Clinical characteristics of non-alcoholic fatty liver disease patients with concurrent acute drug-induced liver injury across varied age cohorts

Abstract

Abstract: Objective The clinical characteristics of patients with nonalcoholic fatty liver disease (NAFLD) complicated by acute drug-induced liver injury (DILI) were analyzed retrospectively to furnish both clinical and experimental frameworks for guiding therapeutic drug choices in NAFLD patients.Methods In this retrospective analysis, the general demographics, medication utilization patterns, and laboratory data for a cohort of 68 patients diagnosed with NAFLD concomitant with DILI in our hospital between the years 2020 to 2022 were statistically analyzed. Results The sample comprised 32 males and 36 females, with an age range spanning 24 to 82 years. The cohort included 44 elderly patients and 24 middle-aged individuls. The primary medications imlicated in acute DILI were cardiovascular drugs, followed by non-steroidal anti-inflammatory drugs, anti-gout medications, antidiabetic agents, and anti-tumor drugs. With respect to the clinical severity of DILI, the majority of cases were catogorized as Grade 1(mild), accounting for 65 patients (95.59%). In terms of liver function, the ALT levels were notably elevated in the young and middle-aged group as compared to the elderly cohort[88 (60.5) U/L vs. 58.5 (24.25) U/L, P<0.01]; Lipid profile analyses revealed that levels of HDL and Apo A were significantly lower in the middle-aged group compared to the elderly[1.09 (0.3525) μmol/L vs. 1.21 (0.3425) μmol/L and 1.15 ± 0.27 g/L vs. 1.34 ± 0.22 g/L, P<0.05, P<0.01]. Converstly, Apo B levels were elevated in the middle-age cohort[0.88 (0.28) g/L vs. 0.74 (0.27) g/L, P<0.05]. From a hematological standpoint, the percentage of neutrophils(N)was lower in the middle-aged group compared to the elderly group [52.17 ± 9.3% vs. 57.94 ± 9.05%, P<0.05], whereas levels of lymphocyes(L) and platelets(PLT) were significantly higher[36.11 ± 8.93% vs. 30.86 ± 8.56%, and 248.5 (63.75)] × 10⁹/L vs. 205.5 (69.25) × 10⁹/L,P＜0.05,P＜0.01]. Conclusion Mild liver injury emerged as the predominat clinical manifestation among NAFLD patients experiencing acute DILI. Interestingle, while elderly NAFLD patients appeared to be more susceptible to developing acute DILI compared to their younger and middle-aged counterparts, the severity of liver injury did not demonstrate a direst correlation with age. The etiology of acute DILI in this cohort may be linked to the medications prescribed for comorbidities commonly found in the elderly population.

Key words: Non-alcoholic Fatty Liver Disease, Acute Drug-induced Liver Injury, Clinical Characteristics

ZHANG Si-min, YUAN Yi-fu, WU Xiao-xi, DU Sheng-nan, CAO Qin, JIANG Yuan-ye. Clinical characteristics of non-alcoholic fatty liver disease patients with concurrent acute drug-induced liver injury across varied age cohorts[J]. Chinese Hepatolgy, 2023, 28(9): 1088-1092.

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