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. 2022 Apr 14:9:847091.
doi: 10.3389/fmed.2022.847091. eCollection 2022.

Influence of Metabolic Risk Factors on the Risk of Bacterial Infections in Hepatitis B-Related Cirrhosis: A 10-Year Cohort Study

Qiao Yang  1 , Yifan Tong  2 , Borui Pi  1 , Hong Yu  2 , Fangfang Lv  1
Affiliations

Influence of Metabolic Risk Factors on the Risk of Bacterial Infections in Hepatitis B-Related Cirrhosis: A 10-Year Cohort Study

Qiao Yang et al. Front Med (Lausanne). .

Abstract

Aim: The effect of metabolic factors on the risk of bacterial infections (BIs) in patients with hepatitis B virus (HBV)-related cirrhosis has not been demonstrated. This study aimed to explore specific metabolic factors associated with the BIs in these patients.

Methods: A population-based cohort of 471 patients with HBV-related cirrhosis was retrospectively enrolled between 2009 and 2019. The primary end point was the incidence of BIs during hospitalization, which were compared according to the metabolism-related indicators, namely, presence of diabetes, level of high-density lipoprotein cholesterol (HDLC) and triglyceride, and body mass index (BMI). The propensity score matching (PSM) was adopted to eliminate baseline discrepancies.

Results: Compared with the non-diabetic group, the incidences of BIs were higher in the diabetic group before and after PSM (p = 0.029 and p = 0.027). Similar results were found in the low HDLC group as compared with the normal HDLC group before and after PSM (p < 0.001 and p = 0.025). Further analysis showed that the incidences of BIs in patients with low HDLC alone were lower than patients with both low HDLC and diabetes before and after PSM (p = 0.003 and p = 0.022). Similarly, the incidence of BIs in patients with diabetes alone was lower than those in patients with both low HDLC and diabetes both before and after PSM (p = 0.002 and p = 0.018). However, neither triglyceride nor BMI level was related to BIs in our cohort.

Conclusion: In patients with HBV-related cirrhosis, the presence of diabetes and low level of HDLC were risk factors of BIs, showing a synergistic effect.

Keywords: bacterial infections; body mass index; diabetes; high-density lipoproteins; liver cirrhosis; triglycerides.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart of patient selection. BMI, body mass index; DM, diabetes mellitus; HDLC, high-density lipoprotein cholesterol; PSM, propensity score matching; TG, triglyceride.
FIGURE 2
FIGURE 2
(A) The percentage of patients with diabetes and non-diabetes in infection and non-infection groups; (B) levels of HLDC in infection and non-infection groups; (C) BMI in infection and non-infection groups; and (D) levels of triglyceride in infection and non-infection groups. BMI, body mass index; HDLC, high-density lipoprotein cholesterol.
See this image and copyright information in PMC

References

    1. European Association for the Study of the Liver. EASL clinical practice guidelines for the management of patients with decompensated cirrhosis. J Hepatol. (2018) 69:406–60. 10.1016/j.jhep.2018.03.024 - DOI - PubMed
    1. Shi Y, Yang Y, Hu Y, Wu W, Yang Q, Zheng M, et al. Acute-on-chronic liver failure precipitated by hepatic injury is distinct from that precipitated by extrahepatic insults. Hepatology. (2015) 62:232–42. 10.1002/hep.27795 - DOI - PubMed
    1. Fernández J, Gustot T. Management of bacterial infections in cirrhosis. J Hepatol. (2012) 56(Suppl. 1):S1–12. 10.1016/S0168-8278(12)60002-6 - DOI - PubMed
    1. Watt MJ, Miotto PM, De Nardo W, Montgomery MK. The liver as an endocrine organ-linking NAFLD and insulin resistance. Endocr Rev. (2019) 40:1367–93. 10.1210/er.2019-00034 - DOI - PubMed
    1. Elkrief L, Rautou PE, Sarin S, Valla D, Paradis V, Moreau R. Diabetes mellitus in patients with cirrhosis: clinical implications and management. Liver Int. (2016) 36:936–48. 10.1111/liv.13115 - DOI - PubMed