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Reply to "Metabolic (dysfunction)-associated fatty liver disease metrics and contributions: Correspondence". 回复“代谢(功能障碍)相关的脂肪肝疾病指标和贡献:通信”。
IF 5.9 2区 医学
Hepatology International Pub Date : 2025-04-01 Epub Date: 2025-04-02 DOI: 10.1007/s12072-025-10811-9
Maito Suoh, Saeed Esmaili, Mohammed Eslam, Jacob George
{"title":"Reply to \"Metabolic (dysfunction)-associated fatty liver disease metrics and contributions: Correspondence\".","authors":"Maito Suoh, Saeed Esmaili, Mohammed Eslam, Jacob George","doi":"10.1007/s12072-025-10811-9","DOIUrl":"10.1007/s12072-025-10811-9","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"480-482"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772102","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}
引用次数: 0
Response to the Liver transplantation for pediatric acute liver failure: Need to think beyond King's College hospital criteria and etiology! 肝移植治疗小儿急性肝功能衰竭的反应:需要考虑国王学院医院标准和病因!
IF 5.9 2区 医学
Hepatology International Pub Date : 2025-04-01 Epub Date: 2025-01-24 DOI: 10.1007/s12072-024-10740-z
Viniyendra Pamecha, Nilesh Sadashiv Patil, Nihar Mohapatra
{"title":"Response to the Liver transplantation for pediatric acute liver failure: Need to think beyond King's College hospital criteria and etiology!","authors":"Viniyendra Pamecha, Nilesh Sadashiv Patil, Nihar Mohapatra","doi":"10.1007/s12072-024-10740-z","DOIUrl":"10.1007/s12072-024-10740-z","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"476-477"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033085","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}
引用次数: 0
Semaglutide and the risk of adverse liver outcomes in patients with nonalcoholic fatty liver disease and type 2 diabetes: a multi-institutional cohort study. 塞马鲁肽与非酒精性脂肪肝和 2 型糖尿病患者肝脏不良后果的风险:一项多机构队列研究。
IF 5.9 2区 医学
Hepatology International Pub Date : 2025-04-01 Epub Date: 2024-11-27 DOI: 10.1007/s12072-024-10752-9
Chia-Chih Kuo, Min-Hsiang Chuang, Chun-Hsien Li, Po-Yu Huang, Hsing-Tao Kuo, Chih-Cheng Lai
{"title":"Semaglutide and the risk of adverse liver outcomes in patients with nonalcoholic fatty liver disease and type 2 diabetes: a multi-institutional cohort study.","authors":"Chia-Chih Kuo, Min-Hsiang Chuang, Chun-Hsien Li, Po-Yu Huang, Hsing-Tao Kuo, Chih-Cheng Lai","doi":"10.1007/s12072-024-10752-9","DOIUrl":"10.1007/s12072-024-10752-9","url":null,"abstract":"<p><strong>Background: </strong>Semaglutide has shown potential liver benefits in patients with nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2D). However, no direct comparisons have been made between semaglutide and other antidiabetic medications, including sodium-glucose cotransporter-2 inhibitors (SGLT2i), thiazolidinediones (TZD), and dipeptidyl peptidase-4 inhibitors (DPP-4i), regarding liver outcomes in patients with both NAFLD and T2D.</p><p><strong>Methods: </strong>This retrospective cohort study utilized the TriNetX electronic health record database, a multinational and multi-institutional database. Adults with NAFLD and T2D who received their first prescription for either semaglutide or other antidiabetic medications were included. New users of semaglutide were matched 1:1 via propensity score matching with users of SGLT2i, DPP-4i, and TZD. The primary outcome was major adverse liver outcome (MALO), a composite end point consisting of decompensated cirrhosis, hepatocellular carcinoma, and liver transplantation. Secondary outcomes included the individual components of MALO and all-cause mortality.</p><p><strong>Results: </strong>A total of 648,070 adult patients with T2D and NAFLD were identified, and patients were categorized into three different comparison groups based on their drug of interest. Semaglutide was associated with a lower risk of MALO compared to SGLT2i (adjusted hazard ratio [aHR], 0.73; 95% CI 0.60-0.88), DPP-4i (aHR, 0.72; 95% CI 0.56-0.86), and TZD (aHR, 0.76; 95% CI 0.56-0.99). Additionally, semaglutide was linked to a lower risk of all-cause mortality compared to SGLT2i (aHR, 0.62; 95% CI 0.53-0.72), DPP-4i (aHR, 0.42; 95% CI 0.36-0.49), and TZD (aHR, 0.67; 95% CI 0.54-0.83).</p><p><strong>Conclusion: </strong>Semaglutide is associated with better liver outcomes and a lower risk of all-cause mortality compared to SGLT2i, DPP-4i, and TZD in patients with NAFLD and T2D.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"395-404"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728010","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}
引用次数: 0
