Pretreatment gamma‐glutamyl transferase predicts mortality in patients with chronic hepatitis B treated with nucleotide/nucleoside analogs
Abstract Elevated serum gamma‐glutamyl transferase (GGT) levels are associated with chronic hepatitis B (CHB)‐related hepatocellular carcinoma. However, their role in predicting mortality in patients with CHB treated with nucleotide/nucleoside analogs (NAs) remains elusive. Altogether, 2843 patients...
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Wiley
2024-02-01
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| Series: | Kaohsiung Journal of Medical Sciences |
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| Online Access: | https://doi.org/10.1002/kjm2.12771 |
| _version_ | 1797332670269620224 |
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| author | Tyng‐Yuan Jang Po‐Cheng Liang Dae Won Jun Jang Han Jung Hidenori Toyoda Chih‐Wen Wang Man‐Fung Yuen Ka Shing Cheung Satoshi Yasuda Sung Eun Kim Eileen L. Yoon Jihyun An Masaru Enomoto Ritsuzo Kozuka Makoto Chuma Akito Nozaki Toru Ishikawa Tsunamasa Watanabe Masanori Atsukawa Taeang Arai Korenobu Hayama Masatoshi Ishigami Yong Kyun Cho Eiichi Ogawa Hyoung Su Kim Jae‐Jun Shim Haruki Uojima Soung Won Jeong Sang Bong Ahn Koichi Takaguchi Tomonori Senoh Maria Buti Elena Vargas‐Accarino Hiroshi Abe Hirokazu Takahashi Kaori Inoue Jee‐Fu Huang Wan‐Long Chuang Ming‐Lun Yeh Chia‐Yen Dai Chung‐Feng Huang Mindie H. Nguyen Ming‐Lung Yu |
| author_facet | Tyng‐Yuan Jang Po‐Cheng Liang Dae Won Jun Jang Han Jung Hidenori Toyoda Chih‐Wen Wang Man‐Fung Yuen Ka Shing Cheung Satoshi Yasuda Sung Eun Kim Eileen L. Yoon Jihyun An Masaru Enomoto Ritsuzo Kozuka Makoto Chuma Akito Nozaki Toru Ishikawa Tsunamasa Watanabe Masanori Atsukawa Taeang Arai Korenobu Hayama Masatoshi Ishigami Yong Kyun Cho Eiichi Ogawa Hyoung Su Kim Jae‐Jun Shim Haruki Uojima Soung Won Jeong Sang Bong Ahn Koichi Takaguchi Tomonori Senoh Maria Buti Elena Vargas‐Accarino Hiroshi Abe Hirokazu Takahashi Kaori Inoue Jee‐Fu Huang Wan‐Long Chuang Ming‐Lun Yeh Chia‐Yen Dai Chung‐Feng Huang Mindie H. Nguyen Ming‐Lung Yu |
| author_sort | Tyng‐Yuan Jang |
| collection | DOAJ |
| description | Abstract Elevated serum gamma‐glutamyl transferase (GGT) levels are associated with chronic hepatitis B (CHB)‐related hepatocellular carcinoma. However, their role in predicting mortality in patients with CHB treated with nucleotide/nucleoside analogs (NAs) remains elusive. Altogether, 2843 patients with CHB treated with NAs were recruited from a multinational cohort. Serum GGT levels before and 6 months (Month‐6) after initiating NAs were measured to explore their association with all‐cause, liver‐related, and non‐liver‐related mortality. The annual incidence of all‐cause mortality was 0.9/100 person‐years over a follow‐up period of 17,436.3 person‐years. Compared with patients who survived, those who died had a significantly higher pretreatment (89.3 vs. 67.4 U/L, p = 0.002) and Month‐6‐GGT levels (62.1 vs. 38.4 U/L, p < 0.001). The factors associated with all‐cause mortality included cirrhosis (hazard ratio [HR]/95% confidence interval [CI]: 2.66/1.92–3.70, p < 0.001), pretreatment GGT levels (HR/CI: 1.004/1.003–1.006, p < 0.001), alanine aminotransferase level (HR/CI: 0.996/0.994–0.998, p = 0.001), and age (HR/CI: 1.06/1.04–1.07, p < 0.001). Regarding liver‐related mortality, the independent factors