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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; [...]

Dysmetabolism, Diabetes and Clinical Outcomes in Patients Cured of Chronic Hepatitis C: A Real‐Life Cohort Study

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  • Medientyp: E-Artikel
  • Titel: Dysmetabolism, Diabetes and Clinical Outcomes in Patients Cured of Chronic Hepatitis C: A Real‐Life Cohort Study
  • Beteiligte: 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; [...]
  • Erschienen: Ovid Technologies (Wolters Kluwer Health), 2022
  • Erschienen in: Hepatology Communications
  • Sprache: Englisch
  • DOI: 10.1002/hep4.1851
  • ISSN: 2471-254X
  • Schlagwörter: Hepatology
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:p>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<jats:sup>2</jats:sup>, 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]; <jats:italic toggle="yes">P</jats:italic> &lt; 0.0001 for all). The impact of BMI was greater in those without diabetes (<jats:italic toggle="yes">P</jats:italic> = 0.003). Diabetes was independently associated with less pronounced LSM improvement after viral eradication (<jats:italic toggle="yes">P</jats:italic> = 0.001) and in patients with advanced fibrosis was an independent predictor of the most frequent clinical events, namely <jats:italic toggle="yes">de novo</jats:italic> hepatocellular carcinoma (HCC; hazard ratio [HR] 2.09 [1.20‐3.63]; <jats:italic toggle="yes">P</jats:italic> = 0.009) and cardiovascular events (HR 2.73 [1.16‐6.43]; <jats:italic toggle="yes">P</jats:italic> = 0.021). Metformin showed a protective association against HCC (HR 0.32 [0.11‐0.96]; <jats:italic toggle="yes">P</jats:italic> = 0.043), which was confirmed after adjustment for propensity score (<jats:italic toggle="yes">P</jats:italic> = 0.038). Diabetes diagnosis further refined HCC prediction in patients with compensated advanced chronic liver disease at high baseline risk (<jats:italic toggle="yes">P</jats:italic> = 0.024). <jats:italic toggle="yes">Conclusion:</jats:italic> Metabolic comorbidities were associated with advanced liver fibrosis at baseline, whereas statins were protective. In patients with advanced fibrosis, diabetes increased the risk of <jats:italic toggle="yes">de novo</jats:italic> HCC and of cardiovascular events. Optimization of metabolic comorbidities treatment by a multi‐disciplinary management approach may improve cardiovascular and possibly liver‐related outcomes.</jats:p>
  • Zugangsstatus: Freier Zugang