Metabolic syndrome is independently associated with 1-year readmission in patients with alcohol-associated cirrhosis

Objectives This study aimed to investigate the relationship between metabolic syndrome (MetS) and the risk of 1-year readmission in patients with alcohol-associated cirrhosis and to identify the independent predictors of this outcome. Methods This retrospective cohort study included 379 patients with alcohol-associated cirrhosis who were hospitalized between January 2012 and December 2023. Patients were categorized into two groups according to the presence or absence of MetS. Baseline characteristics, liver function indicators, complications, and causes of readmission were compared. A multivariable logistic regression analysis was used to identify independent predictors of 1-year readmission. Stratified analyses were conducted to evaluate potential effect modification. Results Of the 379 patients (98.9% were male patients, mean age 54.1 ± 10.1 years), 40 of them (10.6%) had MetS. Patients with MetS had a significantly higher 1-year readmission rate than those without MetS (65.0% vs. 44.5%, p = 0.014). Overall, 177 patients (46.7%) were readmitted within 1 year. The readmitted group had higher rates of MetS (14.7% vs. 6.9%, p = 0.014), hepatic encephalopathy (19.2% vs. 10.9%, p = 0.023), and variceal bleeding (13.6% vs. 5.0%, p = 0.003). Ascites was the most common cause of readmission (55.4%), followed by hepatic encephalopathy (19.8%), hepatocellular carcinoma (14.1%), and variceal bleeding (13.6%). A multivariable analysis confirmed that MetS (OR = 2.38, 95% CI: 1.17–4.83, p = 0.017), hepatic encephalopathy, variceal bleeding, and lower alanine aminotransferase (ALT) levels were independent predictors of 1-year readmission. Stratified analyses showed no significant interaction between MetS and the risk of 1-year readmission across different subgroups stratified by age, BMI, hypertension, diabetes, hyperlipidemia, ALT levels, aspartate aminotransferase (ALP) levels, and total bilirubin (TBIL) levels. Conclusion Metabolic syndrome is an independent predictor of 1-year readmission in patients with alcohol-associated cirrhosis, influencing the risk of readmission together with factors such as hepatic encephalopathy and variceal bleeding. The interplay between metabolic dysfunction and alcohol-associated cirrhosis warrants further investigation, and our findings underscore the importance of metabolic risk management in this population.