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CN 22-1108/R
Volume 39 Issue 7
Jul.  2023
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Article Navigation >  Journal of Clinical Hepatology  > 2023  >  39(7): 1578-1585

Value of serum chitinase-3-like protein 1 in predicting the risk of decompensation events in patients with liver cirrhosis

DOI: 10.3969/j.issn.1001-5256.2023.07.011
  • 1.

    Clinical School of The Second People's Hospital, Tianjin Medical University, Tianjin 300070, China

  • 2.

    Department of Hepatology, Tianjin Second People's Hospital, Tianjin 300192, China

Research funding:

Tianjin Key Medical Subject Construction Project (TJYXZDXK-059B);

Tianjin Natural Science Fund (20JCYBJC01150);

Tianjin Health Science Project (TJWJ2021MS034)

More Information
  • Corresponding author: LI Jia, 18622663700@163.com (ORCID: 0000-0003-0100-417X)
  • Received Date: 2022-11-11
  • Accepted Date: 2023-01-02
  • Published Date: 2023-07-20
    Abstract
  •   Objective  To investigate the value of serum chitinase-3-like protein 1 (CHI3L1) in predicting the risk of decompensation events in patients with liver cirrhosis, since prediction of decompensation events and adoption of active preventive measures are the key to improving the survival time of patients with liver cirrhosis.  Methods  A case-control study was conducted for 305 patients with liver cirrhosis who were diagnosed and treated in Tianjin Second People's Hospital from January 2019 to May 2021, among whom there were 200 patients with compensated liver cirrhosis and 105 patients with decompensated liver cirrhosis at baseline. According to whether decompensation events occurred within 1 year, the 305 patients with liver cirrhosis were divided into decompensation group with 79 patients and non-decompensation group with 226 patients; according to whether decompensation events occurred for the first time within 1 year, the 200 patients with compensated liver cirrhosis were divided into first-time decompensation group with 43 patients and non-first-time decompensation group with 157 patients. The independent samples t-test or the Mann-Whitney U test was used for comparison of normally distributed continuous data between groups, and the Wilcoxon rank-sum test or the chi-square test was used for comparison of categorical data between groups. The binary logistic regression analysis was used to investigate the association between each variable and decompensation events; the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) were used to investigate the value of each variable in predicting decompensation events, and the maximum value of Youden index was used to determine the optimal cut-off value.  Results  The patients who experienced decompensation events within 1 year had a significantly higher baseline serum level of CHI3L1 than those who did not experience such events [243.00 (136.00-372.00) ng/mL vs 117.50 (67.75-205.25) ng/mL, U=4720.500, P < 0.001], and the patients who experienced decompensation events for the first time within 1 year had a significantly higher baseline serum level of CHI3L1 than those who did not experience such events [227.98 (110.00-314.00) ng/mL vs 90.00 (58.00-168.50) ng/mL, U=1 681.500, P < 0.001]. Patients with cirrhosis with higher baseline CHI3L1 levels had an increased risk of decompensation events within 1 year (OR=1.004, 95%CI: 1.002-1.006, P < 0.001); Patients with compensated cirrhosis with higher baseline serum CHI3L1 levels had an increased risk of first decompensated event within 1 year (OR=1.006, 95%CI: 1.003-1.008, P < 0.001). The baseline serum level of CHI3L1 had an AUC of 0.751 in predicting the risk of first-time decompensation events, with a sensitivity of 90.7% and a specificity of 55.4% at the optimal cut-off value of 95.5 ng/mL. The predictive model based on the combination of serum CHI3L1 level and Child-Pugh class had an AUC of 0.809, with a sensitivity of 72.1% and a specificity of 77.1% at the maximum value of Youden index.  Conclusion  Serum CHI3L1 level can be used as an effective predictive factor for the risk of first-time decompensation events in patients with compensated liver cirrhosis, and its combination with Child-Pugh class shows a higher predictive value.

     

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    • References(20)
  • [1]
    de FRANCHIS R, BOSCH J, GARCIA-TSAO G, et al. Baveno VⅡ - Renewing consensus in portal hypertension[J]. J Hepatol, 2022, 76(4): 959-974. DOI: 10.1016/j.jhep.2021.12.022.
    [2]
    GINÈS P, KRAG A, ABRALDES JG, et al. Liver cirrhosis[J]. Lancet, 2021, 398(10308): 1359-1376. DOI: 10.1016/S0140-6736(21)01374-X.
    [3]
    KOUANDA A, BINMOELLER K, HAMERSKI C, et al. Safety and efficacy of EUS-guided coil and glue injection for the primary prophylaxis of gastric variceal hemorrhage[J]. Gastrointest Endosc, 2021, 94(2): 291-296. DOI: 10.1016/j.gie.2021.01.025.
    [4]
    Chinese Society of Hepatology, Chinese Medical Association. Chinese guidelinesonthe management of liver cirrhosis[J]. J Clin Hepatol, 2019, 35(11): 2408-2425. DOI: 10.3969/j.issn.1001-5256.2019.11.006.

    中华医学会肝病学分会. 肝硬化诊治指南[J]. 临床肝胆病杂志, 2019, 35(11): 2408-2425. DOI: 10.3969/j.issn.1001-5256.2019.11.006.
    [5]
    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.
    [6]
    Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association. The guideline of prevention and treatment for hepatitis C (2019 version)[J]. J Clin Hepatol, 2019, 35(12): 2670-2686. DOI: 10.3969/j.issn.1001-5256.2019.12.008.

