Liver International最新文献

{"title":"Liver Biopsy in Metabolic Dysfunction-Associated Steatohepatitis Clinical Trials: Potential Pitfalls and Solutions.","authors":"Eric J Lawitz, Fred Poordad, Zachary D Goodman","doi":"10.1111/liv.70808","DOIUrl":"10.1111/liv.70808","url":null,"abstract":"<p><p>Liver biopsy is the reference standard for the evaluation of inflammation and fibrosis in MASH and is the primary endpoint in steatohepatitis clinical trials. An optimal liver biopsy is generally considered to be obtained with a 16-gauge needle, measure at least 2 cm in length and contain at least 10 complete portal tracts, although these features have not been prospectively validated as mandatory thresholds in MASH trials. Published clinical trials for MASH have not consistently reported sufficient details of liver biopsy quality (needle gauge, length, number of portal tracts) at baseline or post-treatment, and biopsy quality metrics are rarely reported separately by treatment arm. Placebo response rates in clinical trials for MASH varied widely (2% to 34%) and this variation could influence the outcomes of clinical trials. Future MASH trials should report biopsy quality metrics (needle gauge, core length and portal tract count) by treatment arm in supplementary appendices of those publications, treat the 16-gauge/≥ 2 cm/≥ 10 portal tract criteria as preferred acquisition standards rather than required thresholds, and may consider pre-specified sensitivity analyses restricted to biopsies meeting adequacy criteria, recognising that such exclusions may alter the disease spectrum and must be interpreted cautiously. Biopsy quality is a plausible contributor to variability in placebo responses and trial outcomes, but direct evidence that needle gauge, core length, or portal tract number independently affect histologic response rates in randomised MASH trials remains limited. As digital pathology/AI tools mature and NIT-based surrogate endpoints advance toward regulatory qualification, ensuring high quality histologic reference standards remains essential.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 8","pages":"e70808"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13390309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549836","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}

{"title":"Neurofilament Light Chain in Cerebrospinal Fluid and Blood Identifies Patients With Minimal and Overt Hepatic Encephalopathy.","authors":"Elise Jonasson, Lea L Grønkjær, Birgitte G Jacobsen, Dorte A Olsen, Charlotte W Wernberg, Jens Kuhle, Jonna S Madsen, Tobias Sejbaek, Mette M Lauridsen","doi":"10.1111/liv.70785","DOIUrl":"10.1111/liv.70785","url":null,"abstract":"<p><strong>Background: </strong>Minimal hepatic encephalopathy (MHE) is an underdiagnosed complication of liver cirrhosis, associated with progression to overt hepatic encephalopathy (HE). The Portosystemic Hepatic Encephalopathy Score (PHES) is the recommended diagnostic standard, but its use is hindered by resource constraints and limited accuracy. Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) are released during neuroaxonal and astrocyte injury and may serve as HE-biomarkers. We investigated NfL and GFAP in cerebrospinal fluid (CSF) and serum across the spectrum of HE and assessed their correlation and diagnostic performance.</p><p><strong>Methods: </strong>In this cross-sectional study, 35 patients with cirrhosis and 14 healthy controls (HC) were included. MHE was defined as PHES < -4, and overt HE was graded according to the West Haven Criteria. NfL and GFAP were quantified in CSF and serum using single-molecule array technology.</p><p><strong>Results: </strong>NfL concentrations in CSF and serum increased stepwise from HC to unimpaired patients, MHE, and overt HE (p < 0.0001). CSF- and serum NfL were strongly correlated (rho = 0.888, p < 0.0001), and CSF and serum NfL discriminated MHE and overt HE from unimpaired patients and HC, with AUROCs of 0.877-0.902 and 0.930-0.951, respectively. GFAP showed moderate correlation between CSF and serum (rho = 0.496, p < 0.0004) and discriminatory value in CSF (AUROCs of 0.777-0.800); however, to a lesser extent than NfL.</p><p><strong>Conclusion: </strong>Neuroaxonal injury is detectable in HE by NfL in both CSF and serum. The strong CSF and serum correlation suggests that serum NfL may serve as a minimally invasive biomarker of MHE and overt HE.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 8","pages":"e70785"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412337","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}

