Circulating high density lipoprotein distinguishes alcoholic hepatitis from heavy drinkers and predicts 90-day outcome: lipoproteins in alcoholic hepatitis.
Circulating high density lipoprotein distinguishes alcoholic hepatitis from heavy drinkers and predicts 90-day outcome: lipoproteins in alcoholic hepatitis.
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DOI：
10.1016/j.jacl.2021.10.002
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发表时间：
2021-11
影响因子：
4.4
通讯作者：
Jiang ZG
中科院分区：
文献类型：
--
作者：
Mathur K;Vilar-Gomez E;Connelly MA;He H;Sanyal AJ;Chalasani N;Jiang ZG
酒精相关性肝病（ALD）和酒精性肝炎（AH）严重影响肝脏，肝脏是脂质和脂蛋白代谢的中心器官。明确酒精性肝炎（AH）受试者与肝功能正常的重度饮酒者的脂质和脂蛋白谱变化，并确定AH介导的脂蛋白表型与AH严重程度和结局的相关性。在一项多中心前瞻性队列研究中确定了AH病例（n=196）和重度饮酒者对照组（n=169）。AH和大量饮酒者之间的血脂面板和脂蛋白谱之间的关系进行了询问使用三种常见的测量：常规的血脂面板，扩展的血脂面板的NMR，NMR为基础的直接脂蛋白分析。AH严重程度和死亡率的预测值采用Harrell's C指数确定。与重度饮酒者相比，AH中的脂质和脂蛋白谱有显著差异。其中，高密度脂蛋白颗粒浓度在AH中与重度饮酒者相比表现出最显著的降低（5.3 ± 3.4 vs 22.3 ± 5.4 μmol/L，p < 0.001）。在AH患者中，HDL颗粒浓度与Madelon判别函数（DF）呈负相关（p < 0.001），即使在校正DF后，HDL颗粒浓度仍与90天和365天的死亡率独立相关（分别为p = 0.02，p = 0.05）。高密度脂蛋白颗粒浓度低于3.5 μmol/L和总胆固醇≤ 96 mg/dL的AH患者90天死亡率较高。AH患者的脂质和脂蛋白谱发生了深刻的改变，有助于预测疾病的严重程度和死亡率。
Alcohol-associated liver disease (ALD) and alcoholic hepatitis (AH) significantly impact the liver, an organ central to the lipid and lipoprotein metabolism. To define changes in the lipid and lipoprotein profiles in subjects with alcoholic hepatitis (AH) versus heavy drinkers with normal liver function and to determine the association of the AH-mediated lipoprotein phenotype with AH severity and outcomes. AH cases (n=196) and a heavy drinker control group (n=169) were identified in a multicenter, prospective cohort. The relationships between lipid panels and lipoprotein profiles among AH and heavy drinkers were interrogated using three common measurements: the conventional lipid panel, extended lipid panel by NMR, and NMR-based direct lipoprotein profiling. Predictive values for AH severity and mortality were determined using Harrell’s C-Index. Lipid and lipoprotein profiles were significantly different in AH compared to heavy drinkers. Among them, high density lipoprotein (HDL) particle concentration exhibited the most significant reduction in AH compared to heavy drinkers (5.3 ± 3.4 vs 22.3 ± 5.4 μmol/L, p < 0.001). Within AH patients, HDL particle concentration was inversely associated with Maddrey’s Discriminant Function (DF) (p < 0.001), and independently associated with mortality at both 90 and 365 days even after adjustment for DF (p = 0.02, p = 0.05 respectively). HDL particle concentration less than 3.5 μmol/L and total cholesterol ≤ 96 mg/dL identified AH patients with higher 90-day mortality. Lipid and lipoprotein profiles are profoundly altered in AH and can help in prognosticating disease severity and mortality.
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影响因子：
3.9
作者：
Bedi S;Garcia E;Jeyarajah EJ;Shalaurova I;Perez-Matos MC;Jiang ZG;Dullaart RPF;Matyus SP;Kirk WJ;Otvos JD;Davidson WS;Connelly MA
通讯作者：
Connelly MA
影响因子：
9.3
作者：
Otvos, James D.;Shalaurova, Irina;Tracy, Russell P.
通讯作者：
Tracy, Russell P.
影响因子：
--
作者：
Tolstrup, Janne S.;Gronbaek, Morten;Nordestgaard, Borge G.
通讯作者：
Nordestgaard, Borge G.
影响因子：
105.7
作者：
Tapper, Elliot B.;Parikh, Neehar D.
通讯作者：
Parikh, Neehar D.
影响因子：
5.8
作者：
Brinton, Eliot A.
通讯作者：
Brinton, Eliot A.