Sanyal AJ, Van Natta ML, Clark J, et al. - In nonalcoholic fatty liver disease (NAFLD), increased risks of liver-related complications and death were observed in relation to fibrosis stages F3 (bridging fibrosis) and F4 (cirrhosis).

• A multicenter patient population of 1,773 adults with NAFLD was followed for a median of 4 years in this prospective study.

• With increasing fibrosis stages, an increase in all-cause mortality was evident.

• Increase in incidence of liver-related complications (per 100 person-years) was evident with fibrosis stage (F0 to F2 [no, mild, or moderate fibrosis] vs F3 vs F4): variceal hemorrhage (0.00 vs 0.06 vs 0.70), ascites (0.04 vs 0.52 vs 1.20), encephalopathy (0.02 vs 0.75 vs 2.39), and hepatocellular cancer (0.04 vs 0.34 vs 0.14).

• Relative to those with stage F0 to F2 fibrosis, a higher incidence of type 2 diabetes and a reduction of more than 40% in the estimated glomerular filtration rate was also detected in those with stage F4 fibrosis.

• Post-adjustment, the incidence of any hepatic decompensation event was related to elevated all-cause mortality (adjusted hazard ratio, 6.8).