Liver International, Journal Year: 2025, Volume and Issue: 45(4)
Published: March 12, 2025
ABSTRACT Metabolic dysfunction‐associated steatotic liver disease (MASLD) has become the most common chronic globally. MASLD is a multisystem where metabolic dysfunction plays key role in development of and its relevant liver‐related morbidities extrahepatic complications, such as cardiovascular disease, kidney certain types cancers. Among least examined MASLD‐related an ever‐increasing number observational studies have reported positive association between risk serious bacterial infections (SBI) requiring hospital admission. This remained significant those statistical analysis was adjusted for age, sex, ethnicity, obesity, type 2 diabetes other comorbidities. Notably, incidence rates SBI were further increased with more advanced MASLD, especially patients cirrhosis, also observed some acute viral infections, including SARS‐CoV‐2 infection, leading to severe COVID‐19. In this narrative review article, we provide overview literature on (a) recent epidemiological data linking non‐bacterial admission, (b) putative underlying mechanisms through which may increase susceptibility both directly immune associated cirrhosis portal hypertension, (c) practical clinical implications growing global population MASLD.
Language: Английский
Citations
1Steatotic Liver Disease and Sepsis Outcomes—A Prospective Cohort Study (SepsisFAT)
Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(3), P. 798 - 798
Published: Jan. 30, 2024
Background: While it has been shown that steatotic liver disease (SLD) is associated with systemic changes in immune response, the impact of SLD on sepsis outcomes not yet established. The aim this study was to investigate association between and severity outcomes. Methods: A prospective observational included consecutively hospitalized adult patients community-acquired during a 16-month period. Results: Of 378 (49.5% male, median age 69, IQR 57–78 years), 174 (46%) were diagnosed SLD. Patients older more frequently fulfilled criteria for metabolic syndrome. There no differences source etiology groups. exhibited higher incidence acute kidney injury (29.3% vs. 17.6%), need renal replacement therapy (16.1% 8.8%), frequent use invasive mechanical ventilation 18.1%). In-hospital mortality significantly group (18.39% 9.8%). multivariable analysis indicated (HR 2.82, 95% CI 1.40–5.71) irrespective other elements within Conclusions: might be in-hospital mortality, development respiratory insufficiency requiring critical care support.
Language: Английский
Citations
5Risk of infections in non‐alcoholic fatty liver disease: A nationwide population‐based cohort study
Liver International, Journal Year: 2023, Volume and Issue: 43(10), P. 2142 - 2152
Published: July 20, 2023
Previous literature suggests an association between non-alcoholic fatty liver disease (NAFLD) and infections. We aimed to determine the rate risk of severe infections in NAFLD compared general population.In this population-based cohort study, we used national registers identify all patients with a hospital-based diagnosis Sweden 1987-2020 (n = 14 869). The were matched ≤10 comparators from population for age, sex, municipality, calendar year 137 145). Cox regression was estimate hazard ratios (HR) comparators. Cumulative incidences calculated while accounting competing risks (non-infection death transplantation).Severe leading or hospitalization occurred 1990 (13.4%) 9899 (7.2%) during median 4.5 6.1 years follow-up, respectively. per 1000 person-years higher (21.0) than (9.1) independently components related metabolic syndrome (adjusted HR 1.9, 95% CI 1.8-2.0). Infection-related mortality also 1.8, 1.6-2.2). 10-year cumulative incidence 16.6% (95% 15.8-17.4) 8.0% 7.8-8.2) comparators.NAFLD associated infection-related mortality, syndrome. Increased clinical vigilance may diminish premature death.
