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. 2023 May;11(4):371-382.
doi: 10.1002/ueg2.12389. Epub 2023 Apr 16.

Metabolic-associated fatty liver disease is associated with acute pancreatitis with more severe course: Post hoc analysis of a prospectively collected international registry

Szilárd Váncsa  1   2   3 , Zoltán Sipos  1   4 , Alex Váradi  1   5   6 , Rita Nagy  1   2   7 , Klementina Ocskay  1   7 , Félix Márk Juhász  1   7 , Katalin Márta  2   3 , Brigitta Teutsch  1   2 , Alexandra Mikó  1   8 , Péter Jenő Hegyi  1   2   3 , Áron Vincze  9 , Ferenc Izbéki  10 , László Czakó  11 , Mária Papp  12 , József Hamvas  13 , Márta Varga  14 , Imola Török  15 , Artautas Mickevicius  16   17 , Bálint Erőss  1   2   3 , Andrea Párniczky  1   2   7 , Andrea Szentesi  1   18 , Gabriella Pár  1   9 , Péter Hegyi  1   2   3   18 ; Hungarian Pancreatic Study Group
Collaborators, Affiliations

Metabolic-associated fatty liver disease is associated with acute pancreatitis with more severe course: Post hoc analysis of a prospectively collected international registry

Szilárd Váncsa et al. United European Gastroenterol J. 2023 May.

Abstract

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a proven risk factor for acute pancreatitis (AP). However, NAFLD has recently been redefined as metabolic-associated fatty liver disease (MAFLD). In this post hoc analysis, we quantified the effect of MAFLD on the outcomes of AP.

Methods: We identified our patients from the multicentric, prospective International Acute Pancreatitis Registry of the Hungarian Pancreatic Study Group. Next, we compared AP patients with and without MAFLD and the individual components of MAFLD regarding in-hospital mortality and AP severity based on the revised Atlanta classification. Lastly, we calculated odds ratios (ORs) with 95% confidence intervals (CIs) using multivariate logistic regression analysis.

Results: MAFLD had a high prevalence in AP, 39% (801/2053). MAFLD increased the odds of moderate-to-severe AP (OR = 1.43, CI: 1.09-1.89). However, the odds of in-hospital mortality (OR = 0.89, CI: 0.42-1.89) and severe AP (OR = 1.70, CI: 0.97-3.01) were not higher in the MAFLD group. Out of the three diagnostic criteria of MAFLD, the highest odds of severe AP was in the group based on metabolic risk abnormalities (OR = 2.68, CI: 1.39-5.09). In addition, the presence of one, two, and three diagnostic criteria dose-dependently increased the odds of moderate-to-severe AP (OR = 1.23, CI: 0.88-1.70, OR = 1.38, CI: 0.93-2.04, and OR = 3.04, CI: 1.63-5.70, respectively) and severe AP (OR = 1.13, CI: 0.54-2.27, OR = 2.08, CI: 0.97-4.35, and OR = 4.76, CI: 1.50-15.4, respectively). Furthermore, in patients with alcohol abuse and aged ≥60 years, the effect of MAFLD became insignificant.

Conclusions: MAFLD is associated with AP severity, which varies based on the components of its diagnostic criteria. Furthermore, MAFLD shows a dose-dependent effect on the outcomes of AP.

Keywords: MAFLD; NAFLD; acute pancreatitis; metabolic syndrome; metabolic-associated fatty liver disease; mortality; non-alcoholic fatty liver disease; prognosis; severity; steatosis.

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Conflict of interest statement

The authors do not have any conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Patient selection flowchart.
FIGURE 2
FIGURE 2
Summary figure showing the rate of in‐hospital mortality, severity, local complications, acute peripancreatic fluid collection, pancreatic necrosis, and pseudocysts based on the different MAFLD groups. Colors for severity show mild (green), moderate (yellow), and severe (red) acute pancreatitis. MAFLD, metabolic‐associated fatty liver disease. *, **, *** represents p < 0.05, p < 0.01, and p < 0.001, respectively.
FIGURE 3
FIGURE 3
Summary figure showing the rate of systemic complications, renal failure, respiratory failure, cardiovascular failure, and diabetes as a complication, and the boxplots for the length of hospital stay and maximum C‐reactive protein based on the different MAFLD groups. MAFLD, metabolic‐associated fatty liver disease. *, **, *** represents p < 0.05, p < 0.01, and p < 0.001, respectively.
See this image and copyright information in PMC

Comment in

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