{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T21:51:31Z","timestamp":1779400291580,"version":"3.53.1"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T00:00:00Z","timestamp":1695600000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Journal of Australia"],"published-print":{"date-parts":[[2023,10,16]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the incidence of decompensated cirrhosis and associated risk factors in people hospitalised with non\u2010alcoholic fatty liver disease (NAFLD) or non\u2010alcoholic steatohepatitis (NASH) with or without cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study; analysis of linked Queensland Hospital Admitted Patient Data Collection, Queensland Registry of Births, Deaths and Marriages, and Queensland Cancer Register data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting, participants<\/jats:title><jats:p>Queensland residents aged 20 years or older admitted to Queensland hospitals with NAFLD\/NASH during 1 July 2009 \u2013 31 December 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Progression to decompensated cirrhosis (ascites, hepatic encephalopathy, or oesophageal variceal bleeding).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included data for 8006 patients in our analysis (10\u2009082 admissions), including 4632 women (58%) and 2514 people with diabetes mellitus (31%); median follow\u2010up time was 4.6 years (interquartile range, 2.7\u20137.2 years). Three hundred and fifty\u2010one people (4.4%) experienced decompensated cirrhosis during the follow\u2010up period. Of the 6900 people without cirrhosis, 4.5% (95% confidence interval [CI], 3.6\u20135.7%) experienced decompensated cirrhosis within ten years (mean, 0.5% per year; 95% CI, 0.4\u20130.6% per year); risk of progression was greater for people aged 70 years or older (<jats:italic>v<\/jats:italic> 20\u201339 years: adjusted hazard ratio [aHR], 4.7; 95% CI, 2.0\u201311.0) and those who had extrahepatic cancers (aHR, 5.0; 95% CI, 3.0\u20138.2), history of major cardiovascular events (aHR, 1.9; 95% CI, 1.2\u20133.1), or diabetes mellitus (aHR, 2.8; 95% CI, 2.0\u20133.9). Of the 1106 people with cirrhosis, 32.4% (95% CI, 27.2\u201338.3%) experienced decompensated cirrhosis within ten years (mean, 5.5% per year; 95% CI, 4.8\u20136.3% per year); risk of progression was greater for those with portal hypertension (aHR, 1.8; 95% CI, 1.3\u20132.7), extrahepatic cancer (aHR, 1.8; 95% CI, 1.1\u20132.9), or diabetes mellitus (aHR, 1.5; 95% CI, 1.1\u20132.0). Compared with people who had neither cirrhosis nor diabetes mellitus, the risk of decompensation was greater for people with cirrhosis (aHR, 10.7; 95% CI, 7.6\u201315.0) or cirrhosis and diabetes mellitus (aHR, 14.4; 95% CI, 10.1\u201320.6).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Given the greater risk of progression to cirrhosis decompensation in people with diabetes mellitus, a disorder common in people with NAFLD\/NASH, identifying advanced fibrosis and providing appropriate treatment for averting disease progression is vital.<\/jats:p><\/jats:sec>","DOI":"10.5694\/mja2.52104","type":"journal-article","created":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T05:48:26Z","timestamp":1695707306000},"page":"358-365","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Diabetes mellitus and the progression of non\u2010alcoholic fatty liver disease to decompensated cirrhosis: a retrospective cohort study"],"prefix":"10.5694","volume":"219","author":[{"given":"James","family":"O'Beirne","sequence":"first","affiliation":[{"name":"University of the Sunshine Coast  Buderim QLD"},{"name":"Sunshine Coast University Hospital  Kawana Waters QLD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Skoien","sequence":"additional","affiliation":[{"name":"Royal Brisbane and Woman's Hospital Health Service District  Brisbane QLD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara A","family":"Leggett","sequence":"additional","affiliation":[{"name":"Royal Brisbane and Woman's Hospital Health Service District  Brisbane QLD"},{"name":"The University of Queensland  Brisbane QLD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunter F","family":"Hartel","sequence":"additional","affiliation":[{"name":"The University of Queensland  Brisbane QLD"},{"name":"QIMR Berghofer Medical Research Institute  Brisbane QLD"},{"name":"Queensland University of Technology  Brisbane QLD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3159-4249","authenticated-orcid":false,"given":"Louisa G","family":"Gordon","sequence":"additional","affiliation":[{"name":"The University of Queensland  Brisbane QLD"},{"name":"QIMR Berghofer Medical Research Institute  Brisbane QLD"},{"name":"Queensland University of Technology  Brisbane QLD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth E","family":"Powell","sequence":"additional","affiliation":[{"name":"The University of Queensland  Brisbane QLD"},{"name":"QIMR Berghofer Medical Research Institute  Brisbane QLD"},{"name":"Princess Alexandra Hospital Health Service District  Brisbane QLD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8823-3006","authenticated-orcid":false,"given":"Patricia C","family":"Valery","sequence":"additional","affiliation":[{"name":"The University of Queensland  Brisbane QLD"},{"name":"QIMR Berghofer Medical Research Institute  Brisbane QLD"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,25]]},"reference":[{"key":"e_1_2_8_1_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.15009"},{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32511-3"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.01.026"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2022-327777"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15679"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15415"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31726"},{"key":"e_1_2_8_8_1","unstructured":"Australian Institute of Health and Welfare.Australian Statistical Geography Standard (ASGS) volume 5. 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