Exploring the predictive value of serum lipids for short-term prognosis in patients with acute-on-chronic liver failure  

作　　者：Yunfeng Fu Kaini Wu Sicheng Yang Yuanping Fan Jianhao Qiu Qi Zhu Yating Pan Xiaqin Chen Sihai Chen Xiaodong Zhou 

机构地区：[1]Department of Gastroenterology,Jiangxi Provincial Key Laboratory of Digestive Diseases,Jiangxi Clinical Research Center for Gastroenterology,Digestive Disease Hospital,The First Affiliated Hospital,Jiangxi Medical College,Nanchang University,Nanchang,Jiangxi,China [2]Department of Diagnostic Teaching and Research,The First Affiliated Hospital,Jiangxi Medical College,Nanchang University,Nanchang,Jiangxi,China [3]First Clinical Medical College,Jiangxi Medical College,Nanchang University,Nanchang,Jiangxi,China

出　　处：《Portal Hypertension & Cirrhosis》2024年第4期184-195,共12页门静脉高压与肝硬化(英文)

基　　金：supported by the Double Thousand Talents Plan of Jiangxi(No.jxsq2023201031);National Natural Science Foundation of China(No.81760524,No.82260599);the Key Laboratory Project of Digestive Diseases in Jiangxi Province(2024SSY06101);Jiangxi Clinical Research Center for Gastroenterology(20223BCG74011).

摘　　要：Aims:Acute-on-chronic liver failure(ACLF)is defined as acute liver injury superimposed on chronic liver disease,resulting in a significantly increased short-term mortality rate.Serum lipids are associated with the severity of liver disease and contribute to the prognostic assessment for cirrhosis and liver failure.However,the presentation of serum lipids varies in different studies,making it difficult to draw definitive conclusions.This study aimed to investigate the predictive value of serum lipids for short-term prognosis in patients with ACLF.Methods:This retrospective analysis was conducted using the clinical data of patients hospitalized for ACLF between January 2018 and December 2021.The collected data were subjected to Least Absolute Shrinkage and Selection Operator and logistic regression analyses to identify the independent predictors of 28-day and 90-day mortality.Separate regression models were developed for each identified serum lipid.These models were combined with the Model for End-Stage Liver Disease(MELD),MELD combined with serum sodium concentration(MELD-Na),Chronic Liver Failure Consortium Acuteon-chronic Liver Failure(CLIF-C ACLF),and Chinese Group on the Study of Severe Hepatitis B-ACLF(COSSH-ACLF)scores to construct new models.The performance of these models was evaluated using the area under the receiver operating characteristic curve(AUC),Nagelkerke R2,Brier score,net reclassification index(NRI),and integrated discrimination improvement(IDI)to assess the prognostic ability of serum lipids.Results:This study included 266 patients with ACLF,of whom 25.9%(69/266)died within 28 days and 38.5%(102/265,with 1 lost to follow-up)died within 90 days.The independent predictors of 28-day mortality were age,the presence of overt hepatic encephalopathy at admission,high-density lipoprotein cholesterol(HDL-C)levels,and international normalized ratio(INR).The independent predictors of 90-day mortality were age,albumin levels,serum creatinine levels,and INR.The comparative analysis revealed that the AUC of

关 键 词：acute-on-chronic liver failure high-density lipoprotein cholesterol serum lipids 

分 类 号：R57[医药卫生—消化系统]