Value of monocyte to high-density lipoprotein cholesterol ratio in predicting the short-term prognosis of hepatitis B virus-related acute-on-chronic liver failure

Lin LIU; Ling WANG; Shanhong TANG

doi:10.3969/j.issn.1001-5256.2023.08.012

Volume 39 Issue 8

Aug. 2023

Turn off MathJax

Article Contents

Article Navigation > Journal of Clinical Hepatology > 2023 > 39(8): 1841-1847

PDF( 1966 KB)

Value of monocyte to high-density lipoprotein cholesterol ratio in predicting the short-term prognosis of hepatitis B virus-related acute-on-chronic liver failure

DOI: 10.3969/j.issn.1001-5256.2023.08.012

Lin LIU^{1, 2},
Ling WANG²,
Shanhong TANG^{1, 2
,
,
,}

1.
Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
2.
Department of Gastroenterology, The General Hospital of Western Theater Command, Chengdu 610083, China

Research funding:

Scientific Research Project of Sichuan Provincial Health Commission (20PJ180)

More Information

Corresponding author: TANG Shanhong, shanhongtang@163.com (ORCID: 0000-0001-6652-2942)
Received Date: 2022-11-19
Accepted Date: 2022-12-25
Published Date: 2023-08-20

Abstract

Abstract

Objective To investigate the value of monocyte to high-density lipoprotein cholesterol ratio (MHR) in predicting the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). Methods A total of 131 patients with HBV-ACLF who were hospitalized in Department of Gastroenterology, The General Hospital of Western Theater Command, from January 1, 2015 to December 31, 2021 were enrolled in this study, and according to the prognosis on day 90 after admission, they were divided into survival group with 87 patients and death group with 44 patients. A retrospective analysis was performed for the data on age, sex, body mass index (BMI), and the results of blood routine test, biochemical parameters, and coagulation function within 24 hours after admission, and monocyte-to-lymphocyte ratio (MLR), MHR, and MELD score were calculated. The independent-samples 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. The binary logistic regression analysis was used to investigate the association between each factor and the short-term prognosis of HBV-ACLF; the receiver operating characteristic (ROC) curve was plotted to analyze the value of MHR in predicting short-term prognosis of HBV-ACLF patients; the Kaplan-Meier method was used to analyze the short-term death of patients in the high MHR group and the low MHR group. Results There were significant differences between the two groups in age, body mass index (BMI), white blood cell count, neutrophil count, lymphocyte count, monocyte count, alpha- fetoprotein, Na⁺, total bilirubin, international normalized ratio, triglyceride (TG), MLR, MHR, and MELD score (all P < 0.05). The binary logistic regression analysis showed that age, BMI, Na⁺, TG, MLR, MHR, and MELD score were independent risk factors for the short-term prognosis of HBV-ACLF (all P < 0.05). MHR had an area under the ROC curve of 0.627 (95% confidence interval: 0.522-0.732, P=0.018) in predicting the 90-day survival rate of HBV-ACLF patients, with a sensitivity of 0.591 and a specificity of 0.690 at the optimal cut-off value of 2.472. The Kaplan-Meier survival analysis showed that the high MHR group (MHR≥2.472) had a significantly lower 90-day survival rate than the low MHR group (MHR < 2.472)(P=0.001). Conclusion After severe cardiovascular disease is excluded, MHR can be used as a clinical predictive factor for the short-term prognosis of HBV-ACLF, and studies with a larger sample size are needed to further investigate its predictive value.
- Monocytes,
- High-Density Lipoprotein Cholesterol,
- Hepatitis B Virus,
- Acute-on-Chronic Liver Failure,
- Prognosis

FullText(HTML)

References(30)

