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Lipids Health Dis. 2019 Mar 30;18(1):79. doi: 10.1186/s12944-019-1005-8.

High-density lipoprotein cholesterol for the prediction of mortality in cirrhosis with portal vein thrombosis: a retrospective study.

Author information

1
Department of Gastroenterology and Clinical Nutrition, Nanjing Medical University Drum Tower Clinical Medical School, 321zhongshan road, Gulou District, Nanjing, 210008, China.
2
Department of Gastroenterology, Drum Tower Hospital, Nanjing University School of Medicine, Nanjing, China.
3
Department of Ultrasonography, Drum Tower Hospital, Nanjing University School of Medicine, Nanjing, China.
4
Department of Radiology, Drum Tower Hospital, Nanjing University School of Medicine, Nanjing, China.
5
Department of Gynecology and Obstetrics, The affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.
6
Department of Gastroenterology and Clinical Nutrition, Nanjing Medical University Drum Tower Clinical Medical School, 321zhongshan road, Gulou District, Nanjing, 210008, China. jsxup@aliyun.com.
7
Department of Gastroenterology and Clinical Nutrition, Nanjing Medical University Drum Tower Clinical Medical School, 321zhongshan road, Gulou District, Nanjing, 210008, China. yuzheng9111963@aliyun.com.
8
Department of Gastroenterology, Drum Tower Hospital, Nanjing University School of Medicine, Nanjing, China. yuzheng9111963@aliyun.com.
9
Department of Gastroenterology and Hepatology, Nanjing Medical University Drum Tower Clinical Medical School, 321zhongshan road, Gulou District, Nanjing, 210008, China. yuzheng9111963@aliyun.com.

Abstract

BACKGROUND:

Lipid 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.

METHODS:

A 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.

RESULTS:

The 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.

CONCLUSIONS:

The 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.

KEYWORDS:

Cirrhosis; High density lipoprotein cholesterol; Liver function; Portal vein thrombosis; Prognosis

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