Non-alcoholic steatohepatitis (NASH) is linked to a 50 percent higher mortality than non-alcoholic fatty liver disease (NAFLD). The findings come from a large population-based cohort of nearly one million people in the U.K. The study looked at the overall burden of cardiovascular disease and all-cause mortality across the spectrum of NAFLD. The four stages of NAFLD are steatosis (fatty liver), non-alcoholic steatohepatitis (NASH), fibrosis, and cirrhosis.
Data was collected from over 900,000 patients and analyzed to identify patients with NAFLD, NASH, and NAFLD cirrhosis. Cardiovascular comorbidities were coded and prevalence was tracked for 14 years.
During the 14-year period, 2,701 patients were diagnosed with NAFLD-spectrum conditions. All-cause mortality was found to be higher in people with NASH than those with NAFLD, and in those with cirrhosis than NAFLD. Congestive heart failure was seen less prevalent in those with NAFLD, compared to patients with NASH and cirrhosis.
Researcher Dr. Jake Mann concluded, “Non-alcoholic fatty liver disease is recognized as a risk factor for cardiovascular disease. Our results suggest that non-alcoholic steatohepatitis conveys an even greater risk. This study provides important new insights into mortality and burden of cardiovascular disease in patients across the non-alcoholic fatty liver disease spectrum.”
Dr. Laurent Castera, vice-secretary at the European Association for the Study of the Liver, commented: “In non-alcoholic fatty liver disease, fat builds up in the liver which can cause inflammation and, eventually, lead to permanent scarring. Non-alcoholic fatty liver disease has four stages and these findings clearly link the severity of the disease with the increased risk of cardiovascular disease and death. It is therefore imperative that we identify people in the early stages of non-alcoholic fatty liver disease so they can be treated through diet and lifestyle interventions before their condition becomes potentially deadly.”
There are no specific therapies for non-alcoholic steatohepatitis, but recommendations to patients are, to reduce weight, eat a balanced and healthy diet, exercise regularly, avoid alcohol, and avoid unnecessary medications. These guidelines are also recommended to patients with cardiovascular disease, diabetes, cholesterol, and blood pressure issues as they are standard modes of treatment to aid in overall health.
Losing weight is heavily stressed in NASH treatment, as studies have shown that weight loss can significantly improve disease outcome and in some cases reverse damage already caused. The research is ongoing to determine what percentage of weight loss must be done for the most improvement in liver health.
NASH liver disease patients generally have higher incidences of other medical conditions such as diabetes, hypertension, or cholesterol. To improve the outcomes of NASH, it’s important that these other medical conditions are properly managed in order to reduce the risk of complications or worsening of liver health.
The ongoing experimental treatments for NASH look at boosting antioxidants as a means of reducing oxidative stress. It is still unknown whether these treatments are effective or not, so if you wish to try them speak to your doctor prior to doing so.