{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T21:18:50Z","timestamp":1787260730035,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T00:00:00Z","timestamp":1726012800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T00:00:00Z","timestamp":1726012800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Previous studies have reported an association between metabolic dysfunction\u2010associated steatotic liver disease (MASLD) and the risk of serious bacterial infections. However, the magnitude of the risk and whether this risk varies with the severity of MASLD remains uncertain. We performed a meta\u2010analysis of observational studies to quantify the association between MASLD and serious bacterial infections requiring hospital admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched PubMed, Scopus, Web of Science and Embase from database inception to 1 April 2024, using predefined keywords to identify studies examining the risk of serious bacterial infections among individuals with and without MASLD. MASLD was diagnosed using liver biopsy, imaging or International Classification of Diseases codes. Meta\u2010analysis was performed using random\u2010effects modelling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified six cross\u2010sectional and two prospective cohort studies with aggregate data on ~26.6 million individuals. MASLD was significantly associated with higher odds of serious bacterial infections (pooled random\u2010effects odds ratio 1.93, 95% confidence interval [CI] 1.44\u20132.58;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>\n                        <jats:italic>2<\/jats:italic>\n                      <\/jats:sup>\n                      \u2009=\u200993%). Meta\u2010analysis of prospective cohort studies showed that MAFLD was associated with an increased risk of developing serious bacterial infections (pooled random\u2010effects hazard ratio 1.80, 95% CI 1.62\u20132.0;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>\n                        <jats:italic>2<\/jats:italic>\n                      <\/jats:sup>\n                      \u2009=\u200989%). This risk further increased across the severity of MASLD, especially the severity of fibrosis (pooled random\u2010effects hazard ratio 2.42, 95% CI 1.89\u20132.29;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>\n                        <jats:italic>2<\/jats:italic>\n                      <\/jats:sup>\n                      \u2009=\u200992%). These results remained significant after adjusting for age, sex, obesity, diabetes and other potential confounders. Sensitivity analyses did not modify these findings. The funnel plot did not reveal any significant publication bias.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This meta\u2010analysis shows a significant association between MASLD and an increased risk of serious bacterial infections requiring hospital admission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.16101","type":"journal-article","created":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T09:14:21Z","timestamp":1726046061000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Association between\n                    <scp>MASLD<\/scp>\n                    and increased risk of serious bacterial infections requiring hospital admission: A meta\u2010analysis"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7271-6329","authenticated-orcid":false,"given":"Alessandro","family":"Mantovani","sequence":"first","affiliation":[{"name":"Department of Medicine, Section of Endocrinology, Diabetes and Metabolism University of Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Morandin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Endocrinology, Diabetes and Metabolism University of Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Fiorio","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Endocrinology, Diabetes and Metabolism University of Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Giovanna","family":"Lando","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Endocrinology, Diabetes and Metabolism University of Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Gaviraghi","sequence":"additional","affiliation":[{"name":"Department of Infectious Tropical Diseases and Microbiology IRCCS Sacro Cuore\u2010Don Calabria Hospital  Negrar di Valpolicella Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Motta","sequence":"additional","affiliation":[{"name":"Department of Infectious Tropical Diseases and Microbiology IRCCS Sacro Cuore\u2010Don Calabria Hospital  Negrar di Valpolicella Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Gobbi","sequence":"additional","affiliation":[{"name":"Department of Infectious Tropical Diseases and Microbiology IRCCS Sacro Cuore\u2010Don Calabria Hospital  Negrar di Valpolicella Italy"},{"name":"Department of Clinical and Experimental Sciences University of Brescia  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herbert","family":"Tilg","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism Medical University Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D.","family":"Byrne","sequence":"additional","affiliation":[{"name":"National Institute for Health and Care Research, Southampton Biomedical Research Centre University Hospital Southampton and University of Southampton  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4325-3900","authenticated-orcid":false,"given":"Giovanni","family":"Targher","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Verona  Verona Italy"},{"name":"Metabolic Diseases Research Unit IRCCS Sacro Cuore\u2010Don Calabria Hospital  Negrar di Valpolicella Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,11]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.06.003"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2024.02.007"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.04.036"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/HC9.0000000000000251"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2020.154170"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(21)00020-0"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-024-10660-y"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2021-324191"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-322572"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(21)00308-3"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-323082"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-011-1736-5"},{"issue":"3","key":"e_1_2_12_17_1","first-page":"198","article-title":"Association 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