International Journal of Hepatology最新文献

{"title":"Incidence of Adverse Cardiac Events After Liver Transplantation in Patients With Different Hemodynamic Classifications of Pulmonary Hypertension.","authors":"David W Wang, Akira Katayama, Marianne M Ligon, Samuel E Crowley, Abhijeet M Sathe, Ezeldeen Abuelkasem","doi":"10.1155/ijh/2869285","DOIUrl":"10.1155/ijh/2869285","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary hypertension (PH) in liver transplantation candidates is associated with elevated morbidity and mortality. Few studies have investigated whether different categories of PH based off hemodynamic characteristics portend worse outcomes. Furthermore, there have been newly defined parameters for PH classifications. Therefore, we aimed to compare postoperative outcomes after liver transplantation in patients within different newly established hemodynamic categories of PH.</p><p><strong>Methods: </strong>This was a 20-year single-center retrospective observational study of adult patients undergoing liver transplantation. Patients with a diagnosis of PH and confirmatory right heart catheterization (RHC) were included in the study. Based off pulmonary artery wedge pressure (PAWP) and Wood units (WU), patients were categorized into four groups: precapillary (PrePH), isolated postcapillary (IpcPH), combined postcapillary (CpcPH), unclassified (UncPH). Our primary outcome was a composite of adverse cardiac events within 30 days postoperatively. Secondary outcomes included prolonged ventilation, acute kidney injury, and mortality at 30 days, 6 months, and 1 year.</p><p><strong>Results: </strong>Of the 2409 patients who underwent liver transplantation in the study period, 80 patients met criteria for inclusion. The incidences of ACEs were 0% in PrePH, 31.4% in IpcPH, 25.0% in CpcPH, and 10.3% in UncPH (<i>p</i> = 0.04). Patients with postoperative ACEs had elevated PAWP (18.1 vs. 14.0 mmHg, <i>p</i> = 0.01) and lower pulmonary vascular resistance (0.79 vs 1.3 WU, <i>p</i> = 0.01). There were no differences observed in secondary outcomes.</p><p><strong>Conclusion: </strong>In this single-center study, we observed that patients with isolated precapillary PH did not have adverse cardiac events. Instead, patients with elevated PAWP, indicating postcapillary PH, were more likely associated with adverse cardiac events. This observation is seen despite milder pulmonary disease, as intended by newly established definitions for PH. Further investigation is warranted, as there may be prognostic implications that can drive future guidelines for liver transplantation in patients with PH.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2026 ","pages":"2869285"},"PeriodicalIF":1.6,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SGLT-2 Inhibitors for Ascites Management in Liver Cirrhosis: A Systematic Review and Meta-Analysis of Available Evidence.","authors":"Abdallah Al Ghnaimat, Nour Aldin T Ahmed, Omar Mahmood Al-Azzawi, EzzElDien A Ibrahim, Roaa Rayyan, Souheb Alkloub, Ekram Al Joufi, Ezz Eldein Breish, Sana Shaik, Noorhan Al-Kadhimi, Batool Al Masalha, Hossam Abdelbaqi, Dalia Atef Abouda","doi":"10.1155/ijh/7257876","DOIUrl":"10.1155/ijh/7257876","url":null,"abstract":"<p><strong>Goal: </strong>The goal is to systematically evaluate the efficacy and safety of SGLT-2 inhibitors (SGLT2i) versus standard therapy for ascites management in liver cirrhosis.</p><p><strong>Background: </strong>SGLT2i promote natriuresis and osmotic diuresis, offering potential therapeutic benefits for fluid overload in cirrhosis, similar to their established role in heart failure. However, high-quality comparative evidence remains limited.</p><p><strong>Study: </strong>A systematic search of PubMed, Scopus, Cochrane, Embase, and Web of Science was conducted through October 2025 following PRISMA 2020 guidelines. Eligible studies included randomized controlled trials and prospective comparative studies enrolling adults (≥ 18 years) with confirmed cirrhosis treated with dapagliflozin or empagliflozin, alone or alongside standard therapy, versus placebo or standard care for ≥ 2 weeks. The primary outcome was complete ascites resolution; secondary outcomes included mortality, body weight, eGFR, and serum creatinine and sodium levels.