2018
DOI: 10.1016/j.jhep.2018.04.016
|View full text |Cite
|
Sign up to set email alerts
|

Class III obesity is a risk factor for the development of acute-on-chronic liver failure in patients with decompensated cirrhosis

Abstract: In this study, we identify that among patients with decompensated cirrhosis, class III obesity (severe/morbid obesity) is a modifiable risk factor for the development of acute-on-chronic liver failure (ACLF). We further demonstrate that regarding the specific organ failures associated with ACLF, renal failure is significantly more prevalent in obese patients, particularly those with class III obesity. These findings underscore the importance of weight management in cirrhosis, to reduce the risk of ACLF. Patien… Show more

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...
1
1
1

Citation Types

3
47
1

Year Published

2019
2019
2021
2021

Publication Types

Select...
6

Relationship

5
1

Authors

Journals

citations
Cited by 65 publications
(51 citation statements)
references
References 37 publications
3
47
1
Order By: Relevance
“…Choudhury et al also point out that EASL ACLF events occurred more often in obese patients in our study cohort as compared with APASL ACLF events (40.6% versus 29.7%). This is consistent with previously published data (4) that increasing body mass index (BMI) is a risk factor for developing EASL ACLF but not APASL ACLF. Thus, we would hypothesize that obesity may be a surrogate for other comorbidities (such as hypertension, diabetes, and chronic kidney disease) that may cause many patients to rule in for nonhepatic EASL OFs and thus be classified as having EASL ACLF.…”
Section: Replysupporting
confidence: 93%
See 1 more Smart Citation
“…Choudhury et al also point out that EASL ACLF events occurred more often in obese patients in our study cohort as compared with APASL ACLF events (40.6% versus 29.7%). This is consistent with previously published data (4) that increasing body mass index (BMI) is a risk factor for developing EASL ACLF but not APASL ACLF. Thus, we would hypothesize that obesity may be a surrogate for other comorbidities (such as hypertension, diabetes, and chronic kidney disease) that may cause many patients to rule in for nonhepatic EASL OFs and thus be classified as having EASL ACLF.…”
Section: Replysupporting
confidence: 93%
“…For example, the regional GDPs per capita of Anhui and Guangxi provinces in 2005 were ¥8,670 (US $1,060) and ¥8,788 (US $1,074), respectively, but in 2017 the former (¥43,401 [US $6,425]) surpassed the latter (¥38,102 [US $5,640]). (4) Therefore, analysis of NAFLD by regional GDP should be performed according to regional GDPs during the study period, including inflation, to more accurately reflect the association.…”
Section: To the Editormentioning
confidence: 99%
“…Retrospective studies of large patient databases also show that obesity is independently associated with increased risk for infection among patients with ESLD, as well as increased in‐hospital mortality among critically ill patients with ESLD . A recent study of UNOS and Nationwide Inpatient Sample registries also identified class III obesity (BMI ≥ 40) to be an independent risk factor for the development of ACLF . In addition, morbidly obese patients with ESLD are also at a paradoxically higher risk for sarcopenia, which is a significant risk factor for increased mortality on the liver transplant wait list .…”
Section: Obesity and Outcomesmentioning
confidence: 99%
“…Multiple studies have found obesity to be associated with significant morbidity and mortality among patients with ESLD. In addition to increased liver transplant wait‐list mortality, obesity has also been identified to be an independent risk factor for liver decompensation and infection in cirrhosis, as well as acute‐on‐chronic liver failure (ACLF) . Therefore, proper understanding and management of this high‐risk population of patients with ESLD is essential to improve clinical outcomes.…”
mentioning
confidence: 99%
“…Acute‐on‐chronic liver failure (ACLF) is a syndrome defined by acute hepatic decompensation of known cirrhosis and resultant extrahepatic organ failures, and is characterized by a systemic inflammatory response . Identification of ACLF is based on the study by the European Association for the Study of the Liver–chronic liver failure (EASL‐CLIF) Consortium called the EASL‐CLIF Acute‐on‐Chronic Liver Failure in Cirrhosis (CANONIC) study, which proposed a diagnostic scoring system and evaluated six different organ systems (liver, kidney, brain, coagulation, circulation, and respiration) for prognostication.…”
mentioning
confidence: 99%