Annals of hepatology最新文献

{"title":"#77 - INFLAMMATORY SARCOPENIA AS A MARKER OF POOR PROGNOSIS IN PATIENTS WITH LIVER CIRRHOSIS","authors":"Denise Silva,&nbsp;Júlia Teixeira,&nbsp;Thaís Dubik,&nbsp;Maurício Pedreira,&nbsp;Igor De Oliveira,&nbsp;Bruno Rocha,&nbsp;Fábio Lewin,&nbsp;Perla Mamone,&nbsp;Andrea Vieira,&nbsp;Roberto Da Silva-Júnior","doi":"10.1016/j.aohep.2026.102349","DOIUrl":"10.1016/j.aohep.2026.102349","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Sarcopenia is a frequent complication of liver cirrhosis and is associated with adverse clinical outcomes. Inflammatory sarcopenia (I-SP), defined by the coexistence of sarcopenia and systemic inflammation, has recently emerged as a potential marker of increased disease severity. To evaluate the prevalence of inflammatory sarcopenia in cirrhotic patients and its association with prognostic scores, including MELD-Na, Child-Pugh, and Albumin-Bilirubin (ALBI).</div></div><div><h3>Materials and Methods</h3><div>This retrospective cross-sectional study was conducted at the hepatology outpatient clinic of a Brazilian tertiary care center. Among 178 initially screened cirrhotic patients, 125 were eligible for sarcopenia assessment after exclusion of cases with inadequate computed tomography (CT) imaging, failed image processing, or incomplete data. For I-SP analysis, only patients with C-reactive protein (CRP) measured within seven days of CT acquisition were included, resulting in a final cohort of 77 patients. Sarcopenia was evaluated using the skeletal muscle index at the L3 vertebral level on CT images analyzed with an artificial intelligence–based software (SarcopenIA).</div></div><div><h3>Results</h3><div>Sarcopenia prevalence was 10.4%, while I-SP was identified in 9.1% of patients. Among sarcopenic individuals, 87.5% had CRP 0.5 mg/dL. Patients with I-SP showed higher median MELD-Na scores (15 vs. 11), higher frequency of Child-Pugh B/C (57.1% vs. 50.0%), and universal ALBI grades 2–3 compared with patients without I-SP, although differences were not statistically significant.</div></div><div><h3>Conclusions</h3><div>Inflammatory sarcopenia was associated with trends toward worse hepatic function and higher prognostic scores, suggesting its potential role as an early marker of increased disease severity in cirrhotic patients.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"31 ","pages":"Article 102349"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148810655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#82 - SURVIVAL OF ACUTE-ON-CHRONIC LIVER FAILURE ACCORDING TO CLINICAL SEVERITY IN A MEXICAN REFERRAL CENTER.","authors":"David Acosta-Sandoval,&nbsp;Francisco Arreola-Banda,&nbsp;Javier Carrillo-Rojas,&nbsp;Kiyoshi Miyagui-Adame,&nbsp;Mauricio Castillo-Barradas","doi":"10.1016/j.aohep.2026.102353","DOIUrl":"10.1016/j.aohep.2026.102353","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Acute-on-chronic liver failure (ACLF) causes high lethality due to multiorgan dysfunction. MELD-Na underestimates extrahepatic failures. Although the CLIF-C score overcomes this limitation, its validation in the Mexican population with a high metabolic prevalence is scarce.</div><div>The objective was to compare the predictive capacity of CLIF-C and MELD-Na for mortality at 7, 30, and 90 days in ACLF.</div></div><div><h3>Materials and Methods</h3><div>Retrospective cohort of adult patients with ACLF treated at a tertiary-care hospital in Mexico between 2022–2026. Demographic variables, etiology, precipitating factors, and prognostic scales were collected. The primary outcome was mortality at 7, 30, and 90 days. The discriminative ability of the CLIF-C Score and MELD-Na was evaluated using ROC curves and the area under the curve (AUC).</div></div><div><h3>Results</h3><div>A total of 170 patients were included. The median age was 60 years (IQR 49–66), and 48.8% were male. The main etiologies were metabolic (31.8%), autoimmune (22.4%), and alcohol (20%). Infection was the most frequent precipitant (46.5%). The predominant organ failures were renal (81.8%) and neurological (51.8%). ACLF grade 3 was present in 37.1% of patients. Mortality was 40% at 7 days, 60.4% at 30 days, and 71.8% at 90 days. The CLIF-C score showed better prognostic performance compared to MELD-Na for mortality at 7 days (AUC 0.795 vs 0.592), 30 days (0.762 vs 0.635), and 90 days (0.759 vs 0.588).