</p><p><strong>Results: </strong>Three studies (two RCTs and one prospective trial; <i>n</i> = 382) were included, comprising 241 patients receiving SGLT2i and 141 controls. SGLT2i significantly increased complete ascites resolution (OR: 2.39, 95% CI: 1.47-3.90; <i>p</i> < 0.001; <i>I</i> ² = 15<i>%</i>) and reduced body weight (MD: -4.86 kg, 95% CI: -7.57 to -2.14; <i>p</i> = 0.0005; <i>I</i> ² = 0<i>%</i>). No significant differences were observed in eGFR, serum creatinine, serum sodium, or mortality within the RCT subgroup (OR: 1.60, 95% CI: 0.53-4.87; <i>I</i> ² = 0<i>%</i>); the overall three-study pool (OR: 0.27, 95% CI: 0.13-0.56; <i>I</i> ² = 87<i>%</i>) was driven by the nonrandomized trial (test for subgroup differences <i>p</i> = 0.001). The only placebo-controlled RCT reported significantly higher rates of AKI (50% vs. 15%, <i>p</i> = 0.04) and infections (55% vs. 20%, <i>p</i> = 0.04) in the SGLT2i arm.</p><p><strong>Conclusions: </strong>SGLT2i improved ascites resolution and body weight without changes in routinely measured renal parameters, but unresolved AKI and infection signals and very low GRADE certainty for mortality preclude routine clinical use. SGLT2i should be considered only as individualized investigational therapy under close monitoring pending larger RCTs. PROSPERO (CRD420261303781).</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2026 ","pages":"7257876"},"PeriodicalIF":1.6,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13292109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibroblast Growth Factor 21 Analogues Improve Fibrosis in Metabolic Dysfunction-Associated Steatohepatitis: An Updated Systematic Review and Meta-Analysis.","authors":"Muhammad Naqash, Abdullah Tariq, Shazma Shayan, Sadaf Manzoor Sargani, Muhammad Asad Raza, Nasar Nasrullah Khan, Aiman Balouch, Rana Muhammad Usama, Khabab Abbasher Hussien Mohamed Ahmed","doi":"10.1155/ijh/7391450","DOIUrl":"10.1155/ijh/7391450","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatohepatitis (MASH) (formerly nonalcoholic steatohepatitis, MASH) is a growing cause of liver morbidity worldwide. Although therapeutic options for MASH fibrosis have expanded, including the approval of resmetirom for noncirrhotic MASH with F2-F3 fibrosis, additional therapies with antifibrotic efficacy remain needed. Fibroblast growth Factor 21 (FGF21) is a liver-derived hormone that regulates lipid metabolism, insulin sensitivity, and energy balance, and long-acting FGF21 analogues have shown promise in Phase 2 trials. We performed a systematic review and meta-analysis to quantify the efficacy and safety of FGF21 analogues in improving liver fibrosis in MASH.</p><p><strong>Methods: </strong>We searched PubMed, Scopus, and the Cochrane Library (through February 2026) for randomized controlled trials (RCTs) comparing an FGF21 analogue versus placebo in adults with biopsy-confirmed MASH. Primary outcomes were ≥ 1-stage histological fibrosis improvement without MASH worsening. Secondary outcomes included changes in hepatic fat, liver enzymes, and key metabolic parameters. Data were pooled using random-effects models, calculating pooled risk ratios (RRs) or standardized mean differences (SMDs) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>We identified 10 RCTs (total: 1113 patients with F1-F4 fibrosis) meeting inclusion criteria. FGF21 analogue treatment significantly increased the likelihood of achieving ≥ 1-stage fibrosis improvement (RR: 2.25, CI: 1.25-4.03) compared with placebo. FGF21 analogues also produced larger reductions in hepatic fat content, liver stiffness, and fibrosis biomarkers than placebo. The incidence of serious adverse events was similar between groups. The most reported treatment-related side effects were gastrointestinal, especially nausea and diarrhea, and local injection reactions; these were generally mild and did not significantly limit therapy.</p><p><strong>Conclusions: </strong>FGF21 analogue therapy is associated with significantly greater histological fibrosis improvement in patients with MASH and appears to be well tolerated. These findings suggest that FGF21 analogues may become a valuable pharmacotherapy for MASH, but confirmatory larger trials and long-term data are needed.