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Volume 40 Issue 10
Oct.  2024
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Article Navigation >  Journal of Clinical Hepatology  > 2024  >  40(10): 1985-1991

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

DOI: 10.12449/JCH241010

  • Department of Infectious Diseases，The Affiliated Hospital of Southwest Medical University，Luzhou，Sichuan 646000，China

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  • Corresponding author: SHENG Yunjian， sheng200410@163.com （ORCID： 0000-0003-0772-5971）
  • Received Date: 2024-01-02
  • Accepted Date: 2024-02-22
  • Published Date: 2024-10-25
    Abstract
  •   Objective  To 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.  Methods  A 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.  Results  The 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.  Conclusion  The 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.

     

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    • References(20)
  • [1]
    Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association; Severe Liver Disease and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association. Guideline for diagnosis and treatment of liver failure(2018)[J]. J Clin Hepatol, 2019, 35( 1): 38- 44. DOI: 10.3969/j.issn.1001-5256.2019.01.007.

    中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组. 肝衰竭诊治指南(2018年版)[J]. 临床肝胆病杂志, 2019, 35( 1): 38- 44. DOI: 10.3969/j.issn.1001-5256.2019.01.007.
    [2]
    CHEN MJ, LI X, TANG SH. Advances in multi-dimensional assessment of liver function in the prognosis of patients with liver failure[J]. Clin J Med Offic, 2023, 51( 9): 901- 903, 907. DOI: 10.16680/j.1671-3826.2023.09.05.

    陈美娟, 李雪, 汤善宏. 多维度评估肝功能在肝衰竭患者预后中研究进展[J]. 临床军医杂志, 2023, 51( 9): 901- 903, 907. DOI: 10.16680/j.1671-3826.2023.09.05.
    [3]
    ASRANI S, SIMONETTO D, KAMATH P. Acute-on-chronic liver failure[J]. Clin Gastroenterol Hepatol, 2015, 13( 12): 2128- 39. DOI: 10.1016/j.cgh.2015.07.008.
    [4]
    MEZZANO G, JUANOLA A, CARDENAS A, et al. Global burden of disease: Acute-on-chronic liver failure, a systematic review and meta-analysis[J]. Gut, 2022, 71( 1): 148- 155. DOI: 10.1136/gutjnl-2020-322161.
    [5]
    BERZIGOTTI A, GARCIA-TSAO G, BOSCH J, et al. Obesity is an independent risk factor for clinical decompensation in patients with cirrhosis[J]. Hepatology, 2011, 54( 2): 555- 561. DOI: 10.1002/hep.24418.
    [6]
    SARIN SK, CHOUDHURY A, SHARMA MK, et al. Acute-on-chronic liver failure: Consensus recommendations of the Asian Pacific Association for the Study of the Liver(APASL): An update[J]. Hepatol Int, 2019, 13( 4): 353- 390. DOI: 10.1007/s12072-019-09946-3.
    [7]
    Chinese Society of Hepatology and Chinese Society of Infectious Disease, Chinese Medical Association. The guideline of prevention and treatment for chronic hepatitis B: 2019 version[J]. J Clin Hepatol, 2019, 35( 12): 2648- 2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.

    中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35( 12): 2648- 2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.
    [8]
    Metabolic Syndrome Research Collaboration Group, Diabetes Branch, Chinese Medical Association. Recommendations on metabolic syndrome, diabetes branch, Chinese Medical Association[J]. Chin J Diabetes, 2004, 12( 3): 5- 10.

    中华医学会糖尿病学分会代谢综合征研究协作组. 中华医学会糖尿病学分会关于代谢综合征的建议[J]. 中华糖尿病杂志, 2004, 12( 3): 5- 10.
    [9]
    FAN Q, LI Z. Liver transplantation for acute-on-chronic liver failure[J]. Organ Transplantation, 2022, 13( 3): 333- 337. DOI: 10.3969/j.issn.1674-7445.2022.03.008.

    范祺, 李照. 慢加急性肝衰竭的肝移植治疗[J]. 器官移植, 2022, 13( 3): 333- 337. DOI: 10.3969/j.issn.1674-7445.2022.03.008.
    [10]
    FAHED G, AOUN L, ZERDAN M BOU, et al. Metabolic syndrome: Updates on pathophysiology and management in 2021[J]. Int J Mol Sci, 2022, 23( 2): 786. DOI: 10.3390/ijms23020786.
    [11]
    LAM DW, LEROITH D, FEINGOLD KR, et al. Metabolic syndrome[R]. Endotext. MDText.com, Inc, 2000.
    [12]
    HIRODE G, WONG RJ. Trends in the prevalence of metabolic syndrome in the United States, 2011-2016[J]. JAMA, 2020, 323( 24): 2526- 2528. DOI: 10.1001/jama.2020.4501.
    [13]
    SETO WK. Chronic hepatitis B and metabolic risk factors: A call for rigorous longitudinal studies[J]. World J Gastroenterol, 2019, 25( 3): 282- 286. DOI: 10.3748/wjg.v25.i3.282.
    [14]
    REN HN, WANG JN, GAO Y, et al. Metabolic syndrome and liver-related events: A systematic review and meta-analysis[J]. BMC Endocr Disord, 2019, 19( 1): 40. DOI: 10.1186/s12902-019-0366-3.
    [15]
    DIAO YT, HU DQ, HU X, et al. The role of metabolic factors and steatosis in treatment-Naïve patients with chronic hepatitis B and normal alanine aminotransferase[J]. Infect Dis Ther, 2022, 11( 3): 1133- 1148. DOI: 10.1007/s40121-022-00629-5.
    [16]
    DUSEJA A, DE A, TANEJA S, et al. Impact of metabolic risk factors on the severity and outcome of patients with alcohol-associated acute-on-chronic liver failure[J]. Liver Int, 2021, 41( 1): 150- 157. DOI: 10.1111/liv.14671.
    [17]
    ENGIN A. The pathogenesis of obesity-associated adipose tissue inflammation[J]. Adv Exp Med Biol, 2017, 960: 221- 245. DOI: 10.1007/978-3-319-48382-5_9.
    [18]
    PARADIS V, PERLEMUTER G, BONVOUST F, et al. High glucose and hyperinsulinemia stimulate connective tissue growth factor expression: A potential mechanism involved in progression to fibrosis in nonalcoholic steatohepatitis[J]. Hepatology, 2001, 34( 4 Pt 1): 738- 744. DOI: 10.1053/jhep.2001.28055.
    [19]
    PERGOLA GD, PANNACCIULLI N. Coagulation and fibrinolysis abnormalities in obesity[J]. J Endocrinol Invest, 2002, 25( 10): 899- 904. DOI: 10.1007/BF03344054.
    [20]
    LAAT-KREMERS RD, CASTELNUOVO AD, van der VORM L, et al. Increased BMI and blood lipids are associated with a hypercoagulable state in the moli-sani cohort[J]. Front Cardiovasc Med, 2022, 9: 897733. DOI: 10.3389/fcvm.2022.897733.
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