Hepatic Venous Pressure Gradient, Noninvasive Tests, and Prognosis Across the Subtypes of Advanced Steatotic Liver Disease

作者：Benedikt S. HOFER, Sarah Shalaby, Wilhelmus KWANTEN, Dario Saltini, Luis Téllez, José Luis CALLEJA, Federico Cáceres, Ángela Puente, Alba JIMÉNEZ-MASIP, Lucile Moga, Daniel Gutmann, Grazia Pennisi, Petra Fischer, Raluca PAIS, Dominik BETTINGER, Lisa SANDMANN, Alba Ardèvol, Christian SEBESTA, Isabel Graupera, Lotte Schoenmakers, Thomas VANWOLLEGHEM, Esther Maderuelo, Anna Brujats, Angela ANTON, Juan M. Pericàs, Helena Masnou, Benjamin MAASOUMY, Vlad RATZIU, Bogdan Procopet, Salvatore PETTA, Emmanuel A. TSOCHATZIS, Pierre-Emmanuel RAUTOU, Joan GENESCÀ, José Ignacio Fortea, Edilmar ALVARADO-TAPIAS, Elba Llop, Agustín ALBILLOS, Filippo SCHEPIS, Michael TRAUNER, Mattias MANDORFER, Thomas Reiberger, Sven FRANCQUE, Virginia HERNANDEZ-GEA, Georg Semmler · 发表于：Clinical Gastroenterology and Hepatology · 年份：2026 · DOI：10.1016/j.cgh.2026.05.033 · 研究领域：Liver Disease Diagnosis and Treatment、Liver Disease and Transplantation、Hepatocellular Carcinoma Treatment and Prognosis

BACKGROUND & AIMS: Steatotic liver disease encompasses metabolic dysfunction-associated steatotic liver disease, alcohol-related liver disease, and a mixed type (metabolic dysfunction-associated and alcohol-related liver disease). We investigated the course of compensated advanced chronic liver disease across steatotic liver disease subtypes, the impact of clinically significant portal hypertension, and the role of noninvasive tests. METHODS: This study included patients with steatotic liver disease and compensated advanced chronic liver disease from 17 centers undergoing hepatic venous pressure gradient and noninvasive test assessment through December 2023. Primary outcomes were first hepatic decompensation and liver-related mortality. RESULTS: Among 696 patients (alcohol-related liver disease, 22%; metabolic dysfunction-associated and alcohol-related liver disease, 20%; metabolic dysfunction-associated steatotic liver disease, 58%), 94% had Child-Pugh A, and 60% had clinically significant portal hypertension. Over a median follow-up of 3.8 years, 170 patients decompensated, and 137 died (58% liver-related). The 3-year cumulative decompensation incidence was highest in alcohol-related liver disease (26%), followed by metabolic dysfunction-associated and alcohol-related liver disease (21%) and metabolic dysfunction-associated steatotic liver disease (15%); yet differences were no longer significant after adjusting for age, sex, Model for End-stage Liver Disease, albumin, and ...