Prognostic Value of High-Density Lipoprotein Cholesterol in Patients with Overt Hepatic Encephalopathy

Overt hepatic encephalopathy (OHE), a serious complication of liver cirrhosis, is associated with alterations in lipid and lipoprotein metabolism. We evaluated the correlation between high-density lipoprotein cholesterol (HDL-C) levels and transplant-free (TF) mortality in patients with OHE. Patient...

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Published in:Biomedicines 2024-08, Vol.12 (8), p.1783
Main Authors: Shi, Ke, Bi, Yufei, Wang, Xiaojing, Li, Yanqiu, Zeng, Xuanwei, Feng, Ying, Wang, Xianbo
Format: Article
Language:English
Subjects:
Ascites
Biomarkers
Care and treatment
Cholesterol
Cholesterol, HDL
Cirrhosis
Diagnosis
Health aspects
Hepatic encephalopathy
Hepatitis
High density lipoprotein
high-density lipoprotein cholesterol
Hospitals
Lipid metabolism
Lipids
Lipoproteins
Liver cirrhosis
Liver diseases
Medical prognosis
Mental disorders
Metabolism
Mortality
Patients
prognosis
Regression analysis
Risk groups
transplant-free mortality
Transplants & implants
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Summary:Overt hepatic encephalopathy (OHE), a serious complication of liver cirrhosis, is associated with alterations in lipid and lipoprotein metabolism. We evaluated the correlation between high-density lipoprotein cholesterol (HDL-C) levels and transplant-free (TF) mortality in patients with OHE. Patients with OHE admitted to Beijing Ditan Hospital between January 2010 and August 2016 (n = 821) and between September 2016 and December 2020 (n = 480) were included in the training and validation sets, respectively. Independent predictors were explored by a multivariate Cox regression analysis, and the area under the receiver operating characteristic curve (AUC) was used to assess the prognostic value of these factors. The prognostic value of HDL-C was good (AUC at 1 year: 0.745) and was equivalent to that of the Model for End-Stage Liver Disease (MELD) score (AUC at 1 year: 0.788). The optimal threshold values for HDL-C and MELD were 0.5 mmol/L and 17, respectively. The 1-year TF mortality rates in the low-risk (HDL-C ≥ 0.5 mmol/L and MELD < 17) and high-risk (HDL-C < 0.5 mmol/L and MELD ≥ 17) groups were 7.5% and 51.5% in the training set and 10.1% and 48.2% in the validation set, respectively. HDL-C level < 0.5 mmol/L and MELD score > 17 can facilitate the identification of high-risk patients and provide a basis for timely treatment.
ISSN:2227-9059
2227-9059
DOI:10.3390/biomedicines12081783