{"title":"Baseline DCP May Modify Response to Atezolizumab-Bevacizumab Versus Durvalumab-Tremelimumab in Unresectable HCC.","authors":"Kazunari Tanaka, Kunihiko Tsuji, Atsushi Hiraoka, Toshifumi Tada, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Takashi Nishimura, Toru Ishikawa, Kazuto Tajiri, Hironori Tanaka, Hidenori Toyoda, Chikara Ogawa, Takeshi Hatanaka, Satoru Kakizaki, Kazuhito Kawata, Atsushi Naganuma, Hisashi Kosaka, Tomomitsu Matono, Yoshihide Ueda, Hidekatsu Kuroda, Yutaka Yata, Hiroki Nishikawa, Michitaka Imai, Tomoko Aoki, Hironori Ochi, Jumpei Okamura, Hideyuki Tamai, Shinichiro Nakamura, Yoshiko Nakamura, Osamu Yoshida, Kazuhiro Nouso, Asahiro Morishita, Norio Itokawa, Tomomi Okubo, Taeang Arai, Akemi Tsutsui, Takuya Nagano, Fujimasa Tada, Hideko Ohama, Yuichi Koshiyama, Yuki Kanayama, Hidenao Noritake, Shohei Komatsu, Takumi Fukumoto, Takanori Matsuura, Soo Ki Kim, Hirayuki Enomoto, Kosuke Matsui, Masaki Kaibori, Yoichi Hiasa, Masatoshi Kudo, Takashi Kumada","doi":"10.1111/liv.70803","DOIUrl":"10.1111/liv.70803","url":null,"abstract":"<p><strong>Background and aims: </strong>For unresectable hepatocellular carcinoma (HCC), atezolizumab plus bevacizumab (Atez/Bev) and durvalumab plus tremelimumab (Dur/Tre) are widely used first-line immunotherapies; however, biomarkers to guide regimen selection before treatment initiation remain undefined. We investigated whether baseline des-γ-carboxy prothrombin (DCP) modifies objective response rate (ORR) according to treatment regimen.</p><p><strong>Methods: </strong>We analysed 1464 patients with unresectable HCC treated with first-line systemic therapy between 2020 and 2025 across multiple centers. Patients were divided into training and validation cohorts. Restricted cubic spline-based interaction models were used to evaluate the association between baseline DCP and ORR according to treatment regimen. The predicted absolute difference in ORR (ΔORR) between regimens was examined across continuous DCP values, with a prespecified 10% threshold considered clinically meaningful. Robustness was assessed using leave-one-center-out and repeated random-split sensitivity analyses.</p><p><strong>Results: </strong>Overall ORR did not differ significantly between Atez/Bev and Dur/Tre. However, a significant interaction between baseline DCP and treatment regimen was observed in both cohorts. Atez/Bev showed a relatively stable ORR across DCP concentrations, whereas Dur/Tre showed a DCP-dependent increase in ORR. At low DCP levels, Atez/Bev was favoured; with increasing DCP levels, the relative benefit shifted toward Dur/Tre. Sensitivity analyses confirmed a consistent DCP-dependent transition pattern, although the DCP level at which ΔORR exceeded 10% varied across analyses, supporting a transition zone rather than a fixed cutoff.</p><p><strong>Conclusions: </strong>Baseline DCP may modify the relative treatment benefit between Atez/Bev and Dur/Tre in unresectable HCC. Rather than defining a rigid cutoff, DCP appears to delineate a continuum in which higher levels increasingly favour Dur/Tre, providing a practical framework for individualized immunotherapy selection.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 8","pages":"e70803"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536296","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}

