Angiotensin‐converting enzyme inhibitors prevent liver‐related events in nonalcoholic fatty liver disease
Background and Aims Angiotensin‐converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) can inhibit liver fibrogenesis in animal models. We aimed to evaluate the impact of ACEI/ARB use on the risk of liver cancer and cirrhosis complications in patients with NAFLD. Approach and...
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| Veröffentlicht in: | Hepatology (Baltimore, Md.) Md.), 2022-08, Vol.76 (2), p.469-482 |
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| creator | Zhang, Xinrong Wong, Grace Lai‐Hung Yip, Terry Cheuk‐Fung Tse, Yee‐Kit Liang, Lilian Yan Hui, Vicki Wing‐Ki Lin, Huapeng Li, Guan‐Lin Lai, Jimmy Che‐To Chan, Henry Lik‐Yuen Wong, Vincent Wai‐Sun |
| description | Background and Aims
Angiotensin‐converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) can inhibit liver fibrogenesis in animal models. We aimed to evaluate the impact of ACEI/ARB use on the risk of liver cancer and cirrhosis complications in patients with NAFLD.
Approach and Results
We conducted a retrospective, territory‐wide cohort study of adult patients with NAFLD diagnosed between January 2000 and December 2014 to allow for at least 5 years of follow‐up. ACEI or ARB users were defined as patients who had received ACEI or ARB treatment for at least 6 months. The primary endpoint was liver‐related events (LREs), defined as a composite endpoint of liver cancer and cirrhosis complications. We analyzed data from 12,327 NAFLD patients (mean age, 54.2 ± 14.7 years; 6163 men [50.0%]); 6805 received ACEIs, and 2877 received ARBs. After propensity score weighting, ACEI treatment was associated with a lower risk of LREs (weighted subdistribution hazard ratio [SHR], 0.48; 95% CI, 0.35–0.66; p |
| doi_str_mv | 10.1002/hep.32294 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2613292447</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2690094532</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4194-51999a52b828627721b2e89ebd89bfcf10dc9ab3ff9fcc004f82fe5a51154add3</originalsourceid><addsrcrecordid>eNp10cFO3DAQBmCrououtAdeAEXiQg9h7bGziY8I0YK0Ej2058hxxrtGib3YWartiUfoM_IkeMnCAYnTSKNPvzTzE3LM6DmjFGYrXJ9zACk-kSkroMw5L-gBmVIoaS4ZlxNyGOMdpVQKqL6QCReSS6BiSvoLt7R-QBete3r8r717wDBYt8zQ_dv2mFm3so0dfIjZOuADuiHrbDIJB-zUgG32so1JZs471Wm_8p3VmVHDsB1x1tqIKuJX8tmoLuK3_Twif35c_b68zhe3P28uLxa5FkyKvGBSSlVAU0E1h7IE1gBWEpu2ko3RhtFWS9VwY6TRmlJhKjBYqIKxQqi25UfkbMxdB3-_wTjUvY0au0459JtYw5xxkCBEmejpO3rnNyGdsVNy97GCQ1LfR6WDjzGgqdfB9ipsa0brXQd16qB-6SDZk33ipumxfZOvT09gNoK_tsPtx0n19dWvMfIZ_UeUjg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2690094532</pqid></control><display><type>article</type><title>Angiotensin‐converting enzyme inhibitors prevent liver‐related events in nonalcoholic fatty liver disease</title><source>Wiley Online Library Journals Frontfile Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Zhang, Xinrong ; Wong, Grace Lai‐Hung ; Yip, Terry Cheuk‐Fung ; Tse, Yee‐Kit ; Liang, Lilian Yan ; Hui, Vicki Wing‐Ki ; Lin, Huapeng ; Li, Guan‐Lin ; Lai, Jimmy Che‐To ; Chan, Henry Lik‐Yuen ; Wong, Vincent Wai‐Sun</creator><creatorcontrib>Zhang, Xinrong ; Wong, Grace Lai‐Hung ; Yip, Terry Cheuk‐Fung ; Tse, Yee‐Kit ; Liang, Lilian Yan ; Hui, Vicki Wing‐Ki ; Lin, Huapeng ; Li, Guan‐Lin ; Lai, Jimmy Che‐To ; Chan, Henry Lik‐Yuen ; Wong, Vincent Wai‐Sun</creatorcontrib><description>Background and Aims
Angiotensin‐converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) can inhibit liver fibrogenesis in animal models. We aimed to evaluate the impact of ACEI/ARB use on the risk of liver cancer and cirrhosis complications in patients with NAFLD.
