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Title: Impact of Metabolic Risk Factors on the Severity and Outcome of Patients with Alcohol Associated Acute-on-Chronic Liver Failure.
Authors: Duseja, Ajay
De, Arka
Taneja, Sunil
Choudhury, Ashok Kumar
Devarbhavi, Harshad
Hu, Jinhua
Hamid, Saeed S
Butt, Amna Subhan
Jafri, Syed Muhammad Wasim
Ghazinian, Hasmik
Chawla, Yogesh K
Dhiman, Radha K
Duan, Zhongping
Chen, Yu
Tan, Seok Siam
Kim, Dong Joon
Sahu, Manoj
Sollano, Jose D
Carpio, Gian
Prasad, VG Mohan
Abbas, Zaigham
Lesmana, Laurentius A
Lesmana, Cosmas Rinaldi
Eapen, CE
Goel, Ashish
Sood, Ajit
Midha, Vandana
Goyal, Omesh
Dokmeci, Abdul Kadir
Ning, Qin
Chen, Tao
Ma, Ke
Payawal, Diana A
Lau, George KK
Mahtab, Mamun Al
Rahman, Salimur
Alam, Mohd Shahinul
Shukla, Akash
Shrestha, Ananta
Shah, Samir
Kalal, Chetan Ramesh
Kumar, Guresh
Jain, Priyanka
Paulson, Irene
Sarin, Shiv Kumar
APASL ACLF working Party, APASL ACLF Research Consortium (AARC)
Keywords: Liver failure
alcoholic hepatitis
metabolic syndrome
non-alcoholic fatty liver disease
Issue Date: 24-Sep-2020
Publisher: Wiley
Citation: Duseja, Ajay, De, Arka, Taneja, Sunil, Choudhury, Ashok Kumar, Devarbhavi, Harshad, Hu, Jinhua, Hamid, Saeed S, Butt, Amna Subhan, Jafri, Syed Muhammad Wasim, Ghazinian, Hasmik, Chawla, Yogesh K, Dhiman, Radha K, Duan, Zhongping, Chen, Yu, Tan, Seok Siam, LEE GUAN HUEI, LIM SENG GEE, Kim, Dong Joon, Sahu, Manoj, Sollano, Jose D, Carpio, Gian, Prasad, VG Mohan, Abbas, Zaigham, Lesmana, Laurentius A, Lesmana, Cosmas Rinaldi, Eapen, CE, Goel, Ashish, Sood, Ajit, Midha, Vandana, Goyal, Omesh, Dokmeci, Abdul Kadir, Ning, Qin, Chen, Tao, Ma, Ke, Payawal, Diana A, Lau, George KK, Mahtab, Mamun Al, Rahman, Salimur, Alam, Mohd Shahinul, Shukla, Akash, Shrestha, Ananta, Shah, Samir, Kalal, Chetan Ramesh, Kumar, Guresh, Jain, Priyanka, Paulson, Irene, Sarin, Shiv Kumar, APASL ACLF working Party, APASL ACLF Research Consortium (AARC) (2020-09-24). Impact of Metabolic Risk Factors on the Severity and Outcome of Patients with Alcohol Associated Acute-on-Chronic Liver Failure.. Liver international 41 (1) : 150-157. ScholarBank@NUS Repository.
Abstract: BACKGROUND: Metabolic risk factors may impact the severity and outcome of alcoholic liver disease. Present study evaluated this effect in patients with alcohol associated acute-on-chronic liver failure(ACLF). METHODOLOGY: 1216 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] data base 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 dyslipidemia 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 dyslipidemia 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=0.007) and those with dyslipidemia had higher AARC scores (10.4±1.2 vs 9.8±2, p=0.014). Overweight/ obesity were associated with increased day 30 mortality (HR 1.54, 95% C.I 1.06-2.24, p=0.023). 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% C.I 1.41-2.59,p<0.001),independent of age, CTP, MELD and AARC scores. CONCLUSION: Overweight/obesity and dyslipidemia increase the severity of alcohol associated ACLF, and the former also increases the short-term mortality in these patients.
Source Title: Liver international
ISSN: 1478-3223
DOI: 10.1111/liv.14671
Appears in Collections:Staff Publications

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