, Veronese, N, Notarnicola, M, Cisternino, AM, Reddavide, R, Inguaggiato, R, Guerra, V, Donghia, R, Logroscino, A, Rotolo, O, Chiloiro, M, Leandro, G, De Leonardis, G, Tutino, V, Misciagna, G, Bonfiglio, C, Guerra, R & Osella, A 2019, 'Fatty liver and mortality: a cohort population study in South Italy', BMJ Open, vol. 9, no. 6, pp. e027379. https://doi.org/10.1136/bmjopen-2018-027379
Caruso, Maria Gabriella ; Veronese, Nicola ; Notarnicola, Maria ; Cisternino, Anna Maria ; Reddavide, Rosa ; Inguaggiato, Rosa ; Guerra, Vito ; Donghia, Rossella ; Logroscino, Antonio ; Rotolo, Ornella ; Chiloiro, Marisa ; Leandro, Gioacchino ; De Leonardis, Giampiero ; Tutino, Valeria ; Misciagna, G ; Bonfiglio, Caterina ; Guerra, Rocco ; Osella, Alberto. / Fatty liver and mortality : a cohort population study in South Italy. In: BMJ Open. 2019 ; Vol. 9, No. 6. pp. e027379.
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abstract = "OBJECTIVE: Alcoholic fatty liver (AFLD) and non-alcoholic fatty liver (NAFLD) are two common conditions. However, if they can increase the risk of death is poorly explored. We therefore aimed to investigate the potential association between the presence and severity of liver steatosis and mortality in a large sample of older people.DESIGN: Prospective.SETTING: Community.PARTICIPANTS: Women and men randomly sampled from the electoral rolls of the population of Castellana Grotte, a town in Southern Italy (Apulia region) between 2005 and 2006. Among 1942 initially contacted, 1708 (=87.9{\%}) participated to the baseline survey (Multicentrica Colelitiasi III (MICOL III)). This specific study included 1445 older participants (mean age=65.2 years, females=44.2{\%}).EXPOSURE: NAFLD or AFLD.PRIMARY AND SECONDARY OUTCOMES: Mortality (all-cause and specific-cause).RESULTS: After a median of 12 years, 312 participants (=21.6{\%}) died. After adjusting for nine potential confounders, the presence of steatosis was not associated with any increased risk of death in both NAFLD and AFLD. The severity of liver steatosis was not associated with any increased risk of mortality in NAFLD, while in AFLD, the presence of moderate steatosis significantly increased the risk of overall (HR=2.16; 95{\%} CI 1.19 to 3.91) and cancer-specific (HR=3.54; 95{\%} CI 1.16 to 10.87) death.CONCLUSIONS: Liver steatosis is not associated with any increased risk of death in NAFLD, while moderate steatosis could be a risk factor for mortality (particularly due to cancer) in people affected by AFLD.",
author = "Caruso, {Maria Gabriella} and Nicola Veronese and Maria Notarnicola and Cisternino, {Anna Maria} and Rosa Reddavide and Rosa Inguaggiato and Vito Guerra and Rossella Donghia and Antonio Logroscino and Ornella Rotolo and Marisa Chiloiro and Gioacchino Leandro and {De Leonardis}, Giampiero and Valeria Tutino and G Misciagna and Caterina Bonfiglio and Rocco Guerra and Alberto Osella",
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T1 - Fatty liver and mortality

T2 - a cohort population study in South Italy

AU - Caruso, Maria Gabriella

AU - Veronese, Nicola

AU - Notarnicola, Maria

AU - Cisternino, Anna Maria

AU - Reddavide, Rosa

AU - Inguaggiato, Rosa

AU - Guerra, Vito

AU - Donghia, Rossella

AU - Logroscino, Antonio

AU - Rotolo, Ornella

AU - Chiloiro, Marisa

AU - Leandro, Gioacchino

AU - De Leonardis, Giampiero

AU - Tutino, Valeria

AU - Misciagna, G

AU - Bonfiglio, Caterina

AU - Guerra, Rocco

AU - Osella, Alberto

N1 - © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2019/6/20

Y1 - 2019/6/20

N2 - OBJECTIVE: Alcoholic fatty liver (AFLD) and non-alcoholic fatty liver (NAFLD) are two common conditions. However, if they can increase the risk of death is poorly explored. We therefore aimed to investigate the potential association between the presence and severity of liver steatosis and mortality in a large sample of older people.DESIGN: Prospective.SETTING: Community.PARTICIPANTS: Women and men randomly sampled from the electoral rolls of the population of Castellana Grotte, a town in Southern Italy (Apulia region) between 2005 and 2006. Among 1942 initially contacted, 1708 (=87.9%) participated to the baseline survey (Multicentrica Colelitiasi III (MICOL III)). This specific study included 1445 older participants (mean age=65.2 years, females=44.2%).EXPOSURE: NAFLD or AFLD.PRIMARY AND SECONDARY OUTCOMES: Mortality (all-cause and specific-cause).RESULTS: After a median of 12 years, 312 participants (=21.6%) died. After adjusting for nine potential confounders, the presence of steatosis was not associated with any increased risk of death in both NAFLD and AFLD. The severity of liver steatosis was not associated with any increased risk of mortality in NAFLD, while in AFLD, the presence of moderate steatosis significantly increased the risk of overall (HR=2.16; 95% CI 1.19 to 3.91) and cancer-specific (HR=3.54; 95% CI 1.16 to 10.87) death.CONCLUSIONS: Liver steatosis is not associated with any increased risk of death in NAFLD, while moderate steatosis could be a risk factor for mortality (particularly due to cancer) in people affected by AFLD.

AB - OBJECTIVE: Alcoholic fatty liver (AFLD) and non-alcoholic fatty liver (NAFLD) are two common conditions. However, if they can increase the risk of death is poorly explored. We therefore aimed to investigate the potential association between the presence and severity of liver steatosis and mortality in a large sample of older people.DESIGN: Prospective.SETTING: Community.PARTICIPANTS: Women and men randomly sampled from the electoral rolls of the population of Castellana Grotte, a town in Southern Italy (Apulia region) between 2005 and 2006. Among 1942 initially contacted, 1708 (=87.9%) participated to the baseline survey (Multicentrica Colelitiasi III (MICOL III)). This specific study included 1445 older participants (mean age=65.2 years, females=44.2%).EXPOSURE: NAFLD or AFLD.PRIMARY AND SECONDARY OUTCOMES: Mortality (all-cause and specific-cause).RESULTS: After a median of 12 years, 312 participants (=21.6%) died. After adjusting for nine potential confounders, the presence of steatosis was not associated with any increased risk of death in both NAFLD and AFLD. The severity of liver steatosis was not associated with any increased risk of mortality in NAFLD, while in AFLD, the presence of moderate steatosis significantly increased the risk of overall (HR=2.16; 95% CI 1.19 to 3.91) and cancer-specific (HR=3.54; 95% CI 1.16 to 10.87) death.CONCLUSIONS: Liver steatosis is not associated with any increased risk of death in NAFLD, while moderate steatosis could be a risk factor for mortality (particularly due to cancer) in people affected by AFLD.

U2 - 10.1136/bmjopen-2018-027379

DO - 10.1136/bmjopen-2018-027379

M3 - Article

VL - 9

SP - e027379

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 6

ER -