关于日本非酒精性脂肪肝（NAFLD）患者的肝相关事件预后的报道很少。我们进行了一项观察性研究，比较了日本NAFLD患者中纤维化组和非纤维化组的预后。研究调查了2013年4月至2015年4月期间在多个中心接受肝活检的393名NAFLD患者的预后情况。比较了病理学上纤维化的非酒精性脂肪性肝炎（NASH）组和非纤维化的非酒精性脂肪肝（NAFL）+非纤维化NASH组在发生肝相关事件、心血管事件、发展非肝外部癌症和死亡方面的时间。使用四种非侵入性纤维化预测模型对纤维化分类进行类似的分析。肝活检时的平均年龄和体重指数（BMI）分别为55.7岁和28.04 kg/m2。肝活检后1080天的病理性纤维化NASH组的肝相关事件累积发生率为5.79%，NAFL +非纤维化NASH组为0%，差异显著（p = 0.0334）。在所有四个模型中，预测模型阳性组的肝相关事件累积发生率显著高于阴性组（所有p值 <0.0001）。在心血管事件、非肝外部癌症和死亡的累积发生率方面，病理性纤维化NASH组和NAFL +非纤维化NASH组之间没有显著差异。日本NAFLD患者中，纤维化NASH组的肝相关事件发生率明显高于NAFL +非纤维化NASH组。本文受版权保护，版权归原作者所有。

There are few reports on the prognosis of liver-related events in Japanese patients with nonalcoholic fatty liver disease (NAFLD). We conducted an observational study to compare the prognosis between fibrotic and non-fibrotic groups in Japanese NAFLD patients.Prognosis in 393 NAFLD patients who underwent liver biopsy between April 2013 and April 2015 at multiple centers were investigated. The time to onset of liver-related events, cardiovascular events, development of extrahepatic cancers, and death were compared between pathologically fibrotic non-alcoholic steatohepatitis (NASH) group and non-alcoholic fatty liver (NAFL) + non-fibrotic NASH group. Similar analysis was performed based on the fibrotic classification diagnosed using four non-invasive fibrosis prediction models.The mean age and Body Mass Index (BMI) at the time of liver biopsy was 55.7 years old and 28.04 kg/m2 . The cumulative incidence of liver-related events at 1080 days after liver biopsy was 5.79% in pathologically fibrotic NASH group and 0% in NAFL + non-fibrotic NASH group, with a significant difference (p = 0.0334). The cumulative incidence of liver-related events was significantly higher in the positive group for the prediction model than in the negative group in all four models (all p-values were <0.0001). There was no significant difference between pathologically fibrotic NASH group and NAFL + non-fibrotic NASH group in terms of cumulative incidence of cardiovascular events, development of extrahepatic cancers, and death.The incidence of liver-related events was significantly higher in fibrotic NASH group than that of NAFL + non-fibrotic NASH group in Japanese NAFLD patients. This article is protected by copyright. All rights reserved.This article is protected by copyright. All rights reserved.