Low Growth Hormone Levels Predict Poor Outcome of Hepatitis B Virus-Related Acute-on-Chronic Liver Failure.
Low Growth Hormone Levels Predict Poor Outcome of Hepatitis B Virus-Related Acute-on-Chronic Liver Failure.
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DOI：
10.3389/fmed.2021.655863
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发表时间：
2021
影响因子：
3.9
通讯作者：
Xie Z
中科院分区：
文献类型：
--
作者：
Wu D;Zhang L;Ma S;Zhao Y;Chen R;Zhang F;Liu Q;Xu X;Xie Z
背景与目的：乙型肝炎病毒相关性急性慢性肝功能衰竭(HBVACLF)是一种严重的疾病，病死率高。生长激素(GH)与肝脏的新陈代谢和再生有关。本研究旨在探讨生长激素对乙肝急性加重期肝功能衰竭预后的影响。方法：纳入124名患者的前瞻性队列和142名横断面队列。用双抗体夹心法检测GH和胰岛素样生长因子-1(IGF-1)。收集30天存活率，并分析生长激素与乙肝病毒急性加重期肝病患者30天死亡率之间的关系。结果：整个前瞻性队列的平均年龄为46.61±12.71岁，其中女性19例(15.3%)。死亡组GH水平的中位数为1106.55(674.25,1922.4)pg/ml，显著低于存活组(P<；0.001)。在横断面队列中，肝硬变急性失代偿(LC-AD)组生长激素水平显著高于肝硬化组(P<；0.001)，而胰岛素样生长因子-1在LC、LC-AD、ACLF组显著低于健康对照组(HC)和慢性乙肝组(P<；0.001)。生长激素预测30天死亡率的受试者工作特征曲线下面积为0.793。我们建立了一个新的预后模型，即MELD-GH，它比Child-Pugh、MELD、CLIF-SOFA和CLIF-C ACLF评分显示出更好的预测效果。结论：低生长激素预示着乙肝急性加重期肝功能衰竭患者预后不良。GH和IGF-1水平在HC、CHB、LC、LC-AD和ACLF患者中的分布不同。与Child-Pugh、MELD、CLIF-SOFA和CLIF-C ACLF评分相比，MELD-GH具有更好的预测准确性。
Background and Aims: Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) remains a serious entity with high mortality. Growth hormone (GH) is related to the liver metabolism and regeneration. The present study aimed to explore the changes and prognostic efficacy of GH on the outcome of HBV-ACLF. Methods: A prospective cohort of 124 patients and a cross-sectional cohort of 142 subjects were enrolled. GH and insulin-like growth factor-1(IGF-1) were detected by ELISA. Thirty-day survival was collected and the association between GH and the 30-day mortality of HBV-ACLF was analyzed. Results: The mean age of the whole prospective cohort was 46.61 ± 12.71 years, and 19 (15.3%) patients were female. The median (IQR) of GH levels in non-survivors were 1106.55 (674.25, 1922.4) pg/ml, which were significantly lower than in survivors (p < 0.001). In the cross-sectional cohort, GH level was significantly higher in liver cirrhosis - acute decompensation (LC-AD) group than liver cirrhosis (LC) group (p < 0.001) while IGF-1 decreased significantly in LC, LC-AD, ACLF groups than health control (HC) and chronic Hepatitis B (CHB) groups (p < 0.001). The area under the receiver operating characteristic curve (AUROC) of GH for predicting 30-day mortality was 0.793. We built a new prognostic model, namely MELD-GH, which showed better predictive efficacy than Child-Pugh, MELD, CLIF-SOFA, and CLIF-C ACLF scores. Conclusions: Low GH predicted the poor outcome of HBV-ACLF patients. GH and IGF-1 levels were differently distributed among HC, CHB, LC, LC-AD, and ACLF patients. MELD-GH had better predictive accuracy when compared to Child-Pugh, MELD, CLIF-SOFA, and CLIF-C ACLF scores.
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影响因子：
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作者：
Jalan, Rajiv;Saliba, Faouzi;Arroyo, Vicente
通讯作者：
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DOI：
10.26355/eurrev_201805_15078
发表时间：
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影响因子：
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影响因子：
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DOI：
10.1038/nrgastro.2014.165
发表时间：
2014-10-01
期刊：
Nature reviews. Gastroenterology & hepatology
影响因子：
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作者：
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通讯作者：
Greenhill, Claire