Smoking Aggravates Inflammation, Fibrogenesis, Angiogenesis and Cancer Risk in Patients With Cirrhosis

作者：Nina Dominik, Benedikt Simbrunner, B Scheiner, Michael Schwarz, Lukas Hartl, Mathias Jachs, Lorenz Balcar, Georg Semmler, Georg Kramer, Christian Sebesta, Michael Trauner, Matthias Pinter, Mattias Mandorfer, Thomas Reiberger, Benedikt Hofer · 发表于：Liver International · 年份：2025 · DOI：10.1111/liv.70314 · 被引用次数：4 · 研究领域：Liver Disease Diagnosis and Treatment、Liver Disease and Transplantation、Hepatocellular Carcinoma Treatment and Prognosis

BACKGROUND AND AIMS: Smoking induces a proinflammatory state, yet its role in advanced chronic liver disease (ACLD) remains understudied. This study evaluated its impact on disease-driving mechanisms and clinical outcomes in ACLD patients. METHODS: ACLD patients undergoing hepatic venous pressure gradient measurements from 2017 to 2021 were included. The association of smoking with biomarkers of inflammation, fibrogenesis, angiogenesis and the incidence of hepatocellular carcinoma (HCC), extrahepatic malignancies and mortality was examined. RESULTS: Among 339 ACLD patients (66.1% men, median age: 56.8 years, MELD: 11, HVPG: 17 mmHg), 62% (n = 210) were ever-smokers (n = 78 former, n = 132 active). Compared to never/former smokers, active smokers exhibited significantly higher white blood cell counts (5.49 vs. former: 4.74 vs. never: 4.25 G/L; p < 0.001) and C-reactive protein levels (CRP: 0.36 vs. former: 0.29 vs. 0.21 mg/dL; p = 0.035). Active smokers showed upregulated fibrogenic (TIMP-1: 364 vs. former: 324 vs. never: 278 ng/mL, p < 0.001; P3NP: 20.9 vs. former: 15.6 vs. never: 17.2 μg/L, p = 0.008) and angiogenic (PLGF: 21.7 vs. former: 18.2 vs. never: 19.0 pg/mL, p = 0.004) activity markers. Over a median follow-up of 30.4 months, ever-smokers exhibited a higher incidence of extrahepatic malignancies (SHR: 11.30; p = 0.019) and numerically higher HCC incidence (SHR: 2.27 p = 0.150; mostly evident in Child-Pugh A patients: SHR: 7.44, p = 0.053). All-cause or liver-related...