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Entering a New Era in Metabolic Dysfunction-Associated Steatohepatitis:Examining the Clinical Implications of Emerging Disease-Specific Therapies (Catalyst Medical Education, LLC.) (Complete Session)

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Entering a New Era in Metabolic Dysfunction-Associated Steatohepatitis:Examining the Clinical Implications of Emerging Disease-Specific Therapies (Catalyst Medical Education, LLC.) (Complete Session)

Naim Alkhouri 1, Elisabetta Bugianesi 2, Michael Trauner 3

1 Arizona Liver Health, Tucson, United States of America

2 AOU Città della Salute e della Scienza University of Torino, Torino, Italy, Torino, Italy

3 None, Vienna, Austria

Publisher

Catalyst Medical Education

Event

UEG Week Vienna 2024

Session

Entering a New Era in Metabolic Dysfunction-Associated Steatohepatitis:Examining the Clinical Implications of Emerging Disease-Specific Therapies (Catalyst Medical Education, LLC.)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

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SUGAR- AND LOW/NON-SUGAR-SWEETENED BEVERAGES AND RISKS OF METABOLIC DYSFUNCTION–ASSOCIATED STEATOTIC LIVER DISEASE AND LIVER-RELATED MORTALITY: A PROSPECTIVE ANALYSIS OF THE UK BIOBANK

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Introduction

Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognized as a critical component of multi-system metabolic dysfunction and has emerged as a significant global health issue. A growing body of evidence suggests that intake of sugar and its substitutes is linked to cardiometabolic and kidney diseases. While sugar-sweetened beverages (SSBs) and low- or non-sugar-sweetened beverages (LNSSBs) are widely consumed, their associations with liver health outcomes remain uncertain.

Aims & Methods

In this prospective cohort study of 103,251 UK Biobank participants free of baseline liver disease, we investigated the associations between SSBs and LNSSBs intake and the risk of incident MASLD and liver-related mortality. Beverage consumption was assessed through multiple 24-hour dietary questionnaires. The primary outcome was incident MASLD, and secondary outcomes included liver-related mortality and liver fat content measured by MRI- derived proton density fat fraction. Multivariable Cox regression, linear models, stratified analyses, restricted cubic spline, sensitivity analyses, and beverage substitution analyses were employed.

Results

Over a median 10.3-year follow-up, 949 participants developed MASLD, and 103 died from liver-related causes. Higher intake of LNSSBs (>330 g/day) and SSBs (>330 g/day) were associated with elevated MASLD risk (HR: 1.597 and 1.502, respectively; both p < 0.01). LNSSBs consumption also increased liver-related mortality risk in a dose-dependent manner, while no significant association was observed for SSBs. Both beverages were positively associated with liver fat content. Replacing 330 g/day of either beverage with water significantly reduced MASLD risk by 14.7% (SSBs) and 13.5% (LNSSBs), whereas substitution between LNSSBs and SSBs showed no difference in risk.

Conclusion

High intake of either SSBs or LNSSBs is significantly associated with an increased risk of MASLD, with LNSSBs additionally linked to a higher risk of liver-related mortality. Water substitution may offer benefits. These findings support limiting the intake of both SSBs and LNSSBs as part of comprehensive prevention strategies targeting cardio-renal-liver-metabolic dysfunction.

SUGAR- AND LOW/NON-SUGAR-SWEETENED BEVERAGES AND RISKS OF METABOLIC DYSFUNCTION–ASSOCIATED STEATOTIC LIVER DISEASE AND LIVER-RELATED MORTALITY: A PROSPECTIVE ANALYSIS OF THE UK BIOBANK

Lihe Liu 1, Zhaoyang Zou 1, Guoting Xu 1, JINZHOU ZHU 2, RUI LI 3, Airong Wu 1

1 The First Affiliated Hospital of Soochow University, Suzhou, China

2 The first affiliated hospital of Soochow University, Suzhou, China

3 The First Affiliated Hospital Of Soochow University, Suzhou, China

Event

UEG Week Berlin 2025

Topics

Hepatobiliary

Submission format

Abstract

Session

Lifestyle management and therapy in MASLD

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Upcoming therapies in coeliac disease

Michael Schumann 1

1 Charité Berlin, Berlin, Germany

Event

UEG Week Berlin 2025

Topics

Digestive Oncology Hepatobiliary Immunology Mechanisms & Personalised Medicine Small Intestine & Nutrition

Session

The art of making clinical research precise: What will be new in therapy in 2030?

