{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T16:29:33Z","timestamp":1758817773117,"version":"3.40.5"},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T00:00:00Z","timestamp":1695081600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Several studies reported an association between liver stiffness measurement (LSM) obtained through vibration\u2010controlled transient elastography (VCTE) and all\u2010cause mortality in patients with nonalcoholic fatty liver disease (NAFLD). The objective of this systematic review and meta\u2010analysis was to summarize available evidence on the nature and magnitude of this association.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We systematically searched PubMed\u2010MEDLINE and Scopus up to April 2023 for observational cohort studies in which LSM was measured with VCTE in patients with NAFLD or in general population settings, with a follow\u2010up \u22651\u2009year and with available data on all\u2010cause mortality. Measures of association from individual studies were meta\u2010analysed using random effects models. Of the 517 titles initially scrutinized, we included seven studies with data on 18\u2009771 participants (47.1% male) and a mean follow\u2010up of 3.6\u2009years. We included effect estimates obtained in the models with the highest degree of adjustment for potential confounders available in each study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>When analysed as a categorical variable based on specific LSM cut\u2010offs, liver fibrosis was associated with an increased risk of all\u2010cause death (HR 2.10, 95% CI 1.56\u20132.83; test for overall effect <jats:italic>z<\/jats:italic>\u2009=\u20094.919, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Results were consistent when LSM was considered as a continuous variable (HR for 1\u2009kPa increase: 1.03, 95% CI 1.01\u20131.05; test for overall effect <jats:italic>z<\/jats:italic>\u2009=\u20093.341, p\u2009=\u20090.001). There was borderline significant heterogeneity among the studies (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200950.2% and <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200966.7% in the two analyses, respectively). No significant publication bias was detected by funnel plot analysis and Egger's and Begg's tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The present meta\u2010analysis indicates that LSM, as a proxy of liver fibrosis, is independently and directly associated with a higher mortality risk in patients with NAFLD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.15742","type":"journal-article","created":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T12:03:15Z","timestamp":1695124995000},"page":"2604-2610","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Liver stiffness is associated with all\u2010cause mortality in patients with <scp>NAFLD<\/scp>: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2422-3041","authenticated-orcid":false,"given":"Stefano","family":"Ciardullo","sequence":"first","affiliation":[{"name":"Department of Medicine and Rehabilitation Policlinico di Monza  Monza Italy"},{"name":"School of Medicine and Surgery University of Milano Bicocca  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Muraca","sequence":"additional","affiliation":[{"name":"Department of Medicine and Rehabilitation Policlinico di Monza  Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Zerbini","sequence":"additional","affiliation":[{"name":"Department of Medicine and Rehabilitation Policlinico di Monza  Monza 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