Liver Fibrosis and 8-Year All-Cause Mortality Trajectories in the Aging Cohort of the Salus in Apulia Study - PubMed (original) (raw)

doi: 10.3390/biomedicines9111617.

Fabio Castellana [ 1](#full-view-affiliation-1 "Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy."), Sara De Nucci [ 1](#full-view-affiliation-1 "Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy."), Giovanni De Pergola [ 2](#full-view-affiliation-2 "Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy."), Madia Lozupone [ 1](#full-view-affiliation-1 "Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy."), Ilaria Bortone [ 1](#full-view-affiliation-1 "Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy."), Marco Castellana [ 1](#full-view-affiliation-1 "Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy."), Giancarlo Sborgia [ 3](#full-view-affiliation-3 "Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", 70124 Bari, Italy."), Luisa Lampignano [ 1](#full-view-affiliation-1 "Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy."), Gianluigi Giannelli [ 4](#full-view-affiliation-4 "Scientific Direction, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70124 Bari, Italy."), Francesco Panza [ 1](#full-view-affiliation-1 "Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy."), Rodolfo Sardone [ 1](#full-view-affiliation-1 "Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy.")

Affiliations

Liver Fibrosis and 8-Year All-Cause Mortality Trajectories in the Aging Cohort of the Salus in Apulia Study

Roberta Zupo et al. Biomedicines. 2021.

Abstract

Age is a major contributor to the liver fibrosis rate and its adverse health-related outcomes, including mortality, but older populations are still under-explored. We investigated multimorbidity and inflammatory biomarkers in relation to the increasing liver fibrosis risk to delineate 8-year all-cause mortality trajectories in 1929 older adults from the population-based Salus in Apulia Study. Liver fibrosis risk was assumed using the fibrosis-4 (FIB-4) score, assigned to three liver fibrosis risk groups (low, intermediate, high). In the secondary analyses, the APRI score was also calculated to allow for comparisons. Male subjects (prevalence difference: -13.49, 95% confidence interval (CI): -18.96 to -8.03), a higher multimorbidity burden (effect size, ES: -0.14, 95% CI: -0.26 to -0.02), a higher prevalence of physical frailty (ES: 6.77, 95% CI: 0.07 to 13.47), and a more pronounced inflammatory pattern as indicated by tumor growth factor-α circulating levels (ES: -0.12, 95% CI: -0.23 to -0.01) were significantly more common in the highest-risk FIB-4 score group. Liver function characterized by lipid profile and platelet levels worsened with increasing FIB-4 risk score. The 8-year risk of death was nearly double in subjects in the highest-risk FIB-4 score group, even after controlling for possible confounders. Furthermore, a steeper mortality curve was clearly observed for FIB-4 scores as compared with the APRI scoring system with respect to liver fibrosis risk. In conclusion, using a scoring tool based on simple routine biomarkers to detect liver fibrosis risk may enhance biological knowledge of age-related outcomes of chronic liver disease and be helpful in the clinical setting to identify subjects at risk for adverse health-related outcomes, including mortality.

Keywords: biomarkers; chronic liver disease; frailty; liver fibrosis; survival.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1

Figure 1

Kaplan–Meier survival probability curves for the three categories of fibrosis-4 (FIB-4) score (low-, intermediate-, and high-risk).

Figure 2

Figure 2

Kaplan–Meier survival curves for the probable fibrosis according to APRI scores: fibrosis-free (APRI < 0.50), liver fibrosis (APRI < 1.50) and probable cirrhosis (APRI ≥ 1.50).

References

    1. Chang A.Y., Skirbekk V.F., Tyrovolas S., Kassebaum N.J., Dieleman J.L. Measuring population ageing: An analysis of the Global Burden of Disease Study 2017. Lancet Public Health. 2019;4:e159–e167. doi: 10.1016/S2468-2667(19)30019-2. - DOI - PMC - PubMed
    1. Zupo R., Castellana F., Donghia R., Lampignano L., Guerra V., De Pergola G., Lozupone M., Bortone I., De Nucci S., Tatoli R., et al. Liver frailty and all-cause mortality in the older participants of the Salus in Apulia Study. GeroScience. 2021 doi: 10.1007/s11357-021-00434-x. - DOI - PMC - PubMed
    1. GBD 2015 Mortality and Causes of Death Collaborators Global, Regional, and National Life Expectancy, All-Cause Mortality, and Cause-Specific Mortality for 249 Causes of Death, 1980–2015: A Systematic Analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1459–1544. doi: 10.1016/S0140-6736(16)31012-1. - DOI - PMC - PubMed
    1. GBD 2015 Neurological Disorders Collaborator Group Global, Regional, and National Burden of Neurological Disorders during 1990–2015: A Systematic Analysis for the Global Burden of Disease Study 2015. Lancet Neurol. 2017;16:877–897. - PMC - PubMed
    1. Asrani S.K., Devarbhavi H., Eaton J., Kamath P.S. Burden of liver diseases in the world. J. Hepatol. 2019;70:151–171. doi: 10.1016/j.jhep.2018.09.014. - DOI - PubMed

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