PMID- 32970356
OWN - NLM
STAT- MEDLINE
DCOM- 20210621
LR  - 20210623
IS  - 1478-3231 (Electronic)
IS  - 1478-3223 (Linking)
VI  - 41
IP  - 1
DP  - 2021 Jan
TI  - Impact of metabolic risk factors on the severity and outcome of patients with 
      alcohol-associated acute-on-chronic liver failure.
PG  - 150-157
LID - 10.1111/liv.14671 [doi]
AB  - BACKGROUND: Metabolic risk factors may impact the severity and outcome of 
      alcoholic liver disease. The present study evaluated this effect in patients with 
      alcohol-associated acute-on-chronic liver failure (ACLF). METHODOLOGY: One 
      thousand two hundred and sixteen prospectively enrolled patients with ACLF (males 
      98%, mean age 42.5 +/- 9.4 years, mean CTP, MELD and AARC scores of 12 +/- 1.4, 
      29.7 +/- 7 and 9.8 +/- 2 respectively) from the Asian Pacific Association for the 
      Study of the Liver (APASL) ACLF Research Consortium (AARC) database were analysed 
      retrospectively. Patients with or without metabolic risk factors were compared 
      for severity (CTP, MELD, AARC scores) and day 30 and 90 mortality. Information on 
      overweight/obesity, type 2 diabetes mellitus (T2DM), hypertension and 
      dyslipidaemia were available in 1028 (85%), 1019 (84%), 1017 (84%) and 965 (79%) 
      patients respectively. RESULTS: Overall, 392 (32%) patients died at day 30 and 
      528 (43%) at day 90. Overweight/obesity, T2DM, hypertension and dyslipidaemia 
      were present in 154 (15%), 142 (14%), 66 (7%) and 141 (15%) patients, 
      respectively, with no risk factors in 809 (67%) patients. Patients with 
      overweight/obesity had higher MELD scores (30.6 +/- 7.1 vs 29.2 +/- 6.9, P = .007) 
      and those with dyslipidaemia had higher AARC scores (10.4 +/- 1.2 vs 9.8 +/- 2, 
      P = .014). Overweight/obesity was associated with increased day 30 mortality (HR 
      1.54, 95% CI 1.06-2.24, P = .023). None of other metabolic risk factors, alone or 
      in combination, had any impact on disease severity or mortality. On multivariate 
      analysis, overweight or obesity was significantly associated with 30-day 
      mortality (aHR 1.91, 95% CI 1.41-2.59, P < .001), independent of age, CTP, MELD 
      and AARC scores. CONCLUSION: Overweight/obesity and dyslipidaemia increase the 
      severity of alcohol-associated ACLF, and the former also increases the short-term 
      mortality in these patients.
CI  - (c) 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Duseja, Ajay
AU  - Duseja A
AUID- ORCID: 0000-0003-3590-2664
AD  - Department of Hepatology, Postgraduate Institute of Medical Education and 
      Research, Chandigarh, India.
FAU - De, Arka
AU  - De A
AUID- ORCID: 0000-0002-8567-1676
AD  - Department of Hepatology, Postgraduate Institute of Medical Education and 
      Research, Chandigarh, India.
FAU - Taneja, Sunil
AU  - Taneja S
AUID- ORCID: 0000-0003-3901-6969
AD  - Department of Hepatology, Postgraduate Institute of Medical Education and 
      Research, Chandigarh, India.
FAU - Choudhury, Ashok Kumar
AU  - Choudhury AK
AUID- ORCID: 0000-0001-6540-2623
AD  - Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 
      India.
FAU - Devarbhavi, Harshad
AU  - Devarbhavi H
AUID- ORCID: 0000-0002-3593-3746
AD  - Department of Gastroenterology, St John's Medical College Hospital, Bangalore, 
      India.
FAU - Hu, Jinhua
AU  - Hu J
AUID- ORCID: 0000-0002-0647-9898
AD  - Liver Failure Treatment and Research Center, 302 Military Hospital of China, 
      Beijing, China.
FAU - Hamid, Saeed S
AU  - Hamid SS
AD  - The Aga Khan University, Karachi, Pakistan.
FAU - Butt, Amna Subhan
AU  - Butt AS
AD  - The Aga Khan University, Karachi, Pakistan.
FAU - Jafri, Syed Muhammad Wasim
AU  - Jafri SMW
AD  - The Aga Khan University, Karachi, Pakistan.
FAU - Ghazinian, Hasmik
AU  - Ghazinian H
AD  - Department of Hepatology, Nork Clinical Hospital of Infectious Diseases, Yerevan, 
      Armenia.
FAU - Chawla, Yogesh K
AU  - Chawla YK
AD  - Department of Hepatology, Postgraduate Institute of Medical Education and 
      Research, Chandigarh, India.
FAU - Dhiman, Radha K
AU  - Dhiman RK
AD  - Department of Hepatology, Postgraduate Institute of Medical Education and 
      Research, Chandigarh, India.
FAU - Duan, Zhongping
AU  - Duan Z
AUID- ORCID: 0000-0002-2188-9692
AD  - Beijing Youan Hospital, Capital Medical University, Beijing, China.
FAU - Chen, Yu
AU  - Chen Y
AD  - Beijing Youan Hospital, Capital Medical University, Beijing, China.
FAU - Tan, Soek Siam
AU  - Tan SS
AD  - Department of Hepatology, Selayang Hospital, Selangor, Malaysia.
FAU - Lee, Guan Huei
AU  - Lee GH
AD  - Division of Gastroenterology and Hepatology, National University Health System, 
      Singapore.
