急性伴慢性肝衰竭患者血清代谢组学特征及其对90天预后的预测价值。

IF 5.4 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Yan Liu, Ying Xiao, Lian-Feng Ai, Jing-Jing Zhang, Jian-Dong Zhang, Ze-Qiang Qi, Lei Dong, Ya-Dong Wang
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引用次数: 0

摘要

背景:急性伴慢性肝衰竭(ACLF)以严重的代谢紊乱为特征;然而,具体的代谢组学特征及其对90天预后的预测价值尚不清楚。目的:探讨不同预后的ACLF患者血清代谢组学变化,为临床预测预后和治疗决策提供依据。方法:这项非介入性、观察性病例对照研究纳入了58例ACLF患者。空腹静脉血样本采用靶向代谢组学分析。单因素和多因素统计分析确定了18种氨基酸、11种脂肪酸、5种肠道微生物相关代谢物和4种胆汁酸代谢物的差异代谢物。二元逻辑回归确定了独立的死亡危险因素,通过森林图和受试者工作特征曲线可视化。结果:死亡组与生存组在基线年龄、终末期肝病模型评分、终末期肝病模型钠、中性粒细胞与淋巴细胞比值(NLR)、总胆红素、血清肌酐、血尿素氮、血小板计数等方面差异有统计学意义(P < 0.05)。代谢产物,包括左旋肉碱、肌酐、丙氨酸、精氨酸(Arg)、脯氨酸、胆碱和油酸,在两组之间也有统计学上的显著差异。多因素分析发现,年龄、NLR和Arg是影响ACLF患者90天死亡率的独立危险因素。预测模型age-NLR-Arg = -15.481 + 0.135 × age + 0.156 × NLR + 0.203 × Arg,截断值为0.759,受试者工作特征曲线下面积为0.945,敏感性为84.0%,特异性为87.9%。结论:age-NLR-Arg模型对ACLF患者90天死亡风险具有较强的预测价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Serum metabolomic characteristics and their predictive value for ninety-day prognosis in patients with acute-on-chronic liver failure.

Serum metabolomic characteristics and their predictive value for ninety-day prognosis in patients with acute-on-chronic liver failure.

Serum metabolomic characteristics and their predictive value for ninety-day prognosis in patients with acute-on-chronic liver failure.

Background: Acute-on-chronic liver failure (ACLF) is characterized by severe metabolic disturbances; however, the specific metabolomic features and their predictive value on 90-day prognosis remain unclear.

Aim: To identify serum metabolomic changes in patients with ACLF with different prognoses to support clinical prediction of outcomes and treatment decisions.

Methods: This non-interventional, observational case-control study enrolled 58 patients with ACLF. Fasting venous blood samples were analyzed using targeted metabolomics. Univariate and multivariate statistical analyses identified differential metabolites among 18 amino acids, 11 fatty acids, 5 gut microbiota-related metabolites, and 4 bile acid metabolites. Binary logistic regression identified independent mortality risk factors, visualized via forest plots and receiver operating characteristic curves.

Results: Significant differences (P < 0.05) were observed between the death and survival groups in baseline age, model for end-stage liver disease score, model for end-stage liver disease with sodium, neutrophil-to-lymphocyte ratio (NLR), total bilirubin, serum creatinine, blood urea nitrogen, and platelet count. Metabolites, including L-carnitine, creatinine, alanine, arginine (Arg), proline, choline, and oleic acid, also showed statistically significant differences between the groups. Multivariate analysis identified age, NLR, and Arg as independent risk factors for 90-day mortality in patients with ACLF. The predictive model, age-NLR-Arg = -15.481 + 0.135 × age + 0.156 × NLR + 0.203 × Arg, with a cutoff of 0.759, achieved an area under the receiver operating characteristic curve of 0.945 with sensitivity of 84.0% and specificity of 87.9%.

Conclusion: The age-NLR-Arg model demonstrates a strong predictive value for 90-day mortality risk in patients with ACLF.

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来源期刊
World Journal of Gastroenterology
World Journal of Gastroenterology 医学-胃肠肝病学
CiteScore
7.80
自引率
4.70%
发文量
464
审稿时长
2.4 months
期刊介绍: The primary aims of the WJG are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in gastroenterology and hepatology.
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