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

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-cau...

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Autores principales:	Roberta Zupo, Fabio Castellana, Sara De Nucci, Giovanni De Pergola, Madia Lozupone, Ilaria Bortone, Marco Castellana, Giancarlo Sborgia, Luisa Lampignano, Gianluigi Giannelli, Francesco Panza, Rodolfo Sardone
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	chronic liver disease frailty survival biomarkers liver fibrosis Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/565a71e54596489084e2dcac39927d9b
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spelling	oai:doaj.org-article:565a71e54596489084e2dcac39927d9b2021-11-25T16:49:39ZLiver Fibrosis and 8-Year All-Cause Mortality Trajectories in the Aging Cohort of the Salus in Apulia Study10.3390/biomedicines91116172227-9059https://doaj.org/article/565a71e54596489084e2dcac39927d9b2021-11-01T00:00:00Zhttps://www.mdpi.com/2227-9059/9/11/1617https://doaj.org/toc/2227-9059Age 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.Roberta ZupoFabio CastellanaSara De NucciGiovanni De PergolaMadia LozuponeIlaria BortoneMarco CastellanaGiancarlo SborgiaLuisa LampignanoGianluigi GiannelliFrancesco PanzaRodolfo SardoneMDPI AGarticlechronic liver diseasefrailtysurvivalbiomarkersliver fibrosisBiology (General)QH301-705.5ENBiomedicines, Vol 9, Iss 1617, p 1617 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	chronic liver disease frailty survival biomarkers liver fibrosis Biology (General) QH301-705.5
spellingShingle	chronic liver disease frailty survival biomarkers liver fibrosis Biology (General) QH301-705.5 Roberta Zupo Fabio Castellana Sara De Nucci Giovanni De Pergola Madia Lozupone Ilaria Bortone Marco Castellana Giancarlo Sborgia Luisa Lampignano Gianluigi Giannelli Francesco Panza Rodolfo Sardone Liver Fibrosis and 8-Year All-Cause Mortality Trajectories in the Aging Cohort of the Salus in Apulia Study
description	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.
format	article
author	Roberta Zupo Fabio Castellana Sara De Nucci Giovanni De Pergola Madia Lozupone Ilaria Bortone Marco Castellana Giancarlo Sborgia Luisa Lampignano Gianluigi Giannelli Francesco Panza Rodolfo Sardone
author_facet	Roberta Zupo Fabio Castellana Sara De Nucci Giovanni De Pergola Madia Lozupone Ilaria Bortone Marco Castellana Giancarlo Sborgia Luisa Lampignano Gianluigi Giannelli Francesco Panza Rodolfo Sardone
author_sort	Roberta Zupo
title	Liver Fibrosis and 8-Year All-Cause Mortality Trajectories in the Aging Cohort of the Salus in Apulia Study
title_short	Liver Fibrosis and 8-Year All-Cause Mortality Trajectories in the Aging Cohort of the Salus in Apulia Study
title_full	Liver Fibrosis and 8-Year All-Cause Mortality Trajectories in the Aging Cohort of the Salus in Apulia Study
title_fullStr	Liver Fibrosis and 8-Year All-Cause Mortality Trajectories in the Aging Cohort of the Salus in Apulia Study
title_full_unstemmed	Liver Fibrosis and 8-Year All-Cause Mortality Trajectories in the Aging Cohort of the Salus in Apulia Study
title_sort	liver fibrosis and 8-year all-cause mortality trajectories in the aging cohort of the salus in apulia study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/565a71e54596489084e2dcac39927d9b
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Liver Fibrosis and 8-Year All-Cause Mortality Trajectories in the Aging Cohort of the Salus in Apulia Study

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