Approach and Results
We conducted a retrospective, territory‐wide cohort study of adult patients with NAFLD diagnosed between January 2000 and December 2014 to allow for at least 5 years of follow‐up. ACEI or ARB users were defined as patients who had received ACEI or ARB treatment for at least 6 months. The primary endpoint was liver‐related events (LREs), defined as a composite endpoint of liver cancer and cirrhosis complications. We analyzed data from 12,327 NAFLD patients (mean age, 54.2 ± 14.7 years; 6163 men [50.0%]); 6805 received ACEIs, and 2877 received ARBs. After propensity score weighting, ACEI treatment was associated with a lower risk of LREs (weighted subdistribution hazard ratio [SHR], 0.48; 95% CI, 0.35–0.66; p < 0.001), liver cancer (weighted SHR, 0.46; 95% CI, 0.28–0.75; p = 0.002), and cirrhosis complications (weighted SHR, 0.42; 95% CI, 0.27–0.66; p < 0.001), but ARB was not. In subgroup analysis, ACEI treatment was associated with greater reduction in LREs in patients with chronic kidney diseases (CKDs) than those without (CKD‐weighted SHR, 0.74; 95% CI, 0.52–0.96; p = 0.036; non‐CKD‐weighted SHR, 0.15; 95% CI, 0.07–0.33; p < 0.001).
Conclusions
ACEI, rather than ARB, treatment is associated with a lower risk of LREs in NAFLD patients, especially among those with CKD.</description><identifier>ISSN: 0270-9139</identifier><identifier>EISSN: 1527-3350</identifier><identifier>DOI: 10.1002/hep.32294</identifier><identifier>PMID: 34939204</identifier><language>eng</language><publisher>United States: Wolters Kluwer Health, Inc</publisher><subject>Angiotensin ; Animal models ; Cirrhosis ; Enzymes ; Fatty liver ; Hepatology ; Kidney diseases ; Liver cancer ; Liver cirrhosis ; Liver diseases ; Patients</subject><ispartof>Hepatology (Baltimore, Md.), 2022-08, Vol.76 (2), p.469-482</ispartof><rights>2021 American Association for the Study of Liver Diseases.</rights><rights>2022 American Association for the Study of Liver Diseases.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4194-51999a52b828627721b2e89ebd89bfcf10dc9ab3ff9fcc004f82fe5a51154add3</citedby><cites>FETCH-LOGICAL-c4194-51999a52b828627721b2e89ebd89bfcf10dc9ab3ff9fcc004f82fe5a51154add3</cites><orcidid>0000-0002-8393-8904 ; 0000-0003-2215-9410</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fhep.32294$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fhep.32294$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34939204$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, Xinrong</creatorcontrib><creatorcontrib>Wong, Grace Lai‐Hung</creatorcontrib><creatorcontrib>Yip, Terry Cheuk‐Fung</creatorcontrib><creatorcontrib>Tse, Yee‐Kit</creatorcontrib><creatorcontrib>Liang, Lilian Yan</creatorcontrib><creatorcontrib>Hui, Vicki Wing‐Ki</creatorcontrib><creatorcontrib>Lin, Huapeng</creatorcontrib><creatorcontrib>Li, Guan‐Lin</creatorcontrib><creatorcontrib>Lai, Jimmy Che‐To</creatorcontrib><creatorcontrib>Chan, Henry Lik‐Yuen</creatorcontrib><creatorcontrib>Wong, Vincent Wai‐Sun</creatorcontrib><title>Angiotensin‐converting enzyme inhibitors prevent liver‐related events in nonalcoholic fatty liver disease</title><title>Hepatology (Baltimore, Md.)</title><addtitle>Hepatology</addtitle><description>Background and Aims
Angiotensin‐converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) can inhibit liver fibrogenesis in animal models. We aimed to evaluate the impact of ACEI/ARB use on the risk of liver cancer and cirrhosis complications in patients with NAFLD.