{"title":"Environmental Endocrine-Disrupting Chemicals and Metabolic Dysfunction-Associated Steatotic Liver Disease.","authors":"Yiwei Zhao, Huifen He, Jiao Zeng, Jingjing Zhang","doi":"10.1111/liv.70793","DOIUrl":"10.1111/liv.70793","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aims: &lt;/strong&gt;Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly termed non-alcoholic fatty liver disease (NAFLD), represents the most prevalent chronic liver condition worldwide, affecting approximately 25%-30% of the global adult population. Endocrine-disrupting chemicals (EDCs)-including phthalates, bisphenols, per- and polyfluoroalkyl substances (PFAS), persistent organic pollutants (POPs) and heavy metals-are ubiquitous environmental contaminants with established metabolic toxicity. However, the quantitative association between EDC exposure and MASLD prevalence remains incompletely characterised. We conducted a systematic review and meta-analysis to synthesise the current epidemiological evidence on this association.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We systematically searched PubMed, Embase, Web of Science and the Cochrane Library from inception through January 2026, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines (PROSPERO: CRD420261298624). Studies were eligible if they reported quantitative associations between measured EDC exposures and MASLD/NAFLD/metabolic-associated fatty liver disease (MAFLD) outcomes in human populations. Two investigators independently screened records, extracted data and assessed methodological quality using a customised Newcastle-Ottawa Scale (NOS). Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity was assessed via the I&lt;sup&gt;2&lt;/sup&gt; statistic. Funnel plot asymmetry and Egger's test were used to evaluate publication bias. Sensitivity analyses were performed using leave-one-out methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 427 records identified, 42 studies encompassing diverse global populations met inclusion criteria and were incorporated into the quantitative synthesis. The meta-analysis demonstrated that: Phthalates: mono (2-ethyl-5-carboxypentyl) phthalate (MECPP; weighted mean difference [WMD]: 2.40, 95% CI: 0.71-4.09), mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP; WMD: 2.46, 95% CI: 0.81-4.10) and monobenzyl phthalate (MBzP; WMD: 1.84, 95% CI: 0.10-3.59) showed significant positive associations with MASLD prevalence; pooled analysis of phthalate mixtures yielded an overall OR of 1.17 (95% CI: 1.13-1.21; I&lt;sup&gt;2&lt;/sup&gt; = 41.4%). Bisphenols: pooled analysis demonstrated a significant positive association with MASLD (OR: 1.29, 95% CI: 1.09-1.50; I&lt;sup&gt;2&lt;/sup&gt; = 73.0%), with bisphenol A (BPA; OR: 1.32, 95% CI: 0.92-1.72), bisphenol S (BPS; OR: 1.47, 95% CI: 0.96-1.98) and bisphenol F (BPF; OR: 1.19, 95% CI: 0.77-1.61) contributing to this effect. PFAS: the overall pooled effect was OR 0.95 (95% CI: 0.91-1.00; I&lt;sup&gt;2&lt;/sup&gt; = 22.9%). POPs: the overall OR was 1.30 (95% CI: 1.22-1.37; I&lt;sup&gt;2&lt;/sup&gt; = 29.2%), with organochlorine pesticides (OCPs; OR: 1.30, 95% CI: 1.19-1.42) and polychlorinated biphenyl (PCB)/OCP combinations demonstrating si","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 8","pages":"e70793"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412301","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}

