ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2023
Influence of Nonalcoholic Fatty Liver Disease With Increased Liver Enzyme Levels on the Risk of Cirrhosis and Hepatocellular Carcinoma.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Polyphenol Intervention Ameliorates Non-Alcoholic Fatty Liver Disease: An Updated Comprehensive Systematic Review.Nutrients · 2024Pooled it
- Cardiometabolic Biomarkers for Disease Severity Prediction in Metabolic Dysfunction-Associated Steatotic Liver Disease.The Kaohsiung journal of medical sciences · 2026Article
- [Natural history and risk factors of metabolic associated fatty liver disease in Chinese cohorts].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Review
- Applicability of attenuation imaging and shear wave elastography in non-invasive assessment of liver steatosis and fibrosis in adult patients.Polish journal of radiology · 2026Article
- Association between dietary patterns and lipid profile in patients with non-alcoholic fatty liver disease: a retrospective cross-sectional study.Frontiers in nutrition · 2026Article
- Waist circumference partially mediates the non-linear association between TyHGB and MASLD in non-diabetic Japanese adults.Frontiers in nutrition · 2026Article
- Serum Bile Acid Profiling Across the Full Spectrum of HBV-Related Liver Diseases in Chinese Population: Implications for Diagnosis and Treatment Assessment.Biomedicines · 2025Article
- Article
- Defining 'Normal' Liver Function Tests.Cureus · 2025Article
- Increased Serum Angiopoietin-like Peptide 4 in Impaired Glucose Tolerance and Diabetes Subjects with or Without Hepatic Steatosis.Journal of clinical medicine · 2025Article
- Impact of inflammation levels on the liver during the COVID-19 pandemic: a mediation analysis.BMC public health · 2025Article
- Screening for metabolic-associated fatty liver disease in type 2 diabetes patients using non-invasive scores and ultrasound: a cross-sectional study in Egypt.BMC gastroenterology · 2025Article
- Public health strategies for hepatocellular carcinoma: from risk factors to prevention and control.Journal of liver cancer · 2025Article
- Investigating the Diagnostic Utility of LncRNA GAS5 in NAFLD Patients.Biomedicines · 2025Article
- Tips for Hepatologist Referral of Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease with Alanine Aminotransferase Levels ≤ 30 U/L.Diagnostics (Basel, Switzerland) · 2025Article
- Flexible Parametric Survival Modeling of Transaminases as Predictive Biomarkers for Non-Alcoholic Fatty Liver Disease: A Retrospective Longitudinal Study (2012-2022).International journal of molecular sciences · 2025Article
- Metabolic dysfunction-associated steatotic liver disease and its associated health risks.Journal of the Chinese Medical Association : JCMA · 2025Review
- Mendelian Randomization Assessment of the Genetic Effects of Lipid-Lowering Drugs on Digestive System Cancers.Food science & nutrition · 2025Article
- Lower hepatocellular carcinoma surveillance in metabolic dysfunction-associated steatotic liver disease: Impact on treatment eligibility.Journal of gastroenterology and hepatology · 2024Article
- Air pollution associate with advanced hepatic fibrosis among patients with chronic liver disease.The Kaohsiung journal of medical sciences · 2024Article
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Authors and funding
12 authors at 7 institutions in 3 countries.
Funding
Abstract
BACKGROUND &
aimsThe influence of nonalcoholic fatty liver disease (NAFLD) on the long-term risk of cirrhosis and hepatocellular carcinoma (HCC) in Asian populations has not been widely investigated.
methodsWe enrolled 129,374 adults aged 30 years and older, all of whom participated in a health screening program from 2008 through 2013, were seronegative for hepatitis B surface antigen and anti-hepatitis C virus antibodies, and had limited daily alcohol consumption (<20 g/d for men and <10 g/d for women). Abdominal ultrasonography was performed to determine the presence of NAFLD. The participants were divided into the following groups: NAFLD with increased or normal liver enzyme levels, and non-NAFLD with normal liver enzyme levels. The incidences of cirrhosis and HCC were determined through computerized data linkage with nationwide registries. Cox proportional hazard models were used to estimate the hazard ratios of NAFLD on the risks of cirrhosis and HCC.
resultsThe incidence rates of cirrhosis and HCC increased as follows: non-NAFLD with normal liver enzyme levels (n = 66,801; 51%), NAFLD with normal liver enzyme levels (n = 41,461; 32%), and NAFLD with increased liver enzyme levels (n = 21,112; 16%). In the NAFLD group with increased liver enzyme levels and the NAFLD group with normal liver enzyme levels, the corresponding multivariate-adjusted hazard ratios for cirrhosis were 3.51 (95% confidence interval [CI]: 2.36-5.22) and 0.73 (95% CI: 0.46-1.16), and for HCC were 1.91 (95% CI: 1.08-3.38) and 0.57 (95% CI: 0.31-1.04), respectively, compared with the non-NAFLD group (P for trend < .001). The findings were consistent after restricting the analysis to nonobese individuals (body mass index, <25 kg/m
conclusionsIndividuals with NAFLD and increased liver enzyme levels showed significantly higher risks for cirrhosis and HCC and should be monitored.
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