Influence of metabolic dysfunction-associated fatty liver disease on the prognosis of patients with HBV-related acute-on-chronic liver failure.

IF 3.8 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Expert Review of Gastroenterology & Hepatology Pub Date : 2024-01-01 Epub Date: 2024-01-08 DOI:10.1080/17474124.2023.2298261

Rui-Min Lai, Li-Xi Yao, Shan Lin, Jia-Hui Zhou, Bing-Ping Liu, Zhao-Yi Liang, Tianbin Chen, Jia-Ji Jiang, Qi Zheng, Yueyong Zhu

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Abstract

Objectives: Metabolic-associated fatty liver disease (MAFLD) has clinical relevance in patients with acute-on-chronic liver failure (ACLF). We investigated the association between MAFLD and prognosis in patients with ACLF.

Methods: We included patients with ACLF with available clinical data who visited our hospital for nearly 9 years. We compared the prognosis of patients in the different subgroups of ACLF and predicted the incidence of adverse outcomes. Moreover, a new model based on MAFLD was established.

Results: Among 339 participants, 75 had MAFLD. The prognosis of patients with ACLF was significantly correlated with MAFLD. Patients with ACLF with concomitant MAFLD tended to have a lower cumulative survival rate (p = 0.026) and a higher incidence of hepatorenal syndrome (9.33% versus 3.40%, p = 0.033) than those without MAFLD. We developed an TIM2 model and the area under the ROC curve of the new model for 30-day and 60-day mortality (0.759 and 0.748) was higher than other predictive methods.

Conclusion: The presence of MAFLD in patients with HBV-related ACLF was associated with an increased risk of in-hospital mortality. Moreover, The TIM2 model is a high-performance prognostic score for HBV-related ACLF.

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代谢功能障碍相关脂肪肝对 HBV 相关急性-慢性肝衰竭患者预后的影响。

目标：代谢相关性脂肪肝（MAFLD）在急性-慢性肝衰竭（ACLF）患者中具有临床意义。我们研究了代谢相关性脂肪肝与 ACLF 患者预后之间的关系：我们纳入了近 9 年来在我院就诊的、有临床数据的 ACLF 患者。我们比较了 ACLF 不同亚组患者的预后，并预测了不良预后的发生率。此外，我们还建立了一个基于 MAFLD 的新模型：在 339 名参与者中，75 人患有 MAFLD。前交叉韧带纤维炎患者的预后与 MAFLD 显著相关。与无 MAFLD 的患者相比，伴有 MAFLD 的 ACLF 患者的累积存活率较低（p = 0.026），肝肾综合征的发生率较高（9.33% 对 3.40%，p = 0.033）。我们建立了一个 MIT2 模型，新模型对 30 天和 60 天死亡率的 ROC 曲线下面积（0.759 和 0.748）高于其他预测方法：结论：HBV 相关 ACLF 患者出现 MAFLD 与院内死亡风险增加有关。此外，TIM2 模型是一种高效的 HBV 相关 ACLF 预后评分方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Gastroenterology & Hepatology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

6.80

自引率

2.60%

发文量

审稿时长

6-12 weeks

期刊介绍： The enormous health and economic burden of gastrointestinal disease worldwide warrants a sharp focus on the etiology, epidemiology, prevention, diagnosis, treatment and development of new therapies. By the end of the last century we had seen enormous advances, both in technologies to visualize disease and in curative therapies in areas such as gastric ulcer, with the advent first of the H2-antagonists and then the proton pump inhibitors - clear examples of how advances in medicine can massively benefit the patient. Nevertheless, specialists face ongoing challenges from a wide array of diseases of diverse etiology.