Value of blood lipid parameters in predicting the progression of HBV-related acute-on-chronic pre-liver failure
10.3969/j.issn.1001-5256.2023.07.009
- VernacularTitle:血脂指标对乙型肝炎相关慢加急性肝衰竭前期进展的预测价值
- Author:
Min GUAN
1
,
2
;
Jiani LI
1
,
2
;
Yinjie GAO
3
;
Hao LI
2
;
Xiaoping WANG
4
;
Shanhong TANG
1
,
2
Author Information
1. Medical School of Southwest Jiaotong University, Chengdu 610031, China
2. Department of Gastroenterology, The General hospital of Western Theater Command, Chengdu 610083, China
3. Department of Liver Disease, The Fifth Medical Center of PLA General Hospital, Beijing 100039, China
4. Department of Gastroenterology, Suining Central Hospital, Suining, Sichuan 629018, China
- Publication Type:Original Article_Viral Hepatitis
- Keywords:
Acute-On-Chronic Liver Failure;
Cholesterol;
Lipoproteins, LDL
- From:
Journal of Clinical Hepatology
2023;39(7):1564-1569
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the difference in blood lipid parameters between acute-on-chronic pre-liver failure (pre-ACLF) and acute-on-chronic liver failure (ACLF) and the risk factors for disease progression. Methods A retrospective analysis was performed for the related data of 118 patients with ACLF (ACLF group) and 44 patients with pre-ACLF (pre-ACLF group) who were treated in The General Hospital of Western Theater Command from January 2012 to December 2020, including baseline age, albumin, creatinine, routine blood test results, and blood lipids. The independent samples t -test was used for comparison between normally distributed continuous data; and the Mann-Whitney U test was used for comparison between non-normally distributed continuous data; the chi-square test was used for comparison of categorical data between groups. A binary logistic regression analysis was used for multivariate analysis to identify independent predictive factors. The receiver operating characteristic (ROC) curve was used to compare the sensitivity and specificity of related indicators, and Youden index was used to calculate cut-off values. Results Compared with the pre-ACLF group, the ACLF group had significantly lower levels of total cholesterol (TC)[2.02(1.56-2.37) mmol/L vs 3.01(2.57-3.66) mmol/L, Z =5.411, P < 0.001], high-density lipoprotein [0.40(0.25-0.49) mmol/L vs 0.62(0.47-0.75) mmol/L, Z =4.781, P < 0.001], and low-density lipoprotein (LDL) [1.52(1.22-1.84) mmol/L vs 1.93(1.49-2.36) mmol/L, Z =3.146, P =0.002] and significantly higher levels of total bilirubin [352.13(284.32-451.19) μmol/L vs 135.80(112.80-154.68) μmol/L, Z =-9.775, P < 0.001], international normalized ratio [1.96(1.71-2.51) vs 1.39(1.33-1.44), Z =-9.776, P < 0.001], white blood cell count (WBC) [6.74(5.07-9.19)×10 9 /L vs 5.04(4.13-7.09)×10 9 /L, Z =-3.985, P < 0.001], and neutrophils [4.67(3.40-7.06)×10 9 /L vs 3.30(2.72-5.01)×10 9 /L, Z =-3.676, P < 0.001], while there were no significant differences between the two groups in age, creatinine, albumin, alanine aminotransferase, aspartate aminotransferase, and triglyceride (all P > 0.05). The logistic regression analysis showed that TC (odds ratio [ OR ]=0.003, 95% confidence interval [ CI ]: 0.000-0.068, P < 0.05), LDL ( OR =61.901, 95% CI : 3.354-1142.558, P < 0.05), and WBC ( OR =3.175, 95% CI : 1.097-9.185, P < 0.05) had an independent predictive value, and the ROC analysis showed that the area under the ROC curve of TC was 0.852, the sensitivity of LDL was 0.887, and TC had the best specificity of TC was 0.840. Conclusion There are reductions in blood lipid parameters in the progression from pre-ACLF to ACLF, suggesting that clinicians should pay attention to the changes in lipids in the pre-ACLF stage and adjust the nutritional regimen in a timely manner.
