Influence of Fatty Liver on the Severity and Clinical Outcome in Acute Pancreatitis

Xu, Chunfang; Qiao, Zhenguo; Lu, Yongda; Zhang, Deqing; Jia, Zhenyu; Zhuang, Xiaohui; Shi, Yuqi; Xu, Tao; Lü, Xing; Shen, Jiaqing

doi:10.1371/journal.pone.0142278

Cited by 25 publications

(24 citation statements)

References 41 publications

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“…According to Yoon et al [ 37 ], a strong trend between the presence of FLD and AP severity was observed regardless of the cause of pancreatitis (alcoholic vs. non-alcoholic). Xu et al [ 18 ] have found no difference in AP severity when comparing alcoholic FLD with NAFLD. In both cases the course of AP was worse compared to non-FLD patients.…”

Section: Discussionmentioning

confidence: 99%

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Fatty Liver Disease and Non-Alcoholic Fatty Liver Disease Worsen the Outcome in Acute Pancreatitis: A Systematic Review and Meta-Analysis

Váncsa

Németh

Hegyi

et al. 2020

JCM

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The prevalence of fatty liver disease (FLD) and that of non-alcoholic fatty liver disease (NAFLD) share some risk factors known to exacerbate the course of acute pancreatitis (AP). This meta-analysis aimed to investigate whether FLD or NAFLD carry a higher risk of untoward outcomes in AP. In accordance with PRISMA guidelines, we performed a systematic search in seven medical databases for cohort studies that compared the outcomes of AP for the presence of FLD or NAFLD, and we calculated pooled odds ratio (OR) or weighted mean difference (WMD) with 95% confidence interval (CI). We included 13 articles in our meta-analysis. AP patients with FLD were more likely to die (5.09% vs 1.89%, OR = 3.56, CI = 1.75–7.22), develop severe AP (16.33% vs 7.87%, OR = 2.67, CI = 2.01–3.56), necrotizing pancreatitis (34.83% vs 15.75%, OR = 3.08, CI = 2.44–3.90) and had longer in-hospital stay (10.8 vs 9.2 days, WMD = 1.46, OR = 0.54–2.39). Patients with NAFLD were more likely to have severe AP and longer hospital stay. Both FLD and NAFLD proved to be independent risk factors of a more severe disease course (OR = 3.68, CI = 2.16–6.29 and OR = 3.39, CI = 1.52–7.56 for moderate/ severe vs. mild AP, respectively). FLD and NAFLD worsen the outcomes of AP, which suggests that incorporating FLD or NAFLD into prognostic scoring systems of AP outcomes might improve the prediction of severity and contribute to a more individualized patient care.

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Section: Discussionmentioning

confidence: 99%

“…An experimental study in rat AP model demonstrated that the presence of FLD increased pro-inflammatory cytokine production, which may worsen the course of the disease [ 17 ]. Cross-sectional studies confirmed that AP is often accompanied by FLD, with a prevalence between 18–43% [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Fatty Liver Disease and Non-Alcoholic Fatty Liver Disease Worsen the Outcome in Acute Pancreatitis: A Systematic Review and Meta-Analysis

Váncsa

Németh

Hegyi

et al. 2020

JCM

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“…Xu et al [48] suggested that fatty liver assessed by computed tomography was associated with severity of acute pancreatitis. Mikolasevic et al [49] showed that presence of nonalcoholic fatty liver was related to more severe forms of acute pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

Serum Albumin Is Independently Associated with Persistent Organ Failure in Acute Pancreatitis

Hong

Lin

Zippi

et al. 2017

Canadian Journal of Gastroenterology and Hepatology

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Background and Aims To investigate the association between serum albumin levels within 24 hrs of patient admission and the development of persistent organ failure in acute pancreatitis. Methods A total of 700 patients with acute pancreatitis were enrolled. Multivariate logistic regression and subgroup analysis determined whether decreased albumin was independently associated with persistent organ failure and mortality. The diagnostic performance of serum albumin was evaluated by the area under Receiver Operating Characteristic (ROC) curves. Results As levels of serum albumin decrease, the risk of persistent organ failure significantly increases (Ptrend < 0.001). The incidence of organ failure was 3.5%, 10.6%, and 41.6% in patients with normal albumin and mild and severe hypoalbuminaemia, respectively. Decreased albumin levels were also proportionally associated with prolonged hospital stay (Ptrend < 0.001) and the risk of death (Ptrend < 0.001). Multivariate analysis suggested that biliary etiology, chronic concomitant diseases, hematocrit, blood urea nitrogen, and the serum albumin level were independently associated with persistent organ failure. Blood urea nitrogen and the serum albumin level were also independently associated with mortality. The area under ROC curves of albumin for predicting organ failure and mortality were 0.78 and 0.87, respectively. Conclusion A low serum albumin is independently associated with an increased risk of developing of persistent organ failure and death in acute pancreatitis. It may also be useful for the prediction of the severity of acute pancreatitis.

