What will happen in patients with advanced nonalcoholic fatty liver disease?
Non-alcoholic fatty liver disease (NAFLD) and advanced form non-alcoholic steatohepatitis (NASH) have been become globally major chronic liver diseases (1,2). NAFLD is one of the leading causes of liver cirrhosis, hepatic failure, and hepatocellular carcinoma (HCC) (3). A large number of retrospective studies reported the importance of hepatic fibrosis with NAFLD patients as the strongest factor of liver-related mortality (4,5). On the other hand, NAFLD patients with advanced hepatic fibrosis are thought to have higer risk of developing vascular events and extrahepatic cancers because of the high prevalence of coexisting cardiometabolic risk factors, such as hypertension, diabetes mellitus, dyslipidemia, and obesity (6). However, since former literatures included only few NAFLD patients with advanced hepatic fibrosis, it is hard to estimate the accurate risk on the whole spectrum of these complications.