Hepatology Research最新文献

{"title":"On-Treatment Reassessment of Type IV Collagen 7S and M2BPGi-Qt Improves Long-Term Hepatocellular Carcinoma Risk Stratification in Chronic Hepatitis B.","authors":"Kazumi Yamasaki, Hideko Kozuru, Tomoko Sato, Tomoyuki Suehiro, Yasuhide Motoyoshi, Yuki Kugiyama, Akira Saeki, Shinya Nagaoka, Atsumasa Komori, Hiroshi Yatsuhashi","doi":"10.1111/hepr.70266","DOIUrl":"https://doi.org/10.1111/hepr.70266","url":null,"abstract":"<p><strong>Aims: </strong>Hepatocellular carcinoma (HCC) remains a major complication in patients with chronic hepatitis B receiving nucleos(t)ide analogue (NA) therapy despite effective viral suppression. Although on-treatment assessment of indirect fibrosis indices has been associated with HCC risk, the prognostic value of direct fibrosis markers, particularly type IV collagen 7S (4COL7S), during antiviral therapy remains poorly defined. We investigated whether on-treatment 4COL7S predicts HCC development, with M2BPGi-Qt evaluated as a supportive comparator.</p><p><strong>Methods: </strong>This retrospective cohort study included 319 patients with chronic hepatitis B who initiated NA therapy. Serum 4COL7S and M2BPGi-Qt were measured at baseline and 1 year after treatment initiation. The primary endpoint was HCC development. Landmark, Kaplan-Meier, and multivariable Cox analyses were performed.</p><p><strong>Results: </strong>During a median follow-up of 12.6 years, 45 patients (14.1%) developed HCC. Baseline 4COL7S and M2BPGi-Qt did not significantly stratify cumulative HCC incidence. In contrast, elevated 1-year levels of both markers were significantly associated with increased HCC risk. In multivariable analyses, 1-year 4COL7S remained independently associated with subsequent HCC development after adjustment for baseline mPAGE-B, 1-year HBsAg-HQ, and 1-year HBcrAg (adjusted hazard ratio [HR], 1.167; 95% confidence interval [CI], 1.001-1.344; p = 0.042). M2BPGi-Qt showed consistent supportive findings (adjusted HR, 1.272; 95% CI, 1.101-1.468; p = 0.001).</p><p><strong>Conclusions: </strong>On-treatment 4COL7S was independently associated with subsequent HCC development and may serve as a novel direct fibrosis marker for long-term risk stratification in NA-treated chronic hepatitis B. M2BPGi-Qt provided supportive prognostic information, underscoring the clinical relevance of reassessing residual fibrosis-related risk after antiviral treatment initiation.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discordance Between Japanese and European Definitions of Acute-on-Chronic Liver Failure in Alcohol-Related Cirrhosis: Insights From a 10-Year Consecutive Cohort.","authors":"Hidehiro Kamezaki, Nana Yamada, Terunao Iwanaga, Takafumi Sakuma, Koji Takahashi, Junichi Senoo, Makoto Arai, Tatsuo Kanda, Sadahisa Ogasawara, Jun Kato","doi":"10.1111/hepr.70264","DOIUrl":"https://doi.org/10.1111/hepr.70264","url":null,"abstract":"<p><strong>Aim: </strong>To examine concordance between the Japanese acute-on-chronic liver failure (ACLF) classification and the organ failure (OF)-based European association for the study of the liver-chronic liver failure (EASL-CLIF) framework, and to clarify the medium-term prognostic implications of discordance in alcohol-related cirrhosis.</p><p><strong>Methods: </strong>Adults with alcohol-related cirrhosis were studied in a single-center consecutive cohort. Japanese-defined ACLF episodes were classified as confirmed (bilirubin plus coagulation criteria) or extended (either criterion alone), then cross-classified by EASL-CLIF grade. First ACLF episodes were analyzed for 1-year mortality using Kaplan-Meier, Cox, and receiver operating characteristic (ROC) analyses.