Produção Nacional
Revisado por pares
Genetic Ancestry, Race, and Severity of Acutely Decompensated Cirrhosis in Latin America
2023; Elsevier BV; Volume: 165; Issue: 3 Linguagem: Inglês
10.1053/j.gastro.2023.05.033
ISSN1528-0012
AutoresAlberto Queiróz Farias, A. Vilalta, Patrícia Momoyo Zitelli, Gustavo Pereira, Luciana Lofêgo Gonçalves, Aldo Torre, Juan Manuel Díaz, Adrían Gadano, Ângelo Zambam de Mattos, Liliana Sampaio Costa Mendes, Mário Reis Álvares‐da‐Silva, Paulo Lisboa Bittencourt, Carlos Benítez, Cláudia Alves Couto, Manuel Mendizábal, Claudio L. Toledo, Daniel Ferraz de Campos Mazo, Mauricio Castillo Barradas, Eva M. Uson Raposo, Martín Padilla, Adelina Zarela Lozano Miranda, R. Malé-Velázquez, André Castro Lyra, Milagros Dávalos-Moscol, José L. Pérez Hernández, Rafael Oliveira Ximenes, Giovanni Faria Silva, Oscar A. Beltrán-Galvis, María Sarai González Huezo, Fernando Bessone, Tarciso Daniel Santos Rocha, E Fassio, Carlos Terra, Juan Ignacio Marín, Patricia Sierra Casas, Carlos de la Peña-Ramirez, F. Parera, Flávia Fernandes, Maria da Penha Zago-Gomes, Osvely Méndez-Guerrero, Sebastián Marciano, Ângelo Alves de Mattos, Joao C. Oliveira, Gabriel Tayguara Silveira Guerreiro, Liana Codés, Marco Arrese, Mateus Jorge Nardelli, Marcelo Silva, Renato Palma-Fernández, Camila Alcântara, Cristina Sánchez Garrido, Jonel Trebicka, Thierry Gustot, Javier Fernández, J. J. Clariá, Rajiv Jalan, Paolo Angeli, Vicente Arroyo, Richard Moreau, Flair José Carrilho, Caroline Marcondes Ferreira, Débora Raquel Benedita Terrabuio, Roberto M. Fernandes da Costa, Izabelle Venturini Signorelli, Caroline A. Pinto, A. Estanes-Hernández, Jesús Ruiz Manriquez, María Nelly Gutierrez‐Acevedo, Agustina M. Martinez-Garmendia, M. Ligia Aparecida, Everton Macêdo, Augusto Mantovani, Larisse Longo, Eduardo García Vilela, María G. Valderrama, Michelle V.S. Santos-Rondon, Bertha Cárdenas, Jorge Garavito Rentería, Lilian Montserrat Torres-Made, Laura C. Tenorio Castillo, José M. Aquino Ramos, María de Fátima Higuera de la Tijera, Rodrigo Sebba Aires, Diana C. Salinas-Gómez, Francisca Allendes, Fernando Comunello Schacher, Guilherme John Neto, Raúl Castro Valdivia, Josefina Pagés, Juan Pablo Roblero, Hugo Fainboim, Fernanda Fernandes Souza, Luis Colombato, Renata de Mello Peres, L.O. Miranda, Jade C. Oliveira, Leyla Nazal Ortiz, Daniela Simian, Gabriel Mezzano Puentes, Rita de Cássia Martins Alves da Silva, Iaarah Montalvo Gordon, Luis A. Chi Cervera, Marcos A. Girala Salomón, María Teresa Cuevas, Pedro Montes, Máximo J. Cattaneo Buteler,
Tópico(s)Hepatitis Viruses Studies and Epidemiology
ResumoBackground & AimsGenetic ancestry or racial differences in health outcomes exist in diseases associated with systemic inflammation (eg, COVID-19). This study aimed to investigate the association of genetic ancestry and race with acute-on-chronic liver failure (ACLF), which is characterized by acute systemic inflammation, multi-organ failure, and high risk of short-term death.MethodsThis prospective cohort study analyzed a comprehensive set of data, including genetic ancestry and race among several others, in 1274 patients with acutely decompensated cirrhosis who were nonelectively admitted to 44 hospitals from 7 Latin American countries.ResultsThree hundred ninety-five patients (31.0%) had ACLF of any grade at enrollment. Patients with ACLF had a higher median percentage of Native American genetic ancestry and lower median percentage of European ancestry than patients without ACLF (22.6% vs 12.9% and 53.4% vs 59.6%, respectively). The median percentage of African genetic ancestry was low among patients with ACLF and among those without ACLF. In terms of race, a higher percentage of patients with ACLF than patients without ACLF were Native American and a lower percentage of patients with ACLF than patients without ACLF were European American or African American. In multivariable analyses that adjusted for differences in sociodemographic and clinical characteristics, the odds ratio for ACLF at enrollment was 1.08 (95% CI, 1.03–1.13) with Native American genetic ancestry and 2.57 (95% CI, 1.84–3.58) for Native American race vs European American raceConclusionsIn a large cohort of Latin American patients with acutely decompensated cirrhosis, increasing percentages of Native American ancestry and Native American race were factors independently associated with ACLF at enrollment. Genetic ancestry or racial differences in health outcomes exist in diseases associated with systemic inflammation (eg, COVID-19). This study aimed to investigate the association of genetic ancestry and race with acute-on-chronic liver failure (ACLF), which is characterized by acute systemic inflammation, multi-organ failure, and high risk of short-term death. This prospective cohort study analyzed a comprehensive set of data, including genetic ancestry and race among several others, in 1274 patients with acutely decompensated cirrhosis who were nonelectively admitted to 44 hospitals from 7 Latin American countries. Three hundred ninety-five patients (31.0%) had ACLF of any grade at enrollment. Patients with ACLF had a higher median percentage of Native American genetic ancestry and lower median percentage of European ancestry than patients without ACLF (22.6% vs 12.9% and 53.4% vs 59.6%, respectively). The median percentage of African genetic ancestry was low among patients with ACLF and among those without ACLF. In terms of race, a higher percentage of patients with ACLF than patients without ACLF were Native American and a lower percentage of patients with ACLF than patients without ACLF were European American or African American. In multivariable analyses that adjusted for differences in sociodemographic and clinical characteristics, the odds ratio for ACLF at enrollment was 1.08 (95% CI, 1.03–1.13) with Native American genetic ancestry and 2.57 (95% CI, 1.84–3.58) for Native American race vs European American race In a large cohort of Latin American patients with acutely decompensated cirrhosis, increasing percentages of Native American ancestry and Native American race were factors independently associated with ACLF at enrollment.
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