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Dysmetabolism, Diabetes and Clinical Outcomes in Patients Cured of Chronic Hepatitis C: A Real‐Life Cohort Study
The aim of this study was to examine the impact of features of dysmetabolism on liver disease severity, evolution, and clinical outcomes in a real‐life cohort of patients treated with direct acting antivirals for chronic hepatitis C virus (HCV) infection. To this end, we considered 7,007 patients tr...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8948549/ https://www.ncbi.nlm.nih.gov/pubmed/34811949 http://dx.doi.org/10.1002/hep4.1851 |
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author | Valenti, Luca Pelusi, Serena Aghemo, Alessio Gritti, Sara Pasulo, Luisa Bianco, Cristiana Iegri, Claudia Cologni, Giuliana Degasperi, Elisabetta D’Ambrosio, Roberta del Poggio, Paolo Soria, Alessandro Puoti, Massimo Carderi, Isabella Pigozzi, Marie Graciella Carriero, Canio Spinetti, Angiola Zuccaro, Valentina Memoli, Massimo Giorgini, Alessia Viganò, Mauro Rumi, Maria Grazia Re, Tiziana Spinelli, Ombretta Colombo, Maria Chiara Quirino, Tiziana Menzaghi, Barbara Lorini, Gianpaolo Pan, Angelo D’Arminio Monforte, Antonella Buscarini, Elisabetta Autolitano, Aldo Bonfanti, Paolo Terreni, Natalia Aimo, Gianpiero Mendeni, Monia Prati, Daniele Lampertico, Pietro Colombo, Massimo Fagiuoli, Stefano |
author_facet | Valenti, Luca Pelusi, Serena Aghemo, Alessio Gritti, Sara Pasulo, Luisa Bianco, Cristiana Iegri, Claudia Cologni, Giuliana Degasperi, Elisabetta D’Ambrosio, Roberta del Poggio, Paolo Soria, Alessandro Puoti, Massimo Carderi, Isabella Pigozzi, Marie Graciella Carriero, Canio Spinetti, Angiola Zuccaro, Valentina Memoli, Massimo Giorgini, Alessia Viganò, Mauro Rumi, Maria Grazia Re, Tiziana Spinelli, Ombretta Colombo, Maria Chiara Quirino, Tiziana Menzaghi, Barbara Lorini, Gianpaolo Pan, Angelo D’Arminio Monforte, Antonella Buscarini, Elisabetta Autolitano, Aldo Bonfanti, Paolo Terreni, Natalia Aimo, Gianpiero Mendeni, Monia Prati, Daniele Lampertico, Pietro Colombo, Massimo Fagiuoli, Stefano |
author_sort | Valenti, Luca |
collection | PubMed |
description | The aim of this study was to examine the impact of features of dysmetabolism on liver disease severity, evolution, and clinical outcomes in a real‐life cohort of patients treated with direct acting antivirals for chronic hepatitis C virus (HCV) infection. To this end, we considered 7,007 patients treated between 2014 and 2018, 65.3% with advanced fibrosis, of whom 97.7% achieved viral eradication (NAVIGATORE‐Lombardia registry). In a subset (n = 748), liver stiffness measurement (LSM) was available at baseline and follow‐up. Higher body mass index (BMI; odds ratio [OR] 1.06 per kg/m(2), 1.03‐1.09) and diabetes (OR 2.01 [1.65‐2.46]) were independently associated with advanced fibrosis at baseline, whereas statin use was protective (OR 0.46 [0.35‐0.60]; P < 0.0001 for all). The impact of BMI was greater in those without diabetes (P = 0.003). Diabetes was independently associated with less pronounced LSM improvement after viral eradication (P = 0.001) and in patients with advanced fibrosis was an independent predictor of the most frequent clinical events, namely de novo hepatocellular carcinoma (HCC; hazard ratio [HR] 2.09 [1.20‐3.63]; P = 0.009) and cardiovascular events (HR 2.73 [1.16‐6.43]; P = 0.021). Metformin showed a protective association against HCC (HR 0.32 [0.11‐0.96]; P = 0.043), which was confirmed after adjustment for propensity score (P = 0.038). Diabetes diagnosis further refined HCC prediction in patients with compensated advanced chronic liver disease at high baseline risk (P = 0.024). Conclusion: Metabolic comorbidities were associated with advanced liver fibrosis at baseline, whereas statins were protective. In patients with advanced fibrosis, diabetes increased the risk of de novo HCC and of cardiovascular events. Optimization of metabolic comorbidities treatment by a multi‐disciplinary management approach may improve cardiovascular and possibly liver‐related outcomes. |
format | Online Article Text |
