Metabolic Problems and Weight-Loss Surgery in Alcohol-Related Hepatitis: New Research on Survival Rates
A new VCU study examines how metabolic issues and past weight-loss surgery affect hospitalized patients with acute alcohol-related hepatitis and sheds light on how these conditions influence the severity of the disease and treatment outcomes.
Alcohol-associated hepatitis is a serious liver disease caused by heavy drinking. It has a high risk of death in the short term. Health problems like diabetes and obesity—signs of metabolic dysfunction—are linked to worse liver disease. But there hasn’t been much research on how these metabolic issues affect alcohol-associated hepatitis, now called metabolic dysfunction alcohol-associated hepatitis (MetAH).
This study, published by the journal Clinical Gastroenterology and Hepatology, focused on whether metabolic issues like obesity and/or diabetes and past weight-loss surgery affect 30-day survival rates in hospitalized MetAH patients. Led by Richard K. Sterling, M.D., M.Sc., the institute’s chief clinical officer and chief of hepatology at VCU, the VCU team studied the medical records of 714 patients at VCU Health.
Among the key findings:
- Of 714 patients, 40% had MetAH, of which 78% were obese and 40% had diabetes.
- Patients with obesity had more severe cases of hepatitis based on higher Model for End-Stage Liver Disease (MELD) and Maddrey's Discriminant Function (MDF) scores. However, their 30-day survival was comparable to those with lower BMI without metabolic dysfunction.
- Of patients who had prior weight-loss surgery (71% had Roux-en-Y gastric bypass) had higher bilirubin and blood clotting times, and more severe liver disease. Still, their 30-day survival rate was about the same as those who never had surgery.
- Patients with higher bilirubin, creatinine, and prothrombin time, as well as worse MELD and MDF scores, had a greater risk of dying.
The study suggests that while obesity makes alcohol-related hepatitis more severe, it does not directly affect short-term survival. Also, having had weight-loss surgery might change how the disease appears, but it does not necessarily worsen survival.
The researchers say that better treatment plans are needed as obesity, diabetes, and weight-loss surgery are becoming more common in people with alcohol use disorder.