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Association between MASLD and increased risk of serious bacterial infections requiring hospital admission: A

Alessandro Mantovani1, Riccardo Morandin1, Veronica Fiorio1

  • 1Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Verona, Verona, Italy.

Liver International : Official Journal of the International Association for the Study of the Liver
|September 11, 2024
PubMed
Abstract

Insights

Metabolic dysfunction-associated steatotic liver disease (MASLD) significantly increases the risk of serious bacterial infections. This risk escalates with MASLD severity, particularly advanced fibrosis, requiring hospital admission.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Epidemiology

Background:

  • Metabolic dysfunction-associated steatotic liver disease (MASLD) is linked to serious bacterial infections.
  • The precise risk magnitude and influence of MASLD severity on infection risk remain unclear.

Purpose of the Study:

  • To quantify the association between MASLD and serious bacterial infections requiring hospitalization.
  • To investigate if MASLD severity impacts the risk of serious bacterial infections.

Main Methods:

  • A meta-analysis of observational studies was conducted, searching PubMed, Scopus, Web of Science, and Embase up to April 2024.
  • MASLD diagnosis was confirmed via liver biopsy, imaging, or ICD codes.
  • Random-effects modeling was employed for meta-analysis.

Main Results:

  • Six cross-sectional and two prospective cohort studies involving ~26.6 million individuals were analyzed.
  • MASLD was associated with significantly higher odds of serious bacterial infections (OR 1.93, 95% CI 1.44-2.58).
  • The risk of serious bacterial infections increased with MASLD severity, especially fibrosis (HR 2.42, 95% CI 1.89-2.29), persisting after confounder adjustment.

Conclusions:

  • MASLD is significantly associated with an increased risk of serious bacterial infections requiring hospital admission.
  • The risk of infection escalates with increasing MASLD severity, particularly fibrosis.
Keywords:
MASLDNAFLDmetabolic dysfunction‐associated steatotic liver diseasemeta‐analysisnon‐alcoholic fatty liver diseaseserious bacterial infections

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