Article
作者: Carrilho, Flair J ; de la Peña-Ramirez, Carlos ; Zarela Lozano Miranda, Adelina ; Trebicka, Jonel ; Fernández, Javier ; Arroyo, Vicente ; Aguilar Parera, Ferran ; Castro Lyra, André ; Benitez, Carlos ; Fernandes, Flavia ; Couto, Claudia Alves ; Fassio, Eduardo ; Clària, Joan ; Bittencourt, Paulo L ; Diaz, Juan Manuel ; Ximenes, Rafael O ; Angeli, Paolo ; Silva, Marcelo O ; Pérez Hernández, José L ; Curto Vilalta, Anna ; Goncalves, Luciana L ; Beltrán-Galvis, Oscar A ; Dávalos-Moscol, Milagros B ; Nardelli, Mateus J ; Moreau, Richard ; Malé-Velázquez, René ; Mazo, Daniel F C ; Faria Silva, Giovanni ; Castillo Barradas, Mauricio ; González Huezo, María S ; Guerreiro, Gabriel T S ; Alcantara, Camila ; Sánchez Garrido, Cristina ; Bessone, Fernando ; Torre, Aldo ; Terra, Carlos ; Toledo, Claudio L ; Farias, Alberto Queiroz ; Uson Raposo, Eva M ; Gustot, Thierry ; Oliveira, Joao C ; da Penha Zago-Gomes, Maria ; Mendes, Liliana S C ; Palma-Fernandez, Renato ; Codes, Liana ; Momoyo Zitelli, Patricia ; Marciano, Sebastián ; Mattos, Angelo A ; Pereira, Gustavo ; Marín, Juan I ; Rocha, Tarciso D S ; Padilla-Machaca, P Martín ; Alvares-da-Silva, Mario R ; Jalan, Rajiv ; Mendizabal, Manuel ; Sierra Casas, Patricia ; Arrese, Marco ; Gadano, Adrian C ; Mattos, Angelo Z ; Méndez-Guerrero, Osvely
BACKGROUND & 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 race CONCLUSIONS: 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.