Ming Zhao, Xinyu Han, Hong Fan, Chenyu Liang, Haili Wang, Xin Zhang, Shuzhen Zhao, Chengnan Guo, Zhenqiu Liu, Tiejun Zhang
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Multivariable-adjusted Cox regression was used to estimate hazard ratios (HR) for severe infections in patients with MASLD compared to the non-SLD group. Cumulative incidences were calculated while accounting for competing risks (non-infection-related deaths). Mediation analyses were performed to explore the roles of cardiometabolic risk factors in the association between MASLD and severe infections.</p><p><strong>Results: </strong>Among the 33 072 eligible participants (mean age 56.37 years; 38.20% male), 11 908 (36.01%) were diagnosed with MASLD at baseline. Severe infections occurred in 912 (7.66%) MASLD patients and 1258 (5.94%) non-SLD. The rate of severe infections per 1000 person-years was higher in MASLD patients (13.58) than in comparators (10.48) (fully adjusted HR 1.18, 95% CI 1.07-1.30). The most frequent infections in MASLD were respiratory (7.25/1000 person-years) and urinary tract infections (2.61/1000 person-years). The 5-year cumulative incidence of severe infections was 6.79% (95% CI 6.36-7.26) in MASLD and 5.08% (95% CI 4.79-5.38) in comparators. Cardiometabolic risk factors, including waist circumference, triglycerides and HbA1C, partially mediate the association between MASLD and severe infections.</p><p><strong>Conclusions: </strong>Patients with MASLD were at significantly higher risk of incident severe infections compared to the non-SLD group. 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We categorised the participants into the MASLD group and those without steatotic liver disease (non-SLD). Multivariable-adjusted Cox regression was used to estimate hazard ratios (HR) for severe infections in patients with MASLD compared to the non-SLD group. Cumulative incidences were calculated while accounting for competing risks (non-infection-related deaths). Mediation analyses were performed to explore the roles of cardiometabolic risk factors in the association between MASLD and severe infections.</p><p><strong>Results: </strong>Among the 33 072 eligible participants (mean age 56.37 years; 38.20% male), 11 908 (36.01%) were diagnosed with MASLD at baseline. Severe infections occurred in 912 (7.66%) MASLD patients and 1258 (5.94%) non-SLD. The rate of severe infections per 1000 person-years was higher in MASLD patients (13.58) than in comparators (10.48) (fully adjusted HR 1.18, 95% CI 1.07-1.30). 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引用次数: 0
摘要
背景和目的:代谢功能障碍相关性脂肪性肝病(MASLD)与多种肝内外疾病有关,但其与严重感染性疾病的关系仍有待研究:我们分析了上海郊区成人队列和生物库的数据,包括2016年和2017年入组、有腹部超声造影数据的参与者,并随访至2022年12月(中位随访时间=5.71年)。我们将参与者分为MASLD组和无脂肪性肝病(非SLD)组。与非脂肪肝组相比,我们采用多变量调整后的 Cox 回归来估算 MASLD 患者发生严重感染的危险比 (HR)。在考虑竞争风险(非感染相关死亡)的同时,还计算了累积发病率。研究人员还进行了中介分析,以探讨心脏代谢风险因素在MASLD与严重感染之间关系中的作用:在 33 072 名符合条件的参与者(平均年龄 56.37 岁;38.20% 为男性)中,有 11 908 人(36.01%)在基线时被诊断为 MASLD。912名(7.66%)MASLD患者和1258名(5.94%)非SLD患者发生了严重感染。MASLD 患者的每千人年严重感染率(13.58)高于对照组(10.48)(完全调整 HR 1.18,95% CI 1.07-1.30)。MASLD患者最常见的感染是呼吸道感染(7.25/1000人-年)和尿路感染(2.61/1000人-年)。MASLD患者严重感染的5年累计发生率为6.79%(95% CI 6.36-7.26),而对照组为5.08%(95% CI 4.79-5.38)。包括腰围、甘油三酯和 HbA1C 在内的心脏代谢风险因素部分介导了 MASLD 与严重感染之间的关联:结论:与非SLD组相比,MASLD患者发生严重感染的风险明显更高。未来的研究需要阐明MASLD与严重感染之间的关联机制。
Metabolic Dysfunction-Associated Steatotic Liver Disease Increases the Risk of Severe Infection: A Population-Based Cohort Study.
Background and aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is linked to various intrahepatic and extrahepatic diseases, but its association with severe infectious disease remains to be investigated.
Methods: We analysed data from the Shanghai Suburban Adult Cohort and Biobank, encompassing participants enrolled in 2016 and 2017 with available abdominal ultrasonography data, and followed them up until December 2022 (median follow-up = 5.71 years). We categorised the participants into the MASLD group and those without steatotic liver disease (non-SLD). Multivariable-adjusted Cox regression was used to estimate hazard ratios (HR) for severe infections in patients with MASLD compared to the non-SLD group. Cumulative incidences were calculated while accounting for competing risks (non-infection-related deaths). Mediation analyses were performed to explore the roles of cardiometabolic risk factors in the association between MASLD and severe infections.
Results: Among the 33 072 eligible participants (mean age 56.37 years; 38.20% male), 11 908 (36.01%) were diagnosed with MASLD at baseline. Severe infections occurred in 912 (7.66%) MASLD patients and 1258 (5.94%) non-SLD. The rate of severe infections per 1000 person-years was higher in MASLD patients (13.58) than in comparators (10.48) (fully adjusted HR 1.18, 95% CI 1.07-1.30). The most frequent infections in MASLD were respiratory (7.25/1000 person-years) and urinary tract infections (2.61/1000 person-years). The 5-year cumulative incidence of severe infections was 6.79% (95% CI 6.36-7.26) in MASLD and 5.08% (95% CI 4.79-5.38) in comparators. Cardiometabolic risk factors, including waist circumference, triglycerides and HbA1C, partially mediate the association between MASLD and severe infections.
Conclusions: Patients with MASLD were at significantly higher risk of incident severe infections compared to the non-SLD group. Future studies are needed to elucidate the mechanisms linking MASLD to severe infections.
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.