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2026 ","pages":"7391450"},"PeriodicalIF":1.6,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LC-Pred: A Transformer-Based Interactive Interface for Liver Cirrhosis Prediction.","authors":"Bisweswari Rath, Satya Ranjan Dash, Rajani Kanta Mahapatra","doi":"10.1155/ijh/3655128","DOIUrl":"10.1155/ijh/3655128","url":null,"abstract":"<p><strong>Objectives: </strong>Incorporating transformer, an innovative deep learning-based model with an authenticated and user-friendly client-server web application namely LC-Pred, this study highlights the early prediction of liver cirrhosis (LC), which will be beneficial for both the clinicians and the LC patients. LC-Pred delivers both single and bulk prediction abilities making it fast, sturdy, and secure to be used in healthcare sectors.</p><p><strong>Methods: </strong>This study uses a total of 1098 real-time patients' data having both LC and nonliver cirrhosis (NLC) cases to implement and compare traditional scoring systems and AI-based models, by using 20 clinical parameters with two demographic data such as patients' age and gender.</p><p><strong>Results: </strong>The tool consists of authentication, PDF report generation and spontaneous interface elevated for clinical workflow incorporation. Transformer model exhibits the highest accuracy among all the traditional and artificial intelligence (AI) models and is selected to be linked with LC-Pred for classification of cirrhosis. Transformer model accomplishes a vigorous performance with precision recall area under the curve (PR-AUC) of 0.907, receiver operating characteristics area under the curve (ROC-AUC) of 0.989, sensitivity/recall of 0.857 (for LC detection) and specificity of 0.947 (for NLC prediction), Brier score is of 0.027 and test accuracy of 0.977.</p><p><strong>Conclusion: </strong>The tool exhibits noteworthy upgradation in AI-assisted hepatology, over traditional scoring techniques like model for end-stage liver disease (MELD) and Child-Pugh, by stabilizing the technical intricacy with clinical efficacy. This note delineates the application framework, model training principles, evaluating results and the importance of implementing an aligned AI system to be utilized by the clinicians.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2026 ","pages":"3655128"},"PeriodicalIF":1.6,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Postoperative MELD-Based Scores in Predicting Mortality After Liver Transplantation: A Retrospective Comparative Study.","authors":"Akira Katayama, Ezeldeen Abuelkasem, David W Wang","doi":"10.1155/ijh/3307874","DOIUrl":"10.1155/ijh/3307874","url":null,"abstract":"<p><strong>Background: </strong>Postoperative prognostic assessment is critical for patients undergoing liver transplantation (LT). The Model for End-Stage Liver Disease (MELD) scores calculated in the early postoperative period have been shown to be associated with postoperative outcomes. While MELD-Na and MELD 3.0 were developed to improve mortality prediction in pretransplant settings by incorporating serum sodium, albumin, and sex, their comparative utility in the postoperative period remains unclear.</p><p><strong>Methods: </strong>We conducted a retrospective single-center cohort study including adult LT recipients between January 2012 and June 2023. MELD, MELD-Na, and MELD 3.0 scores were calculated on Postoperative Day (POD) 7. The primary outcome was 30-day all-cause mortality. Predictive performance was assessed using the area under the receiver operating characteristic (ROC) curve (AUC). Subgroup analyses were performed according to serum sodium, albumin levels, and sex.</p><p><strong>Results: </strong>A total of 1038 patients were included. All three MELD-based scores calculated on POD 7 were associated with 30-day mortality (MELD original, hazard ratio [HR] 1.20, 95% CI 1.13-1.27, <i>p</i> < 0.001; MELD-Na, HR 1.20, 95% CI 1.12-1.28, <i>p</i> < 0.001; and MELD 3.0, HR 1.21, 95% CI 1.14-1.29, <i>p</i> < 0.001, respectively). ROC analysis demonstrated comparable predictive accuracy across MELD, MELD-Na, and MELD 3.0 for 30-day mortality (AUCs: MELD original, 0.82; MELD-Na, 0.79; MELD 3.0, 0.82; overall <i>p</i> = 0.24). Exploratory subgroup analyses did not identify any score with consistently superior performance across different strata of sodium, albumin, or sex.