NAFLD among children and young adults associated with increased long-term mortality

In a new study conducted by Tracey G. Simon and colleagues, it was noted that Swedish children and young adults with biopsy-confirmed non-alcoholic fatty liver disease (NAFLD) have significantly higher rates of overall, cancer-, liver-, and cardiometabolic-specific mortality when compared to matched general population controls.

The findings of this study were published in the Journal of hepatology on 2nd July, 2021.

Because longitudinal data on the natural history and long-term risk of mortality in children and young adults with biopsy-confirmed NAFLD are scarce, this nationwide cohort study compared the risk of all-cause and cause-specific mortality in pediatric and young adult patients with biopsy-confirmed NAFLD to matched general population controls in Sweden.

This was a statewide, matched cohort study that included all Swedish children and young people (age 25) with biopsy-confirmed NAFLD from 1966 to 2017 (n = 718). NAFLD was proven histologically in all liver specimens submitted to Sweden's 28 pathology departments, and the condition was further classified as simple steatosis or steatohepatitis (NASH).

Patients with NAFLD were matched to 5 general population controls (n = 3,457) based on age, gender, calendar year, and county. Researchers also compared individuals with NAFLD to full-sibling comparators to account for shared genetic and early-life variables. Estimation of multivariable-adjusted hazard ratios and 95 percent CIs using Cox regression was performed.

This countrywide, matched cohort research assessed total and cause-specific mortality in children and young people (25 years) in Sweden with biopsy-confirmed NAFLD (N = 718). 59 individuals with NAFLD died over a median of 15.8 years, compared to 36 in the control group. The NAFLD group had a 20-year absolute risk of death of 7.7%, while the control group had a risk of 1.1%. Simple steatosis was linked to a 5.26-fold increased adjusted mortality risk, which increased with nonalcoholic steatohepatitis. Cancer, liver disease, and cardiometabolic disease accounted for the majority of the extra mortality.

This study concluded that Swedish children and young people with biopsy-confirmed NAFLD have considerably increased risks of overall, cancer-, liver-, and cardiometabolic-specific death. The study's findings stress the importance of better preventive, risk-stratification, and monitoring measures in order to enhance long-term outcomes for this group.

Reference:

Simon, T. G., Roelstraete, B., Hartjes, K., Shah, U., Khalili, H., Arnell, H., & Ludvigsson, J. F. (2021). Non-alcoholic fatty liver disease in children and young adults is associated with increased long-term mortality. In Journal of Hepatology (Vol. 75, Issue 5, pp. 1034–1041). Elsevier BV. https://doi.org/10.1016/j.jhep.2021.06.034