Nonalcoholic fatty liver disease (NAFLD) among older adults

Pitisuttithum, Panyavee; Treeprasertsuk, Sombat

doi:10.1002/poh2.31

Cited by 7 publications

(1 citation statement)

References 52 publications

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“…Nevertheless, some confounding variables, such as age and BMI, also influence gut microbiota composition, eventually masking the bacterial taxa predictor associated with MASLD progression [10,11]. Indeed, intestinal dysbiosis predisposes individuals to age-related diseases, among them MASLD [10], which an increased prevalence, particularly at an advanced stage, has been reported principally in older patients with this disease [12].…”

Section: Discussionmentioning

confidence: 99%

Alteration of Gut Microbiota Composition in the Progression of Liver Damage in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

Zazueta,

Valenzuela-Pérez,

Ortiz-López

et al. 2024

IJMS

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Metabolic dysfunction-associated steatotic liver disease (MASLD) is a complex disorder whose prevalence is rapidly growing in South America. The disturbances in the microbiota–gut–liver axis impact the liver damaging processes toward fibrosis. Gut microbiota status is shaped by dietary and lifestyle factors, depending on geographic location. We aimed to identify microbial signatures in a group of Chilean MASLD patients. Forty subjects were recruited, including healthy controls (HCs), overweight/obese subjects (Ow/Ob), patients with MASLD without fibrosis (MASLD/F−), and MASLD with fibrosis (MASLD/F+). Both MASLD and fibrosis were detected through elastography and/or biopsy, and fecal microbiota were analyzed through deep sequencing. Despite no differences in α- and β-diversity among all groups, a higher abundance of Bilophila and a lower presence of Defluviitaleaceae, Lachnospiraceae ND3007, and Coprobacter was found in MASLD/F− and MASLD/F+, compared to HC. Ruminococcaceae UCG-013 and Sellimonas were more abundant in MASLD/F+ than in Ow/Ob; both significantly differed between MASLD/F− and MASLD/F+, compared to HC. Significant positive correlations were observed between liver stiffness and Bifidobacterium, Prevotella, Sarcina, and Acidaminococcus abundance. Our results show that MASLD is associated with changes in bacterial taxa that are known to be involved in bile acid metabolism and SCFA production, with some of them being more specifically linked to fibrosis.

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Section: Discussionmentioning

confidence: 99%

Alteration of Gut Microbiota Composition in the Progression of Liver Damage in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

Zazueta,

Valenzuela-Pérez,

Ortiz-López

et al. 2024

IJMS

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Prognostic impact of age on outcomes of hepatic decompensation in patients with compensated cirrhosis (CHESS2102): an international, multicenter cohort study

Liu,

Li,

Wong

et al. 2024

MedComm

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Baveno VII criteria (B7C) and Baveno VI criteria (B6C) have been widely used to estimate the risk of hepatic decompensation. However, the impact of age on these criteria warrants further investigation. The international, multicenter cohort study included 1138 patients with compensated cirrhosis (median follow‐up of 40.6 months), aiming to evaluate the value of age in predicting hepatic decompensation. We identified age as an independent predictor of hepatic decompensation, with 60 years determined as the optimal cut‐off value. The occurrence of decompensation was 18.7% and 6.7% in the older (age ≥60 years) and younger (age <60 years) groups, respectively (p < 0.001). We subsequently integrated age into the existing Baveno criteria. In patients not meeting Baveno criteria (defined as not meeting B6C or B7C), the older group exhibited a significantly elevated risk of decompensation compared to the younger group (p < 0.05). However, no significant difference was observed between the older and younger groups in patients meeting Baveno criteria (p > 0.05). In conclusion, our study demonstrated that integrating age into the Baveno criteria could enhance the assessment of hepatic decompensation. Age should be considered before discharging patients with compensated cirrhosis from the surveillance of hepatic decompensation.

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Progression from Non-alcoholic Steatohepatitis to Advanced Liver Diseases and Mortality Among Medicare Patients

Kim,

Medicis,

Davis

et al. 2024

Adv Ther

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Introduction Non-alcoholic steatohepatitis (NASH) may progress to more advanced liver disease. This study aimed to characterize NASH progression and mortality in the Medicare population. Methods Patients with NASH in 100% Medicare fee-for-service claims accrued from 2015–2021 who were ≥ 66 years old at index diagnosis, continuously enrolled for ≥ 12 months prior to and ≥ 6 months following index (unless death), and had no evidence of other causes of liver disease were included. Diagnosis codes defined severity states: non-cirrhotic NASH, compensated cirrhosis (CC), decompensated cirrhosis (DCC), hepatocellular carcinoma (HCC), and liver transplant (LT). Survival analyses of disease progression and mortality were conducted for each state and by year of progression (Y1–5). Cox proportional hazards models assessed risk factors of worsening disease. Results Mean age and follow-up were 72.2 and 2.8 years in 14,806 unique patients ( n = 12,990 NASH; 1899 CC; 997 DCC; 209 HCC; 140 LT). Progression rates were highest for patients with CC (11–37% for Y1–5), followed by DCC (3–18%), NASH (3–12%), and HCC (2–4%). Mortality rates were highest for patients with HCC (41–85% for Y1–5), followed by DCC (41–76%), LT (7–33%), CC (6–26%), and NASH (2–12%). Patients with any disease progression had a 5-year mortality rate more than double that of patients without progression (41% vs. 16%). Delayed progression from NASH was associated with lower mortality risk; the 5-year mortality rate was 26% lower for patients with progression in Y2 vs. Y1 (32% vs. 43%) and further decreased for progression in Y3-Y5. Risk factors included age, nursing home use, congestive heart failure, coagulopathy, fluid/electrolyte disorders, and unexplained weight loss. Conclusion Medicare patients ≥ 66 years with NASH experience high risk of disease progression associated with increased mortality rates. Slower disease progression is associated with lower mortality rates, suggesting that therapies that can delay or prevent NASH progression may reduce morbidity and mortality. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-024-02979-7.

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Nonalcoholic fatty liver disease (NAFLD) among older adults

Cited by 7 publications

References 52 publications

Alteration of Gut Microbiota Composition in the Progression of Liver Damage in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

Alteration of Gut Microbiota Composition in the Progression of Liver Damage in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

Prognostic impact of age on outcomes of hepatic decompensation in patients with compensated cirrhosis (CHESS2102): an international, multicenter cohort study

Progression from Non-alcoholic Steatohepatitis to Advanced Liver Diseases and Mortality Among Medicare Patients

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