Osteoporosis and bone fractures in alcoholic liver disease: A meta-analysis

Abstract Background Transient elastography-based liver stiffness value (TE-LSV) has been studied for the diagnosis of portal hypertension. Liver stiffness is influenced by the disease etiology. We aimed to perform a meta-analysis to determine the performance of TE-LSV for diagnosing portal hypertension in patients with alcoholic liver disease (ALD). Methods We searched PubMed, Web of Science, Ovid and Cochrane library. A bivariate model was used to compute sensitivity and specificity. A random effects model was used to pool diagnostic odds ratios. Results 9 studies with 679 patients were included. The pooled sensitivity and specificity based on a cut-off value around 21.8 kPa for clinically significant portal hypertension (CSPH) were 0.89 (95 % confidence interval (CI), 0.83–0.93) and 0.71(95 % CI, 0.64–0.78), respectively. For severe portal hypertension (SPH), the pooled sensitivity and specificity for a cut-off value around 29.1 kPa were 0.88 (95 % CI, 0.83–0.92) and 0.74 (95 % CI, 0.67–0.81), respectively. Conclusion TE-LSV showed good performance for diagnosing portal hypertension in patients with ALD. The optimal cut-off value for CSPH and SPH was around 21.8 kPa and 29.1 kPa, respectively, and these two cut-off values showed good sensitivity and modest specificity. The etiology should be clear before using TE-LSV for portal hypertension.

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Mortality After Extrahepatic Gastrointestinal and Abdominal Wall Surgery in Patients With Alcoholic Liver Disease: A Systematic Review and Meta-Analysis

Alcohol and Alcoholism ◽

10.1093/alcalc/agaa043 ◽

2020 ◽

Vol 55 (5) ◽

pp. 497-511

Author(s):

Alfred Adiamah ◽

Lu Ban ◽

John Hammond ◽

Peter Jepsen ◽

Joe West ◽

...

Keyword(s):

Liver Disease ◽

Hospital Mortality ◽

Alcoholic Liver Disease ◽

Meta Analysis ◽

Gastrointestinal Surgery ◽

Secondary Analysis ◽

Postoperative Mortality ◽

Inclusion Criteria ◽

Number Of Patients ◽

Umbilical Hernia Repair

Abstract Aims This meta-analysis aimed to define the perioperative risk of mortality in patients with alcoholic liver disease (ALD) undergoing extrahepatic gastrointestinal surgery. Methods Systematic searches of Embase, Medline and CENTRAL were undertaken to identify studies reporting about patients with ALD undergoing extrahepatic gastrointestinal surgery published since database inception to January 2019. Studies were only considered if they reported on mortality as an outcome. Pooled analysis of mortality was stratified as benign and malignant surgery and specific operative procedures where feasible. Results Of the 2899 studies identified, only five studies met inclusion criteria, representing cholecystectomy (one study), umbilical hernia repair surgery (one study) and oesophagectomy (three studies). The total number of patients with ALD in these studies was 172. Therefore, any study on liver disease patients undergoing extrahepatic surgery that crucially included a subset with alcohol aetiology was included as a secondary analysis even though they failed to stratify mortality by underlying aetiology. The total number of studies that met this expanded inclusion criteria was 62, reporting on 37,703 patients with liver disease of which 1735 (4.5%) had a definite diagnosis of ALD. Meta-analysis of proportions of in-hospital mortality in patients with ALD undergoing upper gastrointestinal cancer surgery (oesophagectomy) was 23% [95% confidence interval (CI) 14–35%, I2 = 0%]. In-hospital mortality following oesophagectomy in liver disease patients of all aetiologies was lower, 14% (95% CI 9–21%, I2 = 41.1%). Conclusion Postoperative in-hospital mortality is high in patients with liver disease and ALD in particular. However, the currently available evidence on ALD is limited and precludes definitive conclusions on postoperative mortality risk.

