Hepatology International最新文献

{"title":"Response to: Effects of dapagliflozin on liver steatosis in patients with nonalcoholic fatty liver disease: a randomized controlled trial.","authors":"Motij Kumar Dalai, Sanjay Jagdish Chandnani","doi":"10.1007/s12072-025-10803-9","DOIUrl":"https://doi.org/10.1007/s12072-025-10803-9","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet slope and long-term clinical outcomes in children and adults with Fontan-associated liver disease.","authors":"Chaowapong Jarasvaraparn, Andrew Rodenbarger, Jessica Thoe, Raj Vuppalanchi, R Mark Payne, Larry Wayne Markham, Jean P Molleston","doi":"10.1007/s12072-025-10819-1","DOIUrl":"https://doi.org/10.1007/s12072-025-10819-1","url":null,"abstract":"<p><strong>Background and objectives: </strong>There is a lack of robust literature describing a relationship between platelet count as a reflection of liver fibrosis and Fontan-associated liver disease (FALD). The present study investigated the serial longitudinal relationship of laboratory tests to cirrhosis and clinical outcomes in patients following Fontan procedure.</p><p><strong>Methods: </strong>This was a retrospective study of patients with Fontan procedure who underwent laboratory evaluation at least 1 year after surgery. Clinical data, including death, failing Fontan physiology, and heart transplantation, were investigated. Cirrhosis was defined as stage 4 fibrosis on liver biopsy and/or evidence of cirrhosis from imaging. Portal hypertension (PHTN) was calculated using the VAST score (one point each for Varices, Ascites, Splenomegaly, and Thrombocytopenia); VAST score ≥ 2 indicating PHTN features.</p><p><strong>Results: </strong>Among 376 patients (184 children and 192 adults), cirrhosis was recorded in 52/376 (13.8%). Platelet counts in those with FALD-associated cirrhosis decreased significantly starting 25, 30 and 35 years after Fontan, compared to the non-cirrhosis group (151 vs. 188; p = 0.01, 134 vs. 174; p = 0.02, and 127 vs. 202 × 10³/uL; p = 0.04, respectively). Patients with cirrhosis and PHTN features had significantly worse heart transplant-free survival, overall survival, and failing Fontan physiology compared to patients without cirrhosis.</p><p><strong>Conclusions: </strong>FALD patients with cirrhosis develop decreasing platelet counts 25 years after Fontan procedure. Lower platelets, even if near normal range, can be a marker of cirrhosis in FALD. Cirrhosis with PHTN is an associated with worse heart transplant-free survival, overall survival, and failing Fontan.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breaking bottlenecks: the future of hepatocellular carcinoma clinical trials and therapeutic targets.","authors":"Weixiong Zhu, Chuanlei Fan, Yongqing Zhao, Youtao Liu, Yusheng Cheng, Wence Zhou","doi":"10.1007/s12072-025-10799-2","DOIUrl":"https://doi.org/10.1007/s12072-025-10799-2","url":null,"abstract":"<p><strong>Background: </strong>To provide a reference for hepatocellular carcinoma (HCC) clinical trials, we analyzed HCC clinical trials and therapeutic targets.</p><p><strong>Methods: </strong>Using the Informa database, we analyzed the global and China HCC clinical trials. We then explored TACE, Apatinib, and emerging strategies (CAR T/NK). Additionally, we analyzed the oncogenic biomarkers and therapeutic targets. We conducted a joint analysis of therapeutic target safety using HPA-RNA, HPA-Proteins, and GTEx-RNA datasets. Finally, we analyzed the specificity and prospects of therapeutic targets using HPA pathology data and CPTAC data.