</p><p><strong>Results: </strong>Among 158 patients, 26 developed Japanese-defined ACLF (30 episodes). Discordance was substantial: 66.7% of extended and 22.2% of confirmed episodes were EASL-CLIF grade 0, not meeting EASL-CLIF criteria. In the first-episode cohort (n = 26), 1-year survival was 77.8% for confirmed and 69.5% for extended ACLF (log-rank p = 0.692). Among Japanese-defined ACLF episodes classified as EASL-CLIF grade 0, the estimated 90-day mortality was 0%, whereas the estimated 1-year mortality was 21.4%. In exploratory ROC analyses, the model for end-stage liver disease (MELD) showed the numerically highest area under the ROC curve for 1-year mortality (AUC 0.797, 95% confidence interval [CI] 0.627-0.967); however, pairwise AUC differences were not significant.</p><p><strong>Conclusions: </strong>Japanese-defined ACLF, particularly extended ACLF, often corresponds to EASL-CLIF grade 0, yet discordant patients showed non-negligible 1-year mortality. These findings suggest that acute hepatic deterioration without overt OF may represent a clinically relevant early-risk phase in alcohol-related cirrhosis. Hepatic- and OF-based frameworks should therefore be interpreted as complementary.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time Matters More Than Distance: The Impact of Transport Logistics on Total Ischemic Time and Survival After Deceased-Donor Liver Transplantation.","authors":"Junya Mita, Yusuke Takemura, Yoshihide Ueda, Juntaro Ashikari, Kaori Kuramitsu, Shohei Yoshiya, Takeo Toshima, Shinji Itoh, Hiroto Egawa, Tomoharu Yoshizumi, Hiroyuki Yokota","doi":"10.1111/hepr.70261","DOIUrl":"https://doi.org/10.1111/hepr.70261","url":null,"abstract":"<p><strong>Background: </strong>Total ischemic time (TIT) is a key determinant of outcomes after deceased-donor liver transplantation (DDLT). In Japan, the nationwide organ allocation system, which does not include regional prioritization, often requires long-distance graft transport. However, the contributions of transport time, distance, and modality to TIT and post-transplant outcomes have not been fully clarified.</p><p><strong>Methods: </strong>We performed a nationwide retrospective cohort study of DDLT cases in Japan between July 2019 and December 2023 using data from the Japan Organ Transplant Network. Associations among transport-related factors, TIT, and post-transplant outcomes were assessed.</p><p><strong>Results: </strong>Among the 415 transplant recipients, TIT was significantly correlated with both transport time and transport distance (p < 0.01), although the strength of these correlations varied according to transport modality. Strong correlations were observed for ground and high-speed rail transportation, whereas the correlation was weaker for air transportation. Restricted cubic spline analyses demonstrated strong, monotonic associations between prolonged TIT and increased mortality risk and between prolonged transport time and mortality risk. Prolonged TIT was independently associated with poorer survival in the multivariable analysis, whereas transport time and modality were not. In the analyses stratified by the combination of TIT and transport time, favorable outcomes were observed in cases with a prolonged transport time when TIT was maintained at a lower level.</p><p><strong>Conclusion: </strong>Prolonged transport time contributes to increased TIT; however, optimization of perioperative management to minimize TIT may preserve post-transplantation outcomes in long-distance transplantation.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Gradual Corticosteroid Tapering for Immune Checkpoint Inhibitor-Induced Liver Injury.","authors":"Naoto Soma, Yoshihito Uchida, Kayoko Sugawara, Masamitsu Nakao, Nobuaki Nakayama, Yukinori Imai, Suguru Mizuno, Satoshi Mochida","doi":"10.1111/hepr.70259","DOIUrl":"https://doi.org/10.1111/hepr.70259","url":null,"abstract":"<p><strong>Background and aim: </strong>Immune checkpoint inhibitor (ICI)-induced liver injury is a clinically important adverse event that may lead to interruption of anticancer therapy. Although systemic corticosteroids are recommended for severe cases, the optimal corticosteroid tapering strategy for relapse prevention and subsequent ICI rechallenge has not been established. We evaluated the clinical outcomes of an empirical institutional gradual corticosteroid tapering strategy developed with reference to Japanese AIH management.