中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 8
Aug.  2023
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2023  >  39(8): 1880-1885

Clinical value of C-reactive protein/albumin ratio in the diagnosis of alcoholic cirrhosis with spontaneous bacterial peritonitis

DOI: 10.3969/j.issn.1001-5256.2023.08.017
  • 1.

    Department of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China

  • 2.

    Graduate School, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China

Research funding:

Capital Health Research and Development Project (2020-2-2172);

The State Administration of Traditional Chinese Medicine Key Specialty of Liver Disease 

More Information
  • Corresponding author: JIANG Yuyong, jyuy11@126.com (ORCID: 0000-0002-6082-1180)
  • Received Date: 2022-10-25
  • Accepted Date: 2022-12-05
  • Published Date: 2023-08-20
    Abstract
  •   Objective  To investigate the clinical value of C-reactive protein/albumin ratio (CAR) in determining spontaneous bacterial peritonitis (SBP) in patients with alcoholic cirrhosis (ALC).  Methods  A retrospective analysis was performed for 329 ALC patients with SBP who were hospitalized in Beijing Ditan Hospital, Capital Medical University, from August 2020 to February 2022, and according to the presence or absence of SBP on admission, they were divided into non-SBP group with 246 patients and SBP group with 83 patients. The two groups were compared in terms of sex, age, comorbidities, complications, blood routine, liver and renal function, blood lipids, and coagulation markers. The independent-samples t test was used for comparison of normally distributed quantitative data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed quantitative data between two groups; the chi-square test was used for comparison of qualitative data between two groups. A multivariate binary logistic regression analysis was used to identify the risk factors for SBP. The receiver operating characteristic (ROC) curve was plotted for CAR to calculate the area under the ROC curve (AUC), the optimal cut-off value, and 95% confidence interval (CI).  Results  Compared with the non-SBP patients, the SBP patients had significantly higher inflammatory indicators (WBC, neutrophils, NLR, monocytes, C-reactive protein, and CAR), significantly higher aspartate aminotransferase, total bilirubin, international normalized ratio, and MELD score, and significantly lower levels of albumin and high-density lipoprotein (all P < 0.05). The multivariate logistic regression analysis showed that CAR (odds ratio [OR]=20.628, 95%CI: 6.720-74.052, P < 0.01) and red blood cell count (OR=0.600, 95%CI: 0.381-0.932, P=0.025) were independent risk factors for determining SBP in ALC patients. CAR had a significantly larger AUC than NLR and WBC (0.825 vs 0.725/0.651) and an optimal cut-off value of 0.324. The patients were divided into high-risk group and low-risk group, and the analysis showed that the high-risk group had a significantly higher proportion of patients with SBP than the low-risk group [63.2% (55/87) vs 11.6%(28/242), χ2=90.495, P < 0.01].  Conclusion  CAR is a good marker for determining SBP in patients with ALC.

     

    • FullText(HTML)
  • loading
    • References(21)
  • [1]
    SHIZUMA T. Spontaneous bacterial and fungal peritonitis in patients with liver cirrhosis: A literature review[J]. World J Hepatol, 2018, 10(2): 254-266. DOI: 10.4254/wjh.v10.i2.254.
    [2]
    GAO XM, LENG XQ. Research advances of serological markers for spontaneous bacterial peritonitis[J]. Med Innov China, 2022, 19(28): 173-176. DOI: 10.3969/j.issn.1674-4985.2022.28.042.

    高小梅, 冷雪芹. 自发性细菌性腹膜炎的血清学标志物研究进展[J]. 中国医学创新, 2022, 19(28): 173-176. DOI: 10.3969/j.issn.1674-4985.2022.28.042.
    [3]
    METWALLY K, FOUAD T, ASSEM M, et al. Predictors of spontaneous bacterial peritonitis in patients with cirrhotic ascites[J]. J Clin Transl Hepatol, 2018, 6(4): 372-376. DOI: 10.14218/JCTH.2018.00001.
    [4]
    POPOIAG RE, SUCEVEANU AI, SUCEVEANU AP, et al. Predictors of spontaneous bacterial peritonitis in Romanian adults with liver cirrhosis: Focus on the neutrophil-to-lymphocyte ratio[J]. Exp Ther Med, 2021, 22(3): 983. DOI: 10.3892/etm.2021.10415.
    [5]
    HAN CJ, LI WH, WU ZX, et al. Role of NLR, LMR and PNI in anti-infective therapy of liver cirrhosis related spontaneous bacterial peritonitis[J]. Int J Lab Med, 2022, 43(24): 3012-3015, 3021. DOI: 10.3969/j.issn.1673-4130.2022.24.015.