Language: Английский
Citations
12Association of metabolic dysfunction-associated fatty liver disease with gastrointestinal infections: insights from National Inpatient Sample Database
BMJ Open Gastroenterology, Journal Year: 2024, Volume and Issue: 11(1), P. e001224 - e001224
Published: Jan. 1, 2024
Objectives The study aimed to compare the risk of gastrointestinal infections among patients with and without metabolic dysfunction-associated fatty liver disease (MAFLD). Methods This was a population-based, retrospective, observational using data from National Inpatient Sample (NIS), largest all-payer US inpatient care database. Setting Hospitalisation adults aged ≥18 years old admitted in 2020 identified NIS. Patients were stratified by presence absence MAFLD. Participants 26.4 million included study. younger than 18 those missing demographic or mortality excluded. Primary secondary outcomes outcome assess overall Secondary demographics comorbidities infection, specific pathogens. Results Of 2020, 755 910 (2.85%) had There higher prevalence bacterial MAFLD (1.6% vs 0.9%, p<0.001). incidence Clostridioides difficile (1.3% 0.8%, p<0.001), Escherichia coli (0.3% 0.01%, Salmonella (0.07% 0.03%, p<0.001) associated odds developing (adjusted OR (aOR) −1.75, 95% CI −1.68 1.83, After adjusting for confounders, results remained statistically significant (aOR −1.36, - 1.30-1.42, Conclusion Even after confounding factors, our demonstrates an increased MAFLD, specifically C. , E. . immune microbiota changes seen within potentially contribute infections.
Language: Английский
Citations
4Nonalcoholic Fatty Liver Disease Increases the Risk of Lung Abscess: Findings from a Nationwide Cohort Study
Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(2), P. 542 - 542
Published: Jan. 16, 2025
Objectives: This study aimed to investigate the association between nonalcoholic fatty liver disease (NAFLD), assessed by Fatty Liver Index (FLI), and occurrence of lung abscess within a large population-based cohort. Method: We conducted nationwide retrospective using data from 367,930 subjects who underwent National Health check-ups 2009 2018. Cox proportional hazards regression was performed evaluate FLI incidence community-acquired pneumonia (CAP) after adjusting for age, sex, relevant covariates. Results: Among population, 455 (0.12%) 44,934 (12.2%) patients were diagnosed with abscesses CAP, respectively. The cumulative higher in individuals elevated values (FLI < 30, 0.10%; 30 ≤ 60, 0.16%; ≥ 0.18%; p 0.001), whereas CAP decreased across groups 12.4%; 12.3%; 11.0%; 0.001). After covariates, risk significantly increased 60 (Hazard ratio (HR) = 1.26; 95% confidence interval (CI), 0.95–1.68; 0.115) (HR 1.67; CI, 1.37–2.29; 0.001) groups, although relatively small both (30 60; HR 1.06; 1.03–1.09; 1.13; 1.08–1.12; Conclusions: Our provides compelling evidence supporting potential link NAFLD, as measured FLI, abscess. These findings suggest importance vigilant monitoring respiratory health NAFLD emphasise need early detection possible complications.
Language: Английский
Citations
0Metabolic Dysfunction‐Associated Steatotic Liver Disease and Pancreatic Disease—A Population‐Based Nationwide Cohort and Sibling‐Controlled Study
United European Gastroenterology Journal, Journal Year: 2025, Volume and Issue: unknown
Published: Jan. 27, 2025
ABSTRACT Introduction Metabolic dysfunction‐associated steatotic liver disease (MASLD) has been linked to pancreatic diseases, but evidence from population‐based studies with histology is lacking. Aims and methods In this cohort including all Swedish adults ( n = 8563) biopsy‐proven MASLD, we aimed investigate incidences of diseases compared matched reference individuals the general population 38,858) full siblings 6696). Using Cox proportional hazard models, calculated multivariable adjusted ratios (aHRs) confidence intervals (CIs). Results We documented 359 incidents in MASLD patients 880 events individuals, resulting an incidence rate difference 1.54 (95% CI, 1.25–1.84). The relative risk was highest first two years after diagnosis (aHR, 2.19 [95% 1.92–2.50), remained statistically significant increased even up ten [aHR, 1.60 1.38–1.85)]. most common acute non‐biliary pancreatitis (1.44 vs. 0.44 events/1000 PY), followed by chronic (0.54 0.12/1000 PY) cancer (0.88 0.47/1000 PY). 130 versus 344 pancreas‐related deaths among their comparators, yielding absolute 0.51/1000 PY aHR 2.41 (95%CI 1.95−2.97). findings were consistent sibling‐controlled analyses 2.21 1.69–2.90). Conclusions associated significantly higher rates predominantly origin, as well mortality.
