Diabetes mellitus in alcohol-associated liver disease: Prevalence and outcomes
Bibliographic record
Abstract
BACKGROUND: Alcohol associated liver disease (ALD) is a common condition that is a significant global cause of morbidity and mortality. Diabetes mellitus (DM) increases the risk of adverse outcomes in other types of steatotic liver disease. This retrospective study sought to explore the relationship between ALD and DM. METHODS: The Worldwide Alcohol-related Liver Disease Outcomes (WALDO) study is an international multicenter cohort of patients with biopsy-proven ALD. The presence of DM at baseline or during follow-up was noted. Clinical events after index biopsy were noted, including death and liver-associated clinical events (LACE). Risks for adverse outcomes were assessed with Cox proportional hazard models with DM as a time-dependent variable to reflect periods of time without or with diabetes. All analyses were done in R. RESULTS: In total, 712 patients with a median age of 52 years were followed up for a median of 4.8 years (IQR: 1.2-9.5). At baseline, DM was present in 113 patients (15.9%), and a further 56 patients (7.8%) developed DM in follow-up. During follow-up, 113 patients developed LACE. One hundred fifty-two patients died from liver disease, and 46 underwent liver transplantation. DM was significantly associated with liver-related mortality (HR: 1.77, 1.15-2.73, p=0.009) and incident LACE (HR: 1.90, 1.23-2.95, p=0.004). In multivariable analysis, DM remained significantly associated with liver-related mortality (HR=1.79, 1.30-2.48, p<0.001). CONCLUSIONS: DM is a frequent comorbidity in persons with ALD and is associated with a higher risk of liver-related mortality. Patients' diabetic status should be an important consideration for clinicians treating people with ALD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".