{"title":"Drug Development for MASH-Related Compensated Cirrhosis: Past, Present and Future.","authors":"Ren-Qiang Zeng, Yi-Xuan Shao, Ru-Tao Lin, Xu-Ting Shen, Qin-Mei Sun, Xin Xin, Ping Liu, Jian-Gao Fan, Yi-Yang Hu, Qin Feng","doi":"10.1111/liv.70784","DOIUrl":"10.1111/liv.70784","url":null,"abstract":"<p><p>Compensated cirrhosis due to metabolic dysfunction-associated steatohepatitis (MASH) represents a major unmet need in hepatology, with no approved treatment to date. Compared with non-cirrhotic MASH, compensated cirrhosis is characterized by concurrent metabolic dysfunction, persistent inflammation, stabilized fibrosis and portal hypertension, making therapeutic development substantially more challenging. In recent years, several agents initially developed for non-cirrhotic disease have advanced into compensated MASH-related cirrhosis, including fibroblast growth factor 21 analogues, glucagon-like peptide-1 receptor/glucagon receptor dual agonists, thyroid hormone receptor-beta agonists and other antifibrotic approaches. Among these, fibroblast growth factor 21 analogues have shown the most encouraging efficacy signals. However, most candidates have not demonstrated clear histological or clinical benefit in this population. The predominance of negative trials suggests that limited progress reflects not only insufficient drug efficacy, but also disease complexity, marked patient heterogeneity and limitations of current endpoint frameworks. This review summarizes recent progress in drug development for compensated MASH-related cirrhosis, evaluates the efficacy and safety of major investigational agents, and discusses key barriers to development, including endpoint limitations, patient stratification and trial design. It also outlines future directions, including precision stratification, composite endpoints, noninvasive assessment tools, combination strategies and earlier screening and intervention.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 8","pages":"e70784"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13358175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430211","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}

{"title":"Interpreting the REACT Score Using the PREDICT Study Framework.","authors":"Rónán O'Connor, Hirannya Karunadasa, Stephen Bloom, Rohit Sawhney","doi":"10.1111/liv.70812","DOIUrl":"10.1111/liv.70812","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 8","pages":"e70812"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536226","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}

{"title":"Response to Letter to the Editor.","authors":"Harish Gopalakrishna, Marwan Ghabril","doi":"10.1111/liv.70815","DOIUrl":"10.1111/liv.70815","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 8","pages":"e70815"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578690","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}

{"title":"Threshold-Defined Liver Stiffness Trajectories and Liver-Related Event Risk in Chronic Liver Disease: A Cohort Study.","authors":"Dong Yun Kim, Jae Seung Lee, Hye Won Lee, Mi Na Kim, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Seung Up Kim","doi":"10.1111/liv.70819","DOIUrl":"10.1111/liv.70819","url":null,"abstract":"<p><strong>Background & aims: </strong>Vibration-controlled transient elastography (VCTE) predicts liver-related events (LREs), but how serial liver stiffness (LS) changes should be translated into clinical risk-whether by their magnitude, direction or movement across established thresholds-remains uncertain. We tested whether a threshold-defined trajectory framework anchored at the Baveno VII 10 kPa criterion would stratify LRE risk across chronic liver disease aetiologies.</p><p><strong>Methods: </strong>From the retrospective V-LINK registry (2006-2020), 6313 event-free patients with baseline and 1-year LS were stratified by the 10 kPa threshold into Stable Low, Improved, Worsened or Persistent High trajectories. A 3-year landmark (LM3) subset (n = 1617) enabled trajectory reassessment over time. Cox models estimated adjusted hazard ratios (HRs).</p><p><strong>Results: </strong>During a median follow-up of 5.5 years, 472 LREs occurred. Compared with Stable Low, adjusted HRs were 1.5 (95% confidence interval [CI], 1.1-2.2) for Improved, 2.5 (1.5-4.3) for Worsened and 4.1 (3.1-5.5) for Persistent High, with 3-year risks of 1.2%, 3.2%, 3.8%, and 15.0%. Persistent High (14.4% of the cohort) accounted for 61.9% of LREs; 65.7% showed a numerical decrease in LS yet remained ≥ 10 kPa. By aetiology, the HR for Persistent High was 6.4 (4.0-10.2) in non-viral aetiologies versus 2.6 (1.8-3.8) in viral aetiologies (p for interaction < 0.001). At LM3, the trajectory-based risk gradient was preserved (Persistent High HR, 3.5; 95% CI, 2.2-5.5).</p><p><strong>Conclusions: </strong>Threshold-defined LS trajectories identified a small subgroup concentrating most LRE risk, with the largest gradient in non-viral aetiologies. Persistent threshold elevation was the most robust prognostic signal, supporting serial LS monitoring pending external validation.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 8","pages":"e70819"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13413616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604006","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}