</p><p><strong>Conclusion: </strong>MELD, MELD-Na, and MELD 3.0 scores calculated on POD 7 showed comparable performance in predicting 30-day mortality after LT. These findings support the use of POD 7 MELD-based scores for postoperative risk stratification, with no meaningful difference in predictive performance among the three scoring systems.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2026 ","pages":"3307874"},"PeriodicalIF":1.6,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Drug-Drug Interaction Burden of Direct-Acting Antiviral Therapy for Hepatitis C: A Single-Center Community Hospital Analysis.","authors":"Satoru Okabe, Akira Doi, Kengo Matsumoto, Masashi Yamamoto, Koji Fukui, Tsutomu Nishida","doi":"10.1155/ijh/5499912","DOIUrl":"10.1155/ijh/5499912","url":null,"abstract":"<p><strong>Background: </strong>Polypharmacy leads to drug-drug interactions (DDIs) with direct-acting antivirals (DAAs). We quantified the DDI burden (Liverpool categories) and evaluated its association with effectiveness and safety. We assessed renal function as a predictor of adverse events (AEs) and reported loss to follow-up (LTFU).</p><p><strong>Methods: </strong>We retrospectively analyzed 145 adults with chronic hepatitis C treated with glecaprevir/pibrentasvir (GLE/PIB) or sofosbuvir/velpatasvir (SOF/VEL) between February 2018 and October 2024. The primary endpoint was sustained virological response 12 weeks after the end of treatment (SVR12); when SVR12 was missing, SVR24 was substituted (hierarchical SVR). Concomitant drugs were screened using the Liverpool HEP Drug Interaction Checker. The predictors of AEs were assessed using multivariable logistic regression and receiver operating characteristic analysis. A conservative intention-to-treat analysis included missing SVR data as a failure.</p><p><strong>Results: </strong>The median patient age was 67 years, and 23.4% of patients had cirrhosis. Polypharmacy (≥ 5 drugs) occurred in 26.9% of patients, DDIs in 50.3%, multiple DDIs in 14.5%, and contraindicated pairs in 1.4% (all GLE/PIB). AEs occurred in 16.6% of patients, were largely Grades 1-2, and began around Week 2. LTFU was 11.0%. The hierarchical SVR was 99.2%, whereas the conservative analysis was 88.3%. A Cr concentration ≥ 0.86 mg/dL independently predicted AEs (adjusted OR 3.4; 95% CI 1.24-9.2), whereas DDI burden and polypharmacy did not.</p><p><strong>Conclusions: </strong>Despite frequent DDIs, DDI burden was not independently associated with SVR or AEs. DAA therapy was highly effective and well tolerated. Renal function showed a modest association with AEs.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2026 ","pages":"5499912"},"PeriodicalIF":1.6,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing Landscape of Chronic Liver Diseases in a Tertiary Level Hospital of Bangladesh Over the Last 10 Years.","authors":"Md Hasan Shahriar, Avizit Sarker, Tapu Ghosh, Md Enamol Hoque, Md Samsul Arafin, Md Tanveer Rahman, Md Shahinul Alam","doi":"10.1155/ijh/5525981","DOIUrl":"10.1155/ijh/5525981","url":null,"abstract":"<p><p>Given significant advances in the treatment of viral hepatitis and the growing epidemic of obesity, the burden of the different types of chronic liver diseases in Bangladesh may be changing. Our aim was to assess the shift in the prevalence of different chronic liver disease etiologies in a tertiary level hospital of Bangladesh over the last 10 years. This was a retrospective observational study conducted in the Department of Hepatology in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. It was based on data from the hospital records (2013-2016 and 2017-2022). A total of 4658 patients were included from the hospital registry between 2013 and 2022. The etiologies of chronic liver disease were compared between two time periods: (2013-2016) and (2017-2022) among these patients. A significant decrease in the prevalence of chronic hepatitis B from 51.1% (2013-2016) to 44.4% (2017-2022) (<i>p</i> < 0.001), chronic hepatitis C from 11.3% (2013-2016) to 10.4% (2017-2022) (<i>p</i> = 0.032), and non-B-non-C from 11.7% (2013-2016) to 8.6% (2017-2022) (<i>p</i> < 0.001) was observed. In contrast, the prevalence of nonalcoholic fatty liver disease (NAFLD/NASH) increased from 1.2% (2013-2016) to 8.1% (2017-2022) (<i>p</i> < 0.001); anti-HBc (total) from 3.2% (2013-2016) to 5.1% (2017-2022) (<i>p</i> = 0.001), and autoimmune hepatitis (AIH) from 0.2% (2013-2016) to 0.4% (2017-2022) (<i>p</i> = 0.038) also showed a significant increase. Over the last decade (2013-2022), NAFLD has emerged as a rapidly increasing cause of chronic liver disease in Bangladesh, whereas viral etiologies and AIH show a declining trend. Policy makers, clinicians, and stakeholders should take attention to recognize the situation and act properly.