Hepatology Research最新文献

{"title":"Human Leukocyte Antigen Genotypes Affect Hepatitis B Virus Mutations Associated With Hepatocellular Carcinoma.","authors":"Masaya Sugiyama, Nao Nishida, Seik-Soon Khor, Tadasu Shin-I, Keisuke Hino, Masao Honda, Shuichi Kaneko, Hiroshi Yatsuhashi, Kazuhiko Koike, Masayuki Kurosaki, Namiki Izumi, Yasuhito Tanaka, Kazumoto Murata, Jong-Hon Kang, Eiji Tanaka, Akinobu Taketomi, Yuichiro Eguchi, Goki Suda, Naoya Sakamoto, Kazuhide Yamamoto, Akihiro Tamori, Shuhei Hige, Yoshito Itoh, Satoshi Mochida, Eiji Mita, Tatsuya Ide, Yoichi Hiasa, Masahiko Watanabe, Ken Yamamoto, Aiko Sakai, Takaji Wakita, Masashi Mizokami, Katsushi Tokunaga","doi":"10.1111/hepr.70007","DOIUrl":"https://doi.org/10.1111/hepr.70007","url":null,"abstract":"<p><strong>Background and aims: </strong>Various viral mutations have been reported to influence disease pathogenesis in infectious diseases. However, these mutations may remain undetected due to patient population changes. Although many causes have been proposed, the exact reasons remain unclear. This study analyzed viral mutations linked to hepatocellular carcinoma (HCC) in patients with hepatitis B by comparing factors between condition-matched patient groups of different human leukocyte antigen (HLA) genotypes.</p><p><strong>Methods: </strong>HLA genotypes of 2281 healthy individuals, 370 patients with hepatitis B virus (HBV)-derived HCC, and 408 patients with chronic hepatitis B were analyzed to identify HLA genotypes associated with HCC development. Patients with HCC were grouped by HLA-DPB1 genotype to identify HBV genomic variants linked to HCC.</p><p><strong>Results: </strong>The HLA-DPB1*02:01, 04:01, and 04:02 alleles suppressed chronic hepatitis B (CHB) and HCC development (P = 4.53 × 10^-9, 3.20 × 10^-3, and 3.03 × 10^-4, respectively). Conversely, HLA-DPB1*05:01 and 09:01 alleles were significantly associated with CHB and HCC development (P = 1.01 × 10^-7, 6.51 × 10^-8, respectively). Among HLA-DPB1*02:01 patients, the S166L amino acid (AA) mutation in the PreS/S region of the HBV genome was significantly identified. HLA-DPB1*05:01 homozygous patients significantly had K130M/V131I AA mutations in the X region of the HBV genome, whereas HLA-DPB1*05:01-09:01 heterozygous patients significantly had the H94Y AA mutation in the X region. Stratification by HLA genotype changed the mutation position and strengthened the odds ratios for developing HCC due to viral mutations.</p><p><strong>Conclusions: </strong>Our analysis revealed that viral mutations associated with HCC vary by HLA genotype. These findings suggest a host-pathogen genetic interaction. HLA genotype stratification may aid in advancing personalized genomic medicine, which has been challenging to apply to chronic diseases.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730061","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":"Excessive Visceral Adipose Tissue Accumulation Increases the Risk of Recurrence and Mortality After Curative Treatment for Metabolic Dysfunction-Associated Steatotic Liver Disease-Associated Hepatocellular Carcinoma.","authors":"Kenji Imai, Koji Takai, Mikita Oi, Masashi Aiba, Shinji Unome, Takao Miwa, Tatsunori Hanai, Hiroyasu Sakai, Yohei Shirakami, Atsushi Suetsugu, Masahito Shimizu","doi":"10.1111/hepr.70008","DOIUrl":"https://doi.org/10.1111/hepr.70008","url":null,"abstract":"<p><strong>Aim: </strong>We investigated the effect of body composition, including skeletal muscle index (SMI) and visceral and subcutaneous adipose tissue indices (VATI and SATI, respectively), on recurrence-free survival (RFS) and overall survival (OS) of patients with metabolic dysfunction-associated steatotic liver disease (MASLD)-associated hepatocellular carcinoma (HCC).