Fatty Liver (Steatosis Hepatis): Complications

The following are the most important diseases or complications that may be contributed to by steatosis hepatis (fatty liver):

Endocrine, nutritional, and metabolic diseases (E00-E90).

Diabetes mellitus type 2 – 2 out of 3 diabetic patients have a fatty liver.
Metabolic syndrome – clinical name for the symptom combination of obesity (overweight), hypertension (high blood pressure), elevated fasting glucose (fasting blood sugar) and fasting insulin serum levels (insulin resistance), and dyslipidemia (elevated VLDL triglycerides, decreased HDL cholesterol). Furthermore, a coagulation disorder (increased tendency to clot), with an increased risk of thromboembolism, is also frequently detected. Increased liver fat in non-alcoholic fatty liver (NAFL; NAFLE; NAFLD, “nonalcoholic fatty liver disease”) is associated with an increased risk of metabolic syndrome

Circulatory system (I00-I99)

Liver, gallbladder, and biliary tract-pancreas (K70-K77; K80-K87).

Fatty liver hepatitis (inflammation of the liver at the base of a fatty liver) or non-alcoholic steatohepatitis (NASH) – circa 5-20% of cases of steatosis hepatis.
Liver cirrhosis (fatty liver cirrhosis; connective tissue remodeling of the liver with functional impairment) – this affects about 2-5% of cases of steatosis hepatis (fatty liver) with fatty liver hepatis.
Hepatic insufficiency (liver weakness)/hepatic coma (liver failure).
Portal hypertension (portal hypertension; portal hypertension).

Neoplasms – tumor diseases (C00-D48)

Hepatocellular carcinoma (HCC; hepatocellular carcinoma) – cirrhosis of the liver is considered a precancerous condition; risk approximately 2%/year for HCC; HCCs have also been described in noncirrhotic NAFLD (nonalcoholic fatty liver) patients
Breast carcinoma/breast cancer (hazard ratio (HR): 1.2 [1.01; 1.43]; p = 0.036).
Tumor disease of the skin (HR: 1.22 [1.07; 1.38]; p = 0.002).
Tumor diseases of the male genital organs ([HR]: 1.26; 95% confidence intervalI: [1.06; 1.5]; p = 0.008).

Further

Nonalcoholic fatty liver disease (NAFLD) = independent risk factor for cardiovascular disease; all-cause mortality (all-cause mortality rate) ↑

Prognostic factors

Age, sex, genetic, and metabolic risk factors (see Causes below) contribute to the disease process from nonalcoholic fatty liver NAFLD to nonalcoholic steatohepatitis (NASH). (strong consensus)
Multiple polymorphisms are associated with advanced fibrosis and hepatocellular carcinoma (HCC) development in NASH.
There is an epidemiologic association between NAFLD and HCC. The risk is particularly increased in the presence of cirrhosis. (strong consensus)
Patients who have undergone liver transplantation for NASH are at increased risk for postoperative cardiovascular events. (strong consensus)
Insulin resistance, inflammation, and alterations in adipokines and angiogenesis factors associated with NAFLD are strongly associated with HCC risk. (strong consensus)
Smoking is associated with advanced liver fibrosis in NAFLD. (strong consensus)
When chemotherapy is administered, the presence of NAFLD and the risk of NASH should be assessed and monitored as appropriate. (strong consensus) (recommendation)
Increased body mass index (BMI) has an impact on chemotherapy-associated steatohepatitis (CASH). (strong consensus)
Steatosis hepatis is exacerbated by chronic cannabis use, especially in the presence of co-existing hepatitis C.

Predictors of serious liver events (hospital admission for liver disease, a liver-related death, or initial diagnosis of hepatocellular carcinoma):

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