Non-alcoholic fatty liver disease and mortality among US adults: prospective cohort study.
Non-alcoholic fatty liver disease and mortality among US adults: prospective cohort study.
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DOI：
10.1136/bmj.d6891
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发表时间：
2011-11-18
期刊：
影响因子：
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通讯作者：
Clark JM
中科院分区：
文献类型：
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作者：
Lazo M;Hernaez R;Bonekamp S;Kamel IR;Brancati FL;Guallar E;Clark JM
目的 在美国一般人群的代表性样本中评估非酒精性脂肪肝与全因和特定原因死亡率之间的关联。设计前瞻性队列研究。制定美国第三次全国健康和营养检查调查（NHANES III：1988-94），跟踪死亡率至 2006 年。参与者 11 371 名 20-74 岁的成年人参加第三次全国健康和营养检查调查，并对肝脂肪变性进行评估。主要结果衡量各种原因导致的死亡率、心血管疾病、癌症和肝脏疾病（长达 18 年的随访）。结果 人群中肝酶水平升高和不升高的非酒精性脂肪肝患病率分别为 3.1% 和 16.4%。与没有脂肪变性的参与者相比，患有非酒精性脂肪肝但肝酶水平正常的参与者的多变量调整后全因死亡风险比为 0.92（95% 置信区间 0.78 至 1.09），心血管疾病死亡风险比为 0.86（0.67 至 1.12），癌症死亡风险比为 0.92（0.67 至 1.27），肝病死亡风险比为 0.64（0.12）。 至 3.59）。与没有脂肪变性的参与者相比，患有非酒精性脂肪肝疾病和肝酶水平升高的参与者的全因死亡风险比为0.80（0.52至1.22），心血管疾病死亡风险比为0.59（0.29至1.20），癌症死亡风险比为0.53（0.26至1.10），肝病死亡风险比为1.17（0.15至8.93）。结论 非酒精性脂肪肝与全因死亡、心血管疾病、癌症或肝脏疾病的风险增加无关。
Objective To evaluate the association between non-alcoholic fatty liver disease and all cause and cause specific mortality in a representative sample of the US general population. Design Prospective cohort study. Setting US Third National Health and Nutrition Examination Survey (NHANES III: 1988-94) with follow-up of mortality to 2006. Participants 11 371 adults aged 20-74 participating in the Third National Health and Nutrition Examination Survey, with assessment of hepatic steatosis. Main outcome measure Mortality from all causes, cardiovascular disease, cancer, and liver disease (up to 18 years of follow-up). Results The prevalence of non-alcoholic fatty liver disease with and without increased levels of liver enzymes in the population was 3.1% and 16.4%, respectively. Compared with participants without steatosis, those with non-alcoholic fatty liver disease but normal liver enzyme levels had multivariate adjusted hazard ratios for deaths from all causes of 0.92 (95% confidence interval 0.78 to 1.09), from cardiovascular disease of 0.86 (0.67 to 1.12), from cancer of 0.92 (0.67 to 1.27), and from liver disease of 0.64 (0.12 to 3.59). Compared with participants without steatosis, those with non-alcoholic fatty liver disease and increased liver enzyme levels had adjusted hazard ratios for deaths from all causes of 0.80 (0.52 to 1.22), from cardiovascular disease of 0.59 (0.29 to 1.20), from cancer of 0.53 (0.26 to 1.10), and from liver disease of 1.17 (0.15 to 8.93). Conclusions Non-alcoholic fatty liver disease was not associated with an increased risk of death from all causes, cardiovascular disease, cancer, or liver disease.