Clinical School of the Second People's Hospital, Tianjin Medical University, Tianjin, China.
Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, No.7, Sudi South Road, Nankai District, Tianjin, 300192, China.
BMC Gastroenterol. 2023 Sep 19;23(1):317. doi: 10.1186/s12876-023-02877-2.
The literature is sparse on the association between serum liver fibrosis markers and the development of hepatic decompensation in patients with compensated cirrhosis. We aimed to assessed whether the serum liver fibrosis markers are predictive of the occurrence of hepatic decompensation.
We ascertained 688 cirrhotic patients with varying etiologies, between December 2015 to December 2019. Serum hyaluronic acid (HA), laminin (LN), collagen IV (CIV), and N-terminal propeptide of type III collagen (PIIINP) levels were measured at enrollment. All subjects were followed for at least 6 months for occurrence of hepatic decompensation. Cox proportional hazard regression models were used to estimate the hazard ratios (HRs) of hepatic decompensation during follow-up.
During a median follow-up of 22.0 (13.0-32.0) months, decompensation occurred in 69 (10.0%) patients. Multivariate analysis indicated that higher LN (HR: 1.008, 95% confidence interval [CI]: 1.002-1.014, P = 0.011) and CIV (HR: 1.004, 95% CI: 1.001-1.007, P = 0.003) levels were independently associated with hepatic decompensation. Furthermore, patients in the tertile 2 and tertile 3 groups for CIV levels had HRs of 4.787 (1.419, 16.152) (P = 0.012) and 5.153 (1.508, 17.604) (P = 0.009), respectively, for occurrence of decompensation event compared with those in the tertile 1 group.
Serum liver fibrosis markers, particularly in CIV, appeared to be reliable biomarkers of disease progression and liver decompensation in patients with compensated cirrhosis with varying etiologies.
文献中关于血清肝纤维化标志物与代偿性肝硬化患者肝失代偿发展之间的关系的资料很少。我们旨在评估血清肝纤维化标志物是否可预测肝失代偿的发生。
我们确定了 2015 年 12 月至 2019 年 12 月间不同病因的 688 例肝硬化患者。在入组时测量血清透明质酸(HA)、层粘连蛋白(LN)、IV 型胶原(CIV)和 III 型前胶原 N 端肽(PIIINP)水平。所有患者均至少随访 6 个月以观察肝失代偿的发生。使用 Cox 比例风险回归模型来估计随访期间肝失代偿的风险比(HR)。
在中位随访 22.0(13.0-32.0)个月期间,69 例(10.0%)患者发生失代偿。多变量分析表明,较高的 LN(HR:1.008,95%置信区间[CI]:1.002-1.014,P=0.011)和 CIV(HR:1.004,95%CI:1.001-1.007,P=0.003)水平与肝失代偿独立相关。此外,CIV 水平三分位 2 组和三分位 3 组患者的 HR 分别为 4.787(1.419,16.152)(P=0.012)和 5.153(1.508,17.604)(P=0.009),与三分位 1 组相比,发生失代偿事件的风险更高。
血清肝纤维化标志物,特别是 CIV,似乎是不同病因代偿性肝硬化患者疾病进展和肝失代偿的可靠生物标志物。