Genetic predisposition of metabolic dysfunction-associated steatotic liver disease: a population-based genome-wide association study. 代谢功能障碍相关脂肪变性肝病的遗传易感性:一项基于人群的全基因组关联研究
IF 5.9 2区 医学
Hepatology International Pub Date : 2025-04-01 Epub Date: 2025-01-05 DOI: 10.1007/s12072-024-10769-0
Shao-Wen Wang, Ching Wang, Yu-Ming Cheng, Chun-Yi Chen, Tsung-Han Hsieh, Chia-Chi Wang, Jia-Horng Kao
{"title":"Genetic predisposition of metabolic dysfunction-associated steatotic liver disease: a population-based genome-wide association study.","authors":"Shao-Wen Wang, Ching Wang, Yu-Ming Cheng, Chun-Yi Chen, Tsung-Han Hsieh, Chia-Chi Wang, Jia-Horng Kao","doi":"10.1007/s12072-024-10769-0","DOIUrl":"10.1007/s12072-024-10769-0","url":null,"abstract":"<p><strong>Background/purpose: </strong>Although metabolic dysfunction-associated steatotic liver disease (MASLD) has been proposed to replace the diagnosis of non-alcoholic fatty liver disease (NAFLD) with new diagnostic criteria since 2023, the genetic predisposition of MASLD remains to be explored.</p><p><strong>Methods: </strong>Participants with data of genome-wide association studies (GWAS) in the Taiwan Biobank database were collected. Patients with missing data, positive for HBsAg, anti-HCV, and alcohol drinking history were excluded. MASLD was defined if having hepatic steatosis on ultrasound, plus at least one of cardiometabolic criteria. The Taiwan biobank used two genetic chips during the period of data collection: Taiwan biobank version 1 (TWBv1) as the initial chip and TWBv2 specifically designed for the Taiwanese population. TWBv2 was used as test group and TWBv1 as validation group. NAFLD fibrosis score (NFS) was used to assess the degree of liver fibrosis, and carotid plaques on duplex ultrasound were employed for the diagnosis of atherosclerosis.</p><p><strong>Results: </strong>In a total of 16,407 (mean age 55.35 ± 10.41; 29.6% males) participants, 6722 (41.0%) had MASLD. Eleven single-nucleotide polymorphisms (SNP) were identified to be associated with MASLD. Their functions were exonic in two and intronic in nine. They were related to the PNALA3, and SAMM50 genes located on chromosome 22. The linkage disequilibrium showed a high correlation with each other. Four SNPs of PNALA3 and SAMM50 genes had increased risk of MASLD and higher levels of AST/ALT. In addition, there was no association of these two genes with glucose metabolism, but better lipid profiles in SAMM50.</p><p><strong>Conclusions: </strong>This large GWAS study indicates that eleven SNPs of PNPLA3 and SAMM50 genes predispose the development of MASLD in Taiwanese population.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"415-427"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931416","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}
引用次数: 0
Role of liver-resident NK cells in liver immunity. 肝脏NK细胞在肝脏免疫中的作用。
IF 5.9 2区 医学
Hepatology International Pub Date : 2025-04-01 Epub Date: 2025-02-01 DOI: 10.1007/s12072-025-10778-7
Zheng Pan, Yan-Shuo Ye, Chang Liu, Wei Li
{"title":"Role of liver-resident NK cells in liver immunity.","authors":"Zheng Pan, Yan-Shuo Ye, Chang Liu, Wei Li","doi":"10.1007/s12072-025-10778-7","DOIUrl":"10.1007/s12072-025-10778-7","url":null,"abstract":"<p><p>The tolerogenic immune microenvironment of the liver (the immune system avoids attacking harmless antigens, such as antigens derived from food and gut microbiota) has garnered significant attention in recent years. Inherent immune cells in the liver play a unique role in regulating this microenvironment. Liver-resident natural killer (LrNK) cells, also known as liver type 1 innate lymphoid cells (ILC1s), are a recently discovered subset of immune cells that possess properties distinct from those of conventional NK (cNK) cells. Accumulating evidence suggests that there are significant differences between LrNK and cNK cells, with LrNK cells potentially exhibiting immunosuppressive functions in the liver. This review summarizes the latest findings on LrNK cells, focusing on their phenotype, heterogeneity, plasticity, origin, development, and the required transcription factors. In addition, immune functions of LrNK cells in various liver diseases, including liver cancer, viral infections, liver injury, and cirrhosis, were analyzed. By elucidating the role of LrNK cells in liver immunity, this review aims to enhance our understanding of the mechanisms underlying liver immunity and contribute to the improvement of liver disease treatment.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"315-324"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Integrating prior decompensation into ACLF definition to enhance clinical management. 将既往失代偿纳入ACLF定义,加强临床管理。