FAU - Lim, Seng Gee
AU  - Lim SG
AD  - Medicine, Yong Loo Lin School of Medicine, Singapore.
FAU - Kim, Dong Joon
AU  - Kim DJ
AUID- ORCID: 0000-0002-5792-1500
AD  - Hallym University Medical Center, Seoul, Korea.
FAU - Sahu, Manoj
AU  - Sahu M
AD  - ISM and SUM Hospital, Bhubaneswar, India.
FAU - Sollano, Jose D
AU  - Sollano JD
AD  - Medicine, Santo Tomas, Manila, Philippines.
FAU - Carpio, Gian
AU  - Carpio G
AD  - University of Santo Tomas, Manila, Philippines.
FAU - Mohan Prasad, Virukalpatti Gopalratnam
AU  - Mohan Prasad VG
AD  - VGM Hospital, Coimbatore, India.
FAU - Abbas, Zaigham
AU  - Abbas Z
AD  - Department of Hepatogastroenterology, Ziauddin University, Karachi, Pakistan.
FAU - Lesmana, Laurentius A
AU  - Lesmana LA
AD  - Medicine, Medistra Hospital, South Jakarta, Indonesia.
FAU - Lesmana, Cosmas Rinaldi
AU  - Lesmana CR
AD  - Medicine, Medistra Hospital, South Jakarta, Indonesia.
FAU - Eapen, Chundamannil E
AU  - Eapen CE
AD  - Christian Medical College, Vellore, India.
FAU - Goel, Ashish
AU  - Goel A
AUID- ORCID: 0000-0003-1659-2103
AD  - Christian Medical College, Vellore, India.
FAU - Sood, Ajit
AU  - Sood A
AD  - Dayanand Medical College and Hospital, Ludhiana, India.
FAU - Midha, Vandana
AU  - Midha V
AD  - Dayanand Medical College and Hospital, Ludhiana, India.
FAU - Goyal, Omesh
AU  - Goyal O
AUID- ORCID: 0000-0002-6347-0988
AD  - Dayanand Medical College and Hospital, Ludhiana, India.
FAU - Dokmeci, Abdul Kadir
AU  - Dokmeci AK
AD  - Department of Gastroenterology, Ankara University, Ankara, Turkey.
FAU - Ning, Qin
AU  - Ning Q
AUID- ORCID: 0000-0002-2027-9593
AD  - Tongji Medical College, Wuhan, China.
FAU - Chen, Tao
AU  - Chen T
AD  - Tongji Medical College, Wuhan, China.
FAU - Ma, Ke
AU  - Ma K
AD  - Tongji Medical College, Wuhan, China.
FAU - Payawal, Diana A
AU  - Payawal DA
AD  - Cardinal Santos Medical Center, San Juan, Philippines.
FAU - Lau, George K K
AU  - Lau GKK
AUID- ORCID: 0000-0002-8928-3769
AD  - Humanity and Health Medical Centre, Hong Kong.
FAU - Al Mahtab, Mamun
AU  - Al Mahtab M
AD  - Seth GS Medical College & Kem Hospital, Mumbai, India.
FAU - Rahman, Salimur
AU  - Rahman S
AD  - Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, 
      Bangladesh.
FAU - Alam, Mohd Shahinul
AU  - Alam MS
AUID- ORCID: 0000-0002-3565-208X
AD  - Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, 
      Bangladesh.
FAU - Shukla, Akash
AU  - Shukla A
AUID- ORCID: 0000-0001-7718-9452
AD  - Seth GS Medical College & Kem Hospital, Mumbai, India.
FAU - Shrestha, Ananta
AU  - Shrestha A
AD  - Foundation Nepal Sitapaila Height, Kathmandu, Nepal.
FAU - Shah, Samir
AU  - Shah S
AD  - Hepatology, Global Hospital, Mumbai, India.
FAU - Kalal, Chetan Ramesh
AU  - Kalal CR
AD  - Hepatology, Global Hospital, Mumbai, India.
FAU - Kumar, Guresh
AU  - Kumar G
AD  - Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India.
FAU - Jain, Priyanka
AU  - Jain P
AD  - Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India.
FAU - Paulson, Irene
AU  - Paulson I
AD  - Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 
      India.
FAU - Sarin, Shiv Kumar
AU  - Sarin SK
AUID- ORCID: 0000-0002-0544-5610
AD  - Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 
      India.
CN  - APASL ACLF Working Party, APASL ACLF Research Consortium (AARC)
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Liver Int
JT  - Liver international : official journal of the International Association for the 
      Study of the Liver
JID - 101160857
SB  - IM
CIN - Liver Int. 2021 Jun;41(6):1438. PMID: 33813798
MH  - *Acute-On-Chronic Liver Failure/epidemiology/etiology
MH  - Adult
MH  - *Diabetes Mellitus, Type 2
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
OTO - NOTNLM
OT  - NAFLD
OT  - NASH
OT  - alcoholic hepatitis
OT  - liver failure
OT  - metabolic syndrome
OT  - non-alcoholic fatty liver disease
OT  - obesity
EDAT- 2020/09/25 06:00
MHDA- 2021/06/22 06:00
CRDT- 2020/09/24 12:14
PHST- 2020/03/12 00:00 [received]
PHST- 2020/09/10 00:00 [revised]
PHST- 2020/09/14 00:00 [accepted]
PHST- 2020/09/25 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/09/24 12:14 [entrez]
AID - 10.1111/liv.14671 [doi]
PST - ppublish
SO  - Liver Int. 2021 Jan;41(1):150-157. doi: 10.1111/liv.14671.