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Volume 40 Issue 10
Oct.  2024
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Article Navigation >  Journal of Clinical Hepatology  > 2024  >  40(10): 1985-1991

Influence of metabolism-related factors on the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure and establishment of a predictive model

DOI: 10.12449/JCH241010

  • Department of Infectious Diseases，The Affiliated Hospital of Southwest Medical University，Luzhou，Sichuan 646000，China

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  • Corresponding author: SHENG Yunjian， sheng200410@163.com （ORCID： 0000-0003-0772-5971）
  • Received Date: 2024-01-02
  • Accepted Date: 2024-02-22
  • Published Date: 2024-10-25
    Abstract
  •   Objective  To investigate the influence of metabolism-related factors （overweight and/or obesity， hyperglycemia， hypertension and dyslipidemia）on the 90-day prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure （HBV-ACLF）， and to establish a predictive model.  Methods  A retrospective analysis was performed for the clinical data of 365 patients with HBV-ACLF who were hospitalized in Department of Infectious Diseases， The Affiliated Hospital of Southwest Medical University， from June 2018 to June 2022， and according to the 90-day follow-up results， they were divided into survival group with 273 patients and death group with 92 patients. General information and related laboratory markers were collected from all patients. The t-test was used for comparison of normally distributed continuous data between groups， and the Mann-Whitney U test was used for comparison of non-normally distribution continuous data between groups； the chi-square test was used for comparison of categorical data between groups. A Logistic regression analysis was used to determine whether metabolism-related factors were independent risk factors for the 90-day prognosis of HBV-ACLF patients， and the Kaplan-Meier analysis was used to investigate the correlation between metabolism-related factors and the 90-day survival rate of HBV-ALCF patients. The area under the ROC curve （AUC） was used to compare the value of different scoring models in predicting the 90-day prognosis of HBV-ACLF patients.  Results  The multivariate Logistic regression analysis showed that hypertension （odds ratio ［OR］=4.698， 95% confidence interval ［CI］： 1.904‍ ‍—‍ ‍11.593， P=0.001）， alanine aminotransferase （OR=0.999， 95%CI： 0.999‍ ‍—‍ ‍1.000， P=0.010）， triglyceride （TG） （OR=4.979， 95%CI： 2.433‍ ‍—‍ ‍10.189， P<0.001）， high-density lipoprotein cholesterol （OR=0.258， 95%CI： 0.087‍ ‍—‍ ‍0.762， P=0.012）， apolipoprotein B （OR=0.118， 95%CI： 0.026‍ ‍—‍ ‍0.547， P=0.006）， and CLIF-C OF score （OR=2.275， 95%CI： 1.150‍ ‍—‍ ‍4.502， P<0.001） were independent influencing factors for the short-term prognosis of HBV-ACLF. The combined predictive model of metabolism-related factors had a larger AUC than the predictive model of a single factor， among which the predictive model of hypertension+TG+CLIF-C OF score had the largest AUC of 0.886. The patients with metabolism-related factors tended to have higher incidence rate of liver complications and 30- and 90-day mortality rates.  Conclusion  The presence of the metabolism-related factors such as hypertension and dyslipidemia can increase the severity of HBV-ACLF and the risk of short-term mortality， and the hypertension+TG+CLIF-C OF score predictive model has a good value in predicting the short-term prognosis of HBV-ACLF patients.

     

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