{"title":"CHAIN Cohort: Prospective Multicenter Study of MASLD With Serial Liver Stiffness Assessments in Cardiovascular Care.","authors":"Xiao-Dong Zhou, Ren Cheng-Han Fan, Jian-Dong Chen, Xi-Qiao Zhou, Qian Tong, Yan-Hang Gao, Xiao-Qi Wang, Ya-Kun Jiang, Xiang-Yuan Pu, Yu Shi, Ming-Wei Wang, Jing Liu, Hai-Bing Jiang, Li Ma, Xin-Gang Zhang, Yi-Ling Li, Su Lin, Hong-Ju Yang, Yao-Hong Song, Yan-Liang Zhang, Cheng-Zhi Lu, Feng-Mei Wang, De-Liang Shen, Hong-Xia Liang, Qiang Luo, En-Qiang Chen, Bo Li, Bi-Hui Zhong, Ying-Wu Liu, Qing Ye, Jie Deng, Fan-Pu Ji, Xian-Lun Li, Qian Wang, Song Yang, Jingjing Zhao, Hui Yang, Fang-Jie Hou, Yong-Ning Xin, You-Fu He, Xin-Hua Luo, Yu-Feng Gao, Hao Guan, Qi Wang, Zhong Ye, Yu-Bao Zheng, Bai-Zhen Deqing, Li-Ting Zhang, Zhen-Qi Ma, Cheng-Long Zhang, Yan Huang, Xiao-Ping Peng, Xiao-Ping Wu, Rui Xiang, Liang Deng, Shali Shalaimaiti, Ming-Feng Xia, Yang Zhao, Xiao-Fan Miao, Xin-Yi Sun, Ge Yu, Yi-Long Man, Ruo-Qi Zhou, Hao-Tian Zhang, Jia-Ke Tang, Cheng-Cheng Feng, Shuai-Ran Zhang, Yue-Yan Hu, Shu-Jun Jiang, Jia Li, Guan-Yue Su, Jun-Zhao Ye, Bao-Xin Qian, Xiao Liang, Yuan-Yuan Ren, Yan Li, Xiao-Qian Zhang, Ning Geng, Hong Peng, Kebinuer Tuerxun, Li-Gai Liu, Chun-Yi He, Jun-Feng Li, Hong-Yan Zhang, Li-Xia Yang, Zheng-Jie Lu, Jin Chai, Cheng-Lv Hong, Ming-Hua Zheng","doi":"10.1111/liv.70805","DOIUrl":"10.1111/liv.70805","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent among patients with cardiovascular disease but remains underrecognized in routine cardiology practice. To address the limited prospective evidence on its progression and clinical impact, we established the CHAIN cohort, a prospective multicenter study enrolling approximately 15 000 adults undergoing coronary evaluation across 40 tertiary hospitals in China. Baseline assessment includes comprehensive cardiometabolic profiling and vibration-controlled transient elastography for evaluation of liver fibrosis and steatosis. Participants will undergo long-term follow-up with repeated liver assessments every 6-12 months. Primary outcomes include liver-related events and major adverse cardiovascular events, while secondary outcomes include longitudinal changes in liver fibrosis and steatosis and their associations with cardiometabolic risk factors and clinical outcomes. This cohort will provide longitudinal evidence to support risk stratification and integrated heart-liver management in cardiovascular care.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 8","pages":"e70805"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456259","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}

{"title":"Deterioration of Primary Haemostasis Measurements After Resolution of Infection in Patients With Decompensated Cirrhosis.","authors":"Florentia Athanasaki, Larisa Vasilieva, Efrosyni Nomikou, Alexandra Alexopoulou","doi":"10.1111/liv.70795","DOIUrl":"10.1111/liv.70795","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 8","pages":"e70795"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412265","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}