</p><p><strong>Methods: </strong>This study included 67 patients with MASLD-associated HCC who received curative treatment. The Cox proportional hazards model was used to evaluate whether body composition (SMI, SATI, and VATI), albumin-bilirubin score, alpha-fetoprotein level, and protein induced by vitamin K absence or antagonist-II (PIVKA-II) score were associated with RFS and OS. The optimal VATI cutoff value yielding the most significant differences in RFS was determined separately for males and females using maximally selected statistics. Survival was estimated using the Kaplan-Meier method, and differences between survival curves were evaluated using the log-rank test.</p><p><strong>Results: </strong>VATI was independently associated with RFS (hazard ratio [HR], 1.020; 95% confidence interval [CI], 1.004-1.036; and p = 0.014) and OS (HR, 1.019; 95% CI, 1.001-1.038; and p = 0.039), along with PIVKA-II. The high VATI group (≥ 70.9 cm²/m² for males and ≥ 71.2 cm²/m² for females) had a significantly shorter RFS (p < 0.001) and OS (p = 0.017) than the low VATI group. The high VATI group had significantly more cases of diabetes (p = 0.001), with no significant difference in the incidence of hypertension or hyperlipidemia.</p><p><strong>Conclusions: </strong>Excessive visceral adipose tissue accumulation increases the risk of recurrence and mortality after curative treatment for MASLD-associated HCC.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730060","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":"Elevation of Immunoglobulin Free Light Chain and BAFF Levels Associated With Immune Activation Predicts Survival Rates in Chronic Liver Disease.","authors":"Motoh Iwasa, Akiko Eguchi, Yasuyuki Tamai, Ryuta Shigefuku, Hideaki Tanaka, Ryo Nakagawa, Mina Tempaku, Yoshinao Kobayashi, Hayato Nakagawa","doi":"10.1111/hepr.70009","DOIUrl":"https://doi.org/10.1111/hepr.70009","url":null,"abstract":"<p><strong>Aims: </strong>Elevated serum free light chain (FLC) and B-cell activating factor (BAFF) levels have been reported to be associated with B-cell activation and to serve as biomarkers reflecting disease severity in various diseases. However, limited investigation has been conducted in the context of chronic liver disease (CLD), and the aim of this study was to clarify the clinical utility of FLC and BAFF in CLD.</p><p><strong>Methods: </strong>Serum FLC and BAFF levels were measured in healthy individuals (HC; n = 23) and in a cohort of patients with chronic hepatitis (CH; n = 107) and liver cirrhosis (LC; n = 50) of various etiologies and the associations of κ-FLC, λ-FLC, or BAFF with liver function test results and survival rates were investigated.</p><p><strong>Results: </strong>Serum FLC and BAFF levels increased in parallel with a decrease in hepatic functional reserve capacity, worsening fibrosis, and impaired renal function. Serum κ-FLC, λ-FLC, or BAFF levels were significantly elevated in CH compared to HC (p < 0.05, p < 0.001, respectively) and further increased in LC (p < 0.0001 vs. both HC and CH). The survival rate was significantly lower in patients with high κ-FLC, λ-FLC, or BAFF compared with patients with low κ-FLC, λ-FLC, or BAFF (p < 0.0001, p < 0.01, respectively). Even in the analysis using the multivariable Cox proportional hazards model, both κ-FLC and λ-FLC were identified as independent prognostic factors.</p><p><strong>Conclusion: </strong>This study specifically demonstrated that serum FLC levels are a strong predictor of survival in patients with CLD and provided important insights into the prognosis of CLD in the context of humoral immunity.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730059","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":"Biopsy After Ablation: Expanding the Frontier of Genomic Insight.","authors":"Takuma Nakatsuka, Hayato Nakagawa, Mitsuhiro Fujishiro, Ryosuke Tateishi","doi":"10.1111/hepr.70006","DOIUrl":"https://doi.org/10.1111/hepr.70006","url":null,"abstract":"","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690057","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":"Dynamic Early Survival Prediction Model for Hepatocellular Carcinoma Patients Treated With Atezolizumab and Bevacizumab: A Longitudinal Deep Learning Analysis.","authors":"Weiming Li, Xiaoqian Xu, Hao Wang, Shun