</div></div><div><h3>Conclusions</h3><div>The CLIF-C score predicts mortality in ACLF significantly better than MELD-Na. Given the etiological shift toward metabolic etiology, its routine integration optimizes early stratification and critical decision-making.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"31 ","pages":"Article 102353"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148810659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#176 - CHARACTERIZING THE GLOBAL DISTRIBUTION OF ALCOHOL-RELATED OUTCOMES AND THEIR CORRELATION STRUCTURE ACROSS 185 COUNTRIES","authors":"Ximena Parraga,&nbsp;Fisher Rhoads,&nbsp;Kriti Soni,&nbsp;Rylyn Reyes,&nbsp;Denisse Rubio-Cruz,&nbsp;Joshua Chen,&nbsp;Adelina Horhat,&nbsp;Hyundam Gu,&nbsp;Vinay Jahagirdhar,&nbsp;Kavin Parmar,&nbsp;Krishan Patel,&nbsp;Stephen Hoang,&nbsp;Luis Díaz,&nbsp;Juan Arab","doi":"10.1016/j.aohep.2026.102284","DOIUrl":"10.1016/j.aohep.2026.102284","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>National \"standard drink\" definitions vary substantially across countries, potentially distorting alcohol risk communication and cross-country comparisons. Despite the WHO's 10-g ethanol benchmark, the global distribution of definitions and their relationship with alcohol-related outcomes remain poorly characterized. We aimed to describe the global landscape of standard drink definitions and their bivariate associations with HED, AUD, and cirrhosis mortality.</div></div><div><h3>Materials and Methods</h3><div>Cross-sectional ecological analysis across 185 countries using the 2024 WHO Global Status Report, WHO GSIAH, and World Bank data. The exposure was national standard drink size (grams ethanol). Outcomes included HED, AUD, and cirrhosis mortality (per 100,000). Spearman's rank correlation assessed bivariate relationships with alcohol per capita (APC) as potential confounder.</div></div><div><h3>Results</h3><div>Among 185 countries, 64 (34.6%) had available definitions (M=11.8g, SD=2.9; range 4-25g). Missingness was non-random, concentrated in African and Eastern Mediterranean regions. The Americas (63.6%, median 14g) and Europe (53%, median 10g) dominated the analytic sample. HED ranged 0.2-48.5% (M=20.2%), AUD averaged 2.3%, and cirrhosis mortality 7.4 per 100,000. APC strongly correlated with HED (=0.78). Standard drink size showed weak-to-modest associations with HED (=0.02), AUD (=0.07), and cirrhosis mortality (=0.16). Regional clustering was the primary confounding source.</div></div><div><h3>Conclusions</h3><div>Global variation in standard drink definitions limits alcohol surveillance comparability. Regional clustering and weak bivariate associations highlight the need for multivariable approaches to clarify public health implications.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"31 ","pages":"Article 102284"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148810723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#33 - IMPROVEMENT OF MASLD AND CARDIOMETABOLIC RISK FACTORS IS TRULY ACHIEVABLE THROUGH A MULTIDISCIPLINARY EDUCATIONAL PROGRAM","authors":"Fátima Higuera,&nbsp;Andres Burak,&nbsp;Kevin Vázquez,&nbsp;Omar Rodriguez-Zúñiga,&nbsp;Maria Castañeda-Aguilar,&nbsp;Marisol Zúñiga-Martínez,&nbsp;José Pérez Hernández,&nbsp;Juan Peralta-Calcáneo","doi":"10.1016/j.aohep.2026.102311","DOIUrl":"10.1016/j.aohep.2026.102311","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>MASLD affects approximately 38% of adults worldwide. Lifestyle modification is the cornerstone of treatment. Sustained adherence remains challenging. Aim: to evaluate a Structured Multidisciplinary Educational “University for Patients” Program (SMEUPP) aimed at improving metabolic and liver-related outcomes.