    中华医学会肝病学分会, 中华医学会感染病学分会. 丙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35(12): 2670-2686. DOI: 10.3969/j.issn.1001-5256.2019.12.008.
    [7]
    National Workshop on Fatty Liver and Alcoholic Liver Disease, Chinese Society of Hepatology, Chinese Medical Association: Fatty Liver Expert Committee, Chinese Medical Doctor Association. Guidelines of prevention and treatment for nonalcoholic fatty liver disease: a 2018 update[J]. J Clin Hepatol, 2018, 34(5): 947-957. DOI: 10.3969/j.issn.1001-5256.2018.05.007.

    中华医学会肝病学分会脂肪肝和酒精性肝病学组, 中国医师协会脂肪性肝病专家委员会. 非酒精性脂肪性肝病防治指南(2018年更新版)[J]. 临床肝胆病杂志, 2018, 34(5): 947-957. DOI: 10.3969/j.issn.1001-5256.2018.05.007.
    [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, Chinese Medical Association. Guidelines on the diagnosis and management of autoimmune hepatitis (2021)[J]. J Clin Hepatol, 2022, 38(1): 42-49. DOI: 10.3969/j.issn.1001-5256.2022.01.008.

    中华医学会肝病学分会. 自身免疫性肝炎诊断和治疗指南(2021)[J]. 临床肝胆病杂志, 2022, 38(1): 42-49. DOI: 10.3969/j.issn.1001-5256.2022.01.008.
    [10]
    Chinese Society of Hepatology, Chinese Medical Association. Guidelines on the diagnosis and management of primary biliary cholangitis(2021)[J]. J Clin Hepatol, 2022, 38(1): 35 -41. DOI: 10.3969/j.issn.1001-5256.2022.01.007.

    中华医学会肝病学分会. 原发性胆汁性胆管炎的诊断和治疗指南(2021)[J]. 临床肝胆病杂志, 2022, 38(1): 35-41. DOI: 10.3969/j.issn.1001-5256.2022.01.007.
    [11]
    OBER C, TAN Z, SUN Y, et al. Effect of variation in CHI3L1 on serum YKL-40 level, risk of asthma, and lung function[J]. N Engl J Med, 2008, 358(16): 1682-1691. DOI: 10.1056/NEJMoa0708801.
    [12]
    HUANG X, ZHUANG J, YANG Y, et al. Diagnostic value of serum chitinase-3-like protein 1 for liver fibrosis: A Meta-analysis[J]. Biomed Res Int, 2022, 2022: 3227957. DOI: 10.1155/2022/3227957.
    [13]
    GARCIA-TSAO G, ABRALDES JG. Nonselective beta-blockers in compensated cirrhosis: Preventing variceal hemorrhage or preventing decompensation?[J]. Gastroenterology, 2021, 161(3): 770-773. DOI: 10.1053/j.gastro.2021.04.077.
    [14]
    LIU Y, LIU C, LI J, et al. Risk stratification of decompensation using liver stiffness and platelet counts in compensated advanced chronic liver disease (CHESS2102)[J]. J Hepatol, 2022, 76(1): 248-250. DOI: 10.1016/j.jhep.2021.10.006.
    [15]
    Chinese Society of Hepatology. Chinese Medical Association; Chinese Socie ty of Gastroenterology, Chinese Medical Association; Chinese Society of Endoscopy. Chinese Medical Association Guidelines for the diagnosis and treatment of esophageal and gastric variceal bleeding in cirrhotic portal hypertensio[J]. J Clin Hepatol, 2016, 32(2): 203-219. DOI: 10.3969/j.issn.1001-5256.2016.02.002.

    中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会内镜学分会. 肝硬化门静脉高压食管胃静脉曲张出血的防治指南[J]. 临床肝胆病杂志, 2016, 32(2): 203-219. DOI: 10.3969/j.issn.1001-5256.2016.02.002.
    [16]
    LIU H, SUN J, LIU G, et al. Establishment of a non-invasive prediction model for the risk of oesophageal variceal bleeding using radiomics based on CT[J]. Clin Radiol, 2022, 77(5): 368-376. DOI: 10.1016/j.crad.2022.01.046.
    [17]
    ZHAO L, WANG T, GUO C, et al. Modified and alternative Baveno VI criteria based on age for ruling out high-risk varices in patients with compensated cirrhosis[J]. Hepatol Int, 2022, 16(4): 936-943. DOI: 10.1007/s12072-022-10359-y.
    [18]
    LUO YX, ZHOU T. Value of systemic immune inflammatory index on predicting the proanosis of patients with decompensated liver cirrhosis[J/CD]. Chin J Liver Dis(Electronic Version) 2021, 13(1): 52-58. DOI: 10.3969/j.issn.1674-7380.2021.01.009.

    罗永祥, 周涛. 全身免疫炎症指数对失代偿期肝硬化患者预后的评估价值[J/CD]. 中国肝脏病杂志(电子版), 2021, 13(1): 52-58. DOI: 10.3969/j.issn.1674-7380.2021.01.009.
    [19]
    COSTA D, SIMBRUNNER B, JACHS M, et al. Systemic inflammation increases across distinct stages of advanced chronic liver disease and correlates with decompensation and mortality[J]. J Hepatol, 2021, 74(4): 819-828. DOI: 10.1016/j.jhep.2020.10.004.
    [20]
    COULON S, HEINDRYCKX F, GEERTS A, et al. Angiogenesis in chronic liver disease and its complications[J]. Liver Int, 2011, 31(2): 146-162. DOI: 10.1111/j.1478-3231.2010.02369.x.
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