References

[1]	Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association; Severe Liver Disease and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association. Guideline for diagnosis and treatment of liver failure (2018)[J]. J Clin Hepatol, 2019, 35(1): 38-44. DOI: 10.3969/j.issn.1001-5256.2019.01.007. 中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组. 肝衰竭诊治指南(2018年版)[J]. 临床肝胆病杂志, 2019, 35(1): 38-44. DOI: 10.3969/j.issn.1001-5256.2019.01.007.
[2]	SETO WK, LO YR, PAWLOTSKY JM, et al. Chronic hepatitis B virus infection[J]. Lancet, 2018, 392(10161): 2313-2324. DOI: 10.1016/S0140-6736(18)31865-8.
[3]	SCHULZ M, TREBICKA J. Acute-on-chronic liver failure: A global disease[J]. Gut, 2022, 71(1): 5-6. DOI: 10.1136/gutjnl-2020-323973.
[4]	MEZZANO G, JUANOLA A, CARDENAS A, et al. Global burden of disease: Acute-on-chronic liver failure, a systematic review and meta-analysis[J]. Gut, 2022, 71(1): 148-155. DOI: 10.1136/gutjnl-2020-322161.
[5]	XU HQ, LI X, TANG SH. Research advances in the role of inflammatory response and related treatment strategies in acute-on-chronic liver failure[J]. J Clin Hepatol, 2022, 38(8): 1927-1930. DOI: 10.3969/j.issn.1001-5256.2022.08.041. 徐华谦, 李雪, 汤善宏. 炎症反应在慢加急性肝衰竭中的作用及治疗策略[J]. 临床肝胆病杂志, 2022, 38(8): 1927-1930. DOI: 10.3969/j.issn.1001-5256.2022.08.041.
[6]	TREBICKA J, FERNANDEZ J, PAPP M, et al. The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology[J]. J Hepatol, 2020, 73(4): 842-854. DOI: 10.1016/j.jhep.2020.06.013.
[7]	CULLARO G, SHARMA R, TREBICKA J, et al. Precipitants of acute-on-chronic liver failure: An opportunity for preventative measures to improve outcomes[J]. Liver Transpl, 2020, 26(2): 283-293. DOI: 10.1002/lt.25678.
[8]	GAUTHERON J, GORES GJ, RODRIGUES CMP. Lytic cell death in metabolic liver disease[J]. J Hepatol, 2020, 73(2): 394-408. DOI: 10.1016/j.jhep.2020.04.001.
[9]	LI JN, SUN MY, LI H, et al. Value of the monocyte-to-lymphocyte ratio in the prognostic evaluation of hepatitis B-related acute-on-chronic liver failure[J]. Chin J Hepatol, 2022, 30(6): 644-648. DOI: 10.3760/cma.j.cn501113-20210726-00361. 李嘉妮, 孙梦滢, 李浩, 等. 单核细胞-淋巴细胞比率在乙型肝炎相关慢加急性肝衰竭预后评估中的价值[J]. 中华肝脏病杂志, 2022, 30(6): 644-648. DOI: 10.3760/cma.j.cn501113-20210726-00361.
[10]	KOHSARI M, MORADINAZAR M, RAHIMI Z, et al. New inflammatory biomarkers (lymphocyte and monocyte percentage to high-density lipoprotein cholesterol ratio and lymphocyte to monocyte percentage ratio) and their association with some cardiometabolic diseases: Results from a large Kurdish cohort study in Iran[J]. Wien Klin Wochenschr, 2022, 134(17-18): 626-635. DOI: 10.1007/s00508-022-02029-8.
[11]	MA JL, ZHANG XP. Predictive value of monocyte to high-density lipoprotein cholesterol ratio for nonalcoholic fatty liver disease merged with metabolic syndrome in community residents and associated factors assessed using multivariate regression tree analysis[J]. Chin Gen Pract, 2022, 25(17): 2126-2134. DOI: 10.12114/j.issn.1007-9572.2021.02.007. 马纪林, 张雪平. 单核细胞与高密度脂蛋白胆固醇比值对社区居民非酒精性脂肪性肝病合并代谢综合征的预测价值及多因素Logistic决策树分析[J]. 中国全科医学, 2022, 25(17): 2126-2134. DOI: 10.12114/j.issn.1007-9572.2021.02.007.