Li, Lichen Shi, Cheng Huang, Hong You, Jidong Jia, Youwen He, Yuanyuan Kong","doi":"10.1111/hepr.70005","DOIUrl":"https://doi.org/10.1111/hepr.70005","url":null,"abstract":"<p><strong>Background: </strong>Atezolizumab combined with bevacizumab has become the standard first-line systemic therapy for unresectable hepatocellular carcinoma (uHCC). Although this regimen offers statistically significant and clinically meaningful benefits, accurately predicting overall survival (OS) remains a challenge. This study aims to identify potential biomarkers to improve early OS prediction in patients with uHCC treated with atezolizumab and bevacizumab.</p><p><strong>Methods: </strong>A longitudinal survival analysis was conducted using data from the GO30140 and IMbrave150 trials. Multiple deep learning architectures for dynamic survival prediction in HCC (DynSurv-HCC) were evaluated to assess their prognostic performance.</p><p><strong>Results: </strong>Of 415 patients with unresectable HCC, 291 and 124 were randomly assigned to training and validation sets in a 7:3 ratio. The DynSurv-HCC model with the random survival forest (RSF) method outperformed other deep learning approaches. In the training set, the DynSurv-HCC model achieved AUCs of 0.93 (95% CI: 0.89-0.97), 0.91 (95% CI: 0.87-0.94), and 0.91 (95% CI: 0.84-0.96) at 6, 12, and 24 months, respectively. In the validation set, the model achieved an AUC of 0.90 (95% CI: 0.82-0.98) at 6 months. Importantly, the DynSurv-HCC model demonstrated robust and consistent predictive accuracy across varying etiologies and baseline α-fetoprotein (AFP) levels.</p><p><strong>Conclusions: </strong>The DynSurv-HCC model with RSF demonstrated promising early OS prediction in patients with HCC receiving atezolizumab and bevacizumab, regardless of etiology or baseline AFP levels. Our findings underscore its clinical potential in guiding personalized treatment strategies and enhancing prognostic assessments for patients with uHCC.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698416","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":"Efficacy and Safety of Glecaprevir/Pibrentasvir in Children Aged 3-11 Years With Chronic Hepatitis C: A Real-World, Prospective, Multicenter Study in Japan.","authors":"Tatsuki Mizuochi, Daiki Abukawa, Ayano Inui, Yoshihiro Azuma, Takako Suzuki, Hiroko Yagi, Hideki Kumagai, Sotaro Mushiake, Daisuke Tokuhara, Naoya Tsumura, Ken Kato, Yasuhito Tanaka, Hitoshi Tajiri","doi":"10.1111/hepr.70004","DOIUrl":"https://doi.org/10.1111/hepr.70004","url":null,"abstract":"<p><strong>Aim: </strong>Part 2 of the DORA study, an international clinical trial evaluating glecaprevir and pibrentasvir (G/P) treatment in children aged 3-11 years with chronic hepatitis C virus (HCV) infection, demonstrated high efficacy and safety. However, there is limited evidence regarding real-world use of G/P in this pediatric population. This prospective multicenter study in Japan evaluated the real-world efficacy and safety of G/P treatment in children aged 3-11 years with chronic HCV.</p><p><strong>Methods: </strong>Children aged 3-11 years with chronic HCV were prospectively enrolled and received a once-daily dose of G/P for either 8 or 12 weeks. The primary endpoint was sustained virologic response at 12 weeks after treatment completion (SVR12). Safety was assessed through adverse events, laboratory tests, and growth measurements.</p><p><strong>Results: </strong>A total of 18 children (8 girls) from 9 pediatric centers in Japan were enrolled, with a median age of 9 years (range, 3-11). Genotype distribution was as follows: 1b (n = 3), 2a (n = 8), 2b (n = 5), 3a (n = 1), and unknown of Serotype 2 (n = 1). All participants were treatment-naïve and completed G/P treatment (17 for 8 weeks, 1 for 12 weeks). SVR12 was achieved in 17 patients (94%). Most adverse events were mild, with no serious events. Treatment led to significant reductions in serum alanine aminotransferase and Wisteria floribunda agglutinin-positive Mac-2 binding protein levels. No impairments in growth were observed.