Tyng-Yuan Jang, Po-Cheng Liang, Dae Won Jun, Jang Han Jung, Hidenori Toyoda, Chih-Wen Wang, Man-Fung Yuen, Ka Shing Cheung, Satoshi Yasuda, Sung Eun Kim, Eileen L Yoon, Jihyun An, Masaru Enomoto, Ritsuzo Kozuka, Makoto Chuma, Akito Nozaki, Toru Ishikawa, Tsunamasa Watanabe, Masanori Atsukawa, Taeang Arai, Korenobu Hayama, Masatoshi Ishigami, Yong Kyun Cho, Eiichi Ogawa, Hyoung Su Kim, Jae-Jun Shim, Haruki Uojima, Soung Won Jeong, Sang Bong Ahn, Koichi Takaguchi, Tomonori Senoh, Maria Buti, Elena Vargas-Accarino, Hiroshi Abe, Hirokazu Takahashi, Kaori Inoue, Jee-Fu Huang, Wan-Long Chuang, Ming-Lun Yeh, Chia-Yen Dai, Chung-Feng Huang, Mindie H Nguyen, Ming-Lung Yu
{"title":"γ-谷氨酰转移酶预处理可预测核苷酸/核苷类似物治疗的慢性乙型肝炎患者的死亡率。","authors":"Tyng-Yuan Jang, Po-Cheng Liang, Dae Won Jun, Jang Han Jung, Hidenori Toyoda, Chih-Wen Wang, Man-Fung Yuen, Ka Shing Cheung, Satoshi Yasuda, Sung Eun Kim, Eileen L Yoon, Jihyun An, Masaru Enomoto, Ritsuzo Kozuka, Makoto Chuma, Akito Nozaki, Toru Ishikawa, Tsunamasa Watanabe, Masanori Atsukawa, Taeang Arai, Korenobu Hayama, Masatoshi Ishigami, Yong Kyun Cho, Eiichi Ogawa, Hyoung Su Kim, Jae-Jun Shim, Haruki Uojima, Soung Won Jeong, Sang Bong Ahn, Koichi Takaguchi, Tomonori Senoh, Maria Buti, Elena Vargas-Accarino, Hiroshi Abe, Hirokazu Takahashi, Kaori Inoue, Jee-Fu Huang, Wan-Long Chuang, Ming-Lun Yeh, Chia-Yen Dai, Chung-Feng Huang, Mindie H Nguyen, Ming-Lung Yu","doi":"10.1002/kjm2.12771","DOIUrl":null,"url":null,"abstract":"<p><p>Elevated serum gamma-glutamyl transferase (GGT) levels are associated with chronic hepatitis B (CHB)-related hepatocellular carcinoma. However, their role in predicting mortality in patients with CHB treated with nucleotide/nucleoside analogs (NAs) remains elusive. Altogether, 2843 patients with CHB treated with NAs were recruited from a multinational cohort. Serum GGT levels before and 6 months (Month-6) after initiating NAs were measured to explore their association with all-cause, liver-related, and non-liver-related mortality. The annual incidence of all-cause mortality was 0.9/100 person-years over a follow-up period of 17,436.3 person-years. Compared with patients who survived, those who died had a significantly higher pretreatment (89.3 vs. 67.4 U/L, p = 0.002) and Month-6-GGT levels (62.1 vs. 38.4 U/L, p < 0.001). The factors associated with all-cause mortality included cirrhosis (hazard ratio [HR]/95% confidence interval [CI]: 2.66/1.92-3.70, p < 0.001), pretreatment GGT levels (HR/CI: 1.004/1.003-1.006, p < 0.001), alanine aminotransferase level (HR/CI: 0.996/0.994-0.998, p = 0.001), and age (HR/CI: 1.06/1.04-1.07, p < 0.001). Regarding liver-related mortality, the independent factors included cirrhosis (HR/CI: 4.36/2.79-6.89, p < 0.001), pretreatment GGT levels (HR/CI: 1.006/1.004-1.008, p < 0.001), alanine aminotransferase level (HR/CI: 0.993/0.990-0.997, p = 0.001), age (HR/CI: 1.03/1.01-1.05, p < 0.001), and fatty liver disease (HR/CI: 0.30/0.15-0.59, p = 0.001). Pretreatment GGT levels were also independently predictive of non-liver-related mortality (HR/CI: 1.003/1.000-1.005, p = 0.03). The results remained consistent after excluding the patients with a history of alcohol use. A dose-dependent manner of <25, 25-75, and >75 percentile of pretreatment GGT levels was observed with respect to the all-cause mortality (trend p < 0.001). Pretreatment serum GGT levels predicted all-cause, liver-related, and non-liver-related mortality in patients with CHB treated with NAs.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pretreatment gamma-glutamyl transferase predicts mortality in patients with chronic hepatitis B treated with nucleotide/nucleoside analogs.\",\"authors\":\"Tyng-Yuan Jang, Po-Cheng Liang, Dae Won Jun, Jang Han Jung, Hidenori Toyoda, Chih-Wen Wang, Man-Fung Yuen, Ka Shing Cheung, Satoshi Yasuda, Sung Eun Kim, Eileen L Yoon, Jihyun An, Masaru Enomoto, Ritsuzo Kozuka, Makoto Chuma, Akito Nozaki, Toru Ishikawa, Tsunamasa Watanabe, Masanori Atsukawa, Taeang Arai, Korenobu Hayama, Masatoshi Ishigami, Yong Kyun Cho, Eiichi Ogawa, Hyoung Su Kim, Jae-Jun Shim, Haruki Uojima, Soung Won Jeong, Sang Bong Ahn, Koichi Takaguchi, Tomonori Senoh, Maria Buti, Elena Vargas-Accarino, Hiroshi Abe, Hirokazu Takahashi, Kaori Inoue, Jee-Fu Huang, Wan-Long Chuang, Ming-Lun Yeh, Chia-Yen Dai, Chung-Feng Huang, Mindie H Nguyen, Ming-Lung Yu\",\"doi\":\"10.1002/kjm2.12771\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Elevated serum gamma-glutamyl transferase (GGT) levels are associated with chronic hepatitis B (CHB)-related hepatocellular carcinoma. However, their role in predicting mortality