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2026 ","pages":"5525981"},"PeriodicalIF":1.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natriuretic Effect of Dapagliflozin in Cirrhosis With Ascites: A Randomized, Placebo-Controlled Crossover Trial.","authors":"Nattaporn Kongphakdee, Setthachai Piewchan, Kanokporn Sanpawithayakul, Soonthorn Chonprasertsuk, Sith Siramolpiwat","doi":"10.1155/ijh/9503323","DOIUrl":"10.1155/ijh/9503323","url":null,"abstract":"<p><strong>Background: </strong>Ascites is a frequent complication of decompensated liver cirrhosis and is associated with a poor prognosis. Dapagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, induces osmotic diuresis and natriuresis, with established use in heart failure. However, studies on SGLT2 inhibitors in cirrhotic patients with ascites are limited.</p><p><strong>Objectives: </strong>The objective of this study is to evaluate changes in urine parameters in cirrhotic patients with ascites treated with dapagliflozin.</p><p><strong>Methods: </strong>This randomized, double-blind, placebo-controlled, crossover trial enrolled 10 patients with Child-Pugh Class B or C cirrhosis who had persistently moderate or tense ascites. Participants received dapagliflozin or placebo for 4 weeks, followed by a 2-week washout, and then crossed over to alternate treatment. The primary outcome was the change in 24-h urine sodium (UNa) excretion on Days 0, 3, and 28. Secondary outcomes included changes in 24-h urine volume (UV) and serum sodium.</p><p><strong>Results: </strong>Dapagliflozin significantly increased 24-h urinary sodium excretion at Day 3 compared with placebo (treatment difference +35.1 mmol/day; 95% CI 17.5-52.7; <i>p</i> < 0.001), indicating a transient natriuretic effect. This effect was not sustained at Day 28 (<i>p</i> = 0.42). There were no significant changes in 24-h UV or serum sodium at either time point. At the end of the dapagliflozin phase, 5 of 7 evaluable participants demonstrated improvement in ascites grade, whereas 2 did not. One serious adverse event occurred; one participant died during the washout period after completing the placebo phase due to variceal bleeding complicated by spontaneous bacterial peritonitis.</p><p><strong>Conclusions: </strong>In cirrhotic patients with persistent ascites, dapagliflozin was associated with a transient increase in 24-h urinary sodium excretion, without significant sustained effects on urine volume or serum sodium. Dapagliflozin was generally well tolerated in this small pilot trial.</p><p><strong>Trial registration: </strong>Thai Clinical Trial Registry: TCTR20241016007.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2026 ","pages":"9503323"},"PeriodicalIF":1.6,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Liver Enzymes and Metabolic Syndrome: A Population-Based Cross-Sectional Study of the Bandar Kong Cohort Study.","authors":"Arezoo Ghazalgoo, Masoumeh Kheirandish, Seyyed Mohammad Hashemi, Elaheh Salarpour, Ayoub Basham, Parsa Saberian, Ehsan Amini-Salehi, Hoda Safa","doi":"10.1155/ijh/8920064","DOIUrl":"10.1155/ijh/8920064","url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome (MetS) is a major global health concern that increases morbidity and mortality from cardiometabolic diseases. We refined the rationale to highlight the mechanistic involvement of the liver in metabolic dysregulation.</p><p><strong>Methods: </strong>This population-based study was conducted on 3896 adults aged between 35 and 70 (57.2% female) who participated in the Bandare-Kong Non-Communicable Diseases (BKNCD) cohort study. Participants were categorized into normal quartiles and abnormal levels of liver enzymes including gamma-glutamyl transferase (GGT), alanine transaminase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP). MetS was defined based on the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria for Iranian population. Logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) and <i>p</i> values, adjusting for age, sex, residence, BMI, physical activity, energy intake, and financial status.