Influence of metabolism-related factors on the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure and establishment of a predictive model
- VernacularTitle:代谢相关因素对HBV相关慢加急性肝衰竭患者短期预后的影响及预测模型构建
- Author:
Wenling LUO
1
;
Yu ZENG
1
;
Xuemei ZHANG
1
;
Yunjian SHENG
1
Author Information
- Publication Type:Journal Article
- Keywords: Hepatitis B virus; Acute-On-Chronic Liver Failure; Metabolism; Prognosis
- From: Journal of Clinical Hepatology 2024;40(10):1985-1991
- CountryChina
- Language:Chinese
- Abstract: ObjectiveTo investigate the influence of metabolism-related factors (overweight and/or obesity, hyperglycemia, hypertension and dyslipidemia)on the 90-day prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF), and to establish a predictive model. MethodsA retrospective analysis was performed for the clinical data of 365 patients with HBV-ACLF who were hospitalized in Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, from June 2018 to June 2022, and according to the 90-day follow-up results, they were divided into survival group with 273 patients and death group with 92 patients. General information and related laboratory markers were collected from all patients. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distribution continuous data between groups; the chi-square test was used for comparison of categorical data between groups. A Logistic regression analysis was used to determine whether metabolism-related factors were independent risk factors for the 90-day prognosis of HBV-ACLF patients, and the Kaplan-Meier analysis was used to investigate the correlation between metabolism-related factors and the 90-day survival rate of HBV-ALCF patients. The area under the ROC curve (AUC) was used to compare the value of different scoring models in predicting the 90-day prognosis of HBV-ACLF patients. ResultsThe multivariate Logistic regression analysis showed that hypertension (odds ratio [OR]=4.698, 95% confidence interval [CI]: 1.904 — 11.593, P=0.001), alanine aminotransferase (OR=0.999, 95%CI: 0.999 — 1.000, P=0.010), triglyceride (TG) (OR=4.979, 95%CI: 2.433 — 10.189, P<0.001), high-density lipoprotein cholesterol (OR=0.258, 95%CI: 0.087 — 0.762, P=0.012), apolipoprotein B (OR=0.118, 95%CI: 0.026 — 0.547, P=0.006), and CLIF-C OF score (OR=2.275, 95%CI: 1.150 — 4.502, P<0.001) were independent influencing factors for the short-term prognosis of HBV-ACLF. The combined predictive model of metabolism-related factors had a larger AUC than the predictive model of a single factor, among which the predictive model of hypertension+TG+CLIF-C OF score had the largest AUC of 0.886. The patients with metabolism-related factors tended to have higher incidence rate of liver complications and 30- and 90-day mortality rates. ConclusionThe presence of the metabolism-related factors such as hypertension and dyslipidemia can increase the severity of HBV-ACLF and the risk of short-term mortality, and the hypertension+TG+CLIF-C OF score predictive model has a good value in predicting the short-term prognosis of HBV-ACLF patients.