</div></div><div><h3>Materials and Methods</h3><div>Patients with T2D and CAP-defined steatosis on vibration-controlled transient elastography (VCTE) were invited to participate in a SMEUPP, including MASLD education, cardiometabolic counseling, nutritional and psychological support, and individualized goals. Clinical, anthropometric, biochemical, metabolic, and VCTE outcomes were reassessed at 6 months and compared with usual-care (UC) using propensity score matching (PSM). Longitudinal changes were evaluated through mixed-effects models and ANCOVA; binary outcomes were assessed using matched-design regression methods.</div></div><div><h3>Results</h3><div>After PSM, 200 patients were analyzed: 100 in SMEUPP and 100 controls, with adequate baseline balance (standardized mean differences &lt;0.10). At 6 months, SMEUPP was associated with greater weight reduction, improved glycemic control, waist circumference, triglycerides, systolic blood pressure, and a significant decrease in CAP versus UC. Liver stiffness showed modest improvement, whereas ALT and AST reductions did not reach statistical significance (see Table). Adequate overall adherence was higher with SMEUPP (60% vs 36%; <em>p</em>=0.001), including follow-up attendance (74% vs 52%; <em>p</em>=0.001), nutritional adherence (57% vs 34%; <em>p</em>=0.001), and physical activity goals (46% vs 28%; <em>p</em>=0.009). Pharmacological adherence was higher in SMEUPP but did not significantly differ from UC (77% vs 68%, p = 0.154).</div></div><div><h3>Conclusions</h3><div>SMEUPP improved adherence and clinically relevant cardiometabolic and steatosis-related outcomes in patients with T2D and MASLD over 6 months.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"31 ","pages":"Article 102311"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148810456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#50 - INTEGRATED COST-EFFECTIVENESS OF SEMAGLUTIDE VERSUS HYPOTHETICAL RESMETIROM FOR MASH WITH F3 FIBROSIS AND CARDIOMETABOLIC OR RENAL COMORBIDITIES IN MEXICO: A MARKOV MODEL","authors":"Fátima Higuera,&nbsp;Anaís Servín-Higuera,&nbsp;Yoali Velasco-Santiago,&nbsp;José Pérez","doi":"10.1016/j.aohep.2026.102325","DOIUrl":"10.1016/j.aohep.2026.102325","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Semaglutide provides hepatic and extrahepatic benefits in metabolic dysfunction-associated steatohepatitis (MASH). We evaluated its integrated economic value versus hypothetical resmetirom and standard of care (SOC) in Mexico.</div></div><div><h3>Materials and Methods</h3><div>An exploratory Mexican public-payer model combined a 10-year, nine-state hepatic Markov core with evidence-compatible extrahepatic overlays. Costs and quality-adjusted life-years (QALYs) were discounted 5% annually. Eligible populations were derived through an ENSANUT-based epidemiological funnel; unobserved MASH F3 and comorbidity proportions were scenario assumptions. Hepatic benefit was informed by ESSENCE; cardiovascular/obesity benefit was added only for a SELECT-compatible phenotype (F3, overweight/obesity, established cardiovascular disease without diabetes); cardiorenal/metabolic benefit was added only for a FLOW-compatible phenotype (F3, type 2 diabetes and chronic kidney disease). SELECT and FLOW benefits were not combined within patients. Healthcare costs used IMSS 2026 tariffs. Semaglutide prices were MXN $117,788/year at regular retail price and MXN $70,673/year under Nuevo Yo®; hypothetical resmetirom was MXN $322,780/year. Non-Mexican extrahepatic cost savings were excluded. The threshold was MXN $253,264/QALY.</div></div><div><h3>Results</h3><div>Under Nuevo Yo®, semaglutide versus SOC yielded ICERs of MXN $2.97 million/QALY for hepatic benefit only, MXN $1.09 million/QALY in the SELECT-compatible scenario, and MXN $516,910/QALY in the FLOW-compatible scenario. The FLOW-compatible scenario required MXN $191,460/patient in additional Mexican cost offsets to reach the threshold. Hypothetical resmetirom yielded MXN $14.03 million/QALY; semaglutide dominated resmetirom in SELECT- and FLOW-compatible scenarios.