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META-ANALYSIS OF HLA-ANTIGEN PREVALENCES IN ALCOHOLICS AND ALCOHOLIC LIVER DISEASE

Alcohol and Alcoholism ◽

10.1093/oxfordjournals.alcalc.a045616 ◽

1994 ◽

Keyword(s):

Liver Disease ◽

Alcoholic Liver Disease ◽

Meta Analysis ◽

Hla Antigen

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Tumor Necrosis Factor Polymorphisms and Alcoholic Liver Disease: A HuGE Review and Meta-Analysis

American Journal of Epidemiology ◽

10.1093/aje/kwp236 ◽

2009 ◽

Vol 170 (8) ◽

pp. 948-956 ◽

Cited By ~ 40

Author(s):

M. Marcos ◽

M. Gomez-Munuera ◽

I. Pastor ◽

R. Gonzalez-Sarmiento ◽

F.-J. Laso

Keyword(s):

Liver Disease ◽

Tumor Necrosis Factor ◽

Alcoholic Liver Disease ◽

Tumor Necrosis ◽

Meta Analysis ◽

Necrosis Factor

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Alcoholic liver disease and risk of cholangiocarcinoma: a systematic review and meta-analysis

OncoTargets and Therapy ◽

10.2147/ott.s184444 ◽

2018 ◽

Vol Volume 11 ◽

pp. 8211-8219

Author(s):

Jianping Xiong ◽

ZiJun Yin ◽

Weiyu Xu ◽

Zheng Shen ◽

Ye Li ◽

...

Keyword(s):

Systematic Review ◽

Liver Disease ◽

Alcoholic Liver Disease ◽

Meta Analysis

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Meta-analysis of propylthiouracil for alcoholic liver disease - a Cochrane Hepato-Biliary Group Review

Liver International ◽

10.1034/j.1600-0676.2001.210606.x ◽

2001 ◽

Vol 21 (6) ◽

pp. 398-404 ◽

Cited By ~ 35

Author(s):

A. Rambaldi ◽

Christian Gluud

Keyword(s):

Liver Disease ◽

Alcoholic Liver Disease ◽

Meta Analysis

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Transient Elastography in Alcoholic Liver Disease and Nonalcoholic Fatty Liver Disease: A Systemic Review and Meta-Analysis

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2021/8859338 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Changzhou Cai ◽

Xin Song ◽

Xueyang Chen ◽

Weihua Zhou ◽

Qi Jin ◽

...

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Sensitivity And Specificity ◽

Alcoholic Liver Disease ◽

Fatty Liver Disease ◽

Transient Elastography ◽

Meta Analysis ◽

Systemic Review ◽

Nonalcoholic Fatty Liver

Background and Aims. Alcoholic liver disease (ALD) and nonalcoholic fatty liver disease (NAFLD) have become common chronic liver diseases. Recent evidence has shown the value of transient elastography (TE) in the context of ALD/NAFLD. The aim of this study is to investigate the accuracy of TE for diagnosing steatosis and fibrosis in ALD/NAFLD patients. Methods. We retrieved relevant English studies from the databases of PubMed, Embase, the Web of Science, and the Cochrane Library through March 31st 2019. We included studies regarding the diagnosis or staging of steatosis or fibrosis by using controlled attenuation parameter (CAP) or liver stiffness measurement (LSM) measured by TE in patients with ALD or NAFLD. The reference standard of all included studies was liver biopsy. A random-effects model was applied. Statistical analyses were performed using STATA. Results. A total of 62 articles were included and analyzed in our meta-analysis. In patients with ALD/NAFLD, the pooled results revealed that the sensitivity and specificity of CAP were 0.84, 0.83, and 0.78 and 0.83, 0.71, and 0.62 for steatosis grades ≥S1, ≥S2, and =S3, respectively. The sensitivity and specificity of LSM for identifying fibrosis grades ≥F1, ≥F2, ≥F3, and =F4 were 0.77, 0.77, 0.83, and 0.91 and 0.80, 0.82, 0.84, and 0.86, respectively. Conclusion. In patients with ALD/NAFLD, CAP was feasible for identifying and screening steatosis, and LSM was accurate for diagnosing fibrosis, especially severe fibrosis and cirrhosis.

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