1,5-Anhydroglucitol Predicts Mortality in Patients with HBV-Related Acute-on-chronic Liver Failure  

作　　者：Lingjian Zhang Yalei Zhao Zhongyang Xie Lanlan Xiao Qingqing Hu Qian Li Shima Tang Jie Wang Lanjuan Li 

机构地区：[1]State Key Laboratory for Diagnosis and Treatment of Infectious Diseases,National Clinical Research Center for Infectious Diseases,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases,The First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou,Zhejiang,China

出　　处：《Journal of Clinical and Translational Hepatology》2022年第4期651-659,共9页临床与转化肝病杂志（英文版）

基　　金：This study was supported by Key research and development project of Department of Science and Technology of Zhejiang Province(2017C03051);Science Fund for Creative Research Groups of the National Natural Science Foundation of China(No.81721091);the National Natural Science Foundation of China(81900572).

摘　　要：Background and Aims:1,5-Anhydroglucitol(1,5AG)activ-ity has been reported in chronic liver disease.Hepatitis B vi-rus(HBV)-related acute-on-chronic liver failure(HBV-ACLF)patients have a high mortality.We aimed to discover the re-lationship between serum 1,5AG and the prognosis of HBV-ACLF.Methods:Serum 1,5AG levels were determined in 333 patients with HBV-ACLF,300 without diabetes were allo-cated to derivation(n=206)and validation cohorts(n=94),and 33 were recruited to evaluate 1,5AG in those with diabe-tes.Forty patients with chronic hepatitis B,40 with liver cir-rhosis,and 40 healthy people were controls in the validation cohort.Results:In the derivation and validation cohorts,serum 1,5AG levels were significantly lower in nonsurvivors than in survivors.The AUC of 1,5AG for 28-day mortality was 0.811.In patients with diabetes,serum 1,5AG levels were also significantly lower in nonsurvivors than in survi-vors.In multivariate Cox regression analysis,serum 1,5AG levels were independently associated with 28-day mortal-ity.A novel predictive model(ACTIG)based on 1,5AG,age,TB,cholesterol,and INR was derived to predict mortality.In ACTIG,the AUC for 28-day mortality was 0.914,which was superior to some prognostic score models.ACTIG was also comparable to those prognostic score models in pre-dicting 6-month mortality.In mice with D-galactosamine/lipopolysaccharide-induced liver failure,1,5AG levels were significantly reduced in serum and significantly increased in urine and liver tissue.Conclusions:Serum 1,5AG levels are a promising predictor of short-term mortality in HBV-ACLF patients.The 1,5AG distribution changed in mice with D-galactosamine/lipopolysaccharide-induced liver failure.

关 键 词：Acute-on-chronic liver failure 1 5-ANHYDROGLUCITOL PROGNOSIS 

分 类 号：R575.3[医药卫生—消化系统]