Impact of hepatic steatosis on treatment response of autoimmune hepatitis: A retrospective multicentre analysis
BackgroundThere is a paucity of data on whether steatosis impacts autoimmune hepatitis (AIH) treatment response. We aimed to evaluate the influence of baseline steatosis on the biochemical response, fibrosis progression, and adverse longterm outcomes of AIH.MethodsSteatosis was diagnosed by a contro...
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1040029/full |
| _version_ | 1811177768256274432 |
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| author | Peiyan Liu Peiyan Liu Mingkai Li Mingkai Li Lili Zhao Lili Zhao Hongsheng Yu Chang Zhao Jianning Chen Ruifang Shi Li Zhou Qi Zhou Qi Zhou Bin Wu Bin Wu Jia Li |
| author_facet | Peiyan Liu Peiyan Liu Mingkai Li Mingkai Li Lili Zhao Lili Zhao Hongsheng Yu Chang Zhao Jianning Chen Ruifang Shi Li Zhou Qi Zhou Qi Zhou Bin Wu Bin Wu Jia Li |
| author_sort | Peiyan Liu |
| collection | DOAJ |
| description | BackgroundThere is a paucity of data on whether steatosis impacts autoimmune hepatitis (AIH) treatment response. We aimed to evaluate the influence of baseline steatosis on the biochemical response, fibrosis progression, and adverse longterm outcomes of AIH.MethodsSteatosis was diagnosed by a controlled attenuation parameter (CAP) ≥ 248 dB / m. Only patients who underwent immunosuppressive therapy with available liver histological material at diagnosis and qualified CAP within seven days of the liver biopsy were included. Univariate and multivariate analyses were subsequently conducted.ResultsThe multicentre and retrospective cohort enrolled 222 subjects (88.3% female, median age 54 years, median follow-up 48 months) in the final analysis, and 56 (25.2%) patients had hepatic steatosis. Diabetes, hypertension, and significant fibrosis at baseline were more common in the steatosis group than in the no steatosis group. After adjusting for confounding factors, hepatic steatosis was an independent predictor of insufficient biochemical response (OR: 8.07) and identified as an independent predictor of long-term adverse outcomes (HR: 4.07). By subgroup multivariate analysis (different degrees of steatosis, fibrosis, and prednisone dose), hepatic steatosis independently showed a relatively stable correlation with treatment response. Furthermore, in contrast to those without steatosis, a significant increase in liver stiffness (LS) was observed in patients with steatosis (4.1%/year vs. -16%/year, P < 0.001).ConclusionsConcomitant hepatic steatosis was significantly associated with poor response to treatment in AIH patients. Routine CAP measurements are therefore essential to guide the management of AIH. |
| first_indexed | 2024-04-11T06:06:41Z |
| format | Article |
| id | doaj.art-a79f0b7f84994549a0dd146eb6a6928c |
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| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-11T06:06:41Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-a79f0b7f84994549a0dd146eb6a6928c2022-12-22T04:41:29ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-12-011310.3389/fimmu.2022.10400291040029Impact of hepatic steatosis on treatment response of autoimmune hepatitis: A retrospective multicentre analysisPeiyan Liu0Peiyan Liu1Mingkai Li2Mingkai Li3Lili Zhao4Lili Zhao5Hongsheng Yu6Chang Zhao7Jianning Chen8Ruifang Shi9Li Zhou10Qi Zhou11Qi Zhou12Bin Wu13Bin Wu14Jia Li15Clinical School of the Second People’s Hospital, Tianjin Medical University, Tianjin, ChinaDepartment of Hepatology, Tianjin Second People’s Hospital, Tianjin, ChinaDepartment of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaClinical School of the Second People’s Hospital, Tianjin Medical University, Tianjin, ChinaDepartment of Hepatology, Tianjin Second People’s Hospital, Tianjin, ChinaDepartment of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaDepartment of Pathology, The Lingnan Hospital of Sun Yat-Sen University, Guangzhou, ChinaDepartment of Pathology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaDepartment of Pathology, Tianjin Second People’s Hospital, Tianjin, ChinaDepartment of Hepatology, Tianjin Second People’s Hospital, Tianjin, ChinaDepartment of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaDepartment of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaDepartment of Hepatology, Tianjin Second People’s Hospital, Tianjin, ChinaBackgroundThere is a paucity of data on whether steatosis impacts autoimmune hepatitis (AIH) treatment response. We aimed to evaluate the influence of baseline steatosis on the biochemical response, fibrosis progression, and adverse longterm outcomes of AIH.MethodsSteatosis was diagnosed by a controlled attenuation parameter (CAP) ≥ 248 dB / m. Only patients who underwent immunosuppressive therapy with available liver histological material at diagnosis and qualified CAP within seven days of the liver biopsy were included. Univariate and multivariate analyses were subsequently conducted.ResultsThe multicentre and retrospective cohort enrolled 222 subjects (88.3% female, median age 54 years, median follow-up 48 months) in the final analysis, and 56 (25.2%) patients had hepatic steatosis. Diabetes, hypertension, and significant fibrosis at baseline were more common in the steatosis group than in the no steatosis group. After adjusting for confounding factors, hepatic steatosis was an independent predictor of insufficient biochemical response (OR: 8.07) and identified as an independent predictor of long-term adverse outcomes (HR: 4.07). By subgroup multivariate analysis (different degrees of steatosis, fibrosis, and prednisone dose), hepatic steatosis independently showed a relatively stable correlation with treatment response. Furthermore, in contrast to those without steatosis, a significant increase in liver stiffness (LS) was observed in patients with steatosis (4.1%/year vs. -16%/year, P < 0.001).ConclusionsConcomitant hepatic steatosis was significantly associated with poor response to treatment in AIH patients. Routine CAP measurements are therefore essential to guide the management of AIH.https://www.frontiersin.org/articles/10.3389/fimmu.2022.1040029/fullAIHhepatic steatosiscontrolled attenuation parametertreatment responseriskprognosis |
| spellingShingle | Peiyan Liu Peiyan Liu Mingkai Li Mingkai Li Lili Zhao Lili Zhao Hongsheng Yu Chang Zhao Jianning Chen Ruifang Shi Li Zhou Qi Zhou Qi Zhou Bin Wu Bin Wu Jia Li Impact of hepatic steatosis on treatment response of autoimmune hepatitis: A retrospective multicentre analysis Frontiers in Immunology AIH hepatic steatosis controlled attenuation parameter treatment response risk prognosis |
| title | Impact of hepatic steatosis on treatment response of autoimmune hepatitis: A retrospective multicentre analysis |
| title_full | Impact of hepatic steatosis on treatment response of autoimmune hepatitis: A retrospective multicentre analysis |
| title_fullStr | Impact of hepatic steatosis on treatment response of autoimmune hepatitis: A retrospective multicentre analysis |
| title_full_unstemmed | Impact of hepatic steatosis on treatment response of autoimmune hepatitis: A retrospective multicentre analysis |
| title_short | Impact of hepatic steatosis on treatment response of autoimmune hepatitis: A retrospective multicentre analysis |
| title_sort | impact of hepatic steatosis on treatment response of autoimmune hepatitis a retrospective multicentre analysis |
| topic | AIH hepatic steatosis controlled attenuation parameter treatment response risk prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1040029/full |
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