</p><p><strong>Conclusions: </strong>In real-world clinical practice, G/P treatment demonstrated high efficacy and good tolerability in children aged 3-11 years with chronic HCV.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682464","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":"Development of Simplified Risk Assessment Scoring System for Sarcopenia in Patients With Chronic Liver Disease.","authors":"Atsushi Hiraoka, Hideko Ohama, Fujimasa Tada, Yuka Kimura, Ayaka Nakamura, Kazuya Murakawa, Takuya Matsuda, Kana Matsuoka, Kanako Kato, Kei Onishi, Hirofumi Izumoto, Shogo Kitahata, Kozue Kanemitsu-Okada, Tomoe Kawamua, Taira Kuroda, Hideki Miyata, Eiji Tsubouchi, Osamu Yoshida, Masashi Hirooka, Masanori Abe, Bunzo Matsuura, Tomoyuki Ninomiya, Sachiyo Yoshio, Yoichi Hiasa","doi":"10.1111/hepr.70002","DOIUrl":"https://doi.org/10.1111/hepr.70002","url":null,"abstract":"<p><strong>Background/aim: </strong>Secondary sarcopenia is frequently observed in patients with chronic liver disease (CLD), and simple and practical assessment tools in aging society are limited. This study aimed to develop a risk scoring system based on the geriatric nutritional risk index (GNRI) to identify muscle abnormalities in patients with CLD.</p><p><strong>Materials/methods: </strong>Retrospective analysis was carried out on 1181 Japanese patients with CLD (median age 70 years; male:female = 748:433 and Child-Pugh A:B:C = 1029:129:23). LC was noted in 684. Handgrip strength decline (HGSD) and muscle volume loss (MVL) were evaluated using cutoffs established by the Japan Society of Hepatology.</p><p><strong>Results: </strong>The proposed scoring system (SDGS-L) was developed using logistic analysis. Factors included abnormal GNRI (< 98) (odds ratio [OR] 4.69), elderly (65-74 years and OR 2.62), late-stage elderly (≥ 75 years and OR 6.34), and female gender (OR 2.16), with points assigned based on OR values: 1 point for OR ≦ 3 and 2 points for OR > 3. Sarcopenia/HGSD/MVL prevalence increased with risk scores: 2.3%/13.8%/7.4%, 8.3%/25.8%/19.7%, 21.2%/29.3%/19.2%, and 37.0%/28.6%/18.0% for low (score 0/1), moderate (score 2), high (score 3), and super-high (score 4/5) scores, respectively (p < 0.001). GNRI cutoffs for HGS decline and muscle volume loss were 101.5 (AUC 0.675) and 97.7 (AUC 0.742). Significant correlations of GNRI with HGS and skeletal muscle index (SMI) were observed in males (r = 0.365)/(r = 0.493) and females (r = 0.297)/(r = 0.462) (each p < 0.001).</p><p><strong>Conclusion: </strong>The SDGS-L scoring system provides a simple cost-effective tool for predicting sarcopenia and muscle abnormalities in patients with CLD, enabling early intervention without specialized equipment.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667535","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":"Lipolysis-Stimulated Lipoprotein Receptor Gene Variants as a Cause of Progressive Familial Intrahepatic Cholestasis: A Case Report.","authors":"Yugo Takaki, Shuichiro Umetsu, Yoshihiko Sugino, Takahiro Yamashita, Takehiko Doi, Kazuo Imagawa, Shogo Ito, Yutaro Mihara, Hisamitsu Hayashi, Ayano Inui","doi":"10.1111/hepr.70003","DOIUrl":"https://doi.org/10.1111/hepr.70003","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the genetic and molecular mechanisms underlying intrahepatic cholestasis associated with lipolysis-stimulated lipoprotein receptor (LSR) deficiency and to evaluate its potential role in conditions similar to progressive familial intrahepatic cholestasis (PFIC).</p><p><strong>Case presentation: </strong>We studied a 4-year-old girl with no significant perinatal history who presented with symptoms of cholestasis-pruritus, poor weight gain, and darkened skin-by 6 months of age. Laboratory tests revealed mild cholestasis with elevated total bile acids and normal gamma-glutamyl transferase (GGT). A liver biopsy revealed chronic cholestasis and mild fibrosis. Whole-exome sequencing identified two compound heterozygous variants in the LSR gene, and immunostaining confirmed reduced LSR expression in the liver. The patient showed persistent cholestasis, normal GGT, and a clinical presentation suggestive of PFIC. Genetic testing revealed LSR gene variants, including a likely pathogenic duplication, confirming LSR deficiency. Despite treatment with ursodeoxycholic acid (UDCA), her pruritus persisted and growth remained stunted. Developmental delays were primarily noted in language acquisition.