Risk of Serious Bacterial and Non‐Bacterial Infections in People With MASLD

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

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Cause-specific mortality in 13,099 patients with metabolic dysfunction-associated steatotic liver disease in Sweden

Journal of Hepatology, Journal Year: 2025, Volume and Issue: unknown

Published: March 1, 2025

Data on cause-specific mortality in metabolic dysfunction-associated steatotic liver disease (MASLD) are limited. We aimed to determine the rate and risk of death from different causes patients with MASLD compared general population Sweden. In this population-based cohort study, we identified individuals an ICD-10 code for inpatient or specialized outpatient care using Swedish healthcare registers 2002-2020 (n=13,099) matched them up 10 controls (median 9) age, sex, municipality, calendar year (n=118,884). used Cox regression estimate adjusted hazard ratios (HR) 95% confidence intervals (CI) eleven primary death. 15-year cumulative incidences were calculated while accounting competing risks. total, 1,628 (12.4%) deaths occurred 9,119 (7.7%) during a median follow-up 4.7 (interquartile range [IQR] 2.0-9.2) 5.8 years (IQR 2.7-10.5), respectively. was associated higher all-cause (HR=1.85, 95%CI=1.74-1.96) rates all specific except mental health disorder. The strongest associations observed non-hepatocellular carcinoma (HCC) liver-related (HR=26.9, 95%CI=19.4-37.3) HCC-related (HR=35.0, 95%CI=17.0-72.1). However, highest estimated incidence non-HCC cancer (7.3%) cardiovascular (7.2%). strongly liver- mortality, but absolute risks disease. Mortality increased nearly MASLD, suggesting that earlier multidisciplinary is needed reduce excess mortality. Previous studies either small, restricted relying biopsy identify thus inducing selection bias, mainly data old cohorts. nationwide study diagnosed Sweden between 2002 2020, found doubled than wide causes, indicating may be premature MASLD. estimates our useful clinicians policymakers inform about their prognosis potentially implement clinical public strategies

Language: Английский

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Inflammatory liver diseases and susceptibility to sepsis

Clinical Science, Journal Year: 2024, Volume and Issue: 138(7), P. 435 - 487

Published: April 1, 2024

Abstract Patients with inflammatory liver diseases, particularly alcohol-associated disease and metabolic dysfunction-associated fatty (MAFLD), have higher incidence of infections mortality rate due to sepsis. The current focus in the development drugs for MAFLD is resolution non-alcoholic steatohepatitis prevention progression cirrhosis. In patients cirrhosis or alcoholic hepatitis, sepsis a major cause death. As center key immune tissue, guardian, modifier, target Septic dysfunction highest compared other organ dysfunctions. addition maintaining homeostasis, produces secretes hepatokines acute phase proteins (APPs) essential tissue protection, immunomodulation, coagulation. Inflammatory diseases profound disorder impairment energy metabolism, regeneration, production/secretion APPs hepatokines. Herein, author reviews roles (1) disorders metabolism glucose, acids, ketone bodies, amino acids as well clearance ammonia lactate pathogenesis sepsis; (2) cytokines/chemokines (3) protection against injury infections; (4) nuclear receptors/signaling pathways underlying injuries drug targets Approaches that on regeneration will not only treat but also prevent severe

Language: Английский

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Prognostic factors for long-term mortality after surgery of left-sided infective endocarditis

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(3), P. e0321068 - e0321068

Published: March 31, 2025

Background Infective endocarditis has low prevalence but a high mortality rate. Left-sided infective (LSIE) higher rate than right-sided endocarditis. Surgical treatment is occasionally considered for LSIE; however, few data are available on the long-term prognostic factors LSIE after surgical treatment. This study investigated risk in patients who underwent Methods retrospective enrolled adult with were admitted to Severance Hospital South Korea and from November 2005 August 2017. The primary outcome was overall all-cause mortality. Multivariable Cox regression analysis performed identify of received Results 239 surgery. median follow-up period 75.9 months, there 34 deaths (14.2%) during period. showed that central nervous system complications (hazard ratio [HR]: 3.55, 95% confidence interval [CI]: 1.76–7.17, P < 0.001), chronic liver disease (CLD) (HR: 4.33, CI: 1.57–11.91, = 0.005), age ≥ 65 years 2.65, 1.28–5.51, 0.009) Kaplan–Meier indicated significant difference survival between without CNS ( 0.001, log-rank). Conclusion Central complications, CLD, older associated surgically treated LSIE. Preventive strategies would improve

Language: Английский

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Association between MASLD and increased risk of serious bacterial infections requiring hospital admission: A meta‐analysis

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

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Impact 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

