Annals of hepatology最新文献

{"title":"Impact of neohepatic albumin-bilirubin scores on renal outcomes following living donor liver transplantation: a propensity score analysis.","authors":"Hye-Won Jeong, Hye-Mee Kwon, Sung-Hoon Kim, Seong-Mi Yang, In-Gu Jun, Jun-Gol Song, Gyu-Sam Hwang","doi":"10.1016/j.aohep.2025.102111","DOIUrl":"10.1016/j.aohep.2025.102111","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Acute kidney injury (AKI) after liver transplantation (LT) impacts patient and graft outcomes. The Albumin-Bilirubin (ALBI) score, an objective and sensitive liver function index, may help predict post-LT outcomes. This study evaluated the association between neohepatic ALBI scores and renal outcomes in living donor LT (LDLT) recipients.</p><p><strong>Patients and methods: </strong>We examined 2171 adult LDLT recipients between 2012 and 2019. Outcomes included severe post-LT AKI, renal replacement therapy (RRT), chronic kidney disease (CKD) at 1 year, early allograft dysfunction (EAD), and overall graft failure. Multivariate logistic regression, Cox proportional hazards regression, and propensity score matched (PSM) analyses were performed to evaluate the association between neohepatic ALBI and post-LT outcomes.</p><p><strong>Results: </strong>Severe AKI, RRT, CKD, EAD, and overall graft failure occurred in 21.6%, 2.2%, 41.9%, 5.9%, and 15.8% of patients, respectively. Higher neohepatic ALBI scores (≥-1.615) were significantly associated with severe AKI (OR: 2.34, 95% CI: 1.79-3.04, P<0.001, multivariate analysis; OR: 2.18, 95% CI: 1.62-2.95, P<0.001, PSM analysis), RRT (OR: 3.80, 95% CI: 1.53-11.31, P=0.008, multivariate analysis; OR: 7.17, 95% CI: 1.61-31.89, P=0.010, PSM analysis), CKD (OR: 1.22, 95% CI: 1.00-1.47, P=0.044, multivariate analysis; OR: 1.43, 95% CI: 1.11-1.85, P=0.006, PSM analysis), and overall graft failure (HR: 1.30, 95% CI: 1.01-1.68, P=0.041, multivariate analysis; HR: 1.55, 95% CI: 1.08-2.23, P=0.018, PSM analysis).</p><p><strong>Conclusions: </strong>Neohepatic ALBI scores are significantly associated with post-LT severe AKI, RRT, CKD, and graft failure, underscoring their prognostic value in LDLT recipients.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"102111"},"PeriodicalIF":4.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032524","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":"Implications of liver fibrosis in clinical trials.","authors":"Vinay Jahagirdar, Kaanthi Rama, Daniel Cabrera, Francisco Idalsoaga, Luis Antonio Díaz, Marco Arrese, Juan Pablo Arab","doi":"10.1016/j.aohep.2025.102112","DOIUrl":"10.1016/j.aohep.2025.102112","url":null,"abstract":"","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"102112"},"PeriodicalIF":4.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032605","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":"Comment on \"outcomes and risk factors for de novo major depressive disorder after liver transplantation: Nested case-control study\".","authors":"Quanhe Zhou, Tieli Kang","doi":"10.1016/j.aohep.2025.102105","DOIUrl":"10.1016/j.aohep.2025.102105","url":null,"abstract":"","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"102105"},"PeriodicalIF":4.4,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008054","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":"DURATION OF TYPE 2 DIABETES AS A CLINICAL PREDICTOR OF LIVER FIBROSIS IN PATIENTS WITH METABOLIC DYSFUNCTION ASSOCIATED STEATOTIC LIVER DISEASE","authors":"Daniza Alexandra Contreras de los Santos ,&nbsp;Invis Perez Mendez ,&nbsp;Omar Ebrahim Ibrahim","doi":"10.1016/j.aohep.2025.101992","DOIUrl":"10.1016/j.aohep.2025.101992","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Metabolic dysfuntion associated liver disease (MASLD) is highly prevalent in patients with type 2 diabetes mellitus (T2DM), and fibrosis progression is the main prognostic factor. However, clinical predictors of fibrosis remain unclear. Diabetes duration has been suggested as a potencial independent risk factor.</div><div>To assess the association between T2DM duration and liver fibrosis estimated by the FIB-4 index and liver stiffness measurement (LSM) in Dominican patients with MASLD.