{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T17:05:40Z","timestamp":1775322340712,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T00:00:00Z","timestamp":1713916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Advanced fibrosis has a strong influence on the occurrence of liver\u2010related events in patients with metabolic dysfunction\u2010associated steatotic liver disease (MASLD), while diabetes mellitus (DM), which is often complicated by MASLD, is associated with the progression of MASLD. We stratified patients with MASLD according to the severity of liver pathological findings and the presence of DM, aiming to examine whether these indices could be used to accurately assess the risk of developing liver\u2010related events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 282 patients with liver biopsy\u2010proven MASLD were included. Liver\u2010related events were defined as the occurrence of hepatocellular carcinoma (HCC) and complications of liver cirrhosis, such as ascites, hepatic encephalopathy, Child\u2013Pugh class B and C, as well as treatment\u2010eligible esophageal and gastric varices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Multivariate analysis adjusted for age, sex, body mass index, alanine aminotransferase, creatinine, hemoglobin A1c, smoking habits, dyslipidemia, hypertension, nonalcoholic fatty liver disease activity score (NAS), or fibrosis stage showed that advanced fibrosis with or without DM was a risk factor for liver\u2010related events. The combined effect of DM and advanced fibrosis increased the risk of HCC onset. However, DM alone or in combination with NAS did not affect the development of liver\u2010related events, including the occurrence of HCC and complications of liver cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While the assessment of fibrosis in patients with MASLD is important for evaluating the risk of developing liver\u2010related events, combining the assessment of DM may be possible to stratify groups at higher risk of developing HCC.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.14049","type":"journal-article","created":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T15:38:30Z","timestamp":1713973110000},"page":"1016-1026","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Combined effect of histological findings and diabetes mellitus on liver\u2010related events in patients with metabolic dysfunction\u2010associated steatotic liver disease"],"prefix":"10.1111","volume":"54","author":[{"given":"Akihito","family":"Shiomi","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teruki","family":"Miyake","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinya","family":"Furukawa","sequence":"additional","affiliation":[{"name":"Health Services Center Ehime University  Matsuyama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bunzo","family":"Matsuura","sequence":"additional","affiliation":[{"name":"Department of Lifestyle\u2010Related Medicine and Endocrinology Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osamu","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takao","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayumi","family":"Kanamoto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masumi","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hironobu","family":"Nakaguchi","sequence":"additional","affiliation":[{"name":"Department of Lifestyle\u2010Related Medicine and Endocrinology Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3008-691X","authenticated-orcid":false,"given":"Yoshio","family":"Tokumoto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5634-5313","authenticated-orcid":false,"given":"Masashi","family":"Hirooka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanori","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4117-339X","authenticated-orcid":false,"given":"Yoichi","family":"Hiasa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,4,24]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28431"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27368"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.01.043"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2029349"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.04.043"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.13688"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29367"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.05.025"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102020\u2010322572"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.02.028"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.26165"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0095485"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1542\u20103565(04)00014\u2010x"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620\u2010013\u20102743\u20105"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.03.039"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20701"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.13925"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc23\u2010s002"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.5551\/jat.gl2017"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41440\u2010019\u20100284\u20109"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2022.01.002"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535\u2010013\u20100911\u20101"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31806"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.4093\/dmj.2023.0200"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09\u20100148"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2021.04.015"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.24001"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.2147\/jhc.s274933"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/hep.0000000000000323"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2019.154001"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa0907929"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(15)00803\u2010x"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2028395"}],"container-title":["Hepatology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hepr.14049","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,7]],"date-time":"2024-12-07T10:48:27Z","timestamp":1733568507000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hepr.14049"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,24]]},"references-count":33,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1111\/hepr.14049"],"URL":"https:\/\/doi.org\/10.1111\/hepr.14049","archive":["Portico"],"relation":{},"ISSN":["1386-6346","1872-034X"],"issn-type":[{"value":"1386-6346","type":"print"},{"value":"1872-034X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,24]]},"assertion":[{"value":"2023-12-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}