Case Control Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2023; 11(34): 8126-8138
Published online Dec 6, 2023. doi: 10.12998/wjcc.v11.i34.8126
Case-control analysis of venous thromboembolism risk in non-alcoholic steatohepatitis diagnosed by transient elastography
Mithil Gowda Suresh, Maya Gogtay, Yuvaraj Singh, Lekha Yadukumar, Ajay Kumar Mishra, George M Abraham
Mithil Gowda Suresh, Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
Maya Gogtay, Department of Hematology and Oncology, University of Nebraska Medical Center, Omaha, NE 68198, United States
Yuvaraj Singh, Department of Gastroenterology and Hepatology, University of Massachusetts, Worcester, MA 01605, United States
Lekha Yadukumar, Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA 18505, United States
Ajay Kumar Mishra, Division of Cardiology, Saint Vincent Hospital, Worcester, MA 01608, United States
George M Abraham, Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
Author contributions: Suresh MG conceived the idea for the study, designed and undertook the literature review, performed the statistical analysis, figures, and appendix and analyzed and interpreted the data; Suresh MG, Singh Y, and Gogtay M collected data; Suresh MG, Singh Y, Gogtay M, Gogtay M, and Yadukumar L wrote the first draft of the manuscript; Suresh MG, Gogtay M, Singh Y, Yadukumar L, Mishra AK, and Abraham GM revised the subsequent manuscript drafts; and all authors reviewed and agreed on the final draft of the manuscript.
Institutional review board statement: The comprehensive investigation into the potential link between non-alcoholic steatohepatitis and venous thromboembolism was conducted in adherence to a well-defined protocol. This protocol was developed, reviewed, and sanctioned by the joint institutional review board at MetroWest Medical Center under Approval No. 2020-035.
Informed consent statement: The ethical requirement for individual informed consent was appropriately waived by the institutional review board due to the retrospective nature of this case-control study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at mithil58@gmail.com. Consent was not obtained, but the presented data are anonymized, and risk of identification is low.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mithil Gowda Suresh, MD, Academic Fellow, Department of Internal Medicine, Saint Vincent Hospital, 123 Summer Street, Worcester, MA 01608, United States. mithilgowda1.suresh@stvincenthospital.com
Received: October 30, 2023
Peer-review started: October 30, 2023
First decision: November 1, 2023
Revised: November 6, 2023
Accepted: November 24, 2023
Article in press: November 24, 2023
Published online: December 6, 2023
ARTICLE HIGHLIGHTS
Research background

To investigate the relationship between nonalcoholic fatty liver disease (NAFLD) and the risk of venous thromboembolism (VTE). The study underscores the need for greater awareness of the risk factors contributing to VTE in the context of NAFLD.

Research motivation

The motivation behind this research is to identify the connection between NAFLD, particularly non-alcoholic steatohepatitis (NASH), and the development of VTE. There is a knowledge gap and a compelling need to understand this association to enhance clinical outcomes and tailor management strategies for patients with NAFLD.

Research objectives

The primary objective was to evaluate the incidence and characteristics of VTE in patients with NAFLD and identify associated risk factors. Achieving this goal is significant for improving the prognosis and management of NAFLD patients by enabling the early detection and treatment of VTE.

Research methods

The case-control study employed comprehensive patient data analysis, logistic regression, and comparative assessments between patient groups with and without VTE. These methods facilitated a detailed examination of the clinical parameters and outcomes, highlighting the robustness and replicability of the study.

Research results

Key findings include the higher prevalence of diabetes mellitus and more severe liver pathology (steatosis and fibrosis) in the VTE group. The study revealed that these patients often required hospitalization and intensive management, including anticoagulation therapy. The results contribute significantly to the current understanding of the relationship between NASH and VTE, emphasizing the importance of monitoring at-risk patients.

Research conclusions

The study proposes that NAFLD, particularly with advanced liver pathology from NAFLD, is a significant factor in the development of VTE.

Research perspectives

Future research should focus on longitudinal studies to further define the causal relationships and investigate the underlying mechanisms that link advanced NAFLD with VTE. Additionally, there is a need for clinical trials to test targeted interventions aimed at reducing the risk of thrombosis in this patient population.