Development, validation, and prognostic evaluation of a risk score for long-term liver-related outcomes in the general population: a multicohort study

Pera, Guillem; Reichert, Mathias; Pericàs, Juan M.; Tsochatztis, Emmanuel A; Hernández, Rosario; Expósito, Carmen Barranco; Martínez, Alba; Martini, Andréa; Pich, Judith; Bonfill, Eva; Hernáez, Rubén; Allen, Alina M.; Knegt, Robert J. de; Wong, Vincent Wai‐Sun; Alvarez, Marifé; Andersen, Peter; Angeli, Paolo; Ardèvol, Alba; Arslanow, Anita; Beggiato, Luca; Abdesselam, Zahia Ben; Bennett, Lucy; Boutouria, Bajiha; Brocca, Alessandra; Broquetas, M. Teresa; Caballería, Llorenç; Calvino, Valeria; Camacho, Judith; Capdevila, Aura; Carol, Marta; Castéra, Laurent; Cervera, Marta; Cucchietti, Fernando; Fuentes, Anna de; Knegt, Rob de; Koning, Harry J. de; Detlefsen, Sönke; Díaz, Alba; Bande, José Diéguez; Esnault, Vanessa; Fabrellas, Núria; Falcó, Josep Lluis; Fernández, Rosa; Fournier, C.; Fuentes, Matilde; Galle, Peter R.; García, E Navarrete; García–Retortillo, Montserrat; Garrido, E.A González; Ginès, Pere; Medina, Rosa Gordillo; Gratacós‐Ginès, Jordi; Graupera, Isabel; Grgurević, Ivica; Guha, Indra Neil; Guix, Eva; Hansen, Johanne Kragh; Harris, Rebecca; Boluda, Elena Hernández; Hernández-Ibañez, Rosario; Hoyo, Jordi; Ikram, M. Arfan; Incicco, Simone; Israelsen, Mads; Juan, Marta; Juanola, Adrià; Kaiser, Ralf I.; Kamath, Patrick S.; Karlsen, Tom H.; Kjærgaard, Maria; Korenjak, Marko; Krag, Aleksander; Krawczyk, Marcin; Laboulaye, Philippe; Lambert, Irina; Lammert, Frank; Sørensen, Simon Langkjær; Laserna, J.J.; Pi, Sonia Lazaro; Ledain, Elsa; Lévy, Vincent; Lindvig, Katrine Prier; Llorca, Anne; Londoño, Vanessa; Loyer, Guirec; T., Ann; Madir, Anita; Manns, Michael P.; Marshall, Denise; Martí, M. Lluïsa; Martínez, Sara; Sala, Ricard Martínez; Masa-Font, Roser; Jensen, Jim; Morillas, Rosa María; Muñoz, Laura; Nadal, Ruth; Napoleone, Laura; Navarrete, J. M.; Newsome, Philip N.; Nielsen, Vibeke Lehmann; Pérez, Martina; Pericás-Pulido, Juan Manuel; Piano, Salvatore; Pich, Judit; Pose, Elisa; Escobet, Judit Presas; Reichert, Matthias; Riba, Carlota; Roulot, Dominique; Rubio, Ana Belén; Sánchez-Morata, Maria; Schattenberg, Jörn M.; Serra-Burriel, Miquel; Serra-Burriel, Feliu; Just, Louise Skovborg; Sonneveld, Milan J.; Soria, Anna; Stern, Christiane; Such, Patricia; Thiele, Maja; Tonon, Marta; Torán, Pere; Torrejón, Antoni; Tsochatzis, Emmanuel; Kleef, Laurens A. van; Wijngaarden, Paulien van; Velázquez, Vanessa; Viu, Ana; Weber, Susanne N.; Wildsmith, Tracey

doi:10.1016/s0140-6736(23)01174-1

Cited by 45 publications

(13 citation statements)

