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עמוד בית
Sat, 15.06.24

ORIGINAL ARTICLES

IMAJ | volume 25

Journal 3, March 2023
pages: 191-195

Nonalcoholic Fatty Liver Disease as a Risk Factor for Severe Cholangitis

1 Faculty of Medicine, Hebrew University of Jerusalem, Israel 2 Department of Gastroenterology and Liver Diseases, Shaare Zedek Medical Center, Jerusalem, Israel 3 Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel 4 Department of Internal Medicine, Tzafon Medical Center, Lower Galilee, Israel

Summary

Background:

Nonalcoholic fatty liver disease (NAFLD) is one of the most prevalent chronic liver disorders. Acute cholangitis (AC) is a life-threatening illness.

Objective:

To determine whether NAFLD is a risk factor for the severity of AC.

Methods:

We retrospectively studied hospitalized patients with a diagnosis of AC over 5 years. Patients were divided into a NAFLD group and a non-NAFLD group. We compared the two groups with regard to demographic characteristics, co-morbidities, laboratory data, and severity of AC (including Charlson Comorbidity Index [CCI] and Tokyo Consensus meeting criteria).

Results:

In all, 298 of 419 hospitalized patients diagnosed with AC met the inclusion criteria. Of these, 73/298 (24.5%) were in the NAFLD group. NAFLD group patients were younger and more likely to be diabetic and obese than the non-NAFLD group. Participants in the NAFLD presented with higher serum C-reactive protein and higher liver enzymes (P < 0.05, for each parameter) and with more events of organ dysfunction (P < 0.001) and bacteremia (P < 0.005). Regarding the severity of AC according to Tokyo Consensus, among the NAFLD group more patients presented with Grade II (39.7 vs. 33.3%, P < 0.001) and Grade III (23.3 vs. 18.3, P < 0.001) cholangitis. More Grade I cholangitis was found among the non-NAFLD group (48.4 vs. 37%, P < 0.001). Multivariate logistic regression analysis showed that NAFLD was independently associated with severe AC, Grade III (odds ratio 3.25, 95% confidence interval 1.65–6.45, P = 0.038).

Conclusions:

NAFLD is an independent risk factor for the severity of AC.

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