[12]	WANG LP, DONG JZ, XU M, et al. Association between monocyte to high-density lipoprotein cholesterol ratio and risk of non-alcoholic fatty liver disease: A cross-sectional study[J]. Front Med (Lausanne), 2022, 9: 898931. DOI: 10.3389/fmed.2022.898931.
[13]	Chinese Society of Infectious Diseases, Chinese Medical Association; Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B(version 2019)[J]. J Clin Hepatol, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007. 中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.
[14]	LAI M, WANG X, YAO QW, et al. Predictive value of the initial MELD score and its derivative scores for early survival rate after liver transplantation in patients with liver failure[J]. Organ Transplant, 2022, 13(4): 489-494. DOI: 10.3969/j.issn.1674-7445.2022.04.012. 赖曼, 王鑫, 姚勤伟, 等. 术后首次MELD评分及其衍生评分对肝衰竭患者肝移植术后早期生存率的预测价值[J]. 器官移植, 2022, 13(4): 489-494. DOI: 10.3969/j.issn.1674-7445.2022.04.012.
[15]	LI JQ, LIANG X, YOU SL, et al. Development and validation of a new prognostic score for hepatitis B virus-related acute-on-chronic liver failure[J]. J Hepatol, 2021, 75(5): 1104-1115. DOI: 10.1016/j.jhep.2021.05.026.
[16]	BOUTENS L, HOOIVELD GJ, DHINGRA S, et al. Unique metabolic activation of adipose tissue macrophages in obesity promotes inflammatory responses[J]. Diabetologia, 2018, 61(4): 942-953. DOI: 10.1007/s00125-017-4526-6.
[17]	SHI C, PAMER EG. Monocyte recruitment during infection and inflammation[J]. Nat Rev Immunol, 2011, 11(11): 762-774. DOI: 10.1038/nri3070.
[18]	SONG P, ZHANG JB, ZHANG YW, et al. Hepatic recruitment of CD11b⁺ Ly6C⁺ inflammatory monocytes promotes hepatic ischemia/reperfusion injury[J]. Int J Mol Med, 2018, 41(2): 935-945. DOI: 10.3892/ijmm.2017.3315.
[19]	WU B, DU LY, MA YJ, et al. Effects of different combinations of artificial liver support system on efficacy and inflammatory indexes of patients with hepatitis B virus-related acute-on-chronic liver failure in early and middle stages[J/CD]. Chin J Liver Dis (Electronic Version), 2021, 13(1): 32-38. DOI: 10.3969/j.issn.1674-7380.2021.01.006. 吴蓓, 杜凌遥, 马元吉, 等. 不同组合人工肝支持系统治疗乙型肝炎病毒相关早、中期慢加急性肝衰竭患者的疗效及对炎症指标的影响[J/CD]. 中国肝脏病杂志(电子版), 2021, 13(1): 32-38. DOI: 10.3969/j.issn.1674-7380.2021.01.006.
[20]	LI JY, YAO RQ, LIU SQ, et al. Efficiency of monocyte/high-density lipoprotein cholesterol ratio combined with neutrophil/lymphocyte ratio in predicting 28-day mortality in patients with Sepsis[J]. Front Med (Lausanne), 2021, 8: 741015. DOI: 10.3389/fmed.2021.741015.
[21]	von ECKARDSTEIN A, NORDESTGAARD BG, REMALEY AT, et al. High-density lipoprotein revisited: Biological functions and clinical relevance[J]. Eur Heart J, 2022. DOI: 10.1093/eurheartj/ehac605.[Online ahead of print]
[22]	TRIEB M, RAINER F, STADLBAUER V, et al. HDL-related biomarkers are robust predictors of survival in patients with chronic liver failure[J]. J Hepatol, 2020, 73(1): 113-120. DOI: 10.1016/j.jhep.2020.01.026.
