Association between serum ascites albumin gradient and esophagogastric variceal bleeding in patients with liver cirrhosis: a Meta-analysis

Objective To investigate the association between serum ascites albumin gradient( SAAG) and esophagogastric variceal bleeding in patients with liver cirrhosis. Methods The databases Pub Med,Embase,the Cochrane Library,Wanfang Data,VIP,and CNKI were searched to obtain Chinese articles on SAAG and esophagogastric variceal bleeding in patients with liver cirrhosis published between January 2001 and June 2015,and each article should include a bleeding group and a non- bleeding group. Strengthening the reporting of observational studies in epidemiology( STROBE) was used as a reference to evaluate the quality of articles. The mean ± standard deviation( SD) of SAAG in bleeding groups and non- bleeding groups were pooled and analyzed. The Meta- Analyst software was used to calculate standardized mean differences( SMD) of SAAG between bleeding groups and non- bleeding groups and perform the meta- analysis. The chi- square test was applied for comparison of categorical data between groups. Results Thirteen articles met the inclusion criteria. SAAG was( 22. 54 ± 4. 69) g / L in bleeding groups and( 15. 91 ± 4. 20) g / L in non- bleeding groups. The test for heterogeneity showed significant heterogeneity( Q = 100. 735,I2=89. 065,P < 0. 001),and the bleeding groups had a significantly higher SAAG than the non- bleeding groups( SMD = 1. 970,95% CI: 1. 425- 2. 515,P < 0. 001). According to the SAAG level,the patients were divided into the group with a SAAG of < 15 g / L,the group with a SAAG of ≥15 g / L and ≤19. 9 g / L,and the group with a SAAG of ≥20 g / L,and with the increasing SAAG,the proportion of patients experiencing variceal bleeding increased significantly( χ2= 111. 702,P < 0. 001). Conclusions SAAG is closely associated with esophagogastric variceal bleeding in patients with liver cirrhosis,and the bleeding groups have a higher SAAG than the non- bleeding groups. SAAG may be applied as a valuable indicator to predict esophagogastric variceal bleeding in patients with liver cirrhosis.