included cirrhosis (HR/CI: 4.36/2.79–6.89, p < 0.001), pretreatment GGT levels (HR/CI: 1.006/1.004–1.008, p < 0.001), alanine aminotransferase level (HR/CI: 0.993/0.990–0.997, p = 0.001), age (HR/CI: 1.03/1.01–1.05, p < 0.001), and fatty liver disease (HR/CI: 0.30/0.15–0.59, p = 0.001). Pretreatment GGT levels were also independently predictive of non‐liver‐related mortality (HR/CI: 1.003/1.000–1.005, p = 0.03). The results remained consistent after excluding the patients with a history of alcohol use. A dose‐dependent manner of <25, 25–75, and >75 percentile of pretreatment GGT levels was observed with respect to the all‐cause mortality (trend p < 0.001). Pretreatment serum GGT levels predicted all‐cause, liver‐related, and non‐liver‐related mortality in patients with CHB treated with NAs. |
| first_indexed | 2024-03-08T07:53:15Z |
| format | Article |
| id | doaj.art-e34d44b81a6e43dbaa69ede33654fff2 |
| institution | Directory Open Access Journal |
| issn | 1607-551X 2410-8650 |
| language | English |
| last_indexed | 2024-03-08T07:53:15Z |
| publishDate | 2024-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Kaohsiung Journal of Medical Sciences |
| spelling | doaj.art-e34d44b81a6e43dbaa69ede33654fff22024-02-02T14:35:41ZengWileyKaohsiung Journal of Medical Sciences1607-551X2410-86502024-02-0140218819710.1002/kjm2.12771Pretreatment gamma‐glutamyl transferase predicts mortality in patients with chronic hepatitis B treated with nucleotide/nucleoside analogsTyng‐Yuan Jang0Po‐Cheng Liang1Dae Won Jun2Jang Han Jung3Hidenori Toyoda4Chih‐Wen Wang5Man‐Fung Yuen6Ka Shing Cheung7Satoshi Yasuda8Sung Eun Kim9Eileen L. Yoon10Jihyun An11Masaru Enomoto12Ritsuzo Kozuka13Makoto Chuma14Akito Nozaki15Toru Ishikawa16Tsunamasa Watanabe17Masanori Atsukawa18Taeang Arai19Korenobu Hayama20Masatoshi Ishigami21Yong Kyun Cho22Eiichi Ogawa23Hyoung Su Kim24Jae‐Jun Shim25Haruki Uojima26Soung Won Jeong27Sang Bong Ahn28Koichi Takaguchi29Tomonori Senoh30Maria Buti31Elena Vargas‐Accarino32Hiroshi Abe33Hirokazu Takahashi34Kaori Inoue35Jee‐Fu Huang36Wan‐Long Chuang37Ming‐Lun Yeh38Chia‐Yen Dai39Chung‐Feng Huang40Mindie H. Nguyen41Ming‐Lung Yu42Ph.D. Program in Environmental and Occupational Medicine, College of Medicine Kaohsiung Medical University and National Health Research Institutes Kaohsiung TaiwanHepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital Kaohsiung TaiwanDepartment of Internal Medicine Hanyang University Hospital, Hanyang University College of Medicine Seoul South KoreaDivision of Gastroenterology, Department of Internal Medicine Severance Hospital, Yonsei University College of Medicine Seoul KoreaDepartment of Gastroenterology and Hepatology Ogaki Municipal Hospital Gifu JapanHepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital Kaohsiung TaiwanDepartment of Medicine School of Clinical Medicine, Queen Mary Hospital, The University of Hong Kong Hong Kong Hong KongDepartment of Medicine School of Clinical Medicine, Queen Mary Hospital, The University of Hong Kong Hong Kong Hong KongDepartment of Gastroenterology and Hepatology Ogaki Municipal Hospital Gifu JapanDepartment of Internal Medicine Hallym University Sacred Heart Hospital, Hallym University College of Medicine Anyang South KoreaDepartment of Internal Medicine Hanyang University Hospital, Hanyang University College of Medicine Seoul South KoreaDepartment of Internal Medicine Hanyang