Rationale, aims and objectives: Chronic hepatitis B virus (HBV) infection and alcoholism are the leading cirrhotic etiologies. Cirrhosis cases caused by different etiologies have different clinical features, which leads to different clinical outcomes. This study aimed to investigate the differences in complications between HBV- and alcohol-related cirrhosis. Methods: Medical records of hospitalized patients with HBV- or alcohol-related cirrhosis treated from January 2014 to January 2021 were retrospectively reviewed. The unadjusted rate and adjusted risk of cirrhotic complications between the two groups were assessed. Results: The rates of hepatocellular carcinoma (HCC) and hypersplenism were notably higher in HBV-related cirrhosis (HCC: 39.55% vs 1.45%, P < 0.001; hypersplenism: 45.84% vs 28.99%, P = 0.009), whereas the rates of hepatic encephalopathy (HE) and acute-on-chronic liver failure (ACLF) were higher in alcohol-related cirrhosis (HE: 15.94% vs 4.49%, P = 0.001; ALCF: 7.25% vs 2.28%, P = 0.040). After adjusting for potential confounders, HBV-related cirrhotic patients still had higher risks of HCC (odds ratio [OR] = 34.06, 95% confidence interval [CI]: 4.61–251.77, P = 0.001) and hypersplenism (OR = 2.29, 95% CI: 1.18–4.42, P = 0.014), while alcohol-related cirrhotic patients still had higher risks of HE (OR= 0.22, 95% CI: 0.06–0.73, P = 0.013) and ACLF (OR = 0.30, 95% CI: 0.14–0.73, P = 0.020). Conclusion: HBV-related cirrhotic patients had increased risks of HCC and hypersplenism, while alcohol-related cirrhotic patients more readily developed HE and ACLF.

Objective To investigate the association between intestinal permeability and severity of nonalcoholic fatty liver disease (NAFLD), and the value of intestinal permeability in predicting the efficacy of metabolic therapy for NAFLD. Methods Disease severity was compared between patients with normal and elevated intestinal permeability; correlations between D-lactate and different NAFLD parameters were analyzed; and the effects of metabolic therapy on NAFLD patients with normal and elevated intestinal permeability were evaluated. Results A total of 190 patients with NAFLD were enrolled. NAFLD patients with elevated intestinal permeability had significantly higher levels of liver test parameters, liver ultrasonographic fat attenuation parameter, triglyceride, homeostasis model assessment of insulin resistance value and diamine oxidase (all P˂0.05) than NAFLD patients with normal intestinal permeability. Further, serum D-lactate levels were positively correlated with alanine transaminase, aspartate transaminase, gamma-glutamyl transpeptidase, total bilirubin, indirect bilirubin, fat attenuation parameter, triglyceride, and diamine oxidase (all P˂0.05). Moreover, NAFLD patients with elevated intestinal permeability showed less improvement in TG levels (P=0.014) after metabolic therapy. Conclusion Intestinal permeability correlates with the disease severity in patients with NAFLD. Moreover, intestinal permeability may have value for predicting the efficacy of metabolic therapy for NAFLD patients.