Inflammatory lipid biomarkers and transplant-free mortality risk in hepatitis B-related cirrhosis and hepatic encephalopathy
ObjectiveInflammatory reactions and dyslipidemia are associated with the pathogenesis and prognosis of hepatitis B virus-related cirrhosis. We aimed to assess the predictive ability of these parameters in patients with hepatitis B virus-related cirrhosis and overt hepatic encephalopathy (HBV-related...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1528733/full |
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| author | Ke Shi Xiaojing Wang Zhang Yi Yanqiu Li Ying Feng Xianbo Wang |
| author_facet | Ke Shi Xiaojing Wang Zhang Yi Yanqiu Li Ying Feng Xianbo Wang |
| author_sort | Ke Shi |
| collection | DOAJ |
| description | ObjectiveInflammatory reactions and dyslipidemia are associated with the pathogenesis and prognosis of hepatitis B virus-related cirrhosis. We aimed to assess the predictive ability of these parameters in patients with hepatitis B virus-related cirrhosis and overt hepatic encephalopathy (HBV-related OHE).DesignWe conducted an analysis of 1,404 participants diagnosed with HBV-related OHE between January 2008 and July 2023. The prognostic significance of the neutrophil-to-high-density lipoprotein cholesterol (HDL-C) ratio (NHR), lymphocyte-to-HDL-C ratio (LHR), and monocyte-to-HDL-C ratio (MHR) was evaluated using the area under the receiver operating characteristic curve (AUC). Restrictive cubic splines (RCS) were employed to explore the relationship between NHR and 12-month transplant-free (TF) mortality. This study included a prospective test cohort of 328 patients.ResultsNHR was identified as an independent risk factor for 12-month TF mortality. The AUC for NHR (0.776) was similar to that of the model end-stage liver disease (MELD) score (AUC: 0.777). In the test cohort, NHR demonstrated AUC values comparable to MELD, with significantly higher AUCs than LHR and MHR (both p < 0.05). Based on cutoff values for NHR and MELD, patients were classified into four risk subgroups: very-low (NHR < 10 and MELD <18), low (NHR ≥ 10 and MELD <18), moderate (NHR < 10 and MELD ≥18), and high (NHR ≥ 10 and MELD ≥18). The 12-month TF mortality rates in the training cohort were 7.2, 23.5, 30.8, and 51.4%, respectively, for these subgroups, while in the test cohort, the rates were 8.7, 20.5, 30.7, and 46.0%.ConclusionNHR is a valuable and accessible prognostic indicator for 12-month TF mortality in patients with HBV-related OHE. Patients with both NHR ≥ 10 and MELD ≥18 are at the highest risk of mortality. |
| format | Article |
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| institution | Kabale University |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj-art-8aa9695fea8842afa392609ca88d94b22025-01-23T06:56:43ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-01-011210.3389/fmed.2025.15287331528733Inflammatory lipid biomarkers and transplant-free mortality risk in hepatitis B-related cirrhosis and hepatic encephalopathyKe ShiXiaojing WangZhang YiYanqiu LiYing FengXianbo WangObjectiveInflammatory reactions and dyslipidemia are associated with the pathogenesis and prognosis of hepatitis B virus-related cirrhosis. We aimed to assess the predictive ability of these parameters in patients with hepatitis B virus-related cirrhosis and overt hepatic encephalopathy (HBV-related OHE).DesignWe conducted an analysis of 1,404 participants diagnosed with HBV-related OHE between January 2008 and July 2023. The prognostic significance of the neutrophil-to-high-density lipoprotein cholesterol (HDL-C) ratio (NHR), lymphocyte-to-HDL-C ratio (LHR), and monocyte-to-HDL-C ratio (MHR) was evaluated using the area under the receiver operating characteristic curve (AUC). Restrictive cubic splines (RCS) were employed to explore the relationship between NHR and 12-month transplant-free (TF) mortality. This study included a prospective test cohort of 328 patients.ResultsNHR was identified as an independent risk factor for 12-month TF mortality. The AUC for NHR (0.776) was similar to that of the model end-stage liver disease (MELD) score (AUC: 0.777). In the test cohort, NHR demonstrated AUC values comparable to MELD, with significantly higher AUCs than LHR and MHR (both p < 0.05). Based on cutoff values for NHR and MELD, patients were classified into four risk subgroups: very-low (NHR < 10 and MELD <18), low (NHR ≥ 10 and MELD <18), moderate (NHR < 10 and MELD ≥18), and high (NHR ≥ 10 and MELD ≥18). The 12-month TF mortality rates in the training cohort were 7.2, 23.5, 30.8, and 51.4%, respectively, for these subgroups, while in the test cohort, the rates were 8.7, 20.5, 30.7, and 46.0%.ConclusionNHR is a valuable and accessible prognostic indicator for 12-month TF mortality in patients with HBV-related OHE. Patients with both NHR ≥ 10 and MELD ≥18 are at the highest risk of mortality.https://www.frontiersin.org/articles/10.3389/fmed.2025.1528733/fullhepatitis B virushepatic encephalopathymodel end-stage liver disease scoreinflammatoryhigh density lipoprotein cholesterol |
| spellingShingle | Ke Shi Xiaojing Wang Zhang Yi Yanqiu Li Ying Feng Xianbo Wang Inflammatory lipid biomarkers and transplant-free mortality risk in hepatitis B-related cirrhosis and hepatic encephalopathy Frontiers in Medicine hepatitis B virus hepatic encephalopathy model end-stage liver disease score inflammatory high density lipoprotein cholesterol |
| title | Inflammatory lipid biomarkers and transplant-free mortality risk in hepatitis B-related cirrhosis and hepatic encephalopathy |
| title_full | Inflammatory lipid biomarkers and transplant-free mortality risk in hepatitis B-related cirrhosis and hepatic encephalopathy |
| title_fullStr | Inflammatory lipid biomarkers and transplant-free mortality risk in hepatitis B-related cirrhosis and hepatic encephalopathy |
| title_full_unstemmed | Inflammatory lipid biomarkers and transplant-free mortality risk in hepatitis B-related cirrhosis and hepatic encephalopathy |
| title_short | Inflammatory lipid biomarkers and transplant-free mortality risk in hepatitis B-related cirrhosis and hepatic encephalopathy |
| title_sort | inflammatory lipid biomarkers and transplant free mortality risk in hepatitis b related cirrhosis and hepatic encephalopathy |
| topic | hepatitis B virus hepatic encephalopathy model end-stage liver disease score inflammatory high density lipoprotein cholesterol |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1528733/full |
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