</div></div><div><h3>Conclusions</h3><div>Extrahepatic benefits substantially improved semaglutide value, particularly in MASH F3 with diabetes and chronic kidney disease; local cardiorenal costs are required to confirm cost-effectiveness versus SOC for decision-making in Mexican public healthcare.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"31 ","pages":"Article 102325"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148810483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#45 - SARCOPENIA IN PATIENTS WITH LIVER CIRRHOSIS: ANALYSIS USING ARTIFICIAL INTELLIGENCE AND PROGNOSTIC CORRELATION","authors":"Thaís Dubik,&nbsp;Júlia Teixeira,&nbsp;Maurício Pedreira,&nbsp;Igor Oliveira,&nbsp;Bruno Rocha,&nbsp;Fábio Lewin,&nbsp;Perla Mamone,&nbsp;Andrea Vieira,&nbsp;Roberto Gomes","doi":"10.1016/j.aohep.2026.102320","DOIUrl":"10.1016/j.aohep.2026.102320","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Sarcopenia is a common complication of liver cirrhosis associated with poor prognosis, increased complications, and higher mortality. To evaluate the prevalence of sarcopenia in cirrhotic patients using the SARC-Calf questionnaire and automated tomographic analysis of the skeletal muscle index (SMI), correlating findings with prognostic parameters and clinical outcomes.</div></div><div><h3>Materials and Methods</h3><div>This longitudinal observational study included 125 cirrhotic patients followed at a tertiary hepatology outpatient clinic. Muscle assessment was performed using abdominal computed tomography at the L3 level with the SarcopenIA software for automated body composition analysis and SMI determination. Findings were correlated with MELD, Child-Pugh classification, serum albumin, liver transplantation, and mortality. The study was approved by the Ethics Committee of Irmandade da Santa Casa de Misericórdia de São Paulo.</div></div><div><h3>Results</h3><div>Sarcopenia prevalence was 20.8% according to SARC-Calf and 7.4% according to SMI. Among sarcopenic patients, 66.7% had hypoalbuminemia versus 30.3% of non-sarcopenic patients (p=0.0077). Child-Pugh B/C classification was more frequent in sarcopenic patients (66.7% vs. 34.8%; p=0.0214). Liver transplantation was performed in 33.3% of sarcopenic patients compared with 8.7% of non-sarcopenic patients (p=0.0133). Mortality was significantly higher in the sarcopenic group (33.3% vs. 5.5%; p=0.0022).</div></div><div><h3>Conclusions</h3><div>Sarcopenia was associated with worse liver function, increased need for liver transplantation, and higher mortality, reinforcing its prognostic relevance in liver cirrhosis.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"31 ","pages":"Article 102320"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148810508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#39 - CARDIAC CELLULAR SENESCENCE AND IGFBP-7 ASSOCIATED WITH CARDIOVASCULAR DAMAGE IN EXPERIMENTAL MODELS OF MASLD, METALD AND ALD","authors":"Edson Hernandez,&nbsp;Josué Jiménez,&nbsp;Francisco Nava,&nbsp;Itzel García,&nbsp;Gabriela Gutiérrez,&nbsp;Carolina Guzmán","doi":"10.1016/j.aohep.2026.102316","DOIUrl":"10.1016/j.aohep.2026.102316","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Metabolic dysfunction associated steatotic liver disease (MASLD), its variant with alcohol consumption (MetALD), and alcohol related liver disease (ALD) are associated with an increased cardiovascular risk (MASLD with a stronger association); however, the mechanisms of damage involved are unknown.</div><div>Senescence constitutes a response to cellular damage and the protein IGFBP-7, described as an inducer, could be involved in the cardiac alterations associated with these liver diseases.</div><div>Our objective was to evaluate cardiac cellular senescence and IGFBP-7 concentrations in experimental murine models of MASLD, MetALD and ALD.</div></div><div><h3>Patients and Methods</h3><div>Ten-week-old C57BL/6 mice (female and male) were divided into four groups: C (Control), HF (high-fat diet), OH (20% ethanol), and HFOH (HF and OH) for four months. Subsequently, hearts were collected (females in diestrus) and senescence associated -galactosidase was evaluated in frozen histological sections. IGFBP-7 was quantified from cardiac protein extract by ELISA. Statistical analysis was performed using Kruskal-Wallis followed by Dunn or Mann-Whitney; data expressed as median and interquartile range (25-75).