</p><p><strong>Methods: </strong>We retrospectively analyzed 36 consecutive patients with grade ≥ 3 ICI-induced liver injury. Prednisolone (PSL) was generally initiated at 0.8 mg/kg/day and tapered gradually at a rate of 5 mg every 2 weeks. Steroid pulse therapy was selectively administered in patients with severe liver injury with signs of liver failure. The primary endpoint was relapse during corticosteroid tapering.</p><p><strong>Results: </strong>Liver injury improved in 35 of 36 patients (97%). The median duration required to taper PSL to ≤ 10 mg/day was 73 (range, 50-168) days. Relapse during corticosteroid tapering occurred in only 1 patient (3%), and no patients required additional immunosuppressive therapy, including mycophenolate mofetil. ICI rechallenge was performed in 13 patients, including 6 with prior CTCAE grade 4 liver injury, and recurrence after rechallenge occurred in only 1 patient (8%). Histopathological findings were characterized predominantly by lobular inflammation with CD8-positive T-cell infiltration, whereas classical autoimmune hepatitis-associated features were relatively limited.</p><p><strong>Conclusions: </strong>An empirical gradual corticosteroid tapering strategy developed with reference to Japanese AIH management may contribute to relapse prevention and facilitate ICI rechallenge in patients with ICI-induced liver injury.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Des-Gamma-Carboxy Prothrombin Is Associated With Tumor Aggressiveness and Recurrence in Resected Early-Stage Hepatocellular Carcinoma: A Clinicopathological and Molecular Analysis.","authors":"Katsuhisa Ohgi, Keiichi Ohshima, Michiie Sakamoto, Yae Kanai, Takeshi Nagashima, Ryo Ashida, Shimpei Otsuka, Hideyuki Dei, Satoshi Matsui, Keiichi Hatakeyama, Kenichi Urakami, Yasuto Akiyama, Katsuhiko Uesaka, Teiichi Sugiura, Ken Yamaguchi","doi":"10.1111/hepr.70260","DOIUrl":"10.1111/hepr.70260","url":null,"abstract":"<p><strong>Aim: </strong>Alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) are widely used tumor markers for hepatocellular carcinoma (HCC); however, their relative prognostic significance in early-stage disease remains unclear. This study aimed to compare the prognostic impact of AFP and DCP in resected HCC and to explore their underlying molecular characteristics.</p><p><strong>Methods: </strong>We retrospectively analyzed 482 patients who underwent curative resection for HCC. Patients were classified into four groups according to AFP and DCP levels: Negative, AFP-only, DCP-only, and Dual-positive. Recurrence-free survival (RFS) and prognostic factors were evaluated. In a subset of 204 patients, gene expression profiling was conducted to investigate molecular differences.</p><p><strong>Results: </strong>Among BCLC stage 0/A patients (n = 406), RFS was stratified according to tumor marker status. The DCP-only group showed significantly worse RFS than the AFP-only group (5-year RFS: 39.5% vs. 52.7%, p = 0.026) and was characterized by larger tumor size (median, 39 vs. 18 mm, p < 0.001) and more frequent portal venous invasion (29% vs. 14%, p = 0.052). Multivariable analysis identified elevated DCP as an independent prognostic factor (hazard ratio 1.48, p = 0.004). In contrast, among stage B/C patients (n = 76), survival outcomes were uniformly poor and not stratified by tumor marker. Gene expression analysis revealed the upregulation of SFN and downregulation of DCN in DCP-elevated tumors, suggesting extracellular matrix destabilization that may contribute to tumor aggressiveness.</p><p><strong>Conclusions: </strong>Elevated DCP reflects aggressive tumor biology and identifies patients at high risk of recurrence after resection for BCLC stage 0/A HCC. These findings support the clinical utility of DCP for risk stratification and postoperative surveillance for early-stage HCC.