id | pubmed-8948549 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-89485492022-03-29 Dysmetabolism, Diabetes and Clinical Outcomes in Patients Cured of Chronic Hepatitis C: A Real‐Life Cohort Study Valenti, Luca Pelusi, Serena Aghemo, Alessio Gritti, Sara Pasulo, Luisa Bianco, Cristiana Iegri, Claudia Cologni, Giuliana Degasperi, Elisabetta D’Ambrosio, Roberta del Poggio, Paolo Soria, Alessandro Puoti, Massimo Carderi, Isabella Pigozzi, Marie Graciella Carriero, Canio Spinetti, Angiola Zuccaro, Valentina Memoli, Massimo Giorgini, Alessia Viganò, Mauro Rumi, Maria Grazia Re, Tiziana Spinelli, Ombretta Colombo, Maria Chiara Quirino, Tiziana Menzaghi, Barbara Lorini, Gianpaolo Pan, Angelo D’Arminio Monforte, Antonella Buscarini, Elisabetta Autolitano, Aldo Bonfanti, Paolo Terreni, Natalia Aimo, Gianpiero Mendeni, Monia Prati, Daniele Lampertico, Pietro Colombo, Massimo Fagiuoli, Stefano Hepatol Commun Original Articles The aim of this study was to examine the impact of features of dysmetabolism on liver disease severity, evolution, and clinical outcomes in a real‐life cohort of patients treated with direct acting antivirals for chronic hepatitis C virus (HCV) infection. To this end, we considered 7,007 patients treated between 2014 and 2018, 65.3% with advanced fibrosis, of whom 97.7% achieved viral eradication (NAVIGATORE‐Lombardia registry). In a subset (n = 748), liver stiffness measurement (LSM) was available at baseline and follow‐up. Higher body mass index (BMI; odds ratio [OR] 1.06 per kg/m(2), 1.03‐1.09) and diabetes (OR 2.01 [1.65‐2.46]) were independently associated with advanced fibrosis at baseline, whereas statin use was protective (OR 0.46 [0.35‐0.60]; P < 0.0001 for all). The impact of BMI was greater in those without diabetes (P = 0.003). Diabetes was independently associated with less pronounced LSM improvement after viral eradication (P = 0.001) and in patients with advanced fibrosis was an independent predictor of the most frequent clinical events, namely de novo hepatocellular carcinoma (HCC; hazard ratio [HR] 2.09 [1.20‐3.63]; P = 0.009) and cardiovascular events (HR 2.73 [1.16‐6.43]; P = 0.021). Metformin showed a protective association against HCC (HR 0.32 [0.11‐0.96]; P = 0.043), which was confirmed after adjustment for propensity score (P = 0.038). Diabetes diagnosis further refined HCC prediction in patients with compensated advanced chronic liver disease at high baseline risk (P = 0.024). Conclusion: Metabolic comorbidities were associated with advanced liver fibrosis at baseline, whereas statins were protective. In patients with advanced fibrosis, diabetes increased the risk of de novo HCC and of cardiovascular events. Optimization of metabolic comorbidities treatment by a multi‐disciplinary management approach may improve cardiovascular and possibly liver‐related outcomes. John Wiley and Sons Inc. 2021-11-22 /pmc/articles/PMC8948549/ /pubmed/34811949 http://dx.doi.org/10.1002/hep4.1851 Text en © 2021 The Authors. Hepatology Communications published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles Valenti, Luca Pelusi, Serena Aghemo, Alessio Gritti, Sara Pasulo, Luisa Bianco, Cristiana Iegri, Claudia Cologni, Giuliana Degasperi, Elisabetta D’Ambrosio, Roberta del Poggio, Paolo Soria, Alessandro Puoti, Massimo Carderi, Isabella Pigozzi, Marie Graciella Carriero, Canio Spinetti, Angiola Zuccaro, Valentina Memoli, Massimo Giorgini, Alessia Viganò, Mauro Rumi, Maria Grazia Re, Tiziana Spinelli, Ombretta Colombo, Maria Chiara Quirino, Tiziana Menzaghi, Barbara Lorini, Gianpaolo Pan, Angelo D’Arminio Monforte, Antonella Buscarini, Elisabetta Autolitano, Aldo Bonfanti, Paolo Terreni, Natalia Aimo, Gianpiero Mendeni, Monia Prati, Daniele Lampertico, Pietro Colombo, Massimo Fagiuoli, Stefano Dysmetabolism, Diabetes and Clinical Outcomes in Patients Cured of Chronic Hepatitis C: A Real‐Life Cohort Study |
title | Dysmetabolism, Diabetes and Clinical Outcomes in Patients Cured of Chronic Hepatitis C: A Real‐Life Cohort Study |
title_full | Dysmetabolism, Diabetes and Clinical Outcomes in Patients Cured of Chronic Hepatitis C: A Real‐Life Cohort Study |
title_fullStr | Dysmetabolism, Diabetes and Clinical Outcomes in Patients Cured of Chronic Hepatitis C: A Real‐Life Cohort Study |
title_full_unstemmed | Dysmetabolism, Diabetes and Clinical Outcomes in Patients Cured of Chronic Hepatitis C: A Real‐Life Cohort Study |
title_short | Dysmetabolism, Diabetes and Clinical Outcomes in Patients Cured of Chronic Hepatitis C: A Real‐Life Cohort Study |
title_sort | dysmetabolism, diabetes and clinical outcomes in patients cured of chronic hepatitis c: a real‐life cohort study |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8948549/ https://www.ncbi.nlm.nih.gov/pubmed/34811949 http://dx.doi.org/10.1002/hep4.1851 |
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