A new prognostic model based on serum apolipoprotein AI in patients with HBV-ACLF and acutely decompensated liver cirrhosis
Abstract Background/Aim To investigate the prognostic value of circulating apolipoprotein AI (apoAI) levels and develop a new prognostic model in individuals with acute-on-chronic liver failure (ACLF) and acute decompensation (AD) of liver cirrhosis caused by hepatitis B virus (HBV) infection. Metho...
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BMC
2025-02-01
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| Series: | Lipids in Health and Disease |
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| Online Access: | https://doi.org/10.1186/s12944-025-02434-8 |
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| author | Ruidong Mo Zhenglan Zhang Yanmei Zhou Yue Wang Pengbo Yin Chenxi Zhang Haoshuang Fu Cong Qian Xiaogang Xiang Rongkun Yin Qing Xie |
| author_facet | Ruidong Mo Zhenglan Zhang Yanmei Zhou Yue Wang Pengbo Yin Chenxi Zhang Haoshuang Fu Cong Qian Xiaogang Xiang Rongkun Yin Qing Xie |
| author_sort | Ruidong Mo |
| collection | DOAJ |
| description | Abstract Background/Aim To investigate the prognostic value of circulating apolipoprotein AI (apoAI) levels and develop a new prognostic model in individuals with acute-on-chronic liver failure (ACLF) and acute decompensation (AD) of liver cirrhosis caused by hepatitis B virus (HBV) infection. Methods Baseline levels of serum lipids were measured, and data concerning the presence of complications were collected from 561 HBV-ACLF and AD patients. Survival analysis was conducted by log-rank test. Proportional hazards model was used to perform multivariate analysis. The dynamics of serum apoAI levels were also explored in 37 HBV-ACLF patients. Results In the cohort, the negatively correlation was found between the Model for End-Stage Liver Disease (MELD) score and serum apoAI levels (r = -0.7946, P < 0.001). Circulating apoAI concentration was an independent risk factor for 90-day survival according to Cox multivariate analysis. A new prognostic score-integrated serum lipid profile for ACLF patients (Lip-ACLF score = 0.86×International Normalized Ratio (INR) + 0.0034×total bilirubin (TBIL) (µmol/L) + 0.99× hepatorenal syndrome (HRS) (HRS: no/1; with/2) + 0.50×hepatic encephalopathy (HE) (grade/ponint: no/1; 1–2/2; 3–4/3) − 2.97×apoAI (g/L) + 5.2) was subsequently designed for the derivation cohort. Compared to MELD score, Child-Turcotte-Pugh (CTP) score or apoAI, Lip-ACLFs was superior for the prediction of 90-day outcomes (receiver operating characteristic curve (ROC): 0.930 vs. 0.885, 0.833 or 0.856, all P < 0.01), as was the validation cohort (ROC 0.906 vs. 0.839, 0.857 or 0.837, all P < 0.05). In Kaplan‒Meier survival analysis, low apoAI levels (< 0.42 g/L) at baseline indicated poor prognosis in ACLF and AD patients. Among the 37 patients, the deceased individuals were characterised with significantly decreased serum apoAI levels during the follow-up test compared with those at baseline (P < 0.05), whereas in patients with a good prognosis, the serum apoAI levels remained stable during the follow-up. Conclusion In HBV-ACLF and AD patients, lower serum apoAI levels suggest greater disease severity and 90-day mortality risk. For predicting the short-term prognosis of these patients, the new Lip-ACLF score might serve as a potential model. |
| format | Article |
| id | doaj-art-ce5b76cb1e7b45faa9f37ea0267581a7 |
| institution | Kabale University |
| issn | 1476-511X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | Lipids in Health and Disease |
