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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 8
Aug.  2023
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Article Contents

Value of monocyte to high-density lipoprotein cholesterol ratio in predicting the short-term prognosis of hepatitis B virus-related acute-on-chronic liver failure

DOI: 10.3969/j.issn.1001-5256.2023.08.012
Research funding:

Scientific Research Project of Sichuan Provincial Health Commission (20PJ180)

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  • Corresponding author: TANG Shanhong, shanhongtang@163.com (ORCID: 0000-0001-6652-2942)
  • Received Date: 2022-11-19
  • Accepted Date: 2022-12-25
  • Published Date: 2023-08-20
  •   Objective  To investigate the value of monocyte to high-density lipoprotein cholesterol ratio (MHR) in predicting the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).  Methods  A total of 131 patients with HBV-ACLF who were hospitalized in Department of Gastroenterology, The General Hospital of Western Theater Command, from January 1, 2015 to December 31, 2021 were enrolled in this study, and according to the prognosis on day 90 after admission, they were divided into survival group with 87 patients and death group with 44 patients. A retrospective analysis was performed for the data on age, sex, body mass index (BMI), and the results of blood routine test, biochemical parameters, and coagulation function within 24 hours after admission, and monocyte-to-lymphocyte ratio (MLR), MHR, and MELD score were calculated. The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The binary logistic regression analysis was used to investigate the association between each factor and the short-term prognosis of HBV-ACLF; the receiver operating characteristic (ROC) curve was plotted to analyze the value of MHR in predicting short-term prognosis of HBV-ACLF patients; the Kaplan-Meier method was used to analyze the short-term death of patients in the high MHR group and the low MHR group.  Results  There were significant differences between the two groups in age, body mass index (BMI), white blood cell count, neutrophil count, lymphocyte count, monocyte count, alpha- fetoprotein, Na+, total bilirubin, international normalized ratio, triglyceride (TG), MLR, MHR, and MELD score (all P < 0.05). The binary logistic regression analysis showed that age, BMI, Na+, TG, MLR, MHR, and MELD score were independent risk factors for the short-term prognosis of HBV-ACLF (all P < 0.05). MHR had an area under the ROC curve of 0.627 (95% confidence interval: 0.522-0.732, P=0.018) in predicting the 90-day survival rate of HBV-ACLF patients, with a sensitivity of 0.591 and a specificity of 0.690 at the optimal cut-off value of 2.472. The Kaplan-Meier survival analysis showed that the high MHR group (MHR≥2.472) had a significantly lower 90-day survival rate than the low MHR group (MHR < 2.472)(P=0.001).  Conclusion  After severe cardiovascular disease is excluded, MHR can be used as a clinical predictive factor for the short-term prognosis of HBV-ACLF, and studies with a larger sample size are needed to further investigate its predictive value.

     

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