</div></div><div><h3>Results</h3><div>In females, senescence associated -galactosidase in the heart increased significantly in the HFOH group compared to C (p=0.039). In males, IGFBP-7 quantification showed an increase in the OH group compared to C (p=0.03).</div></div><div><h3>Conclusions</h3><div>Consumption of a high-fat diet and ethanol promotes cardiac cellular senescence, particularly in females, suggesting possible sexual dimorphism. In males, IGFBP-7 is overexpressed with ethanol consumption. These findings suggest cellular senescence as a mechanism involved in the increased cardiovascular risk.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"31 ","pages":"Article 102316"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148810510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#74 - IMPACT OF MALNUTRITION IN PATIENTS DIAGNOSED WITH ALCOHOL-ASSOCIATED HEPATITIS","authors":"Ana Escobedo,&nbsp;Fátima Higuera,&nbsp;Ángel Santana,&nbsp;José Pérez","doi":"10.1016/j.aohep.2026.102346","DOIUrl":"10.1016/j.aohep.2026.102346","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Outcomes in patients diagnosed with alcohol-associated hepatitis are worse in those with sarcopenia, with increased mortality rates. Nutritional assessment is challenging due to fluid distribution abnormalities and third-space fluid accumulation. Bioelectrical impedance analysis (BIA) is a tool that more accurately evaluates the degree of sarcopenia.</div><div>To evaluate the prevalence of malnutrition assessed by phase angle using bioelectrical impedance analysis in patients with probable severe alcohol-associated hepatitis and to determine its association with 3-month mortality.</div></div><div><h3>Materials and Methods</h3><div>An observational, descriptive, prospective study was conducted in patients older than 18 years with a diagnosis of probable severe alcohol-associated hepatitis. Demographic, clinical, and biochemical variables were collected. All patients underwent bioelectrical impedance analysis. Malnutrition was defined as a phase angle &lt;5° in men and &lt;4.6° in women. Associations with 3-month mortality were analyzed using Fisher’s exact test and exploratory logistic regression models adjusted for MELD score.</div></div><div><h3>Results</h3><div>A total of 46 patients were included; 88.4% were male, with a mean age of 41.9 ± 7.2 years and a mean MELD score of 24.4 ± 7.5. The prevalence of malnutrition was 55.8%, and 3-month mortality was 41.3%. Patients with malnutrition had significantly higher mortality compared with those without malnutrition (58.3% vs. 10.5%; p=0.0016; OR=11.9). Infection was also associated with increased mortality (63.2% vs. 16.7%; p=0.0036). Phase angle demonstrated excellent discriminative ability for mortality (AUROC=0.93).</div></div><div><h3>Conclusions</h3><div>Malnutrition assessed by phase angle was significantly associated with mortality in alcohol-associated hepatitis and may represent a useful prognostic stratification tool.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"31 ","pages":"Article 102346"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148810643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#8 - PREFRAILTY AND FRAILTY PREDICT HOSPITALIZATION IN PATIENTS WITH CIRRHOSIS","authors":"Dagoberto Duarte,&nbsp;Ismael Yepes,&nbsp;Fernando García","doi":"10.1016/j.aohep.2026.102290","DOIUrl":"10.1016/j.aohep.2026.102290","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>The Liver Frailty Index (LFI) has emerged as a clinically relevant predictor of hospitalization and adverse outcomes in cirrhosis. However, the LFI validation has limited representation of Latin American patients. Given regional differences in muscle mass and strength, its prognostic performance may vary across populations. We aimed to evaluate the prognostic value of the LFI for hospitalization in patients with cirrhosis in Colombia.