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ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 38 Issue 1
Jan.  2022
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Article Navigation >  Journal of Clinical Hepatology  > 2022  >  38(1): 81-85

Value of serum free triiodothyronine level in predicting the prognosis of patients with HBV-related acute-on-chronic liver failure

DOI: 10.3969/j.issn.1001-5256.2022.01.012

  • Difficult & Complicated Liver Diseases and Artificial Liver Center, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China

Research funding:

National Science and Technology Key Project on "Major Infectious Disease such as HIV/AIDS, Viral Hepatitis Prevention and Treatment" (2017ZX10302201-004-002)

  • Received Date: 2021-06-26
  • Published Date: 2022-01-20
    Abstract
  •   Objective  To investigate the value of serum free triiodothyronine (FT3) level in predicting the 90-day prognosis of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF).  Methods  Related clinical data were collected from 122 patients with HBV-ACLF who were hospitalized in Beijing YouAn Hospital, Capital Medical University, from September 2018 to January 2020, and according to their prognosis on day 90 after confirmed diagnosis, they were divided into survival group with 77 patients and death group with 45 patients. ELISA was used to measure the serum level of FT3, which was then compared between the two groups; a logistic regression analysis was used to investigate the risk factors for prognosis and establish an FT3-related predictive model; the area under the receiver operating characteristic (ROC) curve (AUC) of the predicted probability value was used to evaluate the discriminatory ability of the predictive model, and a linear regression analysis was used to evaluate calibration degree. AUC was used to compare the predictive value of this model and Model for End-Stage Liver Disease (MELD) score. The t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups; univariate and multivariate logistic regression analyses were used to investigate the influencing factors for prognosis.  Results  The death group had a significantly lower serum level of FT3 than the survival group (2.27±0.38 pmol/L vs 2.69±0.55 pmol/L, t=4.526, P < 0.001). FT3 (odds ratio [OR]=0.534, 95% confidence interval [CI]: 0.300-0.950, P=0.013) was an independent protective factor against poor prognosis, while age (OR=1.047, 95%CI: 1.013-1.082, P=0.007), total bilirubin (TBil) (OR=1.096, 95%CI: 1.059-1.134, P < 0.001), international normalized ratio (INR) (OR=1.101, 95%CI: 1.029-1.178, P < 0.005), and creatinine (Cr) (OR=4.583, 95%CI: 2.102-7.992, P < 0.001) were independent risk factors. In terms of discriminatory ability, the FT3-related predictive model had an AUC of 0.869 (95%CI: 0.831-0.907, P < 0.001), and for calibration ability, R2=0.340, P=0.268. The FT3-related formula was better than MELD score in predicting prognosis (P < 0.05).  Conclusion  FT3 is an independent influencing factor for 90-day prognosis in patients with HBV-ACLF, and the FT3-related predictive model based on FT3 in combination with age, TBil, INR, and Cr has a good value in predicting 90-day prognosis.

     

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