IF 5.9 2区 医学
Hepatology International Pub Date : 2025-03-31 DOI: 10.1007/s12072-025-10805-7
Meiqian Hu, Jinjin Luo, Yu Wu, Jing Zhang, Peng Li, Xi Liang, Jiaojiao Xin, Dongyan Shi, Heng Yao, Shiwen Ma, Taoying Wei, Qiuzhi Wang, Xiao Wu, Yuheng Kong, Xingping Zhou, Jiaxian Chen, Hui Yang, Wen Hu, Bingqi Li, Feiyang Sun, Qingyang Ruan, Yu Chen, Jun Li, Jing Jiang
{"title":"Integrating prior decompensation into ACLF definition to enhance clinical management.","authors":"Meiqian Hu, Jinjin Luo, Yu Wu, Jing Zhang, Peng Li, Xi Liang, Jiaojiao Xin, Dongyan Shi, Heng Yao, Shiwen Ma, Taoying Wei, Qiuzhi Wang, Xiao Wu, Yuheng Kong, Xingping Zhou, Jiaxian Chen, Hui Yang, Wen Hu, Bingqi Li, Feiyang Sun, Qingyang Ruan, Yu Chen, Jun Li, Jing Jiang","doi":"10.1007/s12072-025-10805-7","DOIUrl":"https://doi.org/10.1007/s12072-025-10805-7","url":null,"abstract":"<p><strong>Background: </strong>Acute-on-chronic liver failure (ACLF) is a complicated syndrome associated with high short-term mortality and reversibility. Whether the prior decompensation should be included in the definition of ACLF is controversial.</p><p><strong>Methods: </strong>A total of 532 patients with decompensation (prior or first) of chronic liver disease were retrospectively enrolled and analyzed from January 2018 to June 2023. Clinical data were used to identify the characteristics and determine prognosis.</p><p><strong>Results: </strong>Of the 532 patients, 99 patients did not meet APASL-ACLF criteria due to the existence of prior decompensation and 433 patients met the Asian Pacific Association for the Study of the Liver (APASL)-ACLF criteria. The two groups had similar characteristics including prognosis scores (Chinese Group on the Study of Severe Hepatitis B (COSSH)-ACLF II score: 7.59 vs. 7.67, p = 0.934; Chronic Liver Failure (CLIF) Consortium ACLF score: 42.90 vs. 44.81, p = 0.273), the distribution of patients with APASL ACLF research consortium score (AARC score) (5-7: 19.2%/12.0%; 8-10: 56.6%/55.0%; 11-15: 24.2%/33.0%, p > 0.05) and the 28-/90-day mortality rates (30.5%/43.2% vs. 36.3%/43.1%, p = 0.267/0.978). In all integrated ACLF patients, Receiver Operating Characteristic (ROC) curve analysis and decision curve analysis (DCA) showed that COSSH-ACLF IIs had higher prognostic efficiency and clinical net benefit than AARC score and CLIF-C ACLFs for 28-/90-day mortality.</p><p><strong>Conclusion: </strong>Prior decompensated patients exhibited clinical characteristics and high short-term mortality similar to those of first decompensated patients. The COSSH-ACLF IIs demonstrated the highest prognostic efficiency for all integrated ACLF patients. Including prior decompensation in the ACLF definition can help to simplify and improve clinical management.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752264","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}
引用次数: 0
Response to: Effects of dapagliflozin on liver steatosis in patients with nonalcoholic fatty liver disease: a randomized controlled trial. 达格列净对非酒精性脂肪肝患者肝脂肪变性的影响:一项随机对照试验
IF 5.9 2区 医学
Hepatology International Pub Date : 2025-03-30 DOI: 10.1007/s12072-025-10803-9
Motij Kumar Dalai, Sanjay Jagdish Chandnani
{"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}
引用次数: 0
Platelet slope and long-term clinical outcomes in children and adults with Fontan-associated liver disease. 丰坦相关肝病儿童和成人的血小板斜率和长期临床结局
IF 5.9 2区 医学
Hepatology International Pub Date : 2025-03-29 DOI: 10.1007/s12072-025-10819-1
Chaowapong Jarasvaraparn, Andrew Rodenbarger, Jessica Thoe, Raj Vuppalanchi, R Mark Payne, Larry Wayne Markham, Jean P Molleston
{"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 × 10<sup>3</sup>/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}
引用次数: 0
Breaking bottlenecks: the future of hepatocellular carcinoma clinical trials and therapeutic targets. 打破瓶颈:肝细胞癌临床试验和治疗目标的未来。
IF 5.9 2区 医学
Hepatology International Pub Date : 2025-03-29 DOI: 10.1007/s12072-025-10799-2
Weixiong Zhu, Chuanlei Fan, Yongqing Zhao, Youtao Liu, Yusheng Cheng, Wence Zhou
{"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}
引用次数: 0
Risk stratification for patients with primary biliary cholangitis: early versus advanced-stage or non-cirrhosis versus cirrhosis? 原发性胆管炎患者的风险分层:早期vs晚期,非肝硬化vs肝硬化?
IF 5.9 2区 医学
Hepatology International Pub Date : 2025-03-28 DOI: 10.1007/s12072-025-10820-8
Dawei Ding, Gui Jia, Guanya Guo, Lina Cui, Ying Han
{"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}
引用次数: 0
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