[23]	ARAIN SQ, TALPUR FN, CHANNA NA, et al. Serum lipids as an indicator for the alteration of liver function in patients with hepatitis B[J]. Lipids Health Dis, 2018, 17(1): 36. DOI: 10.1186/s12944-018-0683-y.
[24]	RESS C, KASER S. Mechanisms of intrahepatic triglyceride accumulation[J]. World J Gastroenterol, 2016, 22(4): 1664-1673. DOI: 10.3748/wjg.v22.i4.1664.
[25]	LIOU JW, MANI H, YEN JH. Viral hepatitis, cholesterol metabolism, and cholesterol-lowering natural compounds[J]. Int J Mol Sci, 2022, 23(7): 3897. DOI: 10.3390/ijms23073897.
[26]	XU Y, HUANG XP, CHEN L, et al. Value of high-density lipoprotein cholesterol in evaluating the severity and prognosis of hepatitis B virus-associated acute-on-chronic liver failure[J]. J Clin Hepatol, 2021, 37(7): 1632-1635. DOI: 10.3969/j.issn.1001-5256.2021.07.030. 徐英, 黄小平, 陈丽, 等. 高密度脂蛋白胆固醇对HBV相关慢加急性肝衰竭严重程度及预后的预测价值[J]. 临床肝胆病杂志, 2021, 37(7): 1632-1635. DOI: 10.3969/j.issn.1001-5256.2021.07.030.
[27]	SUN MY, CHEN BJ, LI H, et al. Analysis of prognosis-related factors in patients with hepatitis B virus-related acute-on-chronic liver failure[J]. Chin J Hepatol, 2021, 29(10): 983-986. DOI: 10.3760/cma.j.cn501113-20200630-00354. 孙梦滢, 陈备金, 李浩, 等. 晚期乙型肝炎相关慢加急性肝衰竭患者预后相关因素分析[J]. 中华肝脏病杂志, 2021, 29(10): 983-986. DOI: 10.3760/cma.j.cn501113-20200630-00354.
[28]	LIU L, LI H, TANG SH. Pathogenesis, clinical diagnosis and treatment of hyponatremia in hepatorenal syn-drome[J]. Chin J Gastroenterol Hepatol, 2022, 31(5): 594-597. DOI: 10.3969/j.issn.1006-5709.2022.05.023. 刘林, 李浩, 汤善宏. 肝肾综合征低钠血症的发病机制及临床诊治进展[J]. 胃肠病学和肝病学杂志, 2022, 31(5): 594-597. DOI: 10.3969/j.issn.1006-5709.2022.05.023.
[29]	WANG XP, SHEN CF, YANG JJ, et al. Alpha-fetoprotein as a predictive marker for patients with hepatitis B-related acute-on-chronic liver failure[J]. Can J Gastroenterol Hepatol, 2018, 2018: 1232785. DOI: 10.1155/2018/1232785.
[30]	QIN S, TANG SH, WANG XH, et al. Value of serum alpha-fetoprotein for the prognostic evaluation of hepatitis B virus-related acute-on-chronic liver failure treated with artificial liver[J]. Chin J Hepatol, 2020, 28(1): 69-72. DOI: 10.3760/cma.j.issn.1007-3418.2020.01.016. 秦森, 汤善宏, 王显红, 等. 血清甲胎蛋白在人工肝治疗乙型肝炎相关慢加急性肝衰竭预后评估中的价值[J]. 中华肝脏病杂志, 2020, 28(1): 69-72. DOI: 10.3760/cma.j.issn.1007-3418.2020.01.016.

Relative Articles

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Figures(2) / Tables(3)

Get Citation

PDF

XML

Article Metrics

Article views (226) PDF downloads(30)

Value of monocyte to high-density lipoprotein cholesterol ratio in predicting the short-term prognosis of hepatitis B virus-related acute-on-chronic liver failure

DOI: 10.3969/j.issn.1001-5256.2023.08.012

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Value of monocyte to high-density lipoprotein cholesterol ratio in predicting the short-term prognosis of hepatitis B virus-related acute-on-chronic liver failure

DOI: 10.3969/j.issn.1001-5256.2023.08.012

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content