Clinical features of drug-induced liver injury and related risk factors

Objective To investigate the clinical features of drug-induced liver injury (DILI) and related risk factors. Methods A retrospective analysis was performed for the clinical data of 208 patients who were diagnosed with DILI in The Affiliated Hospital of Southwest Medical University from January 2013 to November 2017, including the type of drugs, clinical data, and laboratory examination results, and among these patients, 80 with DILI caused by antitubercular agents, antitumor drugs, and immune agents were enrolled as observation group. A total of 80 patients who used these three types of drugs and did not develop DILI were enrolled as control group. Related risk factors were analyzed. An analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups. The chi-square test was used for unordered variables of categorical data, the Mann-Whitney U test was used for ranked data, and a logistic regression analysis was used to identify risk factors. Results Of all patients with DILI, 30. 8% had DILI caused by traditional Chinese medicine. There were significant differences in sex, alanine aminotransferase, aspartate aminotransferase (AST) , total bilirubin (TBil) , gamma-glutamyl transpeptidase (GGT) , and total bile acid (TBA) between patients with different types of DILI (χ2= 6. 081, H = 54. 349, 45. 993, 78. 902, 49. 940, and 21. 934, all P < 0. 05) . There were significant differences in AST, TBil, GGT, and TBA between the patients with different prognoses (H = 1. 728, 6. 322, 6. 440, and 2. 353, all P < 0. 05) . Smoking (odds ratio [OR]= 2. 856, P = 0. 026) , diabetes (OR = 2. 726, P = 0. 042) , hyperlipidemia (OR = 3. 390, P = 0. 003) , and body mass index (BMI) ≥28 kg/m2 (OR = 3. 142, P =0. 009) were risk factors for DILI. Conclusion Most DILI cases are caused by traditional Chinese medicine, and hepatocellular type is the most common type of liver injury. Smoking, diabetes, hyperlipidemia, and BMI ≥28 kg/m2 are risk factors for DILI.