University College of Medicine, Hanyang University Guri Hospital Guri South KoreaDepartment of Hepatology Graduate School of Medicine, Osaka Metropolitan University Osaka JapanDepartment of Hepatology Graduate School of Medicine, Osaka Metropolitan University Osaka JapanGastroenterological Center Yokohama City University Medical Center Yokohama JapanGastroenterological Center Yokohama City University Medical Center Yokohama JapanDepartment of Gastroenterology Saiseikai Niigata Hospital Niigata JapanDivision of Gastroenterology and Hepatology St. Marianna University School of Medicine Kawasaki JapanDivision of Gastroenterology and Hepatology Nippon Medical School Tokyo JapanDivision of Gastroenterology and Hepatology Nippon Medical School Tokyo JapanDivision of Gastroenterology and Hepatology Nippon Medical School Tokyo JapanDepartment of Gastroenterology & Hepatology Nagoya University Graduate School of Medicine Nagoya JapanDepartment of Internal Medicine Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Seoul South KoreaDepartment of General Internal Medicine Kyushu University Kyushu JapanDepartment of Internal Medicine Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine Seoul South KoreaDepartment of Internal Medicine Kyung Hee University Hospital, Kyung Hee University School of Medicine Seoul South KoreaDepartment of Gastroenterology Internal Medicine, Kitasato University School of Medicine Sagamihara JapanDepartment of Internal Medicine Soonchunhyang University Hospital, Soonchunhyang University College of Medicine Seoul South KoreaDepartment of Internal Medicine Nowon Eulji Medical Center, Eulji University College of Medicine Seoul South KoreaDepartment of Hepatology Kagawa Prefectural Central Hospital Kagawa JapanDepartment of Hepatology Kagawa Prefectural Central Hospital Kagawa JapanLiver Unit Hospital Universitari Vall d'Hebron and CIBEREHD del Instituto Carlos III Barcelona SpainLiver Unit Hospital Universitari Vall d'Hebron and CIBEREHD del Instituto Carlos III Barcelona SpainDivision of Gastroenterology and Hepatology Shinmatsudo Central General Hospital Chiba JapanLiver Center Saga University Hospital Saga JapanLiver Center Saga University Hospital Saga JapanHepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital Kaohsiung TaiwanHepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital Kaohsiung TaiwanKaohsiung Medical University Hospital Kaohsiung TaiwanHepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital Kaohsiung TaiwanHepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital Kaohsiung TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine Stanford University Medical Center Palo Alto California USAHepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital Kaohsiung TaiwanAbstract Elevated serum gamma‐glutamyl transferase (GGT) levels are associated with chronic hepatitis B (CHB)‐related hepatocellular carcinoma. However, their role in predicting mortality in patients with CHB treated with nucleotide/nucleoside analogs (NAs) remains elusive. Altogether, 2843 patients with CHB treated with NAs were recruited from a multinational cohort. Serum GGT levels before and 6 months (Month‐6) after initiating NAs were measured to explore their association with all‐cause, liver‐related, and non‐liver‐related mortality. The annual incidence of all‐cause mortality was 0.9/100 person‐years over a follow‐up