Language: Английский
Citations
0Association between
Liver International, Journal Year: 2024, Volume and Issue: unknown
Published: Sept. 11, 2024
Abstract Background Previous studies have reported an association between metabolic dysfunction‐associated steatotic liver disease (MASLD) and the risk of serious bacterial infections. However, magnitude whether this varies with severity MASLD remains uncertain. We performed a meta‐analysis observational to quantify infections requiring hospital admission. Methods systematically searched PubMed, Scopus, Web Science Embase from database inception 1 April 2024, using predefined keywords identify examining among individuals without MASLD. was diagnosed biopsy, imaging or International Classification Diseases codes. Meta‐analysis random‐effects modelling. Results identified six cross‐sectional two prospective cohort aggregate data on ~26.6 million individuals. significantly associated higher odds (pooled ratio 1.93, 95% confidence interval [CI] 1.44–2.58; I 2 = 93%). showed that MAFLD increased developing hazard 1.80, CI 1.62–2.0; 89%). This further across MASLD, especially fibrosis 2.42, 1.89–2.29; 92%). These results remained significant after adjusting for age, sex, obesity, diabetes other potential confounders. Sensitivity analyses did not modify these findings. The funnel plot reveal any publication bias. Conclusions shows
Language: Английский
Citations
3Risk of severe infection in patients with non‐alcoholic fatty liver disease: Implication on clinical management
Liver International, Journal Year: 2023, Volume and Issue: 43(10), P. 2057 - 2059
Published: Sept. 18, 2023
Non-alcoholic fatty liver disease (NAFLD), recently renamed metabolic dysfunction-associated steatotic (MASLD), is currently affecting 30% of the global adult population.1 The prevalence MASLD expected to increase further in future, paralleled by rising obesity and type 2 diabetes. burden extends beyond liver-related morbidity mortality, different extra-hepatic organs regulatory pathways.2 For example, has been associated with an increased risk cardiovascular disease, extrahepatic cancers chronic kidney disease,3 which are common causes death patients MASLD.4 Bacterial infections cirrhosis can result hepatic decompensation mortality.5 Particularly, bacterial translocation plays a crucial role development infection cirrhosis.6 Meanwhile, previous studies also suggested that significant proportion have intestinal permeability gut overgrowth, promoting extraintestinal translocation.7 Notably, levels immune function impairment due systemic dysregulations such as inflammation, altered microenvironment under excessive fat accumulation,8 both lead progression MASLD.9 As processes antigen-rich blood from gastrointestinal tract, impaired cells may vulnerability among MASLD. In addition, closely related diabetes, known susceptibility infections. While all these suggest at infection, large-scale data investigate remain limited. this issue Liver International, Shang et al. conducted retrospective, nationwide study utilizing Swedish National Patient Register evaluate severe total, 14 869 137 145 matched controls general population were included. authors demonstrated had two-fold compared (Figure 1). 10-year cumulative incidence was 16.6% 8.0% population, respectively. Additionally, infection-related mortality higher (adjusted hazard ratio 1.8, 95% confidence interval 1.6–2.2). Factors like syndrome be patients.10, 11 al.'s adjusted for impact other diseases, suggesting independently serious infection. results remained robust subgroup analyses age, sex, diabetes cirrhosis. 