</div></div><div><h3>Materials and Methods</h3><div>A retrospective cohort study was conducted including 127 adults with MASLD, diagnosed based on hepatic steatosis detected by abdominal ultrasound and coexisting T2DM, following international criteria. Patients were evaluated at a tertiary care center in the Dominican Republic between July 2024 and January 2025.</div><div>The FIB-4 was calculated using AST, ALT, platelet count, and age.LSM by transient elastography was available 32 cases. Diabetes duration was extracted from medical records and categorized into five groups (0-5, 6-10, 11-15, 16-20 y &gt;20 years). Spearman correlation assessed associations between diabetes duration, FIB-4, and LSM. Nonparametric test compared fibrosis by duration groups. Significance was set at p&lt;0.05.</div></div><div><h3>Results</h3><div>Mean age was 56.6 ± 13.9 years; 63 % were women. FIB-4 showed moderate correlation with T2DM duration (ρ=0.26, p=0.005) and age (ρ=0.49, p&lt;0.001). In patient aged 35-65 years, FIB-4 strongly correlated with LSM (ρ=0.77, p&lt;0.001). According to FIB-4 classification, 63.8% were low-risk (&lt;1.3), 32.3% intermediate-risk (1.3-2.67), and 3.9% high-risk (&gt;2.67) for advanced fibrosis.</div></div><div><h3>Conclusions</h3><div>T2DM duration moderately correlates with FIB-4, especially in mind-aged adults, supporting its role in fibrosis risk models.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101992"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154152","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":"INFLUENCE OF CARDIOMETABOLIC RISK FACTORS AND ALCOHOL CONSUMPTION ON LIVER STIFFNESS IN PATIENTS WITH MASLD: A MULTICENTER STUDY IN COLOMBIA","authors":"Ismael de Jesus Yepes Barreto ,&nbsp;Nicole Chamorro ,&nbsp;Guillermo Donado ,&nbsp;Pablo Osorio ,&nbsp;Juan Carlos Restrepo ,&nbsp;Santiago Pino ,&nbsp;Clara Caez ,&nbsp;Jorge Ortiz ,&nbsp;Yohana Poveda","doi":"10.1016/j.aohep.2025.101979","DOIUrl":"10.1016/j.aohep.2025.101979","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) includes patients with hepatic steatosis and at least one cardiometabolic risk factor (CMRF). However, the influence of individual CMRFs and their interactions on disease progression remains unclear.</div><div>To assess the association between CMRFs, their interactions (including with alcohol consumption), and liver stiffness in MASLD</div></div><div><h3>Patients and Methods</h3><div>This multicenter study included patients with MASLD from four Colombian cities. Transient elastography was used to assess liver stiffness. Other causes of chronic liver disease were excluded. Patients with significant alcohol intake (≥30 g/day for men, ≥20 g/day for women) were excluded. CMRFs were defined using ATP III criteria. Alcohol consumption was estimated as grams per week based on standard drink units. A multivariate linear regression model evaluated associations with liver stiffness, including interaction terms between CMRFs and with alcohol. Statistical significance was set at p ≤ 0.05</div></div><div><h3>Results</h3><div>A total of 354 patients were included (mean age: 54 years; 39.3% male). CMRF distribution: 1 (30.2%), 2 (31.9%), 3 (29.4%), and 4 (8.5%). The most prevalent CMRFs were dyslipidemia (68.6%) and hypertension (54.2%). In multivariate analysis, BMI (β = 0.14; 95% CI: 0.03–0.27; p = 0.012) and impaired glucose metabolism (β = 0.11; 95% CI: 0.08–2.6; p = 0.03) were independently associated with liver stiffness. Among interaction terms, only the diabetes–waist circumference interaction remained significant (β = 0.19; 95% CI: 1.15–4.4; p &lt; 0.01). Alcohol consumption showed no association.</div></div><div><h3>Conclusions</h3><div>Diabetes and its interaction with waist circumference are key drivers of liver stiffness in MASLD, independent of alcohol intake.