{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:50:05Z","timestamp":1791413405930,"version":"4.3.3"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T00:00:00Z","timestamp":1689811200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009336","name":"Bengt Ihres Foundation","doi-asserted-by":"publisher","award":["SLS\u2010973809"],"award-info":[{"award-number":["SLS\u2010973809"]}],"id":[{"id":"10.13039\/501100009336","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009800","name":"Stiftelsen Professor Nanna Svartz Fond","doi-asserted-by":"publisher","award":["2022\u201000448"],"award-info":[{"award-number":["2022\u201000448"]}],"id":[{"id":"10.13039\/501100009800","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["P500PM_210866"],"award-info":[{"award-number":["P500PM_210866"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2021\u201001293"],"award-info":[{"award-number":["2021\u201001293"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Previous literature suggests an association between non\u2010alcoholic fatty liver disease (NAFLD) and infections. We aimed to determine the rate and risk of severe infections in NAFLD compared to the general population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this population\u2010based cohort study, we used national registers to identify all patients with a hospital\u2010based diagnosis of NAFLD in Sweden 1987\u20132020 (<jats:italic>n<\/jats:italic>\u2009=\u200914\u2009869). The patients were matched with \u226410 comparators from the general population for age, sex, municipality, and calendar year (<jats:italic>n<\/jats:italic>\u2009=\u2009137\u2009145). Cox regression was used to estimate hazard ratios (HR) for infections in patients with NAFLD compared to comparators. Cumulative incidences were calculated while accounting for competing risks (non\u2010infection death and liver transplantation).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Severe infections leading to death or hospitalization occurred in 1990 (13.4%) patients with NAFLD and 9899 (7.2%) comparators during a median of 4.5 and 6.1\u2009years of follow\u2010up, respectively. The rate of severe infections per 1000 person\u2010years was higher in patients with NAFLD (21.0) than comparators (9.1) independently of components related to the metabolic syndrome (adjusted HR 1.9, 95% CI\u2009=\u20091.8\u20132.0). Infection\u2010related mortality was also higher in NAFLD compared to comparators (adjusted HR 1.8, 95% CI\u2009=\u20091.6\u20132.2). The 10\u2010year cumulative incidence of severe infections was 16.6% (95% CI\u2009=\u200915.8\u201317.4) in NAFLD and 8.0% (95% CI\u2009=\u20097.8\u20138.2) in comparators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>NAFLD was associated with severe infections and infection\u2010related mortality, independently of components associated with the metabolic syndrome. Increased clinical vigilance of severe infections in NAFLD may diminish the risk of premature death.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.15680","type":"journal-article","created":{"date-parts":[[2023,7,21]],"date-time":"2023-07-21T07:07:30Z","timestamp":1689923250000},"page":"2142-2152","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Risk of infections in non\u2010alcoholic fatty liver disease: A nationwide population\u2010based cohort study"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1496-1799","authenticated-orcid":false,"given":"Ying","family":"Shang","sequence":"first","affiliation":[{"name":"Department of Medicine, Huddinge Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linnea","family":"Widman","sequence":"additional","affiliation":[{"name":"Department of Medicine, Huddinge Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahim","family":"Ebrahimi","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Gastroenterology and Hepatology University Center for Gastrointestinal and Liver Diseases  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas F.","family":"Ludvigsson","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Pediatrics \u00d6rebro University Hospital  \u00d6rebro Sweden"},{"name":"Department of Medicine Columbia University College of Physicians and Surgeons  New York New York 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