</div></div><div><h3>Materials and Methods</h3><div>We conducted a prospective observational cohort study including consecutive adult patients with cirrhosis attending an outpatient hepatology center. Frailty was assessed at baseline using the LFI, based on handgrip strength, chair stands, and balance tests, and categorised as robust (&lt;3.2), prefrail (3.2–4.5), or frail (&gt;4.5). Patients were followed every 60 days to assess hospitalization.</div></div><div><h3>Results</h3><div>A total of 121 patients were included; 61.2% were female, and most had compensated disease (80.8% Child–Pugh A, 19.2% Child–Pugh B). According to the LFI, 23.1% were robust, 57.0% prefrail, and 19.8% frail. During a median follow-up of 11.1 months, 26.4% experienced at least one hospitalization. Patients classified as Child–Pugh B had higher hospitalisation rates than those with Child–Pugh A (65.2% vs 16.5%, p &lt; 0.001).</div><div>Additional factors associated with hospitalization included prior hospitalization, first episode of hepatic decompensation, older age, lower body mass index, and lower serum albumin levels.</div></div><div><h3>Conclusions</h3><div>Liver Frailty Index was strongly associated with hospitalization risk among frail and prefrail patients. These findings indicate that prefragility represents a stage of vulnerability rather than a benign condition.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"31 ","pages":"Article 102290"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148810652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#89 - CAN NON-INVASIVE TESTS REPLACE LIVER BIOPSY IN MASH TRIALS? A TRIAL-LEVEL BAYESIAN SURROGACY ANALYSIS","authors":"Pedro Passos,&nbsp;Valbert Costa-Filho,&nbsp;Bernardo Moraes,&nbsp;Igor Silveira,&nbsp;Leonardo Süffert,&nbsp;Guilherme Cançado","doi":"10.1016/j.aohep.2026.102359","DOIUrl":"10.1016/j.aohep.2026.102359","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>MASH trials commonly rely on liver biopsy to assess efficacy, despite its invasiveness and cost. We evaluated the trial-level surrogacy and outcome-level association of changes in non-invasive tests (NITs), including liver stiffness measurement (LSM), MRI-derived liver fat content (LFC), fibrosis-4 score (FIB-4), and Enhanced-Liver-Fibrosis (ELF), with histological response.</div></div><div><h3>Materials and Methods</h3><div>We searched PubMed, Embase, and CENTRAL through February 2026 for MASH RCTs reporting serial NIT measurements and histological endpoints, including fibrosis improvement or MASH resolution. Trial-level surrogacy was assessed using the squared Bayesian posterior correlation of treatment effects. Associations with histological outcomes were estimated using measurement error models.</div></div><div><h3>Results</h3><div>Thirty-four studies were included. At the trial-level, treatment effects on all NITs showed weak correlations with histological improvement, except for LFC, which showed probable moderate surrogacy for MASH resolution (R²=53%, 95%CrI 3%–93%). For the remaining NITs, posterior probabilities of moderate or strong surrogacy were low. By contrast, a 30% relative reduction in LSM was likely associated with fibrosis improvement (OR 1.89, 95%CrI 1.00–3.14) and was near-certainly associated with MASH resolution (OR 2.57, 95%CrI 1.25–4.72). A 30% decrease in LFC was also near-certainly associated with MASH resolution (OR 1.94, 95%CrI 1.16–3.14). Probable-to-likely associations were additionally observed for FIB-4 and ELF with one or both histological outcomes.</div></div><div><h3>Conclusions</h3><div>Changes in LFC and LSM were associated with histological response at the outcome-level, but overall trial-level surrogacy was limited and imprecise across biomarkers. These findings suggest that consistent trial-level surrogacy remains unproven, although biomarker-specific utility exists.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"31 ","pages":"Article 102359"},"PeriodicalIF":6.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148810714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}