</p><p><strong>Results: </strong>HCC clinical trials have developed rapidly over the past decade but have now reached a bottleneck, with most breakthroughs focusing on combination therapies. China and the USA dominate in the number of trials. TACE combined with systemic therapy has become an effective treatment strategy for intermediate to advanced HCC. Apatinib and TACE combined with systemic therapy are characteristic of China, while the latter is also mainly conducted in Japan and the USA. Currently, targeted immune therapies dominate the field, and CAR T/NK still in the early stages. Most therapeutic targets are related to the VEGF pathway, which indirectly confirms the predominant role of TKI-ICI combination therapy in HCC treatment. Most targets have low safety and poor specificity. However, RRM2, KDR, and AURKA have strong safety and specificity, showing excellent prospects for targeted HCC therapy.</p><p><strong>Conclusions: </strong>This study analyzed and summarized the overview of HCC clinical trials and the safety and specificity of therapeutic targets, providing a reference for HCC clinical research.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk stratification for patients with primary biliary cholangitis: early versus advanced-stage or non-cirrhosis versus cirrhosis?","authors":"Dawei Ding, Gui Jia, Guanya Guo, Lina Cui, Ying Han","doi":"10.1007/s12072-025-10820-8","DOIUrl":"https://doi.org/10.1007/s12072-025-10820-8","url":null,"abstract":"<p><strong>Background: </strong>Primary biliary cholangitis (PBC) is divided into early and advanced stages, which are two distinct disease states, and whether this division is optimal remains to be demonstrated.</p><p><strong>Aims: </strong>A risk stratification strategy was re-established according to histological stages and response criteria were defined accordingly.</p><p><strong>Methods: </strong>We retrospectively analyzed 721 patients with histological data. The endpoint events were liver-related death and liver transplantation (LT).</p><p><strong>Results: </strong>Histological stage IV was associated with LT-free survival compared to stage III (HR: 2.764, 95% CI: 1.457-5.247, p = 0.002); and stage III was not associated with LT-free survival compared to stage II (HR: 1.632, 95% CI: 0.833-3.195, p = 0.153). Total bilirubin was associated with LT-free survival (HR: 1.162, 95% CI: 1.079-1.251, p < 0.001), whereas alkaline phosphatase was not associated with LT-free survival in cirrhotic patients (HR: 1.256, 95% CI: 0.958-1.648, p = 0.100). Compared to Paris I, Paris II, and Toronto, Rotterdam had the highest area under the receiver operating characteristic curve (AUC) for predicting the 5-year endpoint events in cirrhotic patients (0.652 [0.558-0.745]). Patients who had poor response according to Rotterdam criteria had worse prognosis than those who were biochemical responders (p = 0.036). Compared to Paris II and Paris I (for stage III) + Paris II (for stage I-II), Paris I, Rotterdam, and Toronto had higher AUC in non-cirrhotic patients (p < 0.05).</p><p><strong>Conclusions: </strong>Risk stratification based on histological classification of non-cirrhosis versus cirrhosis demonstrates superior clinical utility compared to the early versus advanced stage stratification. Furthermore, the Rotterdam criteria proved to be clinically applicable for assessing biochemical responses specifically in patients with histological cirrhosis.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Bile acids induce liver fibrosis through the NLRP3 inflammasome pathway and the mechanism of FXR inhibition of NLRP3 activation.","authors":"Shu Feng, Xingming Xie, Jianchao Li, Xu Xu, Chaochun Chen, Gaoliang Zou, Guoyuan Lin, Tao Huang, Ruihan Hu, Tao Ran, Lu Han, Qingxiu Zhang, Yuanqingxiao Li, Xueke Zhao","doi":"10.1007/s12072-025-10791-w","DOIUrl":"https://doi.org/10.1007/s12072-025-10791-w","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of radiotherapy versus transarterial chemoembolization in combination with lenvatinib and camrelizumab for hepatocellular carcinoma with inferior vena cava/right atrium tumor thrombus: a multicenter study.","authors":"Qizhen Huang, Xiaohong Zhong, Shaoxing Chen, Wenhui Liu, Jing Yang, Qingjing Chen, Tingting Yang, Fuqun Wei, Juhui Chen, Yufei Zhou, Lijuan Zhan, Xiuhui Liang, Jianji Pan, Kongying Lin, Jinsheng Hong, Yongyi Zeng","doi":"10.1007/s12072-025-10794-7","DOIUrl":"https://doi.org/10.1007/s12072-025-10794-7","url":null,"abstract":"<p><strong>Background and purpose: </strong>This study aims to compare the efficacy and safety of radiotherapy (RT) and transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) with inferior vena cava/right atrium tumor thrombus (IVC/RATT) treated with lenvatinib and camrelizumab.