Fatty liver disease is associated with the severity of acute pancreatitis:A systematic review and meta-analysis

Hou, Sen; Tang, Xi; Cui, Huxiao; Liu, Chaoxu; Bai, Xiangyu; Li-ming, Shi; Shi, Yong

doi:10.1016/j.ijsu.2019.04.003

Cited by 17 publications

(11 citation statements)

References 25 publications

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“…Previously, only one meta-analysis that included a limited number of articles reported increased AP severity in FLD patients [ 39 ]. In this analysis, they reported on the severity of AP in patients with and without FLD, even though one of the included articles in their analysis reported on the association between severe FLD and AP severity.…”

Section: Discussionmentioning

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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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%

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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“…Interestingly, in our study, NAFLD have been shown to be independently related to the occurence of severe cholangitis, regardless of obesity. NAFLD have also been shown to independently correlate with the risk of developing severe pancreatitis, presumably through similar mechanisms [3].…”

Section: Discussionmentioning

confidence: 99%

“…Biliary and pancreatic manifestations have been reported in patients with NAFLD. NAFLD has been positively found to be associated with pancreatitis and its severity [3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Nonalcoholic fatty liver disease as a risk factor for severity of acute cholangitis

Mahmud

Fteiha

Nubani

et al. 2020

Preprint

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Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most prevalent chronic liver disorders worldwide. Acute cholangitis (AC) is a serious and life-threatening illness. We aimed to determine whether NAFLD is a risk factor for severity of AC.Methods: We retrospectively studied hospitalized patients with diagnosis of AC over the span of 5 years. Subjects were divided into a NAFLD group and Non NAFLD group. We compared between the two groups in terms of demographic characteristics, comorbidities, laboratory data, and severity of AC (including Charlson Comorbidity index and Tokyo Consensus meeting criteria). Results: 298 of 419 patients who had AC and were hospitalized met the inclusion criteria and were included in the study. Of them, 73/298 (24.5%) were included in NAFLD group. NAFLD group patients were younger, diabetic and more obese than non NAFLD group. Subjects in the NAFLD presented with higher serum C-reactive protein and higher liver enzymes (p<0.05, for each parameter) and suffered more events of organ dysfunction(p<0.001) and bacteremia (p<0.005). Regarding the severity of AC according to Tokyo classification, among the NAFLD group more subjects presented with Grade II (39.7 Vs 33.3%, p <0.001) and Grade III (23.3 vs 18.3, p<0.001) cholangitis, as opposed more Grade I cholangitis among the non-NAFLD group (48.4 vs 37%, p<0.001). Multivariate logistic regression analysis showed that NAFLD is independently associated with severe AC, grade III (OR 3.25, 95% CI 1.65-6.45, p=0.038). Conclusions: NAFLD is as an independent risk factor for severity of AC.

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“…Even after adjusting for confounding variables (e.g., age, BMI, cause of AP) FL is a statistically significant risk factor for a severe disease course [70]. The results of a meta-analysis performed by Hou et al to investigate the prognostic effect of FL on AP prognosis suggested that FL is independently associated with a severe clinical course of disease [72]. They also found a higher mortality in the FL-related AP group compared with the nonFL related AP group and a greater risk of systemic inflammatory response syndrome and local complications.…”

Section: Effects Of Fatty Livermentioning

confidence: 99%

“…As an inflammatory disease, FL also promotes chronic systemic inflammation [73–75] and likely exacerbates the severity of AP. The serum C-reactive protein level elevation that occurs in patients with FL suggests this chronic inflammatory process occurs [70, 76, 77], and a chronic pro-inflammatory condition in patients with FL may increase the severity of the course of AP [72].…”

Section: Effects Of Fatty Livermentioning

confidence: 99%

Relationships between Metabolic Comorbidities and Occurrence, Severity, and Outcomes in Patients with Acute Pancreatitis: A Narrative Review

Guo

et al. 2019

BioMed Research International

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Background. The population of patients with acute pancreatitis treated by the staff at our department of gastroenterology includes those with mild and self-limited disease ranging to those with severe and fatal disease. Early diagnosis and accurate prediction of the severity and outcome of this disease, which is commonly seen by our department, is important for a successful outcome. Metabolic comorbidities (e.g., diabetes mellitus, fatty liver, obesity, and metabolic syndrome) are relevant to the severity and progression of many diseases. The objective of this review was to examine clinical relationships between metabolic comorbidities and occurrence, severity, and outcome of acute pancreatitis.

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Fatty liver disease is associated with the severity of acute pancreatitis:A systematic review and meta-analysis

Cited by 17 publications

References 25 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

Nonalcoholic fatty liver disease as a risk factor for severity of acute cholangitis

Relationships between Metabolic Comorbidities and Occurrence, Severity, and Outcomes in Patients with Acute Pancreatitis: A Narrative Review

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