period of 17,436.3 person‐years. Compared with patients who survived, those who died had a significantly higher pretreatment (89.3 vs. 67.4 U/L, p = 0.002) and Month‐6‐GGT levels (62.1 vs. 38.4 U/L, p < 0.001). The factors associated with all‐cause mortality included cirrhosis (hazard ratio [HR]/95% confidence interval [CI]: 2.66/1.92–3.70, p < 0.001), pretreatment GGT levels (HR/CI: 1.004/1.003–1.006, p < 0.001), alanine aminotransferase level (HR/CI: 0.996/0.994–0.998, p = 0.001), and age (HR/CI: 1.06/1.04–1.07, p < 0.001). Regarding liver‐related mortality, the independent factors included cirrhosis (HR/CI: 4.36/2.79–6.89, p < 0.001), pretreatment GGT levels (HR/CI: 1.006/1.004–1.008, p < 0.001), alanine aminotransferase level (HR/CI: 0.993/0.990–0.997, p = 0.001), age (HR/CI: 1.03/1.01–1.05, p < 0.001), and fatty liver disease (HR/CI: 0.30/0.15–0.59, p = 0.001). Pretreatment GGT levels were also independently predictive of non‐liver‐related mortality (HR/CI: 1.003/1.000–1.005, p = 0.03). The results remained consistent after excluding the patients with a history of alcohol use. A dose‐dependent manner of <25, 25–75, and >75 percentile of pretreatment GGT levels was observed with respect to the all‐cause mortality (trend p < 0.001). Pretreatment serum GGT levels predicted all‐cause, liver‐related, and non‐liver‐related mortality in patients with CHB treated with NAs.https://doi.org/10.1002/kjm2.12771GGTHBVmortalityNAtreatment |
| spellingShingle | Tyng‐Yuan Jang Po‐Cheng Liang Dae Won Jun Jang Han Jung Hidenori Toyoda Chih‐Wen Wang Man‐Fung Yuen Ka Shing Cheung Satoshi Yasuda Sung Eun Kim Eileen L. Yoon Jihyun An Masaru Enomoto Ritsuzo Kozuka Makoto Chuma Akito Nozaki Toru Ishikawa Tsunamasa Watanabe Masanori Atsukawa Taeang Arai Korenobu Hayama Masatoshi Ishigami Yong Kyun Cho Eiichi Ogawa Hyoung Su Kim Jae‐Jun Shim Haruki Uojima Soung Won Jeong Sang Bong Ahn Koichi Takaguchi Tomonori Senoh Maria Buti Elena Vargas‐Accarino Hiroshi Abe Hirokazu Takahashi Kaori Inoue Jee‐Fu Huang Wan‐Long Chuang Ming‐Lun Yeh Chia‐Yen Dai Chung‐Feng Huang Mindie H. Nguyen Ming‐Lung Yu Pretreatment gamma‐glutamyl transferase predicts mortality in patients with chronic hepatitis B treated with nucleotide/nucleoside analogs Kaohsiung Journal of Medical Sciences GGT HBV mortality NA treatment |
| title | Pretreatment gamma‐glutamyl transferase predicts mortality in patients with chronic hepatitis B treated with nucleotide/nucleoside analogs |
| title_full | Pretreatment gamma‐glutamyl transferase predicts mortality in patients with chronic hepatitis B treated with nucleotide/nucleoside analogs |
| title_fullStr | Pretreatment gamma‐glutamyl transferase predicts mortality in patients with chronic hepatitis B treated with nucleotide/nucleoside analogs |
| title_full_unstemmed | Pretreatment gamma‐glutamyl transferase predicts mortality in patients with chronic hepatitis B treated with nucleotide/nucleoside analogs |
| title_short | Pretreatment gamma‐glutamyl transferase predicts mortality in patients with chronic hepatitis B treated with nucleotide/nucleoside analogs |
| title_sort | pretreatment gamma glutamyl transferase predicts mortality in patients with chronic hepatitis b treated with nucleotide nucleoside analogs |
| topic | GGT HBV mortality NA treatment |
| url | https://doi.org/10.1002/kjm2.12771 |
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