References 26 publications

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“…Interestingly, several genomic studies in Mexican Amerindian and admixed cohorts have identified the signature of positive selection of some serum lipid-modulating gene traits involved in cardiovascular diseases ( 150–152 ) that plausibly could overlap with the natural history of MAFLD. Overall, these genes can be useful for the development and validation of polygenic risk scores testing for the susceptibility in liver diseases among the Mexican population in the context of the tripartite ancestry ( 154–156 ). On the other hand, the impact of nutrition in patients with chronic viral hepatitis, specifically hepatitis B and C is an opportunity of exploration since patients with these pathologies have unmet needs in terms of their nutrition care to prevent further liver damage due to genetic susceptibility and harmful eating habits.…”

Section: Discussionmentioning

confidence: 99%

Personalized medicine and nutrition in hepatology for preventing chronic liver disease in Mexico

Panduro,

Roman,

Mariscal-Martinez

et al. 2024

Front. Nutr.

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Chronic liver disease is a global health issue. Patients with chronic liver disease require a fresh approach that focuses on the genetic and environmental factors that contribute to disease initiation and progression. Emerging knowledge in the fields of Genomic Medicine and Genomic Nutrition demonstrates differences between countries in terms of genetics and lifestyle risk factors such as diet, physical activity, and mental health in chronic liver disease, which serves as the foundation for the implementation of Personalized Medicine and Nutrition (PerMed-Nut) strategies. Most of the world’s populations have descended from various ethnic groupings. Mexico’s population has a tripartite ancestral background, consisting of Amerindian, European, and African lineages, which is common across Latin America’s regional countries. The purpose of this review is to discuss the genetic and environmental components that could be incorporated into a PerMed-Nut model for metabolic-associated liver disease, viral hepatitis B and C, and hepatocellular carcinoma in Mexico. Additionally, the implementation of the PerMed-Nut approach will require updated medicine and nutrition education curricula. Training and equipping future health professionals and researchers with new clinical and investigative abilities focused on preventing liver illnesses in the field of genomic hepatology globally is a vision that clinicians and nutritionists should be concerned about.

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Section: Discussionmentioning

confidence: 99%

Personalized medicine and nutrition in hepatology for preventing chronic liver disease in Mexico

Panduro,

Roman,

Mariscal-Martinez

et al. 2024

Front. Nutr.

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“…The predictive model for clinical diagnosis and prognosis is a valuable tool and has been partially applied in clinical practice ( 22 , 23 ). In a previous study, a nomogram was constructed by combining dopamine transporter (DAT) imaging, CSF biomarkers (p-tau/α-syn and p-tau), and the rs55785911 genotype to predict mild CI in patients with PD and rapid-eye-movement sleep behavior disorder ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

A nomogram based on neuron-specific enolase and substantia nigra hyperechogenicity for identifying cognitive impairment in Parkinson’s disease

Hou,

Yang,

et al. 2024

Quant Imaging Med Surg

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Background One in four individuals with Parkinson’s disease (PD) experience cognitive impairment (CI). However, few practical models integrating clinical and neuroimaging biomarkers have been developed to address CI in PD. This study aimed to evaluate the correlation between circulating neuron-specific enolase (NSE) levels, substantia nigra hyperechogenicity (SNH), and cognitive function in PD and to develop a nomogram based on clinical and neuroimaging biomarkers for predicting CI in patients with PD. Methods A total of 385 patients with PD who underwent transcranial sonography (TCS) from January 2021 to December 2022 at Beijing Tiantan Hospital, Capital Medical University, were recruited as the training cohort. For validation, 165 patients with PD treated from January 2023 to December 2023 were enrolled. Data for SNH, plasma NSE, and other clinical measures were collected, and cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Logistic regression analysis was employed to select potential risk factors and establish a nomogram. The receiver operating characteristic curve and calibration curve were generated to evaluate the performance of the nomogram. Results Patients with PD exhibiting CI displayed advanced age, elevated Unified PD Rating Scale-III (UPDRS-III) score, an increased percentage of SNH, higher levels of plasma NSE and homocysteine (Hcy), a larger SNH area, and lower education levels compared to PD patients without CI. Gender [odds ratio (OR) =0.561, 95% confidence interval (CI): 0.330–0.954, P=0.03], age (OR =1.039; 95% CI: 1.011–1.066; P=0.005), education level (OR =0.892; 95% CI: 0.842–0.954; P<0.001), UPDRS-III scores (OR =1.026; 95% CI: 1.009–1.043; P=0.003), plasma NSE concentration (OR =1.562; 95% CI: 1.374–1.776; P<0.001), and SNH (OR =0.545; 95% CI: 0.330–0.902; P=0.02) were independent predictors of CI in patients with PD. A nomogram developed using these six factors yielded a moderate discrimination performance with an area under the curve (AUC) of 0.823 (95% CI 0.781–0.864; P<0.001). The calibration curve demonstrated acceptable agreement between predicted outcomes and actual values. Validation further confirmed the reliability of the nomogram, with an AUC of 0.864 (95% CI: 0.805–0.922; P<0.001). Conclusions The level of NSE in plasma and the SNH assessed by TCS are associated with CI in patients with PD. The proposed nomogram has the potential to facilitate the detection of cognitive decline in individuals with PD.