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indoleamine 2,3-Dioxygenase 1 as an Adjunctive Histopathological Marker of Cholangitis Activity in Primary Biliary Cholangitis.","authors":"Kaori Yoshimura, Shinji Shimoda, Ryoka Masuda, Tram Nguyen Thi, Rui Yang, Quynh Nguyen Thi, Dong Le Thanh, Yuko Tamano, Yasunori Sato, Taro Yamashita, Kenichi Harada","doi":"10.1111/hepr.70256","DOIUrl":"https://doi.org/10.1111/hepr.70256","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the expression and clinicopathological significance of indoleamine 2,3-dioxygenase 1 (IDO-1) in primary biliary cholangitis (PBC), particularly its potential role as an adjunctive histopathological marker for diagnosis in early or atypical cases and as an indicator of disease activity.</p><p><strong>Methods: </strong>We retrospectively analyzed 83 liver biopsy specimens from patients clinically diagnosed with or suspected of having PBC between 2016 and 2025. IDO-1 expression in interlobular bile ducts was assessed by immunohistochemistry and correlated with clinical, biochemical, and histological features, including a new histological staging and grading system for PBC. Statistical analyses included univariate and multivariate logistic regression, and a subgroup analysis was performed for patients receiving ursodeoxycholic acid (UDCA).</p><p><strong>Results: </strong>IDO-1 was expressed in 64 of 83 cases (77.1%). Our multivariate analysis identified UDCA treatment (OR = 0.105, 95% CI: 0.0138-0.794, p = 0.029) and the cholangitis activity (CA) score (OR = 2.91, 95% CI: 1.18-7.18, p = 0.021) as independent predictors of IDO-1 expression. IDO-1 positivity was significantly reduced in UDCA-treated patients (50.0%) compared with untreated patients (95.9%, p < 0.0001). In the UDCA subgroup, unlike other histological features, IDO-1 expression remained significantly associated with higher CA scores.</p><p><strong>Conclusions: </strong>IDO-1 reflects active cholangitis rather than chronic damage such as fibrosis or bile duct loss. It is a sensitive marker of dynamic immune activity that may serve as an adjunctive histopathological marker.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatoprotective Effects of Imeglimin Are Associated With Preserved Mitochondrial Bioenergetics and Reduced Oxidative Stress in a Murine Cholestasis Model.","authors":"Hiroki Goto, Kazuto Suda, Takehiro Yasukawa, Takashi Fujimoto, Xuxuan Rao, Yosuke Tsunoda, Masataka Hida, Meng Xia, Chengri Piao, Jianqin Zhang, Hikari Taka, Yoshiki Miura, Ayumu Sugiura, Soichiro Kakuta, Tadaharu Okazaki, Atsuyuki Yamataka, Go Miyano","doi":"10.1111/hepr.70258","DOIUrl":"https://doi.org/10.1111/hepr.70258","url":null,"abstract":"<p><strong>Purpose: </strong>Biliary atresia is a cholestatic liver disease that causes persistent inflammation and reduces the hepatic reserve. New therapeutic concepts are crucial to improve native liver survival. We investigated whether imeglimin, a mitochondria-targeting agent, has hepatoprotective effects on cholestatic liver disease using a murine bile duct ligation (BDL) model.</p><p><strong>Methods: </strong>BDL was performed in 4-5-week-old mice. After BDL, the mice received intraperitoneal imeglimin or vehicle injections. Sham-operated mice received vehicle. Blood and liver samples were collected on days 7 and 14 for biochemical and histological analysis. Mitochondrial morphology was examined by transmission electron microscopy. Quantitative PCR and immunoblotting were performed for inflammation and mitochondrial stress markers. Metabolomic profiling was conducted using capillary electrophoresis-mass spectrometry. Transcriptome was analyzed by RNA sequencing. Seahorse assays, ATP quantification, and MitoSOX staining were used to evaluate mitochondrial function and oxidative stress.