{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T09:30:05Z","timestamp":1786613405059,"version":"build-2736575974"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to investigate the relationship between metabolic syndrome (MetS) and the risk of 1-year readmission in patients with alcohol-associated cirrhosis and to identify the independent predictors of this outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 379 patients with alcohol-associated cirrhosis who were hospitalized between January 2012 and December 2023. Patients were categorized into two groups according to the presence or absence of MetS. Baseline characteristics, liver function indicators, complications, and causes of readmission were compared. A multivariable logistic regression analysis was used to identify independent predictors of 1-year readmission. Stratified analyses were conducted to evaluate potential effect modification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 379 patients (98.9% were male patients, mean age 54.1\u202f\u00b1\u202f10.1\u202fyears), 40 of them (10.6%) had MetS. Patients with MetS had a significantly higher 1-year readmission rate than those without MetS (65.0% vs. 44.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.014). Overall, 177 patients (46.7%) were readmitted within 1\u202fyear. The readmitted group had higher rates of MetS (14.7% vs. 6.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.014), hepatic encephalopathy (19.2% vs. 10.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.023), and variceal bleeding (13.6% vs. 5.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.003). Ascites was the most common cause of readmission (55.4%), followed by hepatic encephalopathy (19.8%), hepatocellular carcinoma (14.1%), and variceal bleeding (13.6%). A multivariable analysis confirmed that MetS (OR\u202f=\u202f2.38, 95% CI: 1.17\u20134.83,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.017), hepatic encephalopathy, variceal bleeding, and lower alanine aminotransferase (ALT) levels were independent predictors of 1-year readmission. Stratified analyses showed no significant interaction between MetS and the risk of 1-year readmission across different subgroups stratified by age, BMI, hypertension, diabetes, hyperlipidemia, ALT levels, aspartate aminotransferase (ALP) levels, and total bilirubin (TBIL) levels.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Metabolic syndrome is an independent predictor of 1-year readmission in patients with alcohol-associated cirrhosis, influencing the risk of readmission together with factors such as hepatic encephalopathy and variceal bleeding. The interplay between metabolic dysfunction and alcohol-associated cirrhosis warrants further investigation, and our findings underscore the importance of metabolic risk management in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1861502","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T09:10:07Z","timestamp":1786612207000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Metabolic syndrome is independently associated with 1-year readmission in patients with alcohol-associated cirrhosis"],"prefix":"10.3389","volume":"13","author":[{"given":"Jiarui","family":"Zheng","sequence":"first","affiliation":[{"name":"Peking University People's Hospital, Peking University Hepatology Institute, Infectious Disease and Hepatology Center of Peking University People's Hospital","place":["Beijing, China"]},{"name":"Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxuan","family":"Song","sequence":"additional","affiliation":[{"name":"Peking University People's Hospital, Peking University Hepatology Institute, Infectious Disease and Hepatology Center of Peking University People's Hospital","place":["Beijing, China"]},{"name":"Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanxu","family":"Hao","sequence":"additional","affiliation":[{"name":"Beijing Jingmei Group General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Feng","sequence":"additional","affiliation":[{"name":"Peking University People's Hospital, Peking University Hepatology Institute, Infectious Disease and Hepatology Center of Peking University People's Hospital","place":["Beijing, China"]},{"name":"Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yandi","family":"Xie","sequence":"additional","affiliation":[{"name":"Peking University People's Hospital, Peking University Hepatology Institute, Infectious Disease and Hepatology Center of Peking University People's Hospital","place":["Beijing, China"]},{"name":"Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1186\/s12889-023-15749-x","article-title":"Global prevalence, incidence, and outcomes of alcohol related liver diseases: a systematic review and Meta-analysis","volume":"23","author":"Niu","year":"2023","journal-title":"BMC Public Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1154","DOI":"10.1053\/j.gastro.2018.07.008","article-title":"Changing trends in etiology-based annual mortality from chronic liver disease, from 2007 through 2016","volume":"155","author":"Kim","year":"2018","journal-title":"Gastroenterology"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e1920294","DOI":"10.1001\/jamanetworkopen.2019.20294","article-title":"Trends in liver disease etiology among adults awaiting liver transplantation in the United States, 2014-2019","volume":"3","author":"Wong","year":"2020","journal-title":"JAMA Netw Open"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1016\/j.cgh.2020.05.064","article-title":"Nonalcoholic steatohepatitis is the Most rapidly increasing indication for liver transplantation in the United States","volume":"19","author":"Younossi","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1001\/jama.2021.7683","article-title":"Diagnosis and treatment of alcohol-associated liver disease: a review","volume":"326","author":"Singal","year":"2021","journal-title":"JAMA"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1038\/s41572-024-00563-5","article-title":"Metabolic syndrome","volume":"10","author":"Neeland","year":"2024","journal-title":"Nat