Genetic Ancestry, Race, and Severity of Acutely Decompensated Cirrhosis in Latin America

被引：15

作者：

Farias, Alberto Queiroz ^{[1
]}

Vilalta, Anna Curto ^{[2
]}

Zitelli, Patricia Momoyo ^{[1
]}

Pereira, Gustavo ^{[3
,4
]}

Goncalves, Luciana L. ^{[5
]}

Torre, Aldo ^{[6
]}

Diaz, Juan Manuel ^{[2
,7
,8
]}

Gadano, Adrian C. ^{[7
,8
]}

Mattos, Angelo Z. ^{[9
,10
]}

Mendes, Liliana S. C. ^{[11
]}

Alvares-da-Silva, Mario R. ^{[12
]}

Bittencourt, Paulo L. ^{[13
]}

Benitez, Carlos ^{[14
]}

Couto, Claudia Alves ^{[15
,16
]}

Mendizabal, Manuel ^{[17
]}

Toledo, Claudio L. ^{[18
]}

Mazo, Daniel F. C. ^{[19
]}

Barradas, Mauricio Castillo ^{[20
]}

Raposo, Eva M. Uson ^{[2
]}

Padilla-Machaca, P. Martin ^{[21
,22
]}

Miranda, Adelina Zarela Lozano ^{[23
]}

Male-Velazquez, Rene ^{[24
]}

Lyra, Andre Castro ^{[25
,26
]}

Davalos-Moscol, Milagros B. ^{[27
]}

Hernandez, Jose L. Perez ^{[28
]}

Ximenes, Rafael O. ^{[29
]}

Silva, Giovanni Faria ^{[30
]}

Beltran-Galvis, Oscar A. ^{[31
]}

Huezo, Maria S. Gonzalez ^{[32
]}

Bessone, Fernando ^{[33
]}

Rocha, Tarciso D. S. ^{[34
]}

Fassio, Eduardo ^{[35
]}

Terra, Carlos ^{[36
]}

Marin, Juan I. ^{[37
]}

Casas, Patricia Sierra ^{[2
]}

de la Pena-Ramirez, Carlos ^{[2
]}

Parera, Ferran Aguilar ^{[2
]}

Fernandes, Flavia ^{[3
]}

Zago-Gomes, Maria da Penha ^{[5
]}

Mendez-Guerrero, Osvely ^{[6
]}

Marciano, Sebastian ^{[7
,8
]}

Mattos, Angelo A. ^{[9
,10
]}

Oliveira, Joao C. ^{[11
]}

Guerreiro, Gabriel T. S. ^{[12
]}

Codes, Liana ^{[13
]}

Arrese, Marco ^{[14
,38
]}

Nardelli, Mateus J. ^{[16
]}

Silva, Marcelo O. ^{[17
]}

Palma-Fernandez, Renato ^{[18
]}

Alcantara, Camila ^{[3
]}

机构：

[1] Univ Sao Paulo, Sch Med, Hosp Clin, Dept Gastroenterol, Sao Paulo, Brazil

[2] European Fdn Study Chron Liver Failure, Travessera Gracia 11,7 a, Barcelona 08021, Spain

[3] Minist Hlth, Bonsucesso Fed Hosp, Gastroenterol & Hepatol Unit, Rio De Janeiro, Brazil

[4] Univ Estacio Sa, Sch Med, Rio De Janeiro, Brazil

[5] Univ Fed Espirito Santo, Hosp Univ Cassiano Antonio Moraes, Gastroenterol & Hepatol Unit, Vitoria, Brazil

[6] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Gastroenterol, Mexico City, Mexico

[7] Hosp Italiano Buenos Aires, Liver Unit, Buenos Aires, Argentina

[8] Hosp Italiano Buenos Aires, Dept Res, Buenos Aires, Argentina

[9] Fed Univ Hlth Sci Porto Alegre, Porto Alegre, Brazil

[10] Irmandade Santa Casa Misericordia Porto Alegre, Gastroenterol & Hepatol Unit, Porto Alegre, Brazil

[11] Hosp Base Dist Fed, Brasilia, Brazil

[12] Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, Gastrointestinal & Liver Unit, Porto Alegre, Brazil

[13] Hosp Portugues Bahia, Salvador, Brazil

[14] Pontificia Univ Catolica Chile, Dept Gastroenterol, Sch Med, Santiago, Chile

[15] Univ Fed Minas Gerais, Hosp Clin, Inst Alfa Gastroenterol, Belo Horizonte, Brazil

[16] Univ Fed Minas Gerais, Fac Med, Belo Horizonte, Brazil

[17] Hosp Univ Austral, Unidad Higado & Trasplante Hepat, Pilar, Buenos Aires, Argentina

[18] Univ Austral Chile, Hosp Valdivia, Valdivia, Chile

[19] Univ Estadual Campinas, Div Gastroenterol, Campinas, Brazil

[20] Inst Mexicano Seguro Social, Serv Gastroenterol & Hepatol, Ctr Med Nacl La Raza, Hosp Especialidades, Mexico City, Mexico

