Evidence map›Paper›PMID 40745309›Full record

ArticleBMC medicine2025

Extrahepatic disease clusters and mortality in people with steatotic liver diseases: a prospective analysis of 64,749 females and 113,587 males in the UK Biobank.

Qi Feng, Chioma N Izzi-Engbeaya, Thomas Beaney, Alexander G Smith, Pinelopi Manousou, Mark Woodward

Abstract read
In one paragraph

Article in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
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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

6 authors.

Qi FengThe George Institute for Global Health (UK), School of Public Health, Faculty of Medicine, Imperial College London, 58 Wood Lane, London, W12 7RZ, UK. qfeng@georgeinstitute.org.uk.ORCID http://orcid.org/0000-0001-9323-9421
Chioma N Izzi-EngbeayaSection of Investigative Medicine and Endocrinology, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK.
Thomas BeaneyThe George Institute for Global Health (UK), School of Public Health, Faculty of Medicine, Imperial College London, 58 Wood Lane, London, W12 7RZ, UK.
Alexander G SmithSchool of Public Health, Faculty of Medicine, Imperial College London, London, UK.
Pinelopi ManousouDivision of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK.
Mark WoodwardThe George Institute for Global Health (UK), School of Public Health, Faculty of Medicine, Imperial College London, 58 Wood Lane, London, W12 7RZ, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSteatotic liver disease (SLD) is the most prevalent chronic liver disease worldwide and linked to various liver and extrahepatic diseases. However, the clustering of extrahepatic conditions and their impact on mortality in individuals with SLD remain poorly understood.

methodsWe used UK Biobank data to identify sex-specific disease clusters among individuals with SLD and multimorbidity (having ≥ 2 extrahepatic diseases) using latent class analysis. Multivariable Cox models were used to assess associations between multimorbidity, disease clusters and all-cause mortality and mortality from cardiovascular diseases (CVD), extrahepatic cancers, liver-related diseases and hepatocellular carcinoma.

resultsAmong 178,336 (36.3% female) individuals with SLD, during a median follow-up of 13.8 years, multimorbidity increased mortality by 100% (hazard ratio (95% confidence interval): 2.00 (1.93, 2.08)) and 80% (1.80 (1.71, 1.90)) in males and females, respectively, and increased the risk of death from CVD, extrahepatic cancers and liver-related diseases. Among 36,002 (43.9% female) of the 178,336 with multimorbidity, we identified five disease clusters in both sexes: related to respiratory, mental health, cancer/osteoarthritis and cardiovascular diseases. Males had separate heart and stroke clusters, whereas females had a combined heart/stroke cluster and a unique thyroid cluster. CVD was the leading cause of death in cardiovascular clusters, whereas extrahepatic cancers were the most common cause of death in other clusters. Among all disease clusters, cardiovascular clusters exhibited the highest all-cause mortality risk: 2.90 (2.64, 3.20) for the heart/stroke cluster in females and 2.63 (2.48, 2.78) for the heart cluster and 2.36 (2.16, 2.58) for the stroke cluster in males. All clusters exhibited increased mortality of CVD and extrahepatic cancers.

conclusionsMultimorbidity doubled the death rate in people with SLD. Common multimorbidity clusters of mental health, respiratory, cancer and cardiovascular diseases were found and were associated with varying mortality, with cardiovascular-related clusters showing the highest risk. Females exhibited a unique thyroid disease cluster. These findings highlight the need for tailored prevention and management strategies in SLD populations.

Indexed as

Cardiovascular DiseasesFatty LiverAdultAgedBiological Specimen BanksCause of DeathCluster AnalysisFemaleHumansLiver NeoplasmsMaleMiddle AgedMultimorbidityProspective StudiesSex FactorsUK BiobankDisease clusterLatent class analysisMortalityMultimorbiditySex differenceSteatotic liver disease

Identifiers

PMID40745309
PMCPMC12315339

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

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.