</p><p><strong>Results: </strong>The prevalence of MetS was 36.6%. After multivariable adjustment, abnormal levels of GGT (OR = 1.91, 95% CI: 1.61-2.28, <i>p</i> < 0.001), ALT (OR = 1.60, 95% CI: 1.34-1.90, <i>p</i> < 0.001), ALP (OR = 1.48, 95% CI: 1.07-2.03, <i>p</i> = 0.01), and AST (OR = 1.39, 95% CI: 1.09-1.77, <i>p</i> = 0.007) were significantly associated with higher odds of MetS. Within normal ranges, the highest quartile of GGT (OR = 2.81, 95% CI: 2.22-3.56, <i>p</i> < 0.001), ALT (OR = 2.39, 95% CI: 1.89-3.03, <i>p</i> < 0.001), and ALP (OR = 1.63, 95% CI: 1.30-2.04, <i>p</i> < 0.001) showed significant associations, while AST did not.</p><p><strong>Conclusion: </strong>Serum liver enzyme levels, including those within normal range, were strongly associated with MetS. GGT showed relatively stronger associations compared with other enzymes; however, these findings should not be interpreted as diagnostic superiority because no performance metrics (AUC, PPV, and NPV) were evaluated. ALT and ALP also showed meaningful associations. Future studies should assess diagnostic accuracy before considering clinical implementation.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2026 ","pages":"8920064"},"PeriodicalIF":1.6,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13059668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning Models to Predict Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) With Simple Anthropometric and Biochemical Variables: A Cross-Sectional Study in US Population.","authors":"Shiying Du, Hailiang Yu, Jianbo Du, Yunan Xu","doi":"10.1155/ijh/8221645","DOIUrl":"10.1155/ijh/8221645","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is an emerging global health concern. This study was aimed at exploring the feasibility of utilizing machine learning (ML) algorithms to predict MASLD in large general populations based on simple anthropometric and biochemical parameters.</p><p><strong>Methods: </strong>Data from the 2017-2020 cycles of the US National Health and Nutrition Examination Survey (NHANES) were utilized. A total of 6814 participants (53.0% female) with complete transient elastography data were included. MASLD was defined as a controlled attenuation parameter ≥ 280 dB/m, with cardiometabolic risk factor and without excessive alcohol use. Key characteristics and biomarkers associated with MASLD were identified using the least absolute shrinkage and selection operator (LASSO) and the Boruta algorithms. ML methods, including logistic regression (LR), extreme gradient boosting (XGBoost), bootstrap aggregating, random forest, naive Bayes, light gradient boosting machine (LightGBM), decision tree, and support vector machines, were employed to develop the MASLD prediction models.</p><p><strong>Results: </strong>The median age of the 6814 participants was 53 years (interquartile range: 37~65). MASLD was detected among 2611 (38.3%) participants. Key predictors selected via LASSO and Boruta algorithms included body weight, standing height, waist circumference, diagnosis of diabetes, alanine aminotransferase, aspartate aminotransferase, and gamma glutamyl transferase. The areas under the receiver operating characteristic curves of LR, XGBoost, and other ML models were 0.841, 0.837, 0.815, 0.838, 0.814, 0.842, 0.796, and 0.828 in the internal validation cohort. Results indicate that LR, XGBoost, and LightGBM models outperform other models in predicting MASLD.</p><p><strong>Conclusions: </strong>The ML models of LR, XGBoost, and LightGBM are effective and simplified tools for predicting MASLD in the US general population. This study underscores the potential of ML models with simple noninvasive biomarkers in enhancing early detection and personalized management of fatty liver disease.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2026 ","pages":"8221645"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13042330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}