Approach and Results
We conducted a retrospective, territory‐wide cohort study of adult patients with NAFLD diagnosed between January 2000 and December 2014 to allow for at least 5 years of follow‐up. ACEI or ARB users were defined as patients who had received ACEI or ARB treatment for at least 6 months. The primary endpoint was liver‐related events (LREs), defined as a composite endpoint of liver cancer and cirrhosis complications. We analyzed data from 12,327 NAFLD patients (mean age, 54.2 ± 14.7 years; 6163 men [50.0%]); 6805 received ACEIs, and 2877 received ARBs. After propensity score weighting, ACEI treatment was associated with a lower risk of LREs (weighted subdistribution hazard ratio [SHR], 0.48; 95% CI, 0.35–0.66; p < 0.001), liver cancer (weighted SHR, 0.46; 95% CI, 0.28–0.75; p = 0.002), and cirrhosis complications (weighted SHR, 0.42; 95% CI, 0.27–0.66; p < 0.001), but ARB was not. In subgroup analysis, ACEI treatment was associated with greater reduction in LREs in patients with chronic kidney diseases (CKDs) than those without (CKD‐weighted SHR, 0.74; 95% CI, 0.52–0.96; p = 0.036; non‐CKD‐weighted SHR, 0.15; 95% CI, 0.07–0.33; p < 0.001).
Conclusions
ACEI, rather than ARB, treatment is associated with a lower risk of LREs in NAFLD patients, especially among those with CKD.</description><subject>Angiotensin</subject><subject>Animal models</subject><subject>Cirrhosis</subject><subject>Enzymes</subject><subject>Fatty liver</subject><subject>Hepatology</subject><subject>Kidney diseases</subject><subject>Liver cancer</subject><subject>Liver cirrhosis</subject><subject>Liver diseases</subject><subject>Patients</subject><issn>0270-9139</issn><issn>1527-3350</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp10cFO3DAQBmCrououtAdeAEXiQg9h7bGziY8I0YK0Ej2058hxxrtGib3YWartiUfoM_IkeMnCAYnTSKNPvzTzE3LM6DmjFGYrXJ9zACk-kSkroMw5L-gBmVIoaS4ZlxNyGOMdpVQKqL6QCReSS6BiSvoLt7R-QBete3r8r717wDBYt8zQ_dv2mFm3so0dfIjZOuADuiHrbDIJB-zUgG32so1JZs471Wm_8p3VmVHDsB1x1tqIKuJX8tmoLuK3_Twif35c_b68zhe3P28uLxa5FkyKvGBSSlVAU0E1h7IE1gBWEpu2ko3RhtFWS9VwY6TRmlJhKjBYqIKxQqi25UfkbMxdB3-_wTjUvY0au0459JtYw5xxkCBEmejpO3rnNyGdsVNy97GCQ1LfR6WDjzGgqdfB9ipsa0brXQd16qB-6SDZk33ipumxfZOvT09gNoK_tsPtx0n19dWvMfIZ_UeUjg</recordid><startdate>202208</startdate><enddate>202208</enddate><creator>Zhang, Xinrong</creator><creator>Wong, Grace Lai‐Hung</creator><creator>Yip, Terry Cheuk‐Fung</creator><creator>Tse, Yee‐Kit</creator><creator>Liang, Lilian Yan</creator><creator>Hui, Vicki Wing‐Ki</creator><creator>Lin, Huapeng</creator><creator>Li, Guan‐Lin</creator><creator>Lai, Jimmy Che‐To</creator><creator>Chan, Henry Lik‐Yuen</creator><creator>Wong, Vincent Wai‐Sun</creator><general>Wolters Kluwer Health, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8393-8904</orcidid><orcidid>https://orcid.org/0000-0003-2215-9410</orcidid></search><sort><creationdate>202208</creationdate><title>Angiotensin‐converting enzyme inhibitors prevent liver‐related events in nonalcoholic fatty liver disease</title><author>Zhang, Xinrong ; Wong, Grace Lai‐Hung ; Yip, Terry Cheuk‐Fung ; Tse, Yee‐Kit ; Liang, Lilian Yan ; Hui, Vicki Wing‐Ki ; Lin, Huapeng ; Li, Guan‐Lin ; Lai, Jimmy Che‐To ; Chan, Henry Lik‐Yuen ; Wong, Vincent Wai‐Sun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4194-51999a52b828627721b2e89ebd89bfcf10dc9ab3ff9fcc004f82fe5a51154add3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Angiotensin</topic><topic>Animal models</topic><topic>Cirrhosis</topic><topic>Enzymes</topic><topic>Fatty liver</topic><topic>Hepatology</topic><topic>Kidney diseases</topic><topic>Liver cancer</topic><topic>Liver cirrhosis</topic><topic>Liver