MASLD associated with increased risk of bacterial infections: Study

A new study published in the journal of Liver International unveiled a strong correlation between metabolic dysfunction-associated steatotic liver disease (MASLD) and a higher risk of severe bacterial infections that need hospitalization. An increasing amount of epidemiological data indicates that MASLD may be associated with liver-related problems as well as extrahepatic malignancies, newly developed type 2 diabetes, cardiovascular events, and poor renal outcomes. The primary cause of liver-related morbidity and death as well as the most frequent cause of chronic liver disease is MASLD.

Prior research has indicated a correlation between the risk of severe bacterial infections and steatotic liver disease linked to metabolic dysfunction. It is unclear, therefore, how big the risk is and if it changes depending on how severe MASLD is. Alessandro Mantovani and colleagues assessed the correlation between MASLD and severe bacterial infections necessitating hospitalization by conducting a meta-analysis of observational data.

The study used preset keywords to conduct a systematic search of PubMed, Web of Science, Scopus, and Embase from the creation of database until April 1, 2024. Imaging, liver biopsy, or International Classification of Diseases codes were used to diagnose MASLD. Random-effects modeling was used to conduct the meta-analysis.

A total of 6 cross-sectional and 2 prospective cohort studies including aggregate data on about 26.6 million people were finalized for analysis. Higher risks of major bacterial infections were substantially correlated with MASLD (pooled random-effects odds ratio 1.93, 95% confidence interval [CI] 1.44-2.58; I2 = 93%). MAFLD was linked to a higher risk of having major bacterial infections, according to a meta-analysis of prospective cohort studies (pooled random-effects hazard ratio 1.80, 95% CI 1.62-2.0; I2 = 89%).

This risk rose further with MASLD severity, particularly with increasing fibrosis severity (pooled random-effects hazard ratio 2.42, 95% CI 1.89-2.29; I2 = 92%). Even after accounting for age, sex, diabetes, obesity, and other possible confounders, these findings held significance. Sensitivity studies did not change these conclusions. Overall, this study clearly shows that there is a very high likelihood of bacterial infection after metabolic dysfunction-associated steatotic liver disease, and so, proper care and treatment should be given to the patient admitted with MASLD.

Source:

Mantovani, A., Morandin, R., Fiorio, V., Lando, M. G., Gaviraghi, A., Motta, L., Gobbi, F., Tilg, H., Byrne, C. D., & Targher, G. (2024). Association between MASLD and increased risk of serious bacterial infections requiring hospital admission: A meta‐analysis. In Liver International. Wiley. https://doi.org/10.1111/liv.16101