Abstract
BackgroundLipid profiles disorders frequently occur in patients with chronic liver diseases, and the mortality of cirrhosis complicated with portal vein thrombosis (PVT) remains high. Research identifying simple and objective prognosis indicators for cirrhotic PVT has been limited. The aim of the present study was to investigate the association between lipid profiles and liver function, which may help predict the 1-year mortality in non-malignant cirrhosis with PVT.MethodsA retrospective cohort of 117 subjects with non-malignant cirrhotic PVT was conducted. The primary indicators of lipid profiles included triglyceride, cholesterol, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol. Correlations of lipid profiles with liver function tests, the Child-Turcotte-Pugh (CTP) score and the model for end-stage liver disease (MELD) score were investigated. The relationship between lipid profiles and 1-year mortality was assessed using the area under the receiver operating characteristic curves (AUROC). Logistic regression models were established to confirm the association between HDL-C and mortality.ResultsThe level of HDL-C was significantly decreased in non-survivors (p < 0.01) and patients with more severe liver damage stages (CTP p < 0.001; MELD p < 0.001). There was no significant difference in the HDL-C level among patients with different severities of PVT (p = 0.498). The level of HDL-C was positively correlated with albumin (p < 0.001, R = 0.438) and platelet (p = 0.022, R = 0.212) levels. The level of HDL-C was negatively correlated with bilirubin (p < 0.001, R = − 0.319), C-reactive protein (p < 0.001, R = − 0.342), the aspartate aminotransferase to alanine aminotransferase ratio (p < 0.0.1, R = − 0.237), the CTP score (p < 0.001, R = − 0.397) and the MELD score (p < 0.001, R = − 0.406). The 1-year mortality rate was 12.8%. The AUROC of HDL-C for the prediction of 1-year mortality in this population was 0.744 (p < 0.01, 95%CI 0.609–0.879). The level of HDL-C was independently associated with mortality by multivariate logistic regression models.ConclusionsThe HDL-C level significantly decreases with the deterioration of liver function, which may serve as a potential indicator for the prognosis of non-malignant cirrhotic patients with PVT.
Highlights
Liver cirrhosis can progress into a decompensated stage with a poor prognosis [1, 2]
One-hundred and one patients were excluded: 63 patients were complicated with hepatic malignancy, 1 patient was complicated with lymphoma, 8 patients received liver transplantation before enrollment, 2 patients had coronary diseases, 5 patients used lipid regulation drugs within half a year, 1 patients had primary kidney disease, 2 patients suffered from severe diabetes, 11 patients had a lack of complete medical records, and 8
Lipid profile indicators and model for end-stage liver disease (MELD) score Since no standard threshold point for MELD score was reached in consensus to classify liver function, we used the median score of our study group to stratify patients with different liver functions
Summary
Liver cirrhosis can progress into a decompensated stage with a poor prognosis [1, 2]. The Child-Turcotte-Pugh (CTP) score and the model for end-stage liver disease (MELD) score are widely used to evaluate the severity of liver dysfunction and predict the outcomes of cirrhotic patients [3, 4]. These two score models have not been validated in cirrhosis patients complicated with portal vein thrombosis. Identification of certain objective indicator obtained from routine examinations that can provide a predictive value for patients with liver cirrhosis complicated by PVT is warranted. Lipid profiles disorders frequently occur in patients with chronic liver diseases, and the mortality of cirrhosis complicated with portal vein thrombosis (PVT) remains high. The aim of the present study was to investigate the association between lipid profiles and liver function, which may help predict the 1-year mortality in non-malignant cirrhosis with PVT
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