Rev Dis Primers"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1966","DOI":"10.1097\/HEP.0000000000000520","article-title":"A multisociety Delphi consensus statement on new fatty liver disease nomenclature","volume":"78","author":"Rinella","year":"2023","journal-title":"Hepatology"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/s12902-019-0366-3","article-title":"Metabolic syndrome and liver-related events: a systematic review and Meta-analysis","volume":"19","author":"Ren","year":"2019","journal-title":"BMC Endocr Disord"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.jhep.2022.08.030","article-title":"Alcohol consumption and metabolic syndrome: clinical and epidemiological impact on liver disease","volume":"78","author":"Aberg","year":"2023","journal-title":"J Hepatol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1186\/s13098-024-01312-0","article-title":"Combined impact of alcohol consumption and metabolic syndrome on liver dysfunction in an elderly Chinese population","volume":"16","author":"Zhao","year":"2024","journal-title":"Diabetol Metab Syndr"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2141","DOI":"10.1002\/hep.29631","article-title":"Interaction between alcohol consumption and metabolic syndrome in predicting severe liver disease in the general population","volume":"67","author":"Aberg","year":"2018","journal-title":"Hepatology"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/j.jhep.2017.11.006","article-title":"The bidirectional impacts of alcohol consumption and the metabolic syndrome: cofactors for progressive fatty liver disease","volume":"68","author":"Boyle","year":"2018","journal-title":"J Hepatol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1007\/s40200-021-00965-2","article-title":"Metabolic syndrome; definition, pathogenesis, elements, and the effects of medicinal plants on it's elements","volume":"21","author":"Ahmed","year":"2022","journal-title":"J Diabetes Metab Disord"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1111\/j.1464-5491.2006.01858.x","article-title":"Metabolic syndrome--a new world-wide definition. A consensus statement from the international diabetes federation","volume":"23","author":"Alberti","year":"2006","journal-title":"Diabet Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e100430","DOI":"10.1136\/egastro-2026-100430","article-title":"From static labels to dynamic trajectories: Masld-Metald-Ald as a dynamic continuum within the framework of Steatotic liver disease","volume":"4","author":"Chen","year":"2026","journal-title":"eGastroenterology"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e100196","DOI":"10.1136\/egastro-2025-100196","article-title":"Key takeaways from the updated multidisciplinary European Masld guidelines","volume":"3","author":"Horn","year":"2025","journal-title":"eGastroenterology"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e100319","DOI":"10.1136\/egastro-2025-100319","article-title":"Metabolic dysfunction and alcohol-associated liver disease (Metald)","volume":"3","author":"Gao","year":"2025","journal-title":"eGastroenterology"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1002\/hep.31608","article-title":"Hepatic fibrosis associates with multiple Cardiometabolic disease risk factors: the Framingham heart study","volume":"73","author":"Long","year":"2021","journal-title":"Hepatology"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1757","DOI":"10.1002\/cncr.29971","article-title":"Population attributable fractions of risk factors for hepatocellular carcinoma in the United States","volume":"122","author":"Makarova-Rusher","year":"2016","journal-title":"Cancer"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1002\/ueg2.12524","article-title":"Interactions between the metabolic syndrome and alcohol consumption increases the risk of liver disease","volume":"12","author":"Hagstrom","year":"2024","journal-title":"United European Gastroenterol J"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.cmet.2019.12.002","article-title":"Leveraging human genetics to identify potential new treatments for fatty liver disease","volume":"31","author":"Romeo","year":"2020","journal-title":"Cell Metab"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1634","DOI":"10.1053\/j.gastro.2020.12.023","article-title":"Exome-wide association study on alanine aminotransferase identifies sequence variants in the Gpam and Apoe associated with fatty liver disease","volume":"160","author":"Jamialahmadi","year":"2021","journal-title":"Gastroenterology"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"16226","DOI":"10.3390\/ijms232416226","article-title":"Fatty liver disease-alcoholic and non-alcoholic: similar but different","volume":"23","author":"Malnick","year":"2022","journal-title":"Int J Mol Sci"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1328","DOI":"10.3389\/fimmu.2019.01328","article-title":"Recent insights into the role of immune cells in alcoholic liver disease","volume":"10","author":"Li","year":"2019","journal-title":"Front Immunol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"8221","DOI":"10.3390\/ijms22158221","article-title":"Cyp2e1 in alcoholic and non-alcoholic liver injury. Roles of Ros, reactive intermediates and lipid overload","volume":"22","author":"Harjumaki","year":"2021","journal-title":"Int J Mol Sci"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"G428","DOI":"10.1152\/ajpgi.00217.2019","article-title":"Nanoformulated Sod1 ameliorates the combined Nash and alcohol-associated liver disease partly via regulating Cyp2e1 expression in adipose tissue and liver","volume":"318","author":"Gopal","year":"2020","journal-title":"Am J Physiol Gastrointest Liver Physiol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e100104","DOI":"10.1136\/egastro-2024-100104","article-title":"Cell-to-cell and organ-to-organ crosstalk in the pathogenesis of alcohol-associated liver disease","volume":"2","author":"Gao","year":"2024","journal-title":"eGastroenterology"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/j.chom.2020.07.007","article-title":"Microbiota