Presence of Mood and/or Anxiety Disorders Does Not Affect Success of Weight Management Therapies in Metabolic Dysfunction-Associated Steatotic Liver Disease.

Metabolic dysfunction-associated steatotic liver disease (MASLD) and resultant steatohepatitis (MASH) have been linked to psychiatric comorbidities. The treatment of MASLD/MASH primarily relies upon weight loss, where achieving a 7% total body weight loss is recommended to improve steatohepatitis. We aimed to determine whether achieving a 7% total body weight loss (TBWL) in MASLD/MASH patients was significantly different in the presence of a mood and/or anxiety disorder in an interdisciplinary clinic that integrates weight management and hepatology care. We conducted a single center retrospective cohort study of MASLD/MASH patients segregated into those with an ICD-10 diagnosis of a mood and/or anxiety disorder to those without. The primary outcome was reaching a 7% TBWL at 12 months with univariable and multivariable logistic regression models used to identify treatments predicting a 7% TBWL. Secondary outcomes were noninvasive assessment of steatohepatitis improvement, including change in ALT and FIB-4 scores. Of 567 patients with MASLD/MASH, 366 (64.6%) had a mood and/or anxiety disorder. The presence of psychiatric disease was not a significant predictor of weight loss or any secondary outcome measures at 12 months. Significant predictors of achieving 7% TBWL at 12 months among all patients with MASLD/MASH included semaglutide, phentermine-topiramate, and bariatric surgery. Significant predictors of achieving 7% TBWL at 12 months in patients with MASLD/MASH and a psychiatric comorbidity included semaglutide, topiramate, phentermine-topiramate, and bariatric surgery. Both groups experienced similar improvements in hepatic outcomes. Our findings suggest that obesity management in patients with MASLD/MASH performs similarly in the presence of comorbid mood and/or anxiety disorders. Topiramate and phentermine may be particularly effective in this patient population, yet are underutilized in routine hepatology practice.

Bollinger B ，Cotter R ，Deng Y ，Ilagan-Ying Y ，Gupta V ... -  《-》

Understanding MASH: An Examination of Progression and Clinical Outcomes by Disease Severity in the TARGET-NASH Database.

Metabolic dysfunction-associated steatohepatitis (MASH), the progressive form of metabolic dysfunction-associated steatotic liver disease (MASLD), is linked to cardiometabolic risk factors such as obesity and type 2 diabetes (T2D). The rising prevalence of MASH and risk of hepatic and extra-hepatic complications emphasize the need for a better understanding of disease progression and associated outcomes. This study aimed to evaluate the incidence of, and demographic and clinical characteristics associated with, progression to MASH-related complications by disease severity in patients with non-cirrhotic MASH or MASH cirrhosis. Alignment between noninvasive tests (NITs) and biopsy-determined fibrosis stage was also assessed. This analysis used data from the TARGET-NASH cohort that includes adults with MASH across academic and community sites in the United States. Patients with non-cirrhotic MASH or MASH cirrhosis were stratified by disease severity based on fibrosis stage or cirrhosis. Progression to MASH-related outcomes, including all-cause mortality, cirrhosis, and liver transplantation, was assessed. Among the 2378 patients included in this analysis, 48% had MASH cirrhosis. Incidence of all-cause mortality increased with disease severity from 0.14/100 person-months (100PM) at fibrosis stage 0-1 (F0-F1) to 2.02/100PM with compensated cirrhosis and 4.62/100PM with decompensated cirrhosis. Compared with patients with F0-F1, risk of progression to cirrhosis was higher in patients with F3 [hazard ratio (HR), 95% confidence interval (CI); 18.66, 10.97-31.73] and F2 (HR, 95% CI; 3.74, 2.00-6.98). Among those who progressed to MASH-related outcomes, 67.9% had T2D and 73.9% had hypertension. Vibration-controlled transient elastography showed better alignment with biopsy-determined fibrosis stage than Fibrosis-4 Index (FIB-4). Progression to all-cause mortality in patients with MASH was significantly associated with the presence of higher fibrosis stage and cirrhosis. Cardiometabolic comorbidities such as T2D and hypertension were prevalent in patients with MASH progression. Early identification and management of MASH may mitigate disease progression and liver-related complications.

Luthra R ，Sheth A 《-》

Noninvasive identification of metabolic dysfunction-associated steatohepatitis (INFORM MASH): a retrospective cohort and disease modeling study.

Wood GC ，Hoovler A ，Luthra R ，Still CD ，Shariff H ，Still M ，Hayes J ，Benotti P ，Uzoigwe C ... -  《-》

Weight Loss After Sleeve Gastrectomy According to Metabolic Dysfunction-Associated Steatotic Liver Disease Stage in Patients with Obesity: A Liver Biopsy-Based Prospective Study.

Martínez-Montoro JI ，Arranz-Salas I ，Gutiérrez-Repiso C ，Sánchez-García A ，Ocaña-Wilhelmi L ，Pinazo-Bandera JM ，Fernández-García D ，Muñoz-Garach A ，Morales-García D ，García-Cortés M ，García-Fuentes E ，Tinahones FJ ，Garrido-Sánchez L ... -  《-》

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in People Living With HIV Attending Centre of Excellence in HIV Care at a Tertiary Level Teaching Hospital in North India-A Pilot Study.

Ram R ，Subramanian A ，K R 《-》