Value of alkaline phosphatase level after ursodeoxycholic acid treatment for one month and baseline red blood cell distribution width in predicting the treatment response of primary biliary cholangitis

Nan WANG; Rong HU; Shihui BIAN; Wei ZHONG; Pengfei ZHANG; Youwen TAN

doi:10.12449/JCH240310

Volume 40 Issue 3

Mar. 2024

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Article Navigation > Journal of Clinical Hepatology > 2024 > 40(3): 496-501

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Value of alkaline phosphatase level after ursodeoxycholic acid treatment for one month and baseline red blood cell distribution width in predicting the treatment response of primary biliary cholangitis

DOI: 10.12449/JCH240310

Nan WANG¹,
Rong HU¹,
Shihui BIAN¹,
Wei ZHONG²,
Pengfei ZHANG^{3
,
,
,},
Youwen TAN^{3
,
,
,}

1.
Department of Geriatrics，The People’s Hospital of Jiangsu University，Zhenjiang，Jiangsu 212002，China
2.
Department of Cardiology，Affiliated Hospital of Jiangsu University，Zhenjiang，Jiangsu 212002，China
3.
Department of Hepatology，The Third People’s Hospital of Jiangsu University，Zhenjiang，Jiangsu 212004，China

Research funding:

National Natural Science Foundation of China (82000261);

China Public Health Program (GWLM202002);

Key Project of Medical Education Collaborative Innovation Fund of Jiangsu University (JDY2023020)

More Information

Corresponding author: ZHANG Pengfei， 316959714@qq.com （ORCID： 0009-0007-4358-886X）; TAN Youwen， tyw915@sina.com （ORCID： 0000-0002-5464-1407）
Received Date: 2023-10-09
Accepted Date: 2023-11-08
Published Date: 2024-03-20

Abstract

Abstract

Objective To investigate the value of baseline red cell distribution width （RDW） and alkaline phosphatase （ALP） level after ursodeoxycholic acid （UDCA） treatment for one month in predicting the response to UDCA treatment in patients with primary biliary cholangitis （PBC）. Methods A retrospective analysis was performed for the data of 127 patients with PBC who were diagnosed in Department of Hepatology， The Third People’s Hospital of Jiangsu University， from January 2015 to July 2022， with data collected at baseline， after one month of treatment， and after one year of follow-up. Based on the Paris-I criteria， the patients were divided into good response group and poor response group， and the two groups were analyzed in terms of clinical and laboratory features and their association with response to UDCA. The Logistic regression method was used to investigate the independent risk factors for response to UDCA treatment. The area under the ROC curve （AUC） was used to determine the optimal cut-off values of related indicators； the patients were divided into two groups based on such values， and the two groups were compared in terms of baseline indicators and response. 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. Results Compared with the good response group， the poor response group had significantly higher levels of total bilirubin， aspartate aminotransferase/alanine aminotransferase， ALP， RDW， and RDW-CV at baseline and a significantly higher level of ALP after one month of UDCA treatment （Z=-4.792， -3.697， -2.399， -4.102， -3.220， and -4.236， all P<0.05）. Compared with the good response group， the poor response group had significantly lower levels of albumin， hemoglobin， lymphocytes， hematocrit， and body mass index at baseline （Z=-3.592， -3.603， -2.602， -3.829， -2.432， all P<0.05）， as well as significantly lower levels of prealbumin， albumin/globulin ratio， apolipoprotein A， and free triiodothyronine at baseline （t=4.530， 3.402， 3.485， and 3.639， all P<0.001）. Compared with the poor response group， the good response group had a significantly lower proportion of patients with liver cirrhosis， gallstones/cholecystitis， or anemia （χ²=20.815， 3.892， and 12.283， all P<0.05）. Baseline RDW （odds ratio ［OR］=1.157， 95% confidence interval ［CI］： 1.028‍ — ‍1.301， P=0.015） and ALP level after one month of treatment （OR=1.012， 95%CI： 1.005‍ — ‍1.020， P=0.002） were independent risk factors for response to UDCA， with an AUC of 0.713 and 0.720， respectively. The patients with baseline RDW≥upper limit of normal （ULN） and ALP≥2.2×ULN after one month of UDCA treatment had a lower UDCA response rate （42.6% vs 8.2%， χ²=20.813， P<0.001）. Conclusion Patients with baseline RDW≥ULN and ALP≥2.2×ULN after one month of UDCA treatment tend to have a low biochemical response rate to UDCA.
- Primary Biliary Cholangitis,
- Ursodeoxycholic Acid,
- Risk Factors,
- Biochemical Response

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References

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Value of alkaline phosphatase level after ursodeoxycholic acid treatment for one month and baseline red blood cell distribution width in predicting the treatment response of primary biliary cholangitis

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Value of alkaline phosphatase level after ursodeoxycholic acid treatment for one month and baseline red blood cell distribution width in predicting the treatment response of primary biliary cholangitis

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