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Until recently, nonalcoholic fatty liver disease (NAFLD) — a common cause of elevated serum transaminase levels in asymptomatic people — was considered harmless. But now, many authorities believe that NAFLD sometimes progresses to clinically significant liver disease. Swedish researchers identified 129 consecutive patients (mean age, 51) with biopsy-proven NAFLD among patients referred to a hepatology department for evaluation of persistently elevated AST or ALT. Seventy-one of the patients (55%) had nonalcoholic steatohepatitis (NASH), which represents a subset of NAFLD patients with more advanced pathologic findings.
During an average follow-up of 13.7 years, 26 patients died, 19 of whom had NASH at baseline. This death rate was significan…