Depletion of Small HDL Subclasses Predicts Poor Survival in Liver Cirrhosis

Liver cirrhosis is a complex condition characterized by oxidative stress, inflammation, and metabolic dysfunction, contributing to systemic complications and high mortality. High-density lipoprotein (HDL), particularly its small subclasses, is known for its antioxidant, anti-inflammatory, and choles...

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Main Authors: Anja Pammer, Tobias Madl, Hansjörg Habisch, Jakob Kerbl-Knapp, Florian Rainer, Vanessa Stadlbauer, Angela Horvath, Philipp Douschan, Rudolf E. Stauber, Gunther Marsche
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Antioxidants
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Online Access:https://www.mdpi.com/2076-3921/14/6/664
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author Anja Pammer
Tobias Madl
Hansjörg Habisch
Jakob Kerbl-Knapp
Florian Rainer
Vanessa Stadlbauer
Angela Horvath
Philipp Douschan
Rudolf E. Stauber
Gunther Marsche
author_facet Anja Pammer
Tobias Madl
Hansjörg Habisch
Jakob Kerbl-Knapp
Florian Rainer
Vanessa Stadlbauer
Angela Horvath
Philipp Douschan
Rudolf E. Stauber
Gunther Marsche
author_sort Anja Pammer
collection DOAJ
description Liver cirrhosis is a complex condition characterized by oxidative stress, inflammation, and metabolic dysfunction, contributing to systemic complications and high mortality. High-density lipoprotein (HDL), particularly its small subclasses, is known for its antioxidant, anti-inflammatory, and cholesterol efflux capacities. This study examined changes in HDL subclass distribution and composition in cirrhosis and assessed their prognostic relevance for mortality. We analyzed HDL profiles using nuclear magnetic resonance spectroscopy in patients with compensated (n = 205) and decompensated (n = 158) cirrhosis, compared to healthy controls (n = 16). Across all HDL subclasses in cirrhotic patients, cholesterol content was decreased, and triglyceride levels were elevated. In particular, compensated cirrhosis was associated with a marked reduction in small and extra-small HDL particles, while large HDL levels remained unchanged. This reduction was even more pronounced in decompensated disease. Small HDL particle levels were inversely correlated with oxidative stress markers and liver dysfunction and independently predicted 12-month mortality in patients with compensated cirrhosis, even after adjusting for MELD score. In conclusion, our findings highlight a substantial depletion of small and extra-small HDL particles as a key feature of cirrhosis, linked to oxidative stress and mortality in the compensated stage.
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spelling doaj-art-8cb49b61ddff4fc7a27b488ca4ea290d2025-08-20T03:27:07ZengMDPI AGAntioxidants2076-39212025-05-0114666410.3390/antiox14060664Depletion of Small HDL Subclasses Predicts Poor Survival in Liver CirrhosisAnja Pammer0Tobias Madl1Hansjörg Habisch2Jakob Kerbl-Knapp3Florian Rainer4Vanessa Stadlbauer5Angela Horvath6Philipp Douschan7Rudolf E. Stauber8Gunther Marsche9Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, 8010 Graz, AustriaMedicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, 8010 Graz, AustriaBioTechMed-Graz, 8010 Graz, AustriaDivision of Molecular Biology and Biochemistry, Gottfried Schatz Research Center, Medical University of Graz, 8010 Graz, AustriaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, AustriaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, AustriaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, AustriaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, AustriaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, AustriaDivision of Pharmacology, Otto Loewi Research Center, Medical University of Graz, 8010 Graz, AustriaLiver cirrhosis is a complex condition characterized by oxidative stress, inflammation, and metabolic dysfunction, contributing to systemic complications and high mortality. High-density lipoprotein (HDL), particularly its small subclasses, is known for its antioxidant, anti-inflammatory, and cholesterol efflux capacities. This study examined changes in HDL subclass distribution and composition in cirrhosis and assessed their prognostic relevance for mortality. We analyzed HDL profiles using nuclear magnetic resonance spectroscopy in patients with compensated (n = 205) and decompensated (n = 158) cirrhosis, compared to healthy controls (n = 16). Across all HDL subclasses in cirrhotic patients, cholesterol content was decreased, and triglyceride levels were elevated. In particular, compensated cirrhosis was associated with a marked reduction in small and extra-small HDL particles, while large HDL levels remained unchanged. This reduction was even more pronounced in decompensated disease. Small HDL particle levels were inversely correlated with oxidative stress markers and liver dysfunction and independently predicted 12-month mortality in patients with compensated cirrhosis, even after adjusting for MELD score. In conclusion, our findings highlight a substantial depletion of small and extra-small HDL particles as a key feature of cirrhosis, linked to oxidative stress and mortality in the compensated stage.https://www.mdpi.com/2076-3921/14/6/664HDL subclassesoxidative stress markerNMRliver failurecirrhosismortality
spellingShingle Anja Pammer
Tobias Madl
Hansjörg Habisch
Jakob Kerbl-Knapp
Florian Rainer
Vanessa Stadlbauer
Angela Horvath
Philipp Douschan
Rudolf E. Stauber
Gunther Marsche
Depletion of Small HDL Subclasses Predicts Poor Survival in Liver Cirrhosis
Antioxidants
HDL subclasses
oxidative stress marker
NMR
liver failure
cirrhosis
mortality
title Depletion of Small HDL Subclasses Predicts Poor Survival in Liver Cirrhosis
title_full Depletion of Small HDL Subclasses Predicts Poor Survival in Liver Cirrhosis
title_fullStr Depletion of Small HDL Subclasses Predicts Poor Survival in Liver Cirrhosis
title_full_unstemmed Depletion of Small HDL Subclasses Predicts Poor Survival in Liver Cirrhosis
title_short Depletion of Small HDL Subclasses Predicts Poor Survival in Liver Cirrhosis
title_sort depletion of small hdl subclasses predicts poor survival in liver cirrhosis
topic HDL subclasses
oxidative stress marker
NMR
liver failure
cirrhosis
mortality
url https://www.mdpi.com/2076-3921/14/6/664
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