Autoimmune hepatitis and metabolic syndrome-associated disease development: a US cohort study

Background Autoimmune hepatitis (AIH) may coexist with metabolic syndrome-associated diseases (MSADs) given patients' inherent need for corticosteroid therapy, as well as general population trends. Aim To examine the impact of MSAD risk factors on AIH or its treatment, and vice versa Methods This was a multi-centre retrospective cohort study of 552 patients with AIH diagnosed between January 2000 and December 2019. Data relating to demographic factors, laboratory values, AIH medications and MSADs were collected at diagnosis and at 1- and 3-year follow-up. Statistical relationships were analysed and reported. Results We included 552 patients in the study cohort (median age 50 years, 76.1% female). All MSADs, including hypertension, dyslipidaemia, diabetes and a gain of BMI >= 3 kg/m(2), increased within the AIH cohort over time. Initial treatment regimen impacted de novo diabetes but not other MSAD development. AIH biochemical remission was less frequent at 3 years post-diagnosis among patients with >= 1 MSAD. The incidence of new MSADs could be predicted by baseline factors in certain cases. Conclusion In the largest US-based cohort of patients newly diagnosed with AIH, there was a considerable burden of pre-existing and de novo MSADs that may affect AIH treatment outcomes. Identifying those at highest risk of co-morbid MSADs allows for an individualised approach to management to reduce its long-term sequelae in patients with AIH.

Automated summary

This study found that patients with autoimmune hepatitis (AIH) are at a higher risk of developing metabolic syndrome-associated diseases (MSADs), possibly due to the long-term use of corticosteroid therapy and general population trends. The initial treatment regimen was found to affect the development of new-onset diabetes, and the presence of MSADs was associated with lower rates of biochemical remission in AIH patients.