Decompensation in Advanced Nonalcoholic Fatty Liver Disease May Occur at Lower Hepatic Venous Pressure Gradient Levels Than in Patients With Viral Disease.
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Bassegoda Octavi, Olivas Pol, Turco Laura, Mandorfer Mattias, Serra-Burriel Miquel, Tellez Luis, Kwanten Wilhelmus, Laroyenne Alexia, Farcau Oana, Alvarado Edilmar, Moga Lucile, Vuille-Lessard Elise, Fortea Jose Ignacio, Ibañez Luis, Tosetti Giulia, Vanwolleghem Thomas, Larrue Hélène, Burgos-Santamaría Diego, Stefanescu Horia, Paternostro Rafael, Cippitelli Annalisa, Lens Sabela, Augustin Salvador, Llop Elba, Laleman Wim, Trebicka Jonel, Chang Johannes, Masnou Helena, Zipprich Alexander, Miceli Francesca, Semmler Georg, Forns Xavier, Primignani Massimo, Bañares Rafael, Puente Angela, Berzigotti Annalisa, Rautou Pierre Emmanuel, Villanueva Candid, Ginès Pere, Garcia-Pagan J C, Procopet Bogdan, Bureau Cristophe, Albillos Agustin, Francque Sven, Reiberger Thomas, Schepis Filippo, Graupera Isabel, Hernandez-Gea Virginia
Аннотация
METHODS: Multicenter cross-sectional study included 548 patients with aNAFLD and 444 with advanced RNA-positive hepatitis C (aHCV) who had detailed portal hypertension evaluation (HVPG measurement, gastroscopy, and abdominal imaging). We examined the relationship between etiology, HVPG, and decompensation by logistic regression models. We also compared the proportions of compensated/decompensated patients at different HVPG levels.
RESULTS: Both cohorts, aNAFLD and aHVC, had similar baseline age, gender, Child-Pugh score, and Model for End-Stage Liver Disease score. Median HVPG was lower in the aNAFLD cohort (13 vs 15 mmHg) despite similar liver function and higher rates of decompensation in aNAFLD group (32% vs 25%; P = .019) than in the aHCV group. For any of the HVPG cutoff analyzed (<10, 10-12, or 12 mmHg) the prevalence of decompensation was higher in the aNAFLD group than in the aHCV group.
CONCLUSIONS: Patients with aNAFLD have higher prevalence of portal hypertension-related decompensation at any value of HVPG as compared with aHCV patients. Longitudinal studies aiming to identify HVPG thresholds able to predict decompensation and long-term outcomes in aNAFLD population are strongly needed.