</p><p><strong>Results: </strong>Imeglimin improved survival after BDL, and reduced serum AST, ALT, and bilirubin levels. Tissue fibrosis and Col1a1 and Acta2 expression were attenuated in imeglimin-treated livers. Glycolysis, amino acid metabolism, and mitochondrial electron transport activity were enhanced. Expression of genes associated with mitochondrial function, antioxidant defense, and metabolic regulation was upregulated. Mitochondrial morphology was preserved, and mitochondrial number and size increased. Imeglimin elevated oxygen consumption, extracellular acidification rates, and ATP levels of BDL mice livers, while reducing mitochondrial superoxide and oxidative protein modification by 4-hydroxynonenal. Expression levels of Il1β, Il6, and Tnf decreased.</p><p><strong>Conclusion: </strong>Imeglimin exerted hepatoprotective effects on BDL-operated mice, which are associated with preserved mitochondrial bioenergetic function and reduced oxidative stress.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Effects of Nalmefene on Alcohol Consumption, Liver Function, and Gut Microbiota in Patients With Alcohol-Related Liver Disease.","authors":"Junichi Hanatani, Tadashi Namisaki, Hiroaki Takaya, Hitoshi Mori, Masahumi Oyama, Tatsuya Nakatani, Akihiko Shibamoto, Satoshi Iwai, Yuki Tsuji, Yukihisa Fujinaga, Norihisa Nishimura, Koh Kitagawa, Shinya Sato, Kosuke Kaji, Akira Mitoro, Kiyoshi Asada, Takashi Inoue, Hitoshi Yoshiji","doi":"10.1111/hepr.70257","DOIUrl":"https://doi.org/10.1111/hepr.70257","url":null,"abstract":"<p><strong>Aim: </strong>Evidence concerning the long-term efficacy of nalmefene in alcohol-related liver disease (ALD) remains insufficient, particularly regarding gut microbiota alterations. This study evaluated the 12-month effects of nalmefene on alcohol consumption, liver function, and microbiota in the gut of patients with ALD.</p><p><strong>Methods: </strong>This single-center retrospective study comprised 15 patients with ALD and alcohol consumption disorder who received nalmefene for 12 months. We investigated the changes in heavy drinking days, total alcohol consumption, and drinking risk level. Liver function parameters and adverse events were assessed longitudinally. Gut microbiota composition was analyzed at baseline and at 12 months.</p><p><strong>Results: </strong>Both heavy drinking days and total alcohol consumption showed a significant reduction from month 4 and were maintained through month 12. Drinking risk level improved in 7 patients (46.7%) and showed no change in 8 (53.3%), with no worsening. Liver enzymes, including aspartate aminotransferase and γ-glutamyl transpeptidase, showed marked improvement, whereas hepatic functional reserve parameters remained stable. At the phylum level, a significant decrease in Proteobacteria, accompanied by a Klebsiella reduction at the genus level, was observed after treatment. No significant differences were observed in α-diversity indices. Adverse events were generally mild, occurred predominantly within the first month, and did not increase in severity over the long term.</p><p><strong>Conclusions: </strong>Nalmefene was linked to sustained reductions in alcohol intake and improvements in liver enzyme levels over 12 months in patients with ALD. It may also play a role in beneficial modulation of the gut microbiota. Larger studies are required to validate these findings.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subcutaneous Adipose Tissue Accumulation is Associated With an Improved Prognosis in Patients With Hepatocellular Carcinoma","authors":"Kenji Imai,&nbsp;Koji Takai,&nbsp;Mikita Oi,&nbsp;Masashi Aiba,&nbsp;Shinji Unome,&nbsp;Takao Miwa,&nbsp;Hiroyasu Sakai,&nbsp;Yohei Shirakami,&nbsp;Atsushi Suetsugu,&nbsp;Masahito Shimizu","doi":"10.1111/hepr.70187","DOIUrl":"10.1111/hepr.70187","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study investigated the effects of the subcutaneous adipose tissue index (SATI) and visceral adipose tissue index (VATI) on the overall survival (OS) of patients with hepatocellular carcinoma (HCC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 587 patients with HCC. The Cox