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Decreased vitamin D-binding protein level portends poor outcome in acute-on-chronic liver failure caused by hepatitis B virus.
Wu, Daxian; Rao, Qunfang; Xie, Zhongyang; Zhu, Xiaoqing; Che, Yuanmei; Wu, Jian; Gao, Hainv; Zhang, Jingyu; Hou, Zhouhua; Cheng, Xiaoyu; Sun, Zeyu.
Afiliación
  • Wu D; Department of Infectious Diseases, the First Affiliated Hospital, Nanchang University, Nanchang, China.
  • Rao Q; Department of Infectious Diseases, the First Affiliated Hospital, Nanchang University, Nanchang, China.
  • Xie Z; State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, C
  • Zhu X; Department of Infectious Diseases, the First Affiliated Hospital, Nanchang University, Nanchang, China.
  • Che Y; Department of Infectious Diseases, the First Affiliated Hospital, Nanchang University, Nanchang, China.
  • Wu J; State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, C
  • Gao H; Department of Infectious Diseases, Shulan Hospital of Hangzhou, Hangzhou, China.
  • Zhang J; State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, C
  • Hou Z; Department of Infectious Diseases, Xiangya Hospital of Central South University, Changsha, China.
  • Cheng X; Department of Infectious Diseases, the First Affiliated Hospital, Nanchang University, Nanchang, China.
  • Sun Z; Jinan Microecological Biomedicine Shandong Laboratory, Jinan, China.
Clin Mol Hepatol ; 28(4): 912-925, 2022 10.
Article en En | MEDLINE | ID: mdl-35896280
BACKGROUND/AIMS: Acute-on-chronic liver failure (ACLF) is a catastrophic illness. Few studies investigated the prognostic value of vitamin D-binding protein (VDBP) for hepatitis B virus (HBV)-related ACLF (HBV-ACLF) resulted in conflicting results. METHODS: Two prospective HBV-ACLF cohorts (n=287 and n=119) were enrolled to assess and validate the prognostic performance of VDBP. RESULTS: VDBP levels in the non-survivors were significantly lower than in the survivors (P<0.001). Multivariate Cox regression demonstrated that VDBP was an independent prognostic factor for HBV-ACLF. The VDBP level at admission gradually decreased as the number of failed organs increased (P<0.001), and it was closely related to coagulation failure. The areas under the receiver operating characteristic curve (AUCs) of the Child-Pugh-VDBP and chronic liver failuresequential organ failure assessment (CLIF-SOFA)-VDBP scores were significantly higher than those of Child-Pugh (P<0.001) and CLIF-SOFA (P=0.0013). The AUCs of model for end-stage liver disease (MELD)-VDBP were significantly higher than those of MELD (P= 0.0384) only in the case of cirrhotic HBV-ACLF patients. Similar results were validated using an external multicenter HBV-ACLF cohort. By longitudinal observation, the VDBP levels gradually increased in survivors (P=0.026) and gradually decreased in non-survivors (P<0.001). Additionally, the VDBP levels were found to be significantly decreased in the deterioration group (P=0.012) and tended to be decreased in the fluctuation group (P=0.055). In contrast, they showed a significant increase in the improvement group (P=0.036). CONCLUSION: The VDBP was a promising prognostic biomarker for HBV-ACLF. Sequential measurement of circulating VDBP shows value for the monitoring of ACLF progression.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad Hepática en Estado Terminal / Insuficiencia Hepática Crónica Agudizada Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Clin Mol Hepatol Año: 2022 Tipo del documento: Article País de afiliación: China Pais de publicación: Corea del Sur
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad Hepática en Estado Terminal / Insuficiencia Hepática Crónica Agudizada Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Clin Mol Hepatol Año: 2022 Tipo del documento: Article País de afiliación: China Pais de publicación: Corea del Sur