Evidence mapPaperPMID 36166317Full record

ArticleLiver international : official journal of the International Association for the Study of the Liver2022

Effect of common genetic variants on the risk of cirrhosis in non-alcoholic fatty liver disease during 20 years of follow-up.

Magnus Holmer, Mattias Ekstedt, Patrik Nasr, Robin Zenlander, Axel Wester, Federica Tavaglione, Stefano Romeo, Stergios Kechagias, Per Stål, Hannes Hagström

Open access · hybridAbstract read
In one paragraph

Article in Liver international : official journal of the International Association for the Study of the Liver, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 3 pooled it
5.5field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 36 citations in OpenAlex.

  1. Pooled it
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  4. Article
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  6. Clinical and Genetic Predictors of Non-Alcoholic Steatotic Liver Disease and Fibrosis in Lean Individuals.Liver international : official journal of the International Association for the Study of the Liver · 2025
    Article
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  10. Impact of PNPLA3 I148M on Clinical Outcomes in Patients With MASLD.Liver international : official journal of the International Association for the Study of the Liver · 2025
    Review
  11. Integrating PNPLA3 into clinical risk prediction.Liver international : official journal of the International Association for the Study of the Liver · 2025
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Magnus HolmerDivision of Liver and Pancreatic disease, Department of Upper GI, Karolinska University Hospital, Stockholm, Sweden.ORCID 0000-0001-8962-6517
Mattias EkstedtDepartment of Gastroenterology and Hepatology, Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden.ORCID 0000-0002-5590-8601
Patrik NasrDepartment of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-2928-4188
Robin ZenlanderDepartment of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.
Axel WesterDepartment of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0003-3634-6591
Federica TavaglioneDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden.
Stefano RomeoDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden.ORCID 0000-0001-9168-4898
Stergios KechagiasDepartment of Gastroenterology and Hepatology, Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden.ORCID 0000-0001-7614-739X
Per StålDivision of Liver and Pancreatic disease, Department of Upper GI, Karolinska University Hospital, Stockholm, Sweden.ORCID 0000-0003-2915-1964
Hannes HagströmDivision of Liver and Pancreatic disease, Department of Upper GI, Karolinska University Hospital, Stockholm, Sweden.ORCID 0000-0002-8474-1759
Karolinska University Hospital · SELinköping University · SEKarolinska Institutet · SESahlgrenska University Hospital · SEUniversity of Gothenburg · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsSeveral genotypes associate with a worse histopathological profile in patients with non-alcoholic fatty liver disease (NAFLD). Whether genotypes impact long-term outcomes is unclear. We investigated the importance of PNPLA3, TM6SF2, MBOAT7 and GCKR genotype for the development of severe outcomes in NAFLD.

methodDNA samples were collected from 546 patients with NAFLD. Advanced fibrosis was diagnosed by liver biopsy or elastography. Non-alcoholic steatohepatitis (NASH) was histologically defined. Additionally, 5396 controls matched for age, sex and municipality were identified from population-based registers. Events of severe liver disease and all-cause mortality were collected from national registries. Hazard ratios (HRs) adjusted for age, sex, body mass index and type 2 diabetes were estimated with Cox regression.

resultsIn NAFLD, the G/G genotype of PNPLA3 was associated with a higher prevalence of NASH at baseline (odds ratio [OR] 3.67, 95% CI = 1.66-8.08), but not with advanced fibrosis (OR 1.81, 95% CI = 0.79-4.14). After up to 40 years of follow-up, the PNPLA3 G/G genotype was associated with a higher rate of severe liver disease (adjusted hazard ratio [aHR] 2.27, 95% CI = 1.15-4.47) compared with the C/C variant. NAFLD patients developed cirrhosis at a higher rate than controls (aHR 9.00, 95% CI = 6.85-11.83). The PNPLA3 G/G genotype accentuated this rate (aHR 23.32, 95% = CI 9.14-59.47). Overall mortality was not affected by any genetic variant.

conclusionThe PNPLA3 G/G genotype is associated with an increased rate of cirrhosis in NAFLD. Our results suggest that assessment of the PNPLA3 genotype is of clinical relevance in patients with NAFLD to individualize monitoring and therapeutic strategies.

Indexed as

Diabetes Mellitus, Type 2Non-alcoholic Fatty Liver DiseaseFibrosisFollow-Up StudiesHumansLipaseLiver CirrhosisMembrane ProteinsLipaseMembrane ProteinsNAFLDNASHPNPLA3TM6SF2

Identifiers

PMID36166317
PMCPMC9828463
OpenAlexW4297260345

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.