Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 7, 2019; 25(37): 5667-5675
Published online Oct 7, 2019. doi: 10.3748/wjg.v25.i37.5667
Soluble mannose receptor as a predictor of prognosis of hepatitis B virus-related acute-on-chronic liver failure
Tai-Ping Li, Shi-He Guan, Qin Wang, Li-Wen Chen, Kai Yang, Hao Zhang
Tai-Ping Li, Shi-He Guan, Qin Wang, Li-Wen Chen, Kai Yang, Hao Zhang, Department of Clinical Laboratory, The Second Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
Author contributions: Li TP acquired the data and drafted the manuscript; Li TP and Wang Q collected clinical samples and performed in vitro experiments; Li TP, Wang Q, and Chen LW analyzed the data; Yang K and Zhang H performed statistical analysis; Guan SH reviewed the manuscript, figures, and tables.
Supported by the Class A Project of the Key Research and Development Programs of the Science and Technology Department of Anhui Province, No. 1804h08020236; and the Key Project of the Natural Science Foundation of Anhui Province, No. KJ2018A0206.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Second Hospital of Anhui Medical University.
Informed consent statement: All study participants provided written informed consent prior to study enrolment.
Conflict-of-interest statement: There are no potential conflicts of interest relevant to this article to be reported.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Shi-He Guan, MD, PhD, Full Professor, Department of Clinical Laboratory, The Second Hospital of Anhui Medical University, Furong Road 678#, Hefei 230601, Anhui Province, China. shiheguan@126.com
Telephone: +86-551-63869508 Fax: +86-551-63869400
Received: July 15, 2019
Peer-review started: July 16, 2019
First decision: August 2, 2019
Revised: August 21, 2019
Accepted: September 11, 2019
Article in press: September 11, 2019
Published online: October 7, 2019
Processing time: 76 Days and 13.5 Hours
Abstract
BACKGROUND

Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a syndrome with a high short-term mortality rate, and it is crucial to identify those patients at a high mortality risk clinically.

AIM

To investigate the clinical value of soluble mannose receptor (sMR) in predicting the 90-day mortality of HBV-ACLF patients.

METHODS

A total of 43 patients were diagnosed with HBV-ACLF between October 2017 and October 2018 at the Second Hospital of Anhui Medical University, and all of them were enrolled in this retrospective study. Their serum sMR levels were determined using an enzyme-linked immunosorbent assay. Demographic and clinical data, including gender, age, albumin level, total bilirubin (TBIL) level, international normalized ratio, HBV-DNA level, HBV serological markers, procalcitonin level, interleukin-6 level, and model for end-stage liver disease (MELD) score were accessed at the time of diagnosis of HBV-ACLF. A multivariate logistic regression analysis was used to analyze the independent risk factors for mortality.

RESULTS

Serum sMR level was significantly increased in HBV-ACLF patients compared with chronic hepatitis B patients and healthy controls (P < 0.01). When compared with surviving patients, it was higher in those patients who succumbed to HBV-ACLF (P < 0.05). Serum sMR level was positively correlated with MELD score (rs = 0.533, P = 0.001), HBV-DNA level (rs = 0.497, P = 0.022), and TBIL level (rs = 0.894, P < 0.001). Serum sMR level (odds ratio = 1.007, 95% confidence interval: 1.004–1.012, P = 0.001) was an independent risk factor for the 90-day mortality in the HBV-ACLF cases. The patients with HBV-ACLF were stratified into two groups in accordance with their serum sMR levels at the baseline (low risk: < 99.84 pg/mL and high risk: ≥ 99.84 pg/mL). The 90-day mortality rates were 27.3% in the low-risk group and 87.5% in the high-risk group. Furthermore, sMR level apparently improved the performance of MELD score for predicting the prognosis of patients with HBV-ACLF.

CONCLUSION

Serum sMR level may be a predictor of the prognosis of HBV-ACLF patients.

Keywords: Acute-on-chronic liver failure; Mannose receptor; Model for end-stage liver disease; Prognosis; Risk factor

Core tip: This is a retrospective study to evaluate the value of soluble mannose receptor (sMR) level for predicting the 90-day mortality of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). Serum sMR level was significantly higher in patients with HBV-ACLF, and it was an independent risk factor associated with the prognosis of HBV-ACLF. Furthermore, sMR level significantly improved the performance of model for end-stage liver disease score for predicting the prognosis of HBV-ACLF patients.