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Advances in PBC Management: A Simple Approach (Gilead) (Complete Session)

Holger Hinrichsen 1, Maria-Carlota Londoño 2

1 Gastroenterology and Hepatology Center Kiel and Kiel Liver Study Center, Kiel, Germany

2 Hospital Clínic de Barcelona, Barcelona, Spain

Publisher

Gilead Sciences, Inc.

Event

UEG Week Berlin 2025

Session

Advances in PBC Management: A Simple Approach (Gilead)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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For the medical oncologist

Francesco Sclafani 1

1 Université libre de Bruxelles, Bruxelles, Belgium

Event

UEG Week Berlin 2025

Topics

Digestive Oncology Endoscopy Surgery

Session

Game changers in lower GI over the past decade: Neoplasm

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

UEG Poster

Standard Poster

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Introduction

Cholecystectomy is recommended for patients with acute biliary pancreatitis to prevent recurrence and other biliary complications. However, some patients, due to advanced age and comorbidities, are unfit for surgery. The role of endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (ES) in these cases is not well established^1,2.

Aims & Methods

We aimed to evaluate whether ES reduces the risk of recurrent biliary pancreatitis (RBP) in patients unfit for cholecystectomy.
A unicentric retrospective review was conducted including all patients admitted for a first episode of acute biliary pancreatitis between January 2016 and November 2023 at a non-tertiary hospital, who were deemed unfit for cholecystectomy by either surgical or anesthetic teams. Patients with concurrent acute cholangitis at admission or during hospitalization, as well as those with prior cholecystectomy or ES, were excluded. Time-to-event analysis was performed using Kaplan-Meier survival curves.

Results

A total of 169 patients were included, with a mean age of 79.07 ± 8.25 years, and 65% were female. The mean Charlson Comorbidity Index was 5.11 ± 2.09. Most cases (94%) presented as mild or moderately severe pancreatitis. The mean follow-up period was 3.80 ± 1.95 years.
During the index admission, 37% (n=62) underwent ERCP with ES.
Recurrent biliary pancreatitis (RBP) occurred in 35 patients (21%), 97% of whom had not undergone ES. Only one patient in the ES group was readmitted for a new episode of pancreatitis (p<0.001, OR 0.035; 95% CI 0.005–0.265). The mean time to recurrence was 2.67 ± 7.78 months. Kaplan-Meier survival analysis demonstrated a significantly lower cumulative incidence of RBP in the ES group (log-rank p<0.001).
Endoscopic sphincterotomy did not significantly reduce other biliary events, including choledocholithiasis, acute cholangitis, and acute cholecystitis (all p>0.05). There was no statistically significant difference in overall mortality between the two groups (p=0.585).

	Overall (n=169)	No intervention (n=107)	ERCP + ES (n=62)	p value
Recurrent biliary pancreatitis	21% (n=35)	32% (n=34)	2% (n=1)	p<0.001
Choledocholithiasis	3% (n=5)	4% (n=4)	2% (n=1)	p=0.653
Acute cholangitis	2% (n=4)	3% (n=3)	2% (n=1)	p=1
Acute cholecystitis	7% (n=11)	4% (n=4)	2% (n=1)	p=0.101
Overall mortality	25% (n=43)	27% (n=29)	23% (n=14)	p=0.585

Conclusion

Our findings suggest that ERCP with ES may effectively reduce the recurrence of gallstone pancreatitis in elderly patients with high surgical-anesthetic risk due to comorbidities. Further studies are needed to refine the selection criteria for these patients.

References

1 - Hwang SS, Li BH, Haigh PI. Gallstone pancreatitis without cholecystectomy. JAMA Surg. 2013 Sep;148(9):867-72.
2 - McAlister, V., Davenport, E., & Renouf, E. (2007). Cholecystectomy deferral in patients with endoscopic sphincterotomy. Cochrane Database of Systematic Reviews.