1 year, any severity found one-third patients, while only occurred one-fifth population. Infection came more cause cohort, causing 12.6% deaths, than 9.4% control cohort. During whole follow-up period, 6.8% 4.4% Concordant overall on subtypes showed 1), it should highlighted highest could peritonitis (2.5-fold higher) sepsis (2.4-fold higher). Based analyses, noted special attention paid young female MASLD, whose disorder comparatively stronger effect incident relationship between various types shown studies,12-14 including one using biopsy-proven MASLD.15 Nevertheless, not would undergo biopsy examination, remains unclear. Besides, clinicians still lack specific assessment indicators or support evidence-based clinical strategies. This followed larger spectrum long period country-levelled medical database enrol match them corresponding thus minimizing selection bias enhancing generalizability findings. considered comorbidities obstructive pulmonary models. Obesity defined solely diagnosis code. Ideally, body mass index, smoking status inflammatory laboratory data, become potential influencing factors process taken into account future research. identified codes, some receive correct misclassified non-MASLD hence estimation. At end day, how findings inform practice? Above all, healthcare providers aware most if Patients advised seek case With two- three-fold broad-spectrum antibiotics hospitalized choice refined when culture available. On hand, there insufficient guide strategies prevent Among strongest evidence exists use prophylactic spontaneous (SBP). episodes SBP lifelong oral quinolone prophylaxis. ascites, intravenous cephalosporin given acute during upper bleeding. Primary prophylaxis decompensated ascitic fluid protein concentration below 15 g/L.16 One interesting question whether treatment will reduce risk. same observed COVID-19 pandemic.17 particular major factor treatments reverse fibrosis its well. Studies confirmed reversal achieved through lifestyle intervention,18 bariatric surgery19 and, recently, novel therapeutic agents.20 It imperative understand multisystem nature diseases. careful factors, achieve reduction events but complications All three contributed equally concept, literature review, drafting critical review editorial, approved final version manuscript. Yue Wang declares no competing interests. Vincent Wong served advisory committee member AbbVie, Boehringer Ingelheim, Echosens, Gilead Sciences, Intercept, Inventiva, Merck, Novo Nordisk, Pfizer, Sagimet Biosciences TARGET PharmaSolutions; speaker Abbott, Nordisk Unilab. He received research grant co-founder Illuminatio Medical Technology Limited. Terry Yip Sciences. Data sharing applicable article datasets generated analysed current study.
Language: Английский
Citations
6Impact of Non-Alcoholic Fatty Liver Disease on Sepsis Inpatient Outcomes: A Nationwide Sample Analysis(2000-2019)
Research Square (Research Square), Journal Year: 2024, Volume and Issue: unknown
Published: July 30, 2024
Language: Английский
Citations
1Impact of Non-Alcoholic Fatty Liver Disease on Sepsis Inpatient Outcomes: A Nationwide Sample Analysis (2000–2019)
Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(19), P. 5737 - 5737
Published: Sept. 26, 2024
Background/Objectives: Patients with Non-Alcoholic Fatty Liver Disease (NAFLD) are reported to have an increased risk of developing severe infections, leading hospitalizations sepsis. However, data regarding the impact comorbid NAFLD on in-hospital outcomes patients sepsis is scarce. Methods: This nationwide retrospective observational study using discharge from National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Research Quality included 21,057,911 adult who were admitted hospitals in United States between 2000 2019 a primary diagnosis These categorized according presence or absence NAFLD. The twenty-year trend prevalence among inpatients was elucidated. Multivariable logistic regression analysis used analyze NAFLD’s outcomes. Results: In period, NALFD trended up 1.2% 4.2% 2019. Similar trends observed regional analysis. While overall mortality decreased, consistently associated higher adjusted all-cause rate (adjusted odds ratio (OR), 1.19; 95% confidence interval (CI), 1.07–1.32), septic shock, likelihood development multi–organ dysfunction. Conclusions: Comorbid stage NASH cirrhosis worse clinical inpatients. Addressing this rising epidemic will be paramount importance improve
Language: Английский
Citations
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