</p><p><strong>Materials and methods: </strong>HCC with IVC/RATT from four hospitals were enrolled in this retrospective study. The patients were divided into RT group and TACE group. Stabilized inverse probability of treatment weighting (sIPTW) was used to minimize bias. The primary endpoints were overall survival (OS) and progression free survival (PFS). The second endpoints were objective response rate (ORR) and disease control rate (DCR). In addition, safety was assessed by treatment-related adverse events (TRAEs) between the two groups.</p><p><strong>Results: </strong>Among 108 patients included in this study, 48 patients in TACE group and 60 patients in RT group. The median follow-up time was 24.8 months. After the application of sIPTW, baseline characteristics were well-balanced between the two groups. Before and after sITPW, the median OS and median PFS in the RT group were significantly longer than in the TACE group. Multivariate Cox analysis showed that RT was an independent prognosis factor of both OS and PFS. There was no significant difference between two groups in overall response, while IVC/RATT response rate of RT group was significantly higher than TACE group. Incidence rate of TRAEs in two groups were similar.</p><p><strong>Conclusions: </strong>In combination with lenvatinib and camrelizumab, RT significantly improves the prognosis of HCC with IVC/RATT compared to TACE, with a comparable safety profile.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The promise of incretin-based pharmacotherapies for metabolic dysfunction-associated fatty liver disease.","authors":"Harendran Elangovan, Jenny Elizabeth Gunton, Ming Hua Zheng, Jian-Gao Fan, George Boon Bee Goh, Henning Gronbaek, Jacob George","doi":"10.1007/s12072-025-10795-6","DOIUrl":"https://doi.org/10.1007/s12072-025-10795-6","url":null,"abstract":"<p><strong>Background: </strong>The presence of excess liver fat secondary to metabolic dysregulation represents the end-organ manifestation of a systemic disease that can progress to steatohepatitis, cirrhosis and its feared complications of clinical decompensation and hepatocellular cancer. Since metabolic dysfunction-associated fatty liver disease (MAFLD) is highly prevalent globally, there is a pressing need to augment lifestyle interventions with pharmacotherapies to ameliorate disease burden and reduce adverse liver-related events.</p><p><strong>Purpose: </strong>This review summarises current evidence for the utility of incretin mimetics in the MAFLD/MASH arena.</p><p><strong>Methods: </strong>A literature review that encompassed multiple database searches to inform the evidence base for incretin drugs in MAFLD/MASH.</p><p><strong>Results: </strong>Incretin mimetics demonstrate multifarious benefits across the metabolic diseases spectrum with mounting evidence for their role in remitting steatohepatitis and liver fibrosis. Weight loss and insulin sensitisation contribute, but additional mechanisms may also be engaged. Gastrointestinal adverse effects are common but for most, can be managed while preserving the hepatic and cardiometabolic benefits.</p><p><strong>Conclusion: </strong>The literature reveals benefits from incretin-based therapies for MASH, but data on whether they improve long-term hepatic outcomes are awaited to support their future incorporation into routine clinical care.