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101979"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154153","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":"BIOACTIVE COFFEE COMPOUNDS SYNERGISTICALLY ENHANCE THE ANTITUMOR EFFECTS OF CHEMO AND IMMUNOTHERAPY FOR HEPATOCELLULAR CARCINOMA IN VITRO","authors":"Leticia Valente Cardoso ,&nbsp;Luana Casarin Riechelmann ,&nbsp;Luis Barbisan Fernando ,&nbsp;Guilherme Romualdo Ribeiro","doi":"10.1016/j.aohep.2025.101978","DOIUrl":"10.1016/j.aohep.2025.101978","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Hepatocellular Carcinoma (HCC) yields high global incidence and mortality rates and an unfavorable prognosis. Although current therapies for advanced HCC are promising, their outcomes remain limited. In this context, there is increasing interest in innovative strategies, such as combining bioactive compounds (BCs) with chemo- and immunotherapies. BCs in coffee have stood out due to their chemopreventive effects reported in epidemiological and experimental studies. However, their antitumor potential, particularly in combination with conventional therapies, remains incompletely understood. In this study, we investigated whether coffee-derived compounds could enhance the antitumor effects of sorafenib (SOR) and atezolizumab plus bevacizumab (ATZ+BVZ) in vitro.</div></div><div><h3>Materials and Methods</h3><div>LX2 hepatic stellate cells and HepG2/C3A (HCC) cells were cultured in 3D (spheroids) and 2D (transwell) systems, and treated with caffeine (CAF), trigonelline (TRI), chlorogenic acid (CGA), caffeic acid (CA), kahweol (KWL), SOR, ATZ, and BVZ for 24 and 48 h for half maximum effective concentration (EC50) determination (MTT/LDH assays). Next, the coffee compounds were combined with SOR or ATZ+BVZ at sub-effective and physiologically plausible EC50 fractions (1/5, 1/6, or 1/10) and evaluated by MTT (3D), scratch (migration), and colony formation assays (2D), with combination index calculation.</div></div><div><h3>Results</h3><div>CGA, CA, and TRI showed antagonistic effects to the therapies. In contrast, CAF or KWL synergistically enhanced the anti-tumor effects of SOR and ATZ plus BVZ in reducing spheroid viability. The combination of CAF plus KWL further intensified the anti-tumor effects of both treatments, also inhibiting colony formation and cell motility.</div></div><div><h3>Conclusions</h3><div>These findings suggest that coffee-derived compounds may strengthen the therapeutic efficacy against HCC. Further experiments include in vitro metabolomics and transcriptomics, and in vivo xenograft mouse model.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101978"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154154","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":"GEOREFERENCING AS A MANAGEMENT STRATEGY FOR SITUATIONAL DIAGNOSIS OF THE TERRITORY IN THE CARE OF VIRAL HEPATITIS","authors":"João Vítor da Mota Silva ,&nbsp;Aline Alves da Silva ,&nbsp;Elton Carlos de Almeida ,&nbsp;Leonardo Carrara Matsuura ,&nbsp;Isabelle Cristine de Jesus Macedo ,&nbsp;Ana Paula Maciel Gurski ,&nbsp;Ana Mônica de Mello ,&nbsp;José Nilton Neris Gomes ,&nbsp;Mario Peribanez Gonzalez ,&nbsp;João Vítor da Silva Mota ,&nbsp;Carla Francisca dos Santos Cruz ,&nbsp;Nathalia da Silva Cruz","doi":"10.1016/j.aohep.2025.102046","DOIUrl":"10.1016/j.aohep.2025.102046","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Georeferencing, by mapping geographic coordinates, helps evaluate the decentralization of health services, contributing to increased user access.</div><div>To map the network for diagnosis, treatment, and follow-up of viral hepatitis cases in the municipalities of Santa Catarina.</div></div><div><h3>Materials and Methods</h3><div>This is an evaluative, quantitative study with a descriptive approach. Data were collected through a questionnaire applied throughout Brazil. Santa Catarina was selected for this analysis due to the higher response rate from its municipalities. For service analysis, georeferencing techniques using geographic coordinates of institutions collected via Google Earth were employed, followed by the creation of thematic maps using QGIS software.</div></div><div><h3>Results</h3><div>The study covered 88.8% of municipalities. Regarding georeferencing of services, 99.2% of municipalities offer rapid tests for viral hepatitis. However, 19.5% do not collect biological material for molecular testing. Furthermore, 86.3% of municipalities do not perform molecular testing within their territory. Additionally, 46.2% of municipalities refer patients to specialized services in other municipalities for treatment. Moreover, 41.6% of the patients who require clinical follow-up also needed to travel for care.