Low high-density lipoprotein cholesterol levels predicting poor outcomes in patients with hepatitis B virus-related acute-on-chronic liver failure
BackgroundLipid profile disorders frequently occur in patients with advanced liver diseases. High-density lipoprotein cholesterol (HDL-C) levels decrease rapidly during acute conditions of some diseases, and HDL-C levels may be related to mortality in patients with hepatitis B virus-related acute-on...
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.1001411/full |
| _version_ | 1811186689028128768 |
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| author | Yue Zhang Peng Chen Yun Zhang Yuan Nie Xuan Zhu |
| author_facet | Yue Zhang Peng Chen Yun Zhang Yuan Nie Xuan Zhu |
| author_sort | Yue Zhang |
| collection | DOAJ |
| description | BackgroundLipid profile disorders frequently occur in patients with advanced liver diseases. High-density lipoprotein cholesterol (HDL-C) levels decrease rapidly during acute conditions of some diseases, and HDL-C levels may be related to mortality in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).Materials and methodsA retrospective cohort study was conducted on 200 subjects with HBV-ACLF. The patients were separated into non-survivors and survivors according to their 28-day outcome. Univariate and multivariate Cox regression analyses were performed to identify predictors of mortality, and the performance of these predictors was evaluated by receiver operating characteristic (ROC) curve analysis. Kaplan–Meier analysis was performed to draw survival curves of HDL-C.ResultsThe 28-day mortality in the cohort was 27.0%. HDL-C levels differed markedly between non-survivors and survivors. In the multivariate analysis, HDL-C, the Child-Turcotte-Pugh (CTP), model for end-stage liver disease (MELD), and Chinese Group on the Study of Severe Hepatitis B-ACLF II (COSSH-ACLF II) scores were identified as independent predictors for mortality (HR = 0.806, 95% CI: 0.724–0.898; HR = 1.424, 95% CI: 1.143–1.775; HR = 1.006, 95% CI: 1.002–1.007; and HR = 1.609, 95% CI: 1.005–2.575, respectively). Patients with lower HDL-C levels had a worse prognosis than those with higher HDL-C levels. In ROC analysis, the prognostic accuracy for mortality was similar between HDL-C (AUROC: 0.733) and the CTP, MELD, and COSSH-ACLF II scores (AUROC: 0.753; 0.674 and 0.770, respectively).ConclusionThe HDL-C level may serve as a potential indicator for the prognosis of HBV-ACLF and can be used as a simple marker for risk assessment and selection of therapeutic options. |
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| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-11T13:49:23Z |
| publishDate | 2022-11-01 |
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| series | Frontiers in Medicine |
| spelling | doaj.art-8baf09e90f9042089e68dcd4b1a5c7b92022-12-22T04:20:43ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-11-01910.3389/fmed.2022.10014111001411Low high-density lipoprotein cholesterol levels predicting poor outcomes in patients with hepatitis B virus-related acute-on-chronic liver failureYue ZhangPeng ChenYun ZhangYuan NieXuan ZhuBackgroundLipid profile disorders frequently occur in patients with advanced liver diseases. High-density lipoprotein cholesterol (HDL-C) levels decrease rapidly during acute conditions of some diseases, and HDL-C levels may be related to mortality in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).Materials and methodsA retrospective cohort study was conducted on 200 subjects with HBV-ACLF. The patients were separated into non-survivors and survivors according to their 28-day outcome. Univariate and multivariate Cox regression analyses were performed to identify predictors of mortality, and the performance of these predictors was evaluated by receiver operating characteristic (ROC) curve analysis. Kaplan–Meier analysis was performed to draw survival curves of HDL-C.ResultsThe 28-day mortality in the cohort was 27.0%. HDL-C levels differed markedly between non-survivors and survivors. In the multivariate analysis, HDL-C, the Child-Turcotte-Pugh (CTP), model for end-stage liver disease (MELD), and Chinese Group on the Study of Severe Hepatitis B-ACLF II (COSSH-ACLF II) scores were identified as independent predictors for mortality (HR = 0.806, 95% CI: 0.724–0.898; HR = 1.424, 95% CI: 1.143–1.775; HR = 1.006, 95% CI: 1.002–1.007; and HR = 1.609, 95% CI: 1.005–2.575, respectively). Patients with lower HDL-C levels had a worse prognosis than those with higher HDL-C levels. In ROC analysis, the prognostic accuracy for mortality was similar between HDL-C (AUROC: 0.733) and the CTP, MELD, and COSSH-ACLF II scores (AUROC: 0.753; 0.674 and 0.770, respectively).ConclusionThe HDL-C level may serve as a potential indicator for the prognosis of HBV-ACLF and can be used as a simple marker for risk assessment and selection of therapeutic options.https://www.frontiersin.org/articles/10.3389/fmed.2022.1001411/fullhigh-density lipoprotein cholesterolhepatitis B virusacute-on-chronic liver failureprognosisCTP scoreMELD score |
| spellingShingle | Yue Zhang Peng Chen Yun Zhang Yuan Nie Xuan Zhu Low high-density lipoprotein cholesterol levels predicting poor outcomes in patients with hepatitis B virus-related acute-on-chronic liver failure Frontiers in Medicine high-density lipoprotein cholesterol hepatitis B virus acute-on-chronic liver failure prognosis CTP score MELD score |
| title | Low high-density lipoprotein cholesterol levels predicting poor outcomes in patients with hepatitis B virus-related acute-on-chronic liver failure |
| title_full | Low high-density lipoprotein cholesterol levels predicting poor outcomes in patients with hepatitis B virus-related acute-on-chronic liver failure |
| title_fullStr | Low high-density lipoprotein cholesterol levels predicting poor outcomes in patients with hepatitis B virus-related acute-on-chronic liver failure |
| title_full_unstemmed | Low high-density lipoprotein cholesterol levels predicting poor outcomes in patients with hepatitis B virus-related acute-on-chronic liver failure |
| title_short | Low high-density lipoprotein cholesterol levels predicting poor outcomes in patients with hepatitis B virus-related acute-on-chronic liver failure |
| title_sort | low high density lipoprotein cholesterol levels predicting poor outcomes in patients with hepatitis b virus related acute on chronic liver failure |
| topic | high-density lipoprotein cholesterol hepatitis B virus acute-on-chronic liver failure prognosis CTP score MELD score |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.1001411/full |
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