De novo Portal Vein Thrombosis in Non-Cirrhotic Non-Alcoholic Fatty Liver Disease: A 9-Year Prospective Cohort Study

• DOI: 10.3389/fmed.2021.650818
• Publication Date: 2021-04-29T13:55:41Z
• Authors: Ahmed Abdel-Razik; Nasser Mousa; Walaa Shabana; Ahmed H. Yassen; Mostafa Abdelsalam; Mohamed M. Wahba; Eman Mohamed Helmy; Ahmed M. Tawfik; Khaled Zalata; Ahmad S. Hasan; Rania Elhelaly; Rasha Elzehery; Aya Ahmed Fathy; Niveen El-Wakeel; Waleed Eldars
• Keywords: 0301 basic medicine; Medicine (General); adiponectin; waist circumference; 16. Peace & justice; leptin; 3. Good health; 03 medical and health sciences; R5-920; leptin/adiponectin ratio; NAFLD; Medicine; portal vein thrombosis

Background and Aims: Approximately 30–40% of portal vein thrombosis (PVT) remains of unknown origin. The association between non-alcoholic fatty liver disease (NAFLD) and PVT is a matter of debate. This study aimed to investigate the association between PVT and NAFLD.Methods: We included 94 out of 105 consecutive NAFLD patients in this prospective cohort study in addition to 94 from the healthy control group. We evaluated biochemical, clinical, immunological, and histopathological parameters; waist circumference (WC); leptin; adiponectin; and leptin/adiponectin ratio (LAR) for all participants at baseline and every 3 years thereafter. We described the characteristics of participants at baseline and showed individual WC, LAR, and PVT characteristics. Potential parameters to predict PVT development within 9 years were determined.Results: PVT developed in eight (8.5%) patients, mainly in the portal trunk. Univariate analysis showed three PVT-associated factors: diabetes mellitus (P = 0.013), WC (P < 0.001), and LAR (P = 0.002). After adjusting multiple confounding variables, the multivariate model showed that the only significant variables were WC and LAR. By applying the receiver operating characteristic curve, WC had 98.8% specificity, 87.5% sensitivity, and 0.894 area under the curve (AUC) for prediction of PVT (P < 0.001) at cutoff values of > 105 cm. In comparison, LAR had 60.5% specificity, 87.5% sensitivity, and 0.805 AUC for PVT prediction (P < 0.001) at cutoff values of >7.5.Conclusions: This study suggests that increased central obesity and LAR were independently associated with PVT development in non-cirrhotic NAFLD patients, and they should be considered risk factors that may participate in PVT multifactorial pathogenesis.