</div></div><div><h3>Conclusions</h3><div>Significant progress was observed in expanding access to viral hepatitis diagnosis, with nearly all municipalities offering rapid tests. However, challenges remain in decentralizing biological material collection and molecular test analysis, as well as in access to treatment and clinical follow-up. The need for patient travel compromises care comprehensiveness and hinders treatment adherence.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 102046"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154256","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 RELATIONSHIP BETWEEN QUALITY OF LIFE IN ADULT SUBJECTS WITH COMPENSATED LIVER CIRRHOSIS AND BACTERIAL OVERGROWTH","authors":"Nicole Chamorro Guzmán ,&nbsp;Ismael de Jesús Yepes Barreto ,&nbsp;Sindy Yohana Poveda Salinas","doi":"10.1016/j.aohep.2025.101983","DOIUrl":"10.1016/j.aohep.2025.101983","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Small intestinal bacterial overgrowth (SIBO) has been associated with greater severity of cirrhosis, as measured by the Child-Pugh classification, and with an increased incidence of complications. However, its impact on quality of life and on the progression of compensated liver cirrhosis has been scarcely studied.</div><div>To evaluate the relationship between SIBO and quality of life in patients with compensated liver cirrhosis treated at an outpatient Hepatology center in Cartagena de Indias, Colombia.</div></div><div><h3>Materials and Methods</h3><div>A cross-sectional and analytical study was conducted. Adult patients diagnosed with compensated liver cirrhosis and evaluated in the outpatient Hepatology clinic were included. A hydrogen breath test was used to detect SIBO, and the Chronic Liver Disease Questionnaire (CLDQ) was applied to assess quality of life. Patients with a positive SIBO result were treated with rifaximin according to clinical guidelines. A univariate linear regression analysis was used to examine the relationship between SIBO (independent variable) and CLDQ scores (dependent variable).</div></div><div><h3>Results</h3><div>Most participants were male (62.5%) with a mean age of 65 years. Hypertension was present in 53.1%, and 42.2% had type 2 diabetes. SIBO was detected in 29.7% of patients. The average CLDQ scores across evaluated domains did not show statistically significant differences between patients with and without SIBO: abdominal (p=1.21), fatigue (p=1.46), systemic (p=1.09), activity (p=1.18), emotional (p=0.87), and worry (p=1.00).</div></div><div><h3>Conclusions</h3><div>So far, no significant differences in quality of life have been found between patients with and without SIBO in compensated liver cirrhosis.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101983"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154236","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":"CHANGES IN BODY COMPOSITION AND HEPATIC ELASTOGRAPHY VALUES IN PATIENTS WITH METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE AT A MEDICAL CENTER IN CARTAGENA – COLOMBIA, DURING THE PERIOD FROM OCTOBER 2023 TO JANUARY 2025","authors":"Arturo Jose Viera Oliveros ,&nbsp;Ismael Yepes Barreto ,&nbsp;Yohana Poveda Salinas ,&nbsp;Fernando García del Risco","doi":"10.1016/j.aohep.2025.101985","DOIUrl":"10.1016/j.aohep.2025.101985","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by the accumulation of triglycerides in the liver, linked to cardiometabolic risk factors. Its global prevalence exceeds 30%, rising in parallel with overweight and type 2 diabetes. Visceral fat is associated with systemic inflammation and hepatic fat accumulation. Although elastography is useful for assessing disease progression, its high cost and limited availability necessitate the exploration of alternative tools. The use of body composition parameters has been proposed as potential predictors of disease progression.