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic inflammatory response markers improve the discrimination for prognostic model in hepatocellular carcinoma.","authors":"Alba Rocco, Costantino Sgamato, Filippo Pelizzaro, Vittorio Simeon, Pietro Coccoli, Debora Compare, Elisa Pinto, Giorgio Palano, Francesco Giuseppe Foschi, Giovanni Raimondo, Gabriele Missale, Gianluca Svegliati-Baroni, Franco Trevisani, Eugenio Caturelli, Maurizia Rossana Brunetto, Gianpaolo Vidili, Alberto Masotto, Donatella Magalotti, Claudia Campani, Antonio Gasbarrini, Francesco Azzaroli, Gian Ludovico Rapaccini, Bernardo Stefanini, Rodolfo Sacco, Andrea Mega, Edoardo Giovanni Giannini, Giuseppe Cabibbo, Mariella Di Marco, Maria Guarino, Paolo Chiodini, Fabio Farinati, Gerardo Nardone","doi":"10.1007/s12072-025-10806-6","DOIUrl":"https://doi.org/10.1007/s12072-025-10806-6","url":null,"abstract":"<p><strong>Background/purpose of the study: </strong>We aimed to evaluate the performance of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and their combination (combined NLR-PLR, CNP) in predicting overall survival (OS) and recurrence-free survival (RFS) in a large cohort of unselected hepatocellular carcinoma (HCC) patients.</p><p><strong>Methods: </strong>Training and validation cohort data were retrieved from the Italian Liver Cancer (ITA.LI.CA) database. The optimal cut-offs of NLR and PLR were calculated according to the multivariable fractional polynomial and the minimum p value method. The continuous effect and best cut-off categories of NLR and PLR were analyzed using multivariable Cox regression analysis. A shrinkage procedure adjusted over-fitting hazard ratio (HR) estimates of best cut-off categories. C-statistic and integrated discrimination improvement (IDI) were calculated to evaluate the discrimination properties of the biomarkers when added to clinical survival models.</p><p><strong>Results: </strong>2,286 patients were split into training (n = 1,043) and validation (n = 1,243) cohorts. The optimal cut-offs for NLR and PLR were 1.45 and 188, respectively. NLR (HR 1.58, 95% CI 1.11-2.28, p = 0.014) and PLR (HR 1.79, 95% CI 1.11-2.90, p = 0.018) were independent predictors of OS. When incorporated into a clinical prognostic model that includes age, alpha-fetoprotein (AFP), the CHILD-Pugh score, and the Barcelona Clinic Liver Cancer (BCLC) staging system, CNP had a significant incremental value in predicting OS (IDI 1.3%, p = 0.04). Data were confirmed in the validation cohort. Neither NLR nor PLR significantly predicted RFS in the training cohort.</p><p><strong>Conclusions: </strong>NLR, PLR, and CNP independently predicted shorter OS in HCC patients. The addition of CNP to the survival prediction model significantly improved the model's accuracy in predicting OS.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explainable attention-enhanced heuristic paradigm for multi-view prognostic risk score development in hepatocellular carcinoma.","authors":"Anran Liu, Jiang Zhang, Tong Li, Danyang Zheng, Yihong Ling, Lianghe Lu, Yuanpeng Zhang, Jing Cai","doi":"10.1007/s12072-025-10793-8","DOIUrl":"https://doi.org/10.1007/s12072-025-10793-8","url":null,"abstract":"<p><strong>Purpose: </strong>Existing prognostic staging systems depend on expensive manual extraction by pathologists, potentially overlooking latent patterns critical for prognosis, or use black-box deep learning models, limiting clinical acceptance. This study introduces a novel deep learning-assisted paradigm that complements existing approaches by generating interpretable, multi-view risk scores to stratify prognostic risk in hepatocellular carcinoma (HCC) patients.