Hepatic inflammation, fibrosis influence mid-term mortality in MASLD

In patients with metabolic dysfunction-associated steatotic liver disease (MASLD), mid-term mortality increases in the presence of hepatic inflammation and fibrosis, as reported in a study.

The study included 1,349 patients with biopsy-proven MASLD, who contributed to an observational period of 8,010 person-years. Cox regression analysis was used to examine independent factors associated with mortality in MASLD, while data-mining analysis was used to evaluate pathological profiles related to mortality.

In the cohort, the prevalence rate of metabolic dysfunction-associated steatohepatitis (MASH) was 65.6 percent and that of stage 3/4 fibrosis was 17.4 percent.

A total of 45 patients died during the study. The most common cause of death was liver-related events at 40 percent, followed by extrahepatic malignancies at 26.7 percent. Grade 2/3 lobular inflammation was associated with a 1.9-fold increase in the risk of mortality, while stage 3/4 fibrosis was associated with a 1.8-fold risk increase.

The decision-tree analysis showed that patients with the worst prognosis were those who had grade 2/3 hepatic inflammation, along with advanced ballooning (grade 1/2) and fibrosis (stage 3/4). The mortality rate in this group of patients was 8.3 percent.

Finally, the random forest analysis indicated that hepatic fibrosis and inflammation were the two most important factors that influenced mid-term survival among patients with MASLD.

In light of the findings, researchers stressed the importance of targeting inflammation and fibrosis in the management of patients with MASLD.