Tauseef Abubakar, Zafar Maryam, Rashid Behzad, Thirumalareddy Joseph, Chalfant Victor, Farooque Umar, Mirza Mohsin
Internal Medicine, Creighton University School of Medicine, Omaha, USA.
Internal Medicine, Dow International Medical College, Dow University Hospital, Dow University of Health Sciences, Karachi, PAK.
Cureus. 2020 Oct 18;12(10):e11019. doi: 10.7759/cureus.11019.
Chronic liver disease (CLD) is a term used to describe a wide spectrum of disorders, including idiopathic, infectious, genetic, drug-induced, toxin-induced, and autoimmune disorders. The common consequence of chronic damage to the liver is cirrhosis. Cirrhotic patients are further classified by their severity based on the Child-Pugh scoring system. Currently, Child-Pugh scoring consists of ascites, hepatic encephalopathy (HE), prothrombin time, serum albumin level, and total bilirubin level. Lipid panel in CLD is a great marker in determining the severity of CLD. Method and methodology: It was a descriptive cross-sectional study conducted at a tertiary care hospital. A sample size of 122 was calculated by using a RaoSoft Digital Sample Size Calculator (RaoSoft, Inc., Seattle, WA) in which we used 5% as a margin of error, 95% as confidence interval (CI), 178 as population size, and response distribution as 50%. Non-complicated CLD patients having age in between 15 and 80 years with no cirrhotic complications including HE, spontaneous bacterial peritonitis, hepato-pumonary, or hepato-renal syndrome were included in our study; the rest of the CLD patients were excluded from our study.
The mean age of the study population was 47.09 ± 12.30 years with more than half of the patients lying among the age group 25-50 years. The study population included 76% of males (n=93) and 24% of females (n=29), with a mean age of females higher than the males. Diabetes mellitus (58.19%) was the most frequent comorbidity associated with CLD in subjects included in our study. Parameters of lipid panel were decreased exponentially as the severity of CLD increases from Child score A to C. Total cholesterol, low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), high-density lipoprotein (HDL), and triglyceride (TG) level decreased as the severity increases in our study. The mean model for end-stage liver disease (MELD) score increased as per hypothesized as the severity increases from Child score A to Child score C, respectively.
Our study concluded that as the severity of CLD increases from Child class A to Child class C, the lipid panel profile decreases exponentially which proved the idea that had been hypothesized at the beginning of our study.
慢性肝病（CLD）是一个用于描述多种疾病的术语，包括特发性、感染性、遗传性、药物性、毒素性和自身免疫性疾病。肝脏慢性损伤的常见后果是肝硬化。肝硬化患者根据Child-Pugh评分系统进一步按严重程度分类。目前，Child-Pugh评分包括腹水、肝性脑病（HE）、凝血酶原时间、血清白蛋白水平和总胆红素水平。CLD中的血脂指标是确定CLD严重程度的一个重要指标。方法和方法论：这是一项在三级医疗医院进行的描述性横断面研究。使用RaoSoft数字样本量计算器（RaoSoft公司，华盛顿州西雅图）计算出样本量为122，其中我们将5%作为误差幅度，95%作为置信区间（CI），178作为总体规模，应答分布为50%。年龄在15至80岁之间、无肝硬化并发症（包括HE、自发性细菌性腹膜炎、肝肺综合征或肝肾综合征）的非复杂性CLD患者纳入我们的研究；其余CLD患者被排除在我们的研究之外。
研究人群的平均年龄为47.09±12.30岁，超过一半的患者年龄在25至50岁之间。研究人群中男性占76%（n=93），女性占24%（n=29），女性的平均年龄高于男性。糖尿病（58.19%）是我们研究中纳入的CLD患者最常见的合并症。随着CLD严重程度从Child评分A增加到C，血脂指标呈指数下降。在我们的研究中，随着严重程度增加，总胆固醇、低密度脂蛋白（LDL）、极低密度脂蛋白（VLDL）、高密度脂蛋白（HDL）和甘油三酯（TG）水平下降。终末期肝病（MELD）评分均值如假设的那样随着严重程度从Child评分A分别增加到Child评分C而升高。
我们的研究得出结论，随着CLD严重程度从Child A级增加到Child C级，血脂指标呈指数下降，这证明了我们研究开始时所假设的观点。