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“…A recent study demonstrated that the presence of NAFLD at admission portends a higher risk of severe and moderately severe AP, as well as a higher risk of organ failure. 11 The mechanism by which NAFLD exacerbates pancreatitis remains unclear. The potential reasons could be imbalance of adipocytokines, increased activity of hepatic Kupffer cells, and reduction of alpha-1-antitrypsin levels.…”

Section: Apmentioning

confidence: 99%

“…9,10 Recent data suggest that NAFLD increases the susceptibility and/or worsen outcome of acute pancreatitis (AP), cerebrovascular accident (CVA), and osteoporosis. [11][12][13] There is growing trend of patients with NASH-related cirrhosis requiring liver transplantation (LT). 14,15 The risk of developing progressive liver disease and associated extrahepatic diseases presents a challenge to the healthcare system to develop effective strategies in order to prevent an exponential increase in morbidity and mortality related to it.…”

Section: Introductionmentioning

confidence: 99%

Non-alcoholic Fatty Liver Disease: Growing Burden, Adverse Outcomes and Associations

Kumar¹,

Priyadarshi²,

Anand³

2019

Journal of Clinical and Translational Hepatology

117

123

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Nonalcoholic fatty liver disease (NAFLD) is a systemic disorder with a complex multifactorial pathogenesis and heterogenous clinical manifestations. NAFLD, once believed to be an innocuous condition, has now become the most common cause of chronic liver disease in many countries worldwide. NAFLD is already highly prevalent in the general population, and owing to a rising incidence of obesity and diabetes mellitus, the incidence of NAFLD and its impact on global healthcare are expected to increase in the future. A subset of patients with NAFLD develops progressive liver disease leading to cirrhosis, hepatocellular carcinoma, and liver failure. NAFLD has emerged as one of the leading causes of cirrhosis and hepatocellular carcinoma in recent years. Moreover, HCC can occur in NAFLD even in absence of cirrhosis. Compared with the general population, NAFLD increases the risk of liverrelated, cardiovascular and all-cause mortality. NAFLD is bidirectionally associated with metabolic syndrome. NAFLD increases the risk and contributes to aggravation of the pathophysiology of atherosclerosis, cardiovascular diseases, diabetes mellitus, and chronic kidney disease. In addition, NAFLD is linked to colorectal polyps, polycystic ovarian syndrome, osteoporosis, obstructive sleep apnea, stroke, and various extrahepatic malignancies. Extended resection of steatotic liver is associated with increased risk of liver failure and mortality. There is an increasing trend of NAFLDrelated cirrhosis requiring liver transplantation, and the recurrence of NAFLD in such patients is almost universal. This review discusses the growing burden of NAFLD, its outcomes, and adverse associations with various diseases. Citation of this article: Kumar R, Priyadarshi RN, Anand U. Non-alcoholic fatty liver disease: Growing burden, adverse outcomes and associations. Global burden and rising prevalenceAccording to current estimate, the global prevalence of NAFLD among the general population may be as high as one billion. 2 In a recent meta-analysis of 86 studies, 76

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Influence of Fatty Liver on the Severity and Clinical Outcome in Acute Pancreatitis

Cited by 25 publications

References 41 publications

Fatty Liver Disease and Non-Alcoholic Fatty Liver Disease Worsen the Outcome in Acute Pancreatitis: A Systematic Review and Meta-Analysis

Fatty Liver Disease and Non-Alcoholic Fatty Liver Disease Worsen the Outcome in Acute Pancreatitis: A Systematic Review and Meta-Analysis

Serum Albumin Is Independently Associated with Persistent Organ Failure in Acute Pancreatitis

Non-alcoholic Fatty Liver Disease: Growing Burden, Adverse Outcomes and Associations

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