| spelling | doaj-art-ce5b76cb1e7b45faa9f37ea0267581a72025-02-09T12:52:40ZengBMCLipids in Health and Disease1476-511X2025-02-0124111110.1186/s12944-025-02434-8A new prognostic model based on serum apolipoprotein AI in patients with HBV-ACLF and acutely decompensated liver cirrhosisRuidong Mo0Zhenglan Zhang1Yanmei Zhou2Yue Wang3Pengbo Yin4Chenxi Zhang5Haoshuang Fu6Cong Qian7Xiaogang Xiang8Rongkun Yin9Qing Xie10Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Infectious Diseases, Xing’an people’s HospitalDepartment of Infectious Diseases, The Affiliated Infectious Diseases Hospital of Soochow UniversityDepartment of Infectious Diseases, Luohe Central HospitalDepartment of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Infectious Diseases, Tongren Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineAbstract Background/Aim To investigate the prognostic value of circulating apolipoprotein AI (apoAI) levels and develop a new prognostic model in individuals with acute-on-chronic liver failure (ACLF) and acute decompensation (AD) of liver cirrhosis caused by hepatitis B virus (HBV) infection. Methods Baseline levels of serum lipids were measured, and data concerning the presence of complications were collected from 561 HBV-ACLF and AD patients. Survival analysis was conducted by log-rank test. Proportional hazards model was used to perform multivariate analysis. The dynamics of serum apoAI levels were also explored in 37 HBV-ACLF patients. Results In the cohort, the negatively correlation was found between the Model for End-Stage Liver Disease (MELD) score and serum apoAI levels (r = -0.7946, P < 0.001). Circulating apoAI concentration was an independent risk factor for 90-day survival according to Cox multivariate analysis. A new prognostic score-integrated serum lipid profile for ACLF patients (Lip-ACLF score = 0.86×International Normalized Ratio (INR) + 0.0034×total bilirubin (TBIL) (µmol/L) + 0.99× hepatorenal syndrome (HRS) (HRS: no/1; with/2) + 0.50×hepatic encephalopathy (HE) (grade/ponint: no/1; 1–2/2; 3–4/3) − 2.97×apoAI (g/L) + 5.2) was subsequently designed for the derivation cohort. Compared to MELD score, Child-Turcotte-Pugh (CTP) score or apoAI, Lip-ACLFs was superior for the prediction of 90-day outcomes (receiver operating characteristic curve (ROC): 0.930 vs. 0.885, 0.833 or 0.856, all P < 0.01), as was the validation cohort (ROC 0.906 vs. 0.839, 0.857 or 0.837, all P < 0.05). In Kaplan‒Meier survival analysis, low apoAI levels (< 0.42 g/L) at baseline indicated poor prognosis in ACLF and AD patients. Among the 37 patients, the deceased individuals were characterised with significantly decreased serum apoAI levels during the follow-up test compared with those at baseline (P < 0.05), whereas in patients with a good prognosis, the serum apoAI levels remained stable during the follow-up. Conclusion In HBV-ACLF and AD patients, lower serum apoAI levels suggest greater disease severity and 90-day mortality risk. For predicting the short-term prognosis of these patients, the new Lip-ACLF score might serve as a potential model.https://doi.org/10.1186/s12944-025-02434-8Hepatitis BSerum lipidsAcute-on-chronic-live failureapoAILiver cirrhosis |
| spellingShingle | Ruidong Mo Zhenglan Zhang Yanmei Zhou Yue Wang Pengbo Yin Chenxi Zhang Haoshuang Fu Cong Qian Xiaogang Xiang Rongkun Yin Qing Xie A new prognostic model based on serum apolipoprotein AI in patients with HBV-ACLF and acutely decompensated liver cirrhosis Lipids in Health and Disease Hepatitis B Serum lipids Acute-on-chronic-live failure apoAI Liver cirrhosis |
| title | A new prognostic model based on serum apolipoprotein AI in patients with HBV-ACLF and acutely decompensated liver cirrhosis |
| title_full | A new prognostic model based on serum apolipoprotein AI in patients with HBV-ACLF and acutely decompensated liver cirrhosis |
| title_fullStr | A new prognostic model based on serum apolipoprotein AI in patients with HBV-ACLF and acutely decompensated liver cirrhosis |
| title_full_unstemmed | A new prognostic model based on serum apolipoprotein AI in patients with HBV-ACLF and acutely decompensated liver cirrhosis |
| title_short | A new prognostic model based on serum apolipoprotein AI in patients with HBV-ACLF and acutely decompensated liver cirrhosis |
| title_sort | new prognostic model based on serum apolipoprotein ai in patients with hbv aclf and acutely decompensated liver cirrhosis |
| topic | Hepatitis B Serum lipids Acute-on-chronic-live failure apoAI Liver cirrhosis |
| url | https://doi.org/10.1186/s12944-025-02434-8 |
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