</p><p><strong>Conclusions: </strong>This case suggests that LSR deficiency may contribute to a PFIC-like condition, thus broadening our understanding of the genetic causes of intrahepatic cholestasis. Children presenting with PFIC-like symptoms but without mutations in known PFIC genes should be evaluated for LSR deficiency. Further research is needed to elucidate LSR's role in liver function and its potential classification as a new PFIC subtype, \"PFIC-14.\"</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659045","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":"Cachexia and Type 2 Diabetes Mellitus Are Independent Factors for Mortality in Patients With Cirrhosis.","authors":"Takao Miwa, Goki Suda, Ryosuke Tateishi, Tatsunori Hanai, Masatsugu Ohara, Yasuhiro Hagiwara, Shinji Unome, Kazuya Okushin, Mina Nakagawa, Naoya Sakamoto, Masahito Shimizu","doi":"10.1111/hepr.70001","DOIUrl":"https://doi.org/10.1111/hepr.70001","url":null,"abstract":"","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144617389","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":"The Impact of Inflammatory Markers on Prognosis in Advanced Chronic Liver Disease: Insights From a Prospective Cohort Study","authors":"Jing Liu,&nbsp;Sumeng Li,&nbsp;Yanan Liu,&nbsp;Fengqin Zhou,&nbsp;Jun Wu,&nbsp;Xin Zheng","doi":"10.1111/hepr.14238","DOIUrl":"10.1111/hepr.14238","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Limited research has explored the prognostic significance of the neutrophil-percentage-to-albumin ratio (NPAR), derived neutrophil-to-lymphocyte ratio (dNLR), and systemic immune-inflammation index (SII) in individuals with advanced chronic liver disease (ACLD). This study aimed to examine the association between these inflammatory markers and 90-day transplant-free mortality among patients with ACLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We prospectively recruited hospitalized patients with ACLD from the tertiary teaching hospital. Cox regressions were used to determine the associations between NPAR, dNLR, SII, and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 412 patients with ACLD were included in this study. The 90-day transplant-free mortality increased with higher levels of NPAR, dNLR, and SII. In multivariate analysis, higher NPAR, dNLR, and SII were independently associated with an increased risk of mortality in patients with ACLD after adjustment for confounders. After the adjustment for covariables, the risk of 90-day transplant-free mortality in ACLD patients increased by 66% and 18% for every unit increase in NPAR (OR: 1.66, 95% CI 1.09–2.53) and dNLR (OR: 1.18, 95% CI 1.01–1.38), respectively (<i>p</i> &lt; 0.05). The patients with NPAR &lt; 3.5 (OR: 3.65, 95% CI 1.30–10.27) and dNLR &lt; 3.5 (OR: 2.40, 95% CI 1.19–4.86) had the highest risk. Subgroup analysis revealed that NPAR, dNLR, and SII demonstrated a strong correlation with 90-day transplant-free mortality in both acute decompensation and acute-on-chronic liver failure populations. Subsequent analysis showed a significant association between NPAR, dNLR, SII, and 90-day transplant-free mortality in patients presenting with ascites, infection, and gastrointestinal hemorrhage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Increased NPAR, dNLR, and SII were independently correlated with a higher risk of mortality in patients with ACLD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 10","pages":"1385-1397"},"PeriodicalIF":3.4,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144617390","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}