</div><div>To determine the relationship between changes in body composition and hepatic elastography values in patients with liver disease associated with metabolic dysfunction.</div></div><div><h3>Materials and Methods</h3><div>This was an analytical, observational, and prospective study. Patients over 18 years old with a previous diagnosis of steatotic liver disease were included. All underwent elastography and bioelectrical impedance analysis at baseline and after one year to assess progression risk factors. The patients signed the informed consent.</div></div><div><h3>Results</h3><div>A total of 88 patients were included, 52.3% of whom were women. Initial elastography readings averaged 9.2 kPa; the controlled attenuation parameter (CAP) was 269 dB/m. Factors associated with elevated liver stiffness included type 2 diabetes, chronic kidney disease, AST, APRI, and FIB-4 scores. During follow-up, smoking, alcohol consumption, CAP, and changes in body fat were linked to disease progression. In multivariate analysis, only smoking and baseline CAP were independent predictors.</div></div><div><h3>Conclusions</h3><div>Smoking and baseline CAP were significantly associated with the risk of MASLD progression, suggesting their potential utility in guiding timely interventions.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101985"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154238","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":"EXPLORING THE ROLE OF METABOLIC DYSFUNCTION IN ALCOHOL-ASSOCIATED HEPATITIS: A GLOBAL STUDY","authors":"María Ignacia Pérez Garayar ,&nbsp;Vania Cari Gormaz ,&nbsp;Ignacio Téllez ,&nbsp;Francisco Idalsoaga ,&nbsp;Gene Im ,&nbsp;Bastian Alcayaga ,&nbsp;Muzzafar Haque ,&nbsp;Stephanie Rutledge ,&nbsp;Hanna Blaney ,&nbsp;Pojsakorn Danpanichkul ,&nbsp;Arun Valsan ,&nbsp;Gowripriya Nair ,&nbsp;Gustavo Ayares ,&nbsp;Renata Farías ,&nbsp;Jorge Arnold ,&nbsp;Pedro Acuña ,&nbsp;Kaanthi Rama ,&nbsp;Carlos Esteban Coronel-Castillo ,&nbsp;María Ayala-Valverde ,&nbsp;Carolina Ramirez-Cadiz ,&nbsp;Juan Pablo Arab","doi":"10.1016/j.aohep.2025.101970","DOIUrl":"10.1016/j.aohep.2025.101970","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Severe alcohol-associated hepatitis (AH) carries high mortality. Although the role of cardiometabolic risk factors (CMRF)—including obesity, type 2 diabetes mellitus (T2DM), hypertension (HTN), and dyslipidemia (DLP)—has been characterized in steatotic liver disease, their role in the severity of AH remains unclear.</div><div>To evaluate the impact of CMRF on mortality and infection risk in AH.</div></div><div><h3>Materials and Methods</h3><div>Multinational prospective cohort study (2015–2024) including hospitalized patients with severe AH across 24 centers in 14 countries (Global AlcHep Network). Diagnosis of AH was done using NIAAA criteria. Analyses included competing-risk models, with liver transplantation as a competing risk. Models were adjusted by age, sex, ethnicity, history of cirrhosis, CMRF, corticosteroids use, MELD, and ACLF grade.</div></div><div><h3>Results</h3><div>935 participants were included. Median BMI was 24.2kg/m2, prevalence of T2DM was 21%, HTN 17%, DLP 7%. In adjusted competing-risk models, age (sHR 1.02, 95%CI: 1.01-1.04; p&lt;0.001), MELD (sHR 1.04, 95%CI: 1.01–1.06; p&lt;0.001), infections (sHR 1.76, 95%CI: 1.28–2.41; p&lt;0.001), and ACLF grade 2 (sHR 1.67, 95%CI: 1.05–2.69; p&lt;0.032) and 3 (sHR 3.06, 95%CI: 1.88–4.99; p&lt;0.001) were associated with higher risk of mortality, while obesity (sHR 0.67, 95%CI: 0.48–0.93; p=0.016) and corticosteroids use (sHR 0.67, 95%CI: 0.49–0.92; p=0.014) were associated with lower mortality. T2DM, HTN and DLP weren’t associated with higher mortality.</div></div><div><h3>Conclusions</h3><div>Metabolic dysfunction was not associated with increased mortality in AH. Although obesity may be a protective factor, these findings could be explained by a better nutritional status than the lean population.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101970"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154313","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}