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Associating Appendicitis with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Novel Insight into
Christoph Roderburg1, Dirk Waldschmidt2, Catherine Leyh1
1Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany.
Background:
The gut microbiome modulates the liver immune microenvironment and is deeply integrated into the pathophysiology of metabolic dysfunction-associated steatotic liver disease (MASLD). Appendectomies, which are performed in almost all patients diagnosed with appendicitis, cause long-term alterations to the gut microbiome, providing a potential link with the development of MASLD. We therefore investigated a potential link between appendicitis and the presence of MASLD in a large cohort of outpatients in Germany.
Methods:
The present study included 26,717 individuals with and 26,717 without appendicitis. Univariable Cox-regression analyses were conducted to assess the association between appendicitis and MASLD.
Results:
During the long-term follow-up, 4.8% of patients with appendicitis and 3.4% of those in the non-appendicitis group were diagnosed with MASLD (p < 0.001), corresponding to an incidence of 5.4 (appendicitis cohort) versus 3.5 (non-appendicitis cohort) cases per 1000 patient years. These findings were confirmed in regression analysis, revealing a strong and statistically significant association between appendicitis and the development of MASLD (HR: 1.57; 95% CI: 1.39-1.78). This link was observed for all age groups and was independent of patients' sex.
Conclusion:
We provide evidence from a large cohort of outpatients in Germany suggesting a link between appendicitis and MASLD. This might help to better stratify patients according to their individual risk for the development of chronic liver diseases.
Insights
Appendicitis is linked to an increased risk of developing metabolic dysfunction-associated steatotic liver disease (MASLD). This study suggests appendectomy may influence long-term liver health outcomes.
Area of Science:
- Gastroenterology and Hepatology
- Microbiome Research
- Public Health
Background:
- The gut microbiome plays a crucial role in liver immunity and metabolic dysfunction-associated steatotic liver disease (MASLD) pathophysiology.
- Appendectomies alter the gut microbiome long-term, suggesting a potential connection to MASLD development.
Purpose of the Study:
- To investigate the association between appendicitis and the subsequent development of MASLD.
- To evaluate the long-term impact of appendicitis on liver health in a large patient cohort.
Main Methods:
- A retrospective cohort study involving 26,717 individuals with appendicitis and 26,717 controls.
- Univariable Cox-regression analyses were employed to assess the appendicitis-MASLD association.
Main Results:
- Patients with appendicitis had a higher incidence of MASLD (4.8%) compared to controls (3.4%).
- Appendicitis significantly increased the risk of developing MASLD (HR: 1.57; 95% CI: 1.39-1.78).
- The association was consistent across all age groups and independent of sex.
Conclusions:
- Evidence from a large German cohort indicates a significant link between appendicitis and MASLD development.
- Findings may aid in stratifying patients at risk for chronic liver diseases, potentially informing preventative strategies.
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