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“…Additionally, patients with T2D who also have MASLD have a >2× higher risk of overall mortality compared with patients without MASLD [4,[28][29][30][31]. Although awareness of the need for screening high-risk populations for unrecognized liver disease is increasing, it is still not systematically implemented in routine practice for patients with T2D [11,32,33]. According to our results, 8.9% of patients had a high risk of cACLD, significantly increasing their risk of overall mortality and the risk of poor liver disease outcomes alongside metabolic comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Compensated Advanced Chronic Liver Disease and Steatosis in Patients with Type 2 Diabetes as Assessed through Shear Wave Measurements and Attenuation Measurements

Barisic-Jaman,

Milosevic,

Skurla

et al. 2024

Biomedicines

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Patients with type 2 diabetes (T2D) are at risk of developing metabolic dysfunction-associated steatotic liver disease (MASLD). We investigated the prevalence of compensated advanced chronic liver disease (cACLD) and steatosis in patients with T2D using the new non-invasive diagnostic methods of shear wave measurements (SWMs) and attenuation (ATT) measurements in comparison with those of vibration-controlled transient elastography (VCTE) and the controlled attenuation parameter (CAP), which served as the reference methods. Among 214 T2D patients, steatosis at any grade and cACLD were revealed in 134 (62.6%) and 19 (8.9%) patients, respectively. SWMs showed a high correlation with VCTE (Spearman’s ρ = 0.641), whereas SWMs produced lower (mean of −0.7 kPa) liver stiffness measurements (LSMs) overall. At a LSM of >11.0 kPa (Youden), SWMs had an AUROC of 0.951 that was used to diagnose cACLD (defined as a LSM of >15 kPa through VCTE) with 84.2% sensitivity and 96.4% specificity. The performance of ATT measurements in diagnosing liver steatosis at any grade (defined as the CAP of ≥274 dB/m) was suboptimal (AUROC of 0.744 at the ATT measurement cut-off of >0.63 dB/cm/MHz (Youden) with 59% sensitivity and 81.2% specificity). In conclusion, the prevalence of liver steatosis and previously unrecognized cACLD in patients with T2D is high and SWMs appear to be a reliable diagnostic method for this purpose, whereas further investigation is needed to optimize the diagnostic performance of ATT measurements.

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Development, validation, and prognostic evaluation of a risk score for long-term liver-related outcomes in the general population: a multicohort study

Cited by 45 publications

References 26 publications

Personalized medicine and nutrition in hepatology for preventing chronic liver disease in Mexico

Personalized medicine and nutrition in hepatology for preventing chronic liver disease in Mexico

A nomogram based on neuron-specific enolase and substantia nigra hyperechogenicity for identifying cognitive impairment in Parkinson’s disease

Compensated Advanced Chronic Liver Disease and Steatosis in Patients with Type 2 Diabetes as Assessed through Shear Wave Measurements and Attenuation Measurements

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