Background: DM patients have a 7-8 times higher risk of development of NASH with advanced fibrosis or cirrhosis than non-DM, which are predictors of mortality in NASH patients. This study evaluated mortality in NAFLD/NASH patients by liver disease severity and DM status.

Methods: This was a retrospective study from 2007-2015 of a 20% sample of U.S. Medicare beneficiaries and included NAFLD/NASH-DM patients (ICD codes/medications). Survival analyses performed via Kaplan-Meier curves for incidences of all-cause mortality and disease progression.

Results: This study identified NAFLD/NASH-DM patients: 100,098 with NAFLD/NASH only, 2,520 compensated cirrhosis (CC), 45,881 decompensated cirrhosis (DCC), 408 liver transplant (LT), and 384 hepatocellular carcinoma (HCC). Rates of comorbidities were high (at least 71% with cardiovascular disease). In 1 year, mortality was higher in DCC patients (18.1%) than in CC (4.3%) and NAFLD/NASH only (2.1%) (Figure). This trend continued over the study period. Liver disease progression was higher in CC patients with DM compared to no DM (20% vs. 17%).

Conclusions: NAFLD/NASH-DM patients overall mortality rate of 25.1% was 2-times higher than the expected rate for similarly aged general population of 12.7% (Social Security life table) over 8-year the study period.

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Disclosure

R. Loomba: Consultant; Self; Eli Lilly and Company, Novo Nordisk Inc. J. Fraysse: Employee; Self; Gilead Sciences, Inc. S. Li: Consultant; Self; Gilead Sciences, Inc. A. Ozbay: Employee; Self; Gilead Sciences, Inc. Stock/Shareholder; Self; Gilead Sciences, Inc. S.A. Harrison: Advisory Panel; Self; Gilead Sciences, Inc.

© 2019 by the American Diabetes Association.
2019
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