| [ Summary ] |
In Japan over the last two decades, changes in lifestyle have resulted in a dramatic increase in the prevalence of obesity. The increasing prevalence of obesity has led to a growing incidence of metabolic syndrome (visceral obesity, hyperglycemia, hyperlipidemia, and hypertension). The rising incidence of obesity and metabolic syndrome has paralleled the dramatic increase in nonalcoholic steatohepatitis (NASH). NASH should no longer be considered a primary liver disease, but rather as part of a multifactored metabolic disease. Epidemiological studies and basic research have shown that obesity and diabetes are major risk factors for hepatocellular carcinoma (HCC). Although the natural history of NASH remains unknown, it is clear that it can sometimes progress rapidly or lead to the development of cirrhosis, and may even lead to the development of HCC. In our prospective study, we found that liver failure is the most common cause of morbidity and mortality in patients with NASH complicated with advanced fibrosis (bridging fibrosis and cirrhosis). HCC was the most common cause of death in cases of NASH with advanced fibrosis. We also found that increased age and advanced fibrosis were significant predictors of HCC in NASH. Regular screening for HCC is extremely important in NASH patients with these risk factors. |