MASLD与需要入院治疗的严重细菌感染风险增加之间的关系：荟萃分析

IF 6 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Liver International Pub Date : 2024-09-11 DOI:10.1111/liv.16101

Alessandro Mantovani, Riccardo Morandin, Veronica Fiorio, Maria Giovanna Lando, Alberto Gaviraghi, Leonardo Motta, Federico Gobbi, Herbert Tilg, Christopher D. Byrne, Giovanni Targher

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引用次数: 0

摘要

背景以前的研究报告了代谢功能障碍相关性脂肪性肝病（MASLD）与严重细菌感染风险之间的关系。然而，这种风险的大小以及这种风险是否随 MASLD 的严重程度而变化仍不确定。我们对观察性研究进行了一项荟萃分析，以量化MASLD与需要入院治疗的严重细菌感染之间的关联。方法我们使用预定义的关键词系统地检索了PubMed、Scopus、Web of Science和Embase等数据库，检索时间从数据库建立之初到2024年4月1日，以确定在MASLD患者和非MASLD患者中考察严重细菌感染风险的研究。MASLD通过肝脏活检、影像学检查或国际疾病分类代码进行诊断。结果我们发现了六项横断面研究和两项前瞻性队列研究，共收集了约 2660 万人的数据。MASLD与较高的严重细菌感染几率明显相关（汇总随机效应几率比 1.93，95% 置信区间 [CI] 1.44-2.58；I2 = 93%）。前瞻性队列研究的 Meta 分析表明，MAFLD 与发生严重细菌感染的风险增加有关（汇总随机效应危险比 1.80，95% 置信区间 [CI] 1.62-2.0；I2 = 89%）。这一风险随着MASLD的严重程度，尤其是纤维化的严重程度而进一步增加（汇总随机效应危险比2.42，95% CI 1.89-2.29；I2 = 92%）。在对年龄、性别、肥胖、糖尿病和其他潜在混杂因素进行调整后，这些结果仍具有显著性。敏感性分析并未改变这些结果。结论这项荟萃分析表明，MASLD 与需要入院治疗的严重细菌感染风险增加之间存在显著关联。

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Association between MASLD and increased risk of serious bacterial infections requiring hospital admission: A meta‐analysis

BackgroundPrevious studies have reported an association between metabolic dysfunction‐associated steatotic liver disease (MASLD) and the risk of serious bacterial infections. However, the magnitude of the risk and whether this risk varies with the severity of MASLD remains uncertain. We performed a meta‐analysis of observational studies to quantify the association between MASLD and serious bacterial infections requiring hospital admission.MethodsWe systematically searched PubMed, Scopus, Web of Science and Embase from database inception to 1 April 2024, using predefined keywords to identify studies examining the risk of serious bacterial infections among individuals with and without MASLD. MASLD was diagnosed using liver biopsy, imaging or International Classification of Diseases codes. Meta‐analysis was performed using random‐effects modelling.ResultsWe identified six cross‐sectional and two prospective cohort studies with aggregate data on ~26.6 million individuals. MASLD was significantly associated with higher odds of serious bacterial infections (pooled random‐effects odds ratio 1.93, 95% confidence interval [CI] 1.44–2.58; I2 = 93%). Meta‐analysis of prospective cohort studies showed that MAFLD was associated with an increased risk of developing serious bacterial infections (pooled random‐effects hazard ratio 1.80, 95% CI 1.62–2.0; I2 = 89%). This risk further increased across the severity of MASLD, especially the severity of fibrosis (pooled random‐effects hazard ratio 2.42, 95% CI 1.89–2.29; I2 = 92%). These results remained significant after adjusting for age, sex, obesity, diabetes and other potential confounders. Sensitivity analyses did not modify these findings. The funnel plot did not reveal any significant publication bias.ConclusionsThis meta‐analysis shows a significant association between MASLD and an increased risk of serious bacterial infections requiring hospital admission.

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来源期刊

Liver International 医学-胃肠肝病学

CiteScore

13.90

自引率

4.50%

发文量

348

审稿时长

2 months

期刊介绍： Liver International promotes all aspects of the science of hepatology from basic research to applied clinical studies. Providing an international forum for the publication of high-quality original research in hepatology, it is an essential resource for everyone working on normal and abnormal structure and function in the liver and its constituent cells, including clinicians and basic scientists involved in the multi-disciplinary field of hepatology. The journal welcomes articles from all fields of hepatology, which may be published as original articles, brief definitive reports, reviews, mini-reviews, images in hepatology and letters to the Editor.