    韩才均, 李文浩, 吴政燮, 等. NLR、LMR和PNI在肝硬化相关自发性细菌性腹膜炎抗感染治疗中的作用[J]. 国际检验医学杂志, 2022, 43(24): 3012-3015, 3021. DOI: 10.3969/j.issn.1673-4130.2022.24.015.
    [6]
    OETTL K, BIRNER-GRUENBERGER R, SPINDELBOECK W, et al. Oxidative albumin damage in chronic liver failure: Relation to albumin binding capacity, liver dysfunction and survival[J]. J Hepatol, 2013, 59(5): 978-983. DOI: 10.1016/j.jhep.2013.06.013.
    [7]
    OIKONOMOU T, GOULIS I, KIAPIDOU S, et al. The significance of C-reactive protein to albumin ratio in patients with decompensated cirrhosis[J]. Ann Gastroenterol, 2020, 33(6): 667-674. DOI: 10.20524/aog.2020.0534.
    [8]
    Fatty Liver Expert Committee, Chinese Medical Doctor Association, National Workshop on Fatty Liver and Alcoholic Liver Disease, Chinese Society of Hepatology, Chinese Medical Association. Guidelines of prevention and treatment for alcoholic liver disease: a 2018 update[J]. J Clin Hepatol, 2018, 34(5): 939-946. DOI: 10.3969/j.issn.1001-5256.2018.05.006.

    中国医师协会脂肪性肝病专家委员会, 中华医学会肝病学分会脂肪肝和酒精性肝病学组. 酒精性肝病防治指南(2018年更新版)[J]. 临床肝胆病杂志, 2018, 34(5): 939-946. DOI: 10.3969/j.issn.1001-5256.2018.05.006.
    [9]
    Chinese Society of Hepatology CMA, XU XY, DUAN ZP, et al. Chinese guidelines on the management of ascites and its related complications in cirrhosis[J]. Hepatol Int, 2019, 13(1): 1-21. DOI: 10.1007/s12072-018-09923-2.
    [10]
    BHANDARI R, KHALIQ K, RAVAT V, et al. Chronic alcoholic liver disease and mortality risk in spontaneous bacterial peritonitis: Analysis of 6, 530 hospitalizations[J]. Cureus, 2020, 12(5): e8189. DOI: 10.7759/cureus.8189.
    [11]
    BETRAPALLY NS, GILLEVET PM, BAJAJ JS. Gut microbiome and liver disease[J]. Transl Res, 2017, 179: 49-59. DOI: 10.1016/j.trsl.2016.07.005.
    [12]
    MARCIANO S, DÍAZ JM, DIRCHWOLF M, et al. Spontaneous bacterial peritonitis in patients with cirrhosis: Incidence, outcomes, and treatment strategies[J]. Hepat Med, 2019, 11: 13-22. DOI: 10.2147/HMER.S164250.
    [13]
    SORT P, NAVASA M, ARROYO V, et al. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis[J]. N Engl J Med, 1999, 341(6): 403-409. DOI: 10.1056/NEJM199908053410603.
    [14]
    BIGGINS SW, ANGELI P, GARCIA-TSAO G, et al. Diagnosis, evaluation, and management of ascites, spontaneous bacterial peritonitis and hepatorenal syndrome: 2021 practice guidance by the American association for the study of liver diseases[J]. Hepatology, 2021, 74(2): 1014-1048. DOI: 10.1002/hep.31884.
    [15]
    WEHMEYER MH, KROHM S, KASTEIN F, et al. Prediction of spontaneous bacterial peritonitis in cirrhotic ascites by a simple scoring system[J]. Scand J Gastroenterol, 2014, 49(5): 595-603. DOI: 10.3109/00365521.2013.848471.
    [16]
    ILIAZ R, OZPOLAT T, BARAN B, et al. Predicting mortality in patients with spontaneous bacterial peritonitis using routine inflammatory and biochemical markers[J]. Eur J Gastroenterol Hepatol, 2018, 30(7): 786-791. DOI: 10.1097/MEG.0000000000001111.
    [17]
    DONLON NE, MOHAN H, FREE R, et al. Predictive value of CRP/albumin ratio in major abdominal surgery[J]. Ir J Med Sci, 2020, 189(4): 1465-1470. DOI: 10.1007/s11845-020-02238-y.
    [18]
    KANO H, MIDORIKAWA Y, SONG PP, et al. High C-reactive protein/albumin ratio associated with reduced survival due to advanced stage of intrahepatic cholangiocarcinoma[J]. Biosci Trends, 2020, 14(4): 304-309. DOI: 10.5582/bst.2020.03167.
    [19]
    KINOSHITA A, ONODA H, IMAI N, et al. The C-reactive protein/albumin ratio, a novel inflammation-based prognostic score, predicts outcomes in patients with hepatocellular carcinoma[J]. Ann Surg Oncol, 2015, 22(3): 803-810. DOI: 10.1245/s10434-014-4048-0.
    [20]
    PIOTROWSKI D, SCZEWSKA-PIOTROWSKA A, JAROSZEWICZ J, et al. Lymphocyte-to-monocyte ratio as the best simple predictor of bacterial infection in patients with liver cirrhosis[J]. Int J Environ Res Public Health, 2020, 17(5): 1727. DOI: 10.3390/ijerph17051727.
    [21]
    HUANG SS, XIE DM, CAI YJ, et al. C-reactive protein-to-albumin ratio is a predictor of hepatitis B virus related decompensated cirrhosis: Time-dependent receiver operating characteristics and decision curve analysis[J]. Eur J Gastroenterol Hepatol, 2017, 29(4): 472-480. DOI: 10.1097/MEG.0000000000000807.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    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

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(2)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (254) PDF downloads(29) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return