[21] Hosp Nacl Guillermo Almenara, Lima, Peru

[22] Univ Nacl San Marcos, Lima, Peru

[23] Hosp Nacl Arzobispo Loayza, Unidad Higado, Lima, Peru

[24] Inst Salud Digest & Hepat, Guadalajara, Mexico

[25] Hosp Univ Prof Edgard Santos, Salvador, Brazil

[26] Hosp Sao Rafael, Salvador, Brazil

[27] Hosp Nacl Edgardo Rebagliati Martins EsSalud, Lima, Peru

[28] Hosp Gen Mexico Dr Eduardo Liceaga, Clin Higado, Mexico City, Mexico

[29] Univ Fed Goias, Hosp Clin, Serv Gastroenterol & Hepatol, Goiania, Brazil

[30] Fac Med Botucatu, Botucatu, Brazil

[31] Grp Gastrohepatol & Trasplante Fdn Cardioinfantil, Medellin, Colombia

[32] Inst Seguridad Social Estado Mexico & Municipios, Dept Gastroenterol, Ctr Med, Metepec, Mexico

[33] Univ Nacl Rosario, Hosp Prov Centenario, Rosario, Argentina

[34] Hosp Univ Walter Cantidio, Fortaleza, Brazil

[35] Hosp Nacl Prof Alejandro, Serv Gastroenterol, Secc Higado Vias Biliares & Pancreas, Buenos Aires, Argentina

[36] Univ Estado Rio de Janeiro, Hosp Univ Pedro Ernesto, Serv Gastroenterol, Unidade Hepatol, Rio De Janeiro, Brazil

[37] Bogota & Hosp Pablo Tobon Uribe, Medellin, Colombia

[38] Pontificia Univ Catolica Chile, Ctr Envejecimiento & Regenerac, Fac Ciencias Biol, Dept Biol Celular & Mol, Santiago, Chile

[39] Klin Infektiol, Med Klin B, Gastroenterol Hepatol Endokrinol, Munster, Germany

[40] Univ Libre Bruxelles, Clin Univ Bruxelles Erasme Hosp, Dept Gastroenterol & Hepatopancreatol, Brussels, Belgium

[41] Univ Barcelona, Hosp Clin, Inst Invest Biomed August Pi i Sunyer, Barcelona, Spain

[42] Ctr Invest Biomed Red Enfermedades Hepat & Digest, Barcelona, Spain

[43] UCL, Royal Free Hosp, Inst Liver Dis Hlth, Liver Failure Grp, London, England

[44] Univ Padua, Dept Med, Unit Internal Med & Hepatol, Padua, Italy

[45] Univ Paris Cite, INSERM, Ctr Rech Inflammat, Paris, France

[46] Hop Beaujon, AP HP, Serv Hepatol, Clichy, France

来源：

GASTROENTEROLOGY | 2023年 / 165卷 / 03期

关键词：

Systemic Inflammation; Ethnicity; Sociodemographic Data; Liver Transplantation; Outcomes; CHRONIC LIVER-FAILURE; MORTALITY; SURVIVAL; PREDICT;

D O I：

10.1053/j.gastro.2023.05.033

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

BACKGROUND & AIMS: Genetic ancestry or racial differences in health outcomes exist in diseases associated with systemic inflammation (eg, COVID-19). This study aimed to investigate the association of genetic ancestry and race with acute-on chronic liver failure (ACLF), which is characterized by acute systemic inflammation, multi-organ failure, and high risk of short-term death. METHODS: This prospective cohort study analyzed a comprehensive set of data, including genetic ancestry and race among several others, in 1274 patients with acutely decompensated cirrhosis who were nonelectively admitted to 44 hospitals from 7 Latin American countries. RESULTS: Three hundred ninety-five patients (31.0%) had ACLF of any grade at enrollment. Patients with ACLF had a higher median percentage of Native American genetic ancestry and lower median percentage of European ancestry than patients without ACLF (22.6% vs 12.9% and 53.4% vs 59.6%, respectively). The median percentage of African genetic ancestry was low among patients with ACLF and among those without ACLF. In terms of race, a higher percentage of patients with ACLF than patients without ACLF were Native American and a lower percentage of patients with ACLF than patients without ACLF were European American or African American. In multivariable analyses that adjusted for differences in sociodemographic and clinical characteristics, the odds ratio for ACLF at enrollment was 1.08 (95% CI, 1.03-1.13) with Native American genetic ancestry and 2.57 (95% CI, 1.84-3.58) for Native American race vs European American race CONCLUSIONS: In a large cohort of Latin American patients with acutely decompensated cirrhosis, increasing percentages of Native American ancestry and Native American race were factors independently associated with ACLF at enrollment.

引用

页码：696 / 716

页数：21

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