TY - JOUR T1 - Outcomes of Japanese patients with non-alcoholic fatty liver disease according to genetic background and lifestyle-related diseases JO - Annals of Hepatology T2 - AU - Kogiso,Tomomi AU - Sagawa,Takaomi AU - Kodama,Kazuhisa AU - Taniai,Makiko AU - Hashimoto,Etsuko AU - Tokushige,Katsutoshi SN - 16652681 M3 - 10.1016/j.aohep.2020.09.004 DO - 10.1016/j.aohep.2020.09.004 UR - https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-outcomes-japanese-patients-with-non-alcoholic-S1665268120301757 AB - Introduction and objectivesGenetic background may be involved in the mechanisms of liver injury and the development of non-alcoholic fatty liver disease (NAFLD). However, its contributions to the long-term outcome of NAFLD have been unclear. MethodsWe enrolled 314 Japanese patients with biopsy-confirmed NAFLD from 2000 to 2018 (161 men [51.3%]; median age, 53 [14–84] years; 114 with advanced fibrosis [37.5%]) in the patients without hepatocellular carcinoma at diagnosis. Genomic DNA was extracted from peripheral blood and single nucleotide polymorphisms (SNPs) were analyzed. Associations of mortality with patatin-like phospholipase 3 (PNPLA3) and aldehyde dehydrogenase 2 (ALDH2) were analyzed. Finally, a subgroup analysis according to lifestyle-related disease was performed. ResultsDuring the median 7 years of follow-up, 20 patients (6.4%) died (13 liver-related [4.1%] and 7 non-liver-related deaths [2.2%]). Patients with ALDH2 (non-GG genotype) who had reduced alcohol metabolism tended to have a poor prognosis (p = 0.06). Patients carrying both risk SNPs of PNPLA3 (GG) and ALDH2 (non-GG) had a significantly poor prognosis (p = 0.01). In the subgroup analysis, patients with PNPLA3 (GG) who were non-diabetics (p = 0.06) or non-dyslipidemic (p = 0.03), with ALDH2 (non-GG) who were non-dyslipidemic (p = 0.01) or hypertensive (p = 0.03), also had a poor prognosis. The Cox analysis revealed that ALDH2 (non-GG) was associated with a poor prognosis (Hazard ratio: 4.568, 95% Confidence Interval: 1.294–16.131, p = 0.02) similar to the liver function tests. ConclusionsGenetic background may affect NAFLD prognosis and ALDH2 SNP could predict the outcome. ER -