in patients with CHB treated with nucleotide/nucleoside analogs (NAs) remains elusive. Altogether, 2843 patients with CHB treated with NAs were recruited from a multinational cohort. Serum GGT levels before and 6 months (Month-6) after initiating NAs were measured to explore their association with all-cause, liver-related, and non-liver-related mortality. The annual incidence of all-cause mortality was 0.9/100 person-years over a follow-up period of 17,436.3 person-years. Compared with patients who survived, those who died had a significantly higher pretreatment (89.3 vs. 67.4 U/L, p = 0.002) and Month-6-GGT levels (62.1 vs. 38.4 U/L, p < 0.001). The factors associated with all-cause mortality included cirrhosis (hazard ratio [HR]/95% confidence interval [CI]: 2.66/1.92-3.70, p < 0.001), pretreatment GGT levels (HR/CI: 1.004/1.003-1.006, p < 0.001), alanine aminotransferase level (HR/CI: 0.996/0.994-0.998, p = 0.001), and age (HR/CI: 1.06/1.04-1.07, p < 0.001). Regarding liver-related mortality, the independent factors included cirrhosis (HR/CI: 4.36/2.79-6.89, p < 0.001), pretreatment GGT levels (HR/CI: 1.006/1.004-1.008, p < 0.001), alanine aminotransferase level (HR/CI: 0.993/0.990-0.997, p = 0.001), age (HR/CI: 1.03/1.01-1.05, p < 0.001), and fatty liver disease (HR/CI: 0.30/0.15-0.59, p = 0.001). Pretreatment GGT levels were also independently predictive of non-liver-related mortality (HR/CI: 1.003/1.000-1.005, p = 0.03). The results remained consistent after excluding the patients with a history of alcohol use. A dose-dependent manner of <25, 25-75, and >75 percentile of pretreatment GGT levels was observed with respect to the all-cause mortality (trend p < 0.001). Pretreatment serum GGT levels predicted all-cause, liver-related, and non-liver-related mortality in patients with CHB treated with NAs.</p>\",\"PeriodicalId\":94244,\"journal\":{\"name\":\"The Kaohsiung journal of medical sciences\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Kaohsiung journal of medical sciences\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1002/kjm2.12771\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/10/27 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Kaohsiung journal of medical sciences","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/kjm2.12771","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/10/27 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
Pretreatment gamma-glutamyl transferase predicts mortality in patients with chronic hepatitis B treated with nucleotide/nucleoside analogs.
Elevated serum gamma-glutamyl transferase (GGT) levels are associated with chronic hepatitis B (CHB)-related hepatocellular carcinoma. However, their role in predicting mortality in patients with CHB treated with nucleotide/nucleoside analogs (NAs) remains elusive. Altogether, 2843 patients with CHB treated with NAs were recruited from a multinational cohort. Serum GGT levels before and 6 months (Month-6) after initiating NAs were measured to explore their association with all-cause, liver-related, and non-liver-related mortality. The annual incidence of all-cause mortality was 0.9/100 person-years over a follow-up period of 17,436.3 person-years. Compared with patients who survived, those who died had a significantly higher pretreatment (89.3 vs. 67.4 U/L, p = 0.002) and Month-6-GGT levels (62.1 vs. 38.4 U/L, p < 0.001). The factors associated with all-cause mortality included cirrhosis (hazard ratio [HR]/95% confidence interval [CI]: 2.66/1.92-3.70, p < 0.001), pretreatment GGT levels (HR/CI: 1.004/1.003-1.006, p < 0.001), alanine aminotransferase level (HR/CI: 0.996/0.994-0.998, p = 0.001), and age (HR/CI: 1.06/1.04-1.07, p < 0.001). Regarding liver-related mortality, the independent factors included cirrhosis (HR/CI: 4.36/2.79-6.89, p < 0.001), pretreatment GGT levels (HR/CI: 1.006/1.004-1.008, p < 0.001), alanine aminotransferase level (HR/CI: 0.993/0.990-0.997, p = 0.001), age (HR/CI: 1.03/1.01-1.05, p < 0.001), and fatty liver disease (HR/CI: 0.30/0.15-0.59, p = 0.001). Pretreatment GGT levels were also independently predictive of non-liver-related mortality (HR/CI: 1.003/1.000-1.005, p = 0.03). The results remained consistent after excluding the patients with a history of alcohol use. A dose-dependent manner of <25, 25-75, and >75 percentile of pretreatment GGT levels was observed with respect to the all-cause mortality (trend p < 0.001). Pretreatment serum GGT levels predicted all-cause, liver-related, and non-liver-related mortality in patients with CHB treated with NAs.
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