Dyslipidemia is a Risk Factor for the Incidence and Severity of Drug-Induced Liver Injury (DILI): A Retrospective Population-Based Study in China

Abstract

Background A Chinese population-based study aimed to investigate the risk factors for the incidence and severity of drug-induced liver injury (DILI) from Chinese herbal medicines and conventional Western medicines. Material/Methods Liver biopsy and routine laboratory testing, including serum lipid measurements, was performed on 465 patients, including 168 patients with DILI and 297 patients without DILI. Histological grading of DILI used the METAVIR scoring system and the severity of DILI was graded as levels 0–5. Multivariate and univariate regression analysis were used to compare the two study groups, using a risk-adjusted odds ratio (AOR). Results There was no significant association between age, alcohol status, cardiovascular disease (CVD), hypertension, or type 2 diabetes mellitus and development of DILI. However, when compared with controls, patients with dyslipidemia (AOR, 2.173; 95% CI, 1.388–3.401; P=0.001) had an increased incidence of DILI, and men had a reduced incidence of DILI when compared with women (AOR, 0.276; 95% CI, 0.169–0.450; P<0.001). Risk factors for severe DILI (≥level 3) included drinking alcohol (AOR, 6.506; 95% CI, 2.184–19.384; P =0.001), and dyslipidemia (AOR, 3.095; 95% CI, 1.345–7.123; P=0.008). Patients with an increased duration of drug treatment of >1 year had a reduced risk of developing severe DILI compared with patients with a medication duration of ≤1 month (AOR, 0.259; 95% CI, 0.084–0.802). Conclusions Increased risk of the incidence of DILI was significantly associated with female gender and dyslipidemia, and the risk of developing severe DILI was associated with drinking alcohol and dyslipidemia.

Increased red cell distribution width predicts severity of drug-induced liver injury: a retrospective study

“…Innate/adaptive immune responses have key roles in the biological mechanisms of DILI 41 and could also could affect blood cell levels. Consistent with the results of other studies, we found associations between dyslipidemia, drinking, and the severity of DILI 2 . The detailed mechanisms have been described in our previous study 2 , 41 .…”

“…Consistent with the results of other studies, we found associations between dyslipidemia, drinking, and the severity of DILI 2 . The detailed mechanisms have been described in our previous study 2,41 .…”

“…Although limited data exist on the incidence among the general population of drug-induced liver injury (DILI), it is an important public health problem because many medications are likely involved in the occurrence of liver injury 1 , 2 . Because DILI is a difficult disease to diagnose, the actual values for incidence are likely greater than reported.…”

Epidemiology of Drug- and Herb-Induced Liver Injury Assessed for Causality Using the Updated RUCAM in Two Hospitals from China

“…The liver is an important organ for drug metabolism and transformation as well as for overall metabolism and immunity. The incidence of DILI and HILI has seen a steady increase over recent years, and DILI and HILI has become a common and serious drug-induced condition worldwide [ 16 , 17 ].…”

Prevalence of Adverse Drug Events in Severely Obese Adults and Associated Factors: Clinical Trial Baseline Results

“…The high prevalence of GIT symptoms can be explained by obesity itself, which is a risk factor for hepatic steatosis [36,37], abdominal pain, nausea, vomiting, and diarrhoea [37]. In addition, hepatic steatosis may be associated with changes in drug metabolism, which contribute to the manifestation of GIT-related symptoms [38]. Although CNS-related symptoms have not yet been physiologically elucidated, obesity has been associated with sleep disorders [39], which could explain the sleepiness presented by the patients in our study.…”