Background It was reported that patients with Non-Alcoholic Fatty Liver Disease (NAFLD) were at increased risk of contracting severe infections requiring hospitalization which could end up sepsis. However, data regarding the impact comorbid NAFLD on in-hospital outcomes sepsis admission is scarce. Methods This nationwide retrospective observational study included 21,057,911 adult who admitted into hospitals in United States between 2000 and 2019 a primary discharge diagnosis These categorized according to presence or absence NAFLD. The twenty-year trend prevalence among inpatients elucidated. Multivariate logistic regression analysis used analyze NAFLD's Results In period, NALFD trended from 1.2% 4.2 % 2019. While mortality had down, consistently associated higher adjusted all-cause rate (adjusted odds ratio (OR), 1.45; 95% confidence interval (CI), 1.42-1.48), developing septic shock, multi-organ dysfunctions (including cardiovascular-, renal-, hepatic dysfunction). They more likely be discharged another acute hospital. length stay died hospital significantly shorter than those without Conclusions Comorbid worse clinical inpatients. Addressing this rising epidemic will paramount importance improve outcomes.

Language: Английский

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Impact 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

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Metabolic Dysfunction‐Associated Steatotic Liver Disease Increases the Risk of Severe Infection: A Population‐Based Cohort Study

Liver International, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 18, 2024

ABSTRACT Background and Aims Metabolic dysfunction‐associated steatotic liver disease (MASLD) is linked to various intrahepatic extrahepatic diseases, but its association with severe infectious remains be investigated. Methods We analysed data from the Shanghai Suburban Adult Cohort Biobank, encompassing participants enrolled in 2016 2017 available abdominal ultrasonography data, followed them up until December 2022 (median follow‐up = 5.71 years). categorised into MASLD group those without (non‐SLD). Multivariable‐adjusted Cox regression was used estimate hazard ratios (HR) for infections patients compared non‐SLD group. Cumulative incidences were calculated while accounting competing risks (non‐infection‐related deaths). Mediation analyses performed explore roles of cardiometabolic risk factors between infections. Results Among 33 072 eligible (mean age 56.37 years; 38.20% male), 11 908 (36.01%) diagnosed at baseline. Severe occurred 912 (7.66%) 1258 (5.94%) non‐SLD. The rate per 1000 person‐years higher (13.58) than comparators (10.48) (fully adjusted HR 1.18, 95% CI 1.07–1.30). most frequent respiratory (7.25/1000 person‐years) urinary tract (2.61/1000 person‐years). 5‐year cumulative incidence 6.79% (95% 6.36–7.26) 5.08% 4.79–5.38) comparators. Cardiometabolic factors, including waist circumference, triglycerides HbA1C, partially mediate Conclusions Patients significantly incident Future studies are needed elucidate mechanisms linking

Language: Английский

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Metabolic dysfunction-associated steatotic liver disease and urinary system cancers: Mere coincidence or reason for concern?

Metabolism, Journal Year: 2024, Volume and Issue: unknown, P. 156066 - 156066

Published: Nov. 1, 2024

Language: Английский

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NAFLD and NASH are obesity‐independent risk factors in COVID‐19: Matched real‐world results from the large PINC AI™ Healthcare Database

Liver International, Journal Year: 2023, Volume and Issue: 44(3), P. 715 - 722

Published: Dec. 18, 2023

Abstract Background & Aims Non‐alcoholic fatty liver disease (NAFLD) and non‐alcoholic steatohepatitis (NASH) are potential risk factors for severe pneumonia other infections. Available data on the role of NAFLD/NASH in worsening outcomes COVID‐19 controversial might be confounded by comorbidities. Methods We used PINC AI™ Healthcare Data Special Release (PHD‐SR) to identify patients with (ICD‐10) at approximately 900 hospitals United States. performed exact matching (age, gender, ethnicity) or without NAFLD/NASH, adjusting demographics (admission type, region) comorbidities (e.g., obesity, diabetes) through inverse probability treatment weighting then analysed hospitalisation‐related outcomes. Results Among 513 623 SARS‐CoV‐2 (COVID‐19), we identified 14 667 who could matched controls. Mean age was 57.6 (±14.9) years, 50.8% were females 43.7% non‐Hispanic whites. After matching, baseline characteristics age, ethnicity, gender) hypertension, diabetes, cardiovascular disease) well balanced (standard difference (SD) <.10), except cirrhosis malignancies. Patients had higher FIB‐4 scores, a significantly longer hospital length stay (LOS) intensive care LOS than controls (9.4 vs. 8.3 days, 10.4 9.3, respectively), even after also needing invasive mandatory ventilation (IMV) (odds ratio 1.0727; 95% CI 1.0095–1.1400). Other similar both groups. Conclusions In this large real‐world cohort hospitalised States, obesity‐independent complicated courses.

Language: Английский

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