</p><p><strong>Methods: </strong>510 HCC patients were enrolled in an internal dataset (SYSUCC) as training and validation cohorts to develop the Hybrid Deep Score (HDS). The Attention Activator (ATAT) was designed to heuristically identify tissues with high prognostic risk, and a multi-view risk-scoring system based on ATAT established HDS from microscopic to macroscopic levels. HDS was also validated on an external testing cohort (TCGA-LIHC) with 341 HCC patients. We assessed prognostic significance using Cox regression and the concordance index (c-index).</p><p><strong>Results: </strong>The ATAT first heuristically identified regions where necrosis, lymphocytes, and tumor tissues converge, particularly focusing on their junctions in high-risk patients. From this, this study developed three independent risk factors: microscopic morphological, co-localization, and deep global indicators, which were concatenated and then input into a neural network to generate the final HDS for each patient. The HDS demonstrated competitive results with hazard ratios (HR) (HR 3.24, 95% confidence interval (CI) 1.91-5.43 in SYSUCC; HR 2.34, 95% CI 1.58-3.47 in TCGA-LIHC) and c-index values (0.751 in SYSUCC; 0.729 in TCGA-LIHC) for Disease-Free Survival (DFS). Furthermore, integrating HDS into existing clinical staging systems allows for more refined stratification, which enables the identification of potential high-risk patients within low-risk groups.</p><p><strong>Conclusion: </strong>This novel paradigm, from identifying high-risk tissues to constructing prognostic risk scores, offers fresh insights into HCC research. Additionally, the integration of HDS complements the existing clinical staging system by facilitating more detailed stratification in DFS and Overall Survival (OS).</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global prevalence, metabolic characteristics, and outcomes of lean-MAFLD: a systematic review and meta-analysis.","authors":"Mark C C Cheah, Harry Crane, Jacob George","doi":"10.1007/s12072-025-10801-x","DOIUrl":"https://doi.org/10.1007/s12072-025-10801-x","url":null,"abstract":"<p><strong>Background: </strong>Metabolic Dysfunction-Associated Fatty Liver disease (MAFLD) among lean individuals is increasingly recognized. We aimed to compare the prevalence, metabolic characteristics, and outcomes of lean vs overweight/obese-MAFLD patients.</p><p><strong>Methods: </strong>Databases of Embase, Medline, and Web of Science were searched from inception till October 2023. Only cohorts adhering to the lean-MAFLD criteria as defined by the international consensus statement were included.</p><p><strong>Results: </strong>In the pooled analysis of 10,013,382 individuals, the prevalence of lean-MAFLD in the general population was 1.94% (95% CI 1.10-3.39%, I² = 98.7%). Lean and overweight/obese-MAFLD patients had similar metabolic characteristics for blood pressure, LDL, TG, blood glucose, and HbA1c. There was an increased incidence rate and likelihood for liver-related mortality for lean-MAFLD vs overweight/obese-MAFLD [1.33 per 1000 patient-years (95% CI 1.28-1.39) vs 0.76 (95% CI 0.25-2.28), (OR 3.56 (95% CI 3.45-3.67), p < 0.01). There were similar incidence rates and odds ratios between lean vs overweight/obese-MAFLD for: (1) all-cause mortality [10.08 per 1000 patient-years (95% CI 9.93-10.23) vs 8.94 per 1000 patient-years (95% CI 4.08-19.57), (OR 1.92 (95% CI 0.01-220.57), p = 0.33)]; (2) cardiovascular-related mortality [2.53 per 1000 patient-years (95% CI 0.65-9.96) vs 2.07 per 1000 patient-years (95% CI 0.80-5.39), (OR 1.91 (95% CI 0.02-142.76), p = 0.58)]; and (3) cancer-related mortality [3.42 per 1000 patient-years (95% CI 3.33-3.51) vs 3.15 per 1000 patient-years (95% CI 1.21-8.19), (OR 1.99 (95% CI 0.29-13.52), p = 0.13).</p><p><strong>Conclusion: </strong>Lean-MAFLD patients have an equivalent metabolic burden compared to overweight/obese-MAFLD patients and thus a similar incidence rate of major extrahepatic complications. However, they have an increased risk of liver-related mortality.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}