and fatty liver disease-the known, the unknown, and the future","volume":"28","author":"Lang","year":"2020","journal-title":"Cell Host Microbe"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"890","DOI":"10.3390\/jcm11030890","article-title":"Effects of moderate alcohol consumption in non-alcoholic fatty liver disease","volume":"11","author":"Lemmer","year":"2022","journal-title":"J Clin Med"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"719","DOI":"10.14218\/JCTH.2021.00173","article-title":"Alcohol and metabolic-associated fatty liver disease","volume":"9","author":"Sun","year":"2021","journal-title":"J Clin Transl Hepatol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1038\/nrgastro.2017.116","article-title":"Alcohol, adipose tissue and liver disease: mechanistic links and clinical considerations","volume":"15","author":"Parker","year":"2018","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.1056\/NEJMoa1912035","article-title":"Association of Aspirin with hepatocellular carcinoma and liver-related mortality","volume":"382","author":"Simon","year":"2020","journal-title":"N Engl J Med"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"e0268","DOI":"10.1097\/HC9.0000000000000268","article-title":"Aspirin is associated with a reduced incidence of liver disease in men","volume":"7","author":"Vell","year":"2023","journal-title":"Hepatol Commun"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"920","DOI":"10.1001\/jama.2024.1215","article-title":"Aspirin for metabolic dysfunction-associated Steatotic liver disease without cirrhosis: a randomized clinical trial","volume":"331","author":"Simon","year":"2024","journal-title":"JAMA"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1330","DOI":"10.1101\/gad.339895.120","article-title":"Ampk regulation of raptor and Tsc2 mediate metformin effects on transcriptional control of anabolism and inflammation","volume":"34","author":"Van Nostrand","year":"2020","journal-title":"Genes Dev"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"e2320222","DOI":"10.1001\/jamanetworkopen.2023.20222","article-title":"Association of Statin use with risk of liver disease, hepatocellular carcinoma, and liver-related mortality","volume":"6","author":"Vell","year":"2023","journal-title":"JAMA Netw Open"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"1423","DOI":"10.1016\/j.dld.2019.03.016","article-title":"Predictive models of mortality and hospital readmission of patients with decompensated liver cirrhosis","volume":"51","author":"Gaspar","year":"2019","journal-title":"Dig Liver Dis"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"3220","DOI":"10.1007\/s10620-024-08574-8","article-title":"Discharge outcomes of hospitalized patients with new onset decompensated cirrhosis","volume":"69","author":"Ifrah","year":"2024","journal-title":"Dig Dis Sci"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"3000605231223087","DOI":"10.1177\/03000605231223087","article-title":"Risk factors for hospital readmission among patients with cirrhosis and ascites in China: a retrospective observational study","volume":"52","author":"Li","year":"2024","journal-title":"J Int Med Res"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1093\/gerona\/glx126","article-title":"Low alanine aminotransferase levels in the elderly population: frailty, disability, sarcopenia, and reduced survival","volume":"73","author":"Vespasiani-Gentilucci","year":"2018","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1793","DOI":"10.1111\/jgh.14631","article-title":"Association of low Alanine Aminotransferase with loss of Independence or death: a 5-year population-based cohort study","volume":"34","author":"Yamazaki","year":"2019","journal-title":"J Gastroenterol Hepatol"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"925","DOI":"10.7150\/ijms.8951","article-title":"Alanine aminotransferase-old biomarker and new concept: a review","volume":"11","author":"Liu","year":"2014","journal-title":"Int J Med Sci"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.dci.2010.08.014","article-title":"An ancient molecule with novel function: alanine aminotransferase as a lipopolysaccharide binding protein with Bacteriocidal activity","volume":"35","author":"Jing","year":"2011","journal-title":"Dev Comp Immunol"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"330","DOI":"10.3945\/ajcn.2010.29413","article-title":"Longitudinal Association of Vitamin B-6, folate, and vitamin B-12 with depressive symptoms among older adults over time","volume":"92","author":"Skarupski","year":"2010","journal-title":"Am J Clin Nutr"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"1222","DOI":"10.1093\/gerona\/glz125","article-title":"Association between dietary intakes of B vitamins in midlife and cognitive impairment in late-life: the Singapore Chinese health study","volume":"75","author":"Sheng","year":"2020","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"e001905","DOI":"10.1136\/bmjgast-2025-001905","article-title":"Enhanced liver fibrosis test facilitates stratification of people with alcohol use disorder in primary care","volume":"12","author":"Hung","year":"2025","journal-title":"BMJ Open Gastroenterol"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"e001430","DOI":"10.1136\/bmjgast-2024-001430","article-title":"Systematic review and Meta-analysis of biomarkers predicting decompensation in patients with compensated cirrhosis","volume":"11","author":"Gananandan","year":"2024","journal-title":"BMJ Open Gastroenterol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1861502\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T09:10:08Z","timestamp":1786612208000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1861502\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,13]]},"references-count":47,"alternative-id":["10.3389\/fmed.2026.1861502"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1861502","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,13]]},"article-number":"1861502"}}