diseases</topic><topic>Patients</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Xinrong</creatorcontrib><creatorcontrib>Wong, Grace Lai‐Hung</creatorcontrib><creatorcontrib>Yip, Terry Cheuk‐Fung</creatorcontrib><creatorcontrib>Tse, Yee‐Kit</creatorcontrib><creatorcontrib>Liang, Lilian Yan</creatorcontrib><creatorcontrib>Hui, Vicki Wing‐Ki</creatorcontrib><creatorcontrib>Lin, Huapeng</creatorcontrib><creatorcontrib>Li, Guan‐Lin</creatorcontrib><creatorcontrib>Lai, Jimmy Che‐To</creatorcontrib><creatorcontrib>Chan, Henry Lik‐Yuen</creatorcontrib><creatorcontrib>Wong, Vincent Wai‐Sun</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Hepatology (Baltimore, Md.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Xinrong</au><au>Wong, Grace Lai‐Hung</au><au>Yip, Terry Cheuk‐Fung</au><au>Tse, Yee‐Kit</au><au>Liang, Lilian Yan</au><au>Hui, Vicki Wing‐Ki</au><au>Lin, Huapeng</au><au>Li, Guan‐Lin</au><au>Lai, Jimmy Che‐To</au><au>Chan, Henry Lik‐Yuen</au><au>Wong, Vincent Wai‐Sun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Angiotensin‐converting enzyme inhibitors prevent liver‐related events in nonalcoholic fatty liver disease</atitle><jtitle>Hepatology (Baltimore, Md.)</jtitle><addtitle>Hepatology</addtitle><date>2022-08</date><risdate>2022</risdate><volume>76</volume><issue>2</issue><spage>469</spage><epage>482</epage><pages>469-482</pages><issn>0270-9139</issn><eissn>1527-3350</eissn><abstract>Background and Aims
Angiotensin‐converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) can inhibit liver fibrogenesis in animal models. We aimed to evaluate the impact of ACEI/ARB use on the risk of liver cancer and cirrhosis complications in patients with NAFLD.
Approach and Results
We conducted a retrospective, territory‐wide cohort study of adult patients with NAFLD diagnosed between January 2000 and December 2014 to allow for at least 5 years of follow‐up. ACEI or ARB users were defined as patients who had received ACEI or ARB treatment for at least 6 months. The primary endpoint was liver‐related events (LREs), defined as a composite endpoint of liver cancer and cirrhosis complications. We analyzed data from 12,327 NAFLD patients (mean age, 54.2 ± 14.7 years; 6163 men [50.0%]); 6805 received ACEIs, and 2877 received ARBs. After propensity score weighting, ACEI treatment was associated with a lower risk of LREs (weighted subdistribution hazard ratio [SHR], 0.48; 95% CI, 0.35–0.66; p < 0.001), liver cancer (weighted SHR, 0.46; 95% CI, 0.28–0.75; p = 0.002), and cirrhosis complications (weighted SHR, 0.42; 95% CI, 0.27–0.66; p < 0.001), but ARB was not. In subgroup analysis, ACEI treatment was associated with greater reduction in LREs in patients with chronic kidney diseases (CKDs) than those without (CKD‐weighted SHR, 0.74; 95% CI, 0.52–0.96; p = 0.036; non‐CKD‐weighted SHR, 0.15; 95% CI, 0.07–0.33; p < 0.001).
Conclusions
ACEI, rather than ARB, treatment is associated with a lower risk of LREs in NAFLD patients, especially among those with CKD.</abstract><cop>United States</cop><pub>Wolters Kluwer Health, Inc</pub><pmid>34939204</pmid><doi>10.1002/hep.32294</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-8393-8904</orcidid><orcidid>https://orcid.org/0000-0003-2215-9410</orcidid></addata></record> |
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| subjects | Angiotensin Animal models Cirrhosis Enzymes Fatty liver Hepatology Kidney diseases Liver cancer Liver cirrhosis Liver diseases Patients |
| title | Angiotensin‐converting enzyme inhibitors prevent liver‐related events in nonalcoholic fatty liver disease |
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