Lipid Profile as an Indicator of Severity in Cirrhosis of Liver: Hospital based Cross-sectional Study.

Abstract

Various scoring systems are available to assess the severity of cirrhosis, that is, the Child-Pugh score and Model for End-Stage Liver Disease (MELD) score. Since the liver is the major site for converting excess carbohydrates into various lipids, the deranged lipid profile can act as a prognostic biomarker of cirrhosis. We assessed the lipid profile abnormalities among patients with cirrhosis of the liver and correlated them with the severity of cirrhosisMaterials and methods: This is an analytical cross-sectional study on lipid profile as an indicator of severity in cirrhosis of the liver among patients admitted to the medical ward of a tertiary care teaching hospital in Tamil Nadu. Following detailed investigation and confirmation of cirrhosis, a fasting serum lipid profile was measured in all eligible patients with cirrhosis. Total serum cholesterol, triglyceride (TGL), and high-density lipoprotein (HDL) were measured by direct method and serum low-density lipoprotein (LDL) and very-low-density lipoprotein (VLDL) were calculated by using the Friedwald formulaResults: A total of 120 patients were studied. Of them, 76 (63%) were male. Of them, alcohol (84, 75.0%), hepatitis B (8, 7.1%), and nonalcoholic steatohepatitis (NASH) (6, 5.4%) were the most common cause of cirrhosis. A clear dose-response relationship (decreasing trend) is seen in the levels of lipids for increasing severity based on the Child-Pugh score and MELD score (except for a score of ≤10). Further, the cholesterol, LDL, and HDL were significantly lower among patients with ascites or with spontaneous bacterial peritonitis compared to their respective groups. However, none of the lipid profiles significantly differed based on the presence of upper gastrointestinal (UGI) bleeding Conclusion: This study observed that there is a significant reduction in levels of lipid profile parameters like serum total cholesterol, LDL, VLDL, TGL, and HDL in patients with cirrhosis as the severity increases. Further formulation of the scoring system in association with a preexisting scoring system may provide a better assessment of patients' prognosis in view of morbidity and mortality. We recommend it is necessary to assess the fasting lipid profile in all patients with cirrhosis and prognosticate their disease progression.