proportional hazards model was used to identify independent prognostic factors. The optimal SATI cutoff value that yielded the most significant differences in OS was determined using the maximally selected statistics. Survival was estimated using the Kaplan–Meier method, and differences between survival curves were evaluated using the log-rank test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>SATI (hazard ratio, 0.99; 95% confidence interval, 0.98–0.99; <i>p</i> &lt; 0.001) was significantly associated with improved OS after adjustment for potential confounders. The high-SATI group (≥ 41.1 cm²/m² for males and ≥ 48.9 cm²/m² for females) demonstrated significantly longer survival than those in the low-SATI group (<i>p</i> &lt; 0.001; median survival: 87.0 vs. 40.4 months). The results of the decision tree analysis showed that patients with SATI ≥ 41.0 cm²/m² who received curative treatment demonstrated the best survival (median survival: 191.8 months). Subgroup analyses revealed that the survival advantage of the high-SATI group was consistent across most subgroups, except for patients with metabolic dysfunction-associated steatotic liver disease, alcohol-associated liver disease, body mass index &gt; 25 kg/m², VATI ≥ 85 cm²/m², or hyperlipidemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In the absence of findings indicative of ectopic lipid accumulation, SAT accumulation is associated with an improved prognosis in patients with HCC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"56 8","pages":"1264-1273"},"PeriodicalIF":3.7,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loss of Posterior Occlusal Support Is Associated With Incident Steatotic Liver Disease in a Nationwide Longitudinal Analysis of the JMDC Claims Database","authors":"Takashi Miyano,&nbsp;Taro Kusama,&nbsp;Manami Hoshi-Harada,&nbsp;Ken Osaka,&nbsp;Kenji Takeuchi","doi":"10.1111/hepr.70186","DOIUrl":"10.1111/hepr.70186","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Steatotic liver disease (SLD), including metabolic dysfunction–associated SLD (MASLD) and metabolic dysfunction–associated alcohol-related liver disease (MetALD), is a growing global health burden. Although impaired mastication is linked to metabolic disorders, its role in SLD remains unclear. We examined whether objectively assessed posterior occlusal support predicts incident MASLD and MetALD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed nationwide medical, dental, and health checkup claims from the JMDC database in Japan (2016–2021), including 997,332 adults aged ≥ 40 years. SLD was defined as a fatty liver index ≥ 60, with MASLD and MetALD distinguished according to cardiometabolic abnormalities and estimated alcohol intake. Posterior occlusal support was classified using the Eichner system based on dental claims. Odds ratios (ORs) were estimated using generalized estimating equations to account for within-individual correlations, with multivariable adjustment for demographic, lifestyle, and clinical factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Reduced posterior occlusal support was independently associated with higher odds of incident MASLD, with stronger associations in women. In fully adjusted models, women with partial (Eichner B) or absent (Eichner C) posterior support had higher odds of MASLD (OR 1.15, 95% CI 1.02–1.29; OR 1.55, 95% CI 1.11–2.16) than those with complete support (Eichner A). In men, the associations were weaker but remained significant. No robust association was observed between occlusal support and MetALD after adjustment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Loss of posterior occlusal support independently predicted MASLD, particularly in women, suggesting that impaired mastication may contribute to SLD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"56 8","pages":"1254-1263"},"PeriodicalIF":3.7,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.70186","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}