Clinical outcomes of cryptogenic compared with non‐cryptogenic cirrhosis: A retrospective cohort study

Mohammed, Omar Kadhim; Mahadeva, Sanjiv

doi:10.1111/jgh.12978

Cited by 6 publications

(5 citation statements)

References 25 publications

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“…The stringent definition of diabetes by universal biochemical screening of all undiagnosed cases was used in 91% of studies. The remaining studies reported that the diagnosis was made by either laboratory or current treatment for diabetes, suggesting that undiagnosed cases of DM may still have been overlooked.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of diabetes in liver cirrhosis: A systematic review and meta‐analysis

Lee

Wells

McCall

et al. 2019

Diabetes Metabolism Res

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An association between diabetes mellitus (DM) and liver cirrhosis is well‐known, but estimates of the prevalence of DM in patients with liver cirrhosis vary widely. A systematic review was undertaken to determine the prevalence of DM in adult patients with liver cirrhosis. The Medline, EMBASE, and Cochrane Library databases were searched for peer‐reviewed studies published in English (1979‐2017) that investigated the prevalence of diabetes in adult patients with cirrhosis. Pooled estimates of prevalence of DM were determined for all eligible patients and according to aetiology and severity of liver disease. Fifty‐eight studies satisfied criteria for inclusion, with 9705 patients included in the pooled prevalence analysis. The overall prevalence of DM was 31%. The prevalence of DM was highest in patients with nonalcoholic fatty liver disease (56%), cryptogenic (51%), hepatitis C (32%), or alcoholic (27%) cirrhosis. For assessing prevalence of DM as a function of severity of liver disease, evaluable data were available only for hepatitis C and hepatitis B cirrhosis. DM may be more prevalent in cirrhosis than previously thought. This has implications for prognosis and treatment in these patients.

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Section: Resultsmentioning

confidence: 99%

Prevalence of diabetes in liver cirrhosis: A systematic review and meta‐analysis

Lee

Wells

McCall

et al. 2019

Diabetes Metabolism Res

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“… 21 A majority of patients admitted to our ward for cirrhosis and its complications had cryptogenic cirrhosis, which is due to MASLD in most cases. 22 Similarly, cryptogenic cirrhosis as the etiology of hepatocellular carcinoma (HCC) cases seen in our center has more than doubled from 16% to 34% (not including 7% with established diagnosis of MASH) between the time periods of 2006–2009 and 2011–2014. 23 In the United States, MASH has become one of the leading causes of adult liver transplantation and among patients with HCC undergoing liver transplantation.…”

Section: Epidemiology Natural History and Burden Of Diseasementioning

confidence: 89%

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A State-of-the-Art Review

Chan,

Chuah,

Rajaram

et al. 2023

Journal of Obesity & Metabolic Syndrome

172

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Metabolic dysfunction-associated steatotic liver disease (MASLD) is the latest term for steatotic liver disease associated with metabolic syndrome. MASLD is the most common cause of chronic liver disease and is the leading cause of liver-related morbidity and mortality. It is important that all stakeholders be involved in tackling the public health threat of obesity and obesity-related diseases, including MASLD. A simple and clear assessment and referral pathway using non-invasive tests is essential to ensure that patients with severe MASLD are identified and referred to specialist care, while patients with less severe disease remain in primary care, where they are best managed. While lifestyle intervention is the cornerstone of the management of patients with MASLD, cardiovascular disease risk must be properly assessed and managed because cardiovascular disease is the leading cause of mortality. No pharmacological agent has been approved for the treatment of MASLD, but novel anti-hyperglycemic drugs appear to have benefit. Medications used for the treatment of diabetes and other metabolic conditions may need to be adjusted as liver disease progresses to cirrhosis, especially decompensated cirrhosis. Based on non-invasive tests, the concepts of compensated advanced chronic liver disease and clinically significant portal hypertension provide a practical approach to stratifying patients according to the risk of liver-related complications and can help manage such patients. Finally, prevention and management of sarcopenia should be considered in the management of patients with MASLD.

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“…Second, we found that non-cryptogenic LC was significantly associated with worse outcomes in patients after a 1-MV than cryptogenic LC (AHR = 1.43, 95%CI: 1.32-1.54). In contrast, one retrospective Malaysian cohort study[ 20 ] reported, after comparing the clinical outcomes in 94 cases cryptogenic LC and 207 cases of non-cryptogenic LC, cases that there was no significant difference in mortality between these two groups; however, the sample in that study was relatively small. A Japanese study[ 25 ], which compared 68 patients with cirrhotic non-alcoholic steatohepatitis (NASH) and 69 with HCV-induced LC, found that the 5-year survival rates and liver-related mortality were not significantly different in the two groups.…”

Section: Discussionmentioning

confidence: 98%

“…In addition to viral hepatitis- and alcohol-related LC, cryptogenic cirrhosis, which is defined as LC that cannot be explained by conventional clinical, laboratory, or histological findings[ 15 , 16 ], is becoming increasingly prevalent in Asia[ 17 - 19 ]. The clinical manifestations and outcomes of LC and cryptogenic LC are different[ 20 ]. Thus, we also investigated whether the effects of non-cryptogenic LC and cryptogenic LC on the patients requiring 1-MV are different.…”

Section: Introductionmentioning

confidence: 99%

Effect of liver cirrhosis on long-term outcomes after acute respiratory failure: A population-based study

Lai

Cheng

et al. 2017

WJG

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AIMTo assessed the effect of liver cirrhosis (LC) on the poorly understood long-term mortality risk after first-ever mechanical ventilation (1-MV) for acute respiratory failure.METHODSAll patients in Taiwan given a 1-MV between 1997 and 2013 were identified in Taiwan’s Longitudinal Health Insurance Database 2000. Each patient with LC was individually matched, using a propensity-score method, to two patients without LC. The primary outcome was death after a 1-MV.RESULTSA total of 16653 patients were enrolled: 5551 LC-positive (LC[Pos]) patients, including 1732 with cryptogenic LCs and 11102 LC-negative (LC[Neg]) controls. LC[Pos] patients had more organ failures and were more likely to be admitted to medical department than were LC[Neg] controls. LC[Pos] patients had a significantly lower survival rate (AHR = 1.38, 95%CI: 1.32-1.44). Moreover, the mortality risk was significantly higher for patients with non-cryptogenic LC than for patients with cryptogenic LC (AHR = 1.43, 95%CI: 1.32-1.54) and patients without LC (AHR = 1.56, 95%CI: 1.32-1.54). However, there was no significant difference between patients with cryptogenic and without LC (HR = 1.05, 95%CI: 0.98-1.12).CONCLUSIONLC, especially non-cryptogenic LC, significantly increases the risk of death after a 1-MV.

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Clinical outcomes of cryptogenic compared with non‐cryptogenic cirrhosis: A retrospective cohort study

Abstract: Cryptogenic cirrhosis is associated with a longer duration of hospitalization compared with non-cryptogenic cirrhosis at an early stage of the disease. This difference is due to a greater burden of non-liver-related complications in the former.

Cited by 6 publications

References 25 publications

Prevalence of diabetes in liver cirrhosis: A systematic review and meta‐analysis

Prevalence of diabetes in liver cirrhosis: A systematic review and meta‐analysis

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A State-of-the-Art Review

Effect of liver cirrhosis on long-term outcomes after acute respiratory failure: A population-based study

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