Abstract
We aimed to compare the impact on survival among albumin-bilirubin (ALBI) grade, modified ALBI (mALBI) and our proposed combined ALBI grade and Mac-2 binding protein glycosylation isomer (M2BPGi) or FIB4 index grading system in chronic hepatitis C (CHC) related compensated liver cirrhosis (n = 165, 93 men and 72 women, median age = 67 years). Patients with ALBI grade 1, 2, and 3 were allocated a score of 1, 2, and 3 points, respectively. Patients with mALBI grade 1, 2A, and 2B were allocated a score of 1, 2, and 3 points, respectively. Patients with a high or low M2BPGi were allocated a score of 1 and 0 point. Patients with a high or low FIB4 index were allocated a score of 1 and 0 point. Sum of the point of ALBI (1, 2, or 3) and M2BPGi (0 or 1) or FIB4 index (0 or 1) was defined as ALBI-M2BPGi grade or ALBI-FIB4 grade. Prognostic accuracy was compared using the Akaike information criterion (AIC) value and time dependent receiver operating characteristics (ROC) curve analysis. The median follow-up duration was 5.422 years. AIC value for survival by ALBI-M2BPGi grade was the lowest among 4 prognostic models (AIC: 205.731 in ALBI grade, 200.913 in mALBI grade, 189.816 in ALBI-M2BPGi grade, and 204.671 in ALBI-FIB4 grade). All area under the ROC curves of ALBI-M2BPGi grade in each time point were higher than those of ALBI grade, mALBI grade, and ALBI-FIB4 grade. In conclusion, our proposed ALBI-M2BPGi grading system seems to be helpful for estimating prognosis in patients with CHC related compensated LC.
Highlights
Liver cirrhosis (LC) is an end-stage status in chronic liver injury caused by several factors such as hepatitis virus, alcohol abuse, and autoimmune disorders, etc.[1,2,3] Prognosis in compensatedEditor: Leyi Wang.The authors have no conflicts of interest to disclose. a Division of Hepatobiliary and Pancreatic disease, Department of Internal Medicine, b Center for Clinical Research and Education, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. ∗How to cite this article: Nishikawa H, Enomoto H, Yoh K, Iwata Y, Sakai Y, Kishino K, Ikeda N, Takashima T, Aizawa N, Takata R, Hasegawa K, Ishii N, Yuri Y, Nishimura T, Iijima H, Iijima H, Nishiguchi S
34 patients were treated with interferonbased antiviral treatments and the remaining 49 patients were treated with interferon-free direct acting antivirals (DAAs) treatments
Mac-2 binding protein glycosylation isomer (M2BPGi) and FIB4 index are currently acknowledged as useful liver fibrosis markers in chronic hepatitis C (CHC) patients.[19,20,21,22,23,24,25,26]
Summary
Liver cirrhosis (LC) is an end-stage status in chronic liver injury caused by several factors such as hepatitis virus, alcohol abuse, and autoimmune disorders, etc.[1,2,3] Prognosis in compensatedEditor: Leyi Wang.The authors have no conflicts of interest to disclose. a Division of Hepatobiliary and Pancreatic disease, Department of Internal Medicine, b Center for Clinical Research and Education, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. ∗How to cite this article: Nishikawa H, Enomoto H, Yoh K, Iwata Y, Sakai Y, Kishino K, Ikeda N, Takashima T, Aizawa N, Takata R, Hasegawa K, Ishii N, Yuri Y, Nishimura T, Iijima H, Iijima H, Nishiguchi S. Combined albumin-bilirubin grade and mac-2 binding protein glycosylation isomer as a useful predictor in compensated liver cirrhosis. Medicine 2019;98:50(e18366).Received: 5 August 2019 / Received in final form: 25 October 2019 / Accepted: 13 November 2019 http://dx.doi.org/10.1097/MD.0000000000018366
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