Circulating insulin-like growth factor-binding protein 3 as prognostic biomarker in liver cirrhosis

Table 1 Demographic, clinical and biochemical features of included patients n (%)

	Stable cirrhosis (n = 138)	Acute decompensation (n = 189)
Age; yr, mean ± SD	53.62 ± 12.52	53.58 ± 11.56
Caucasians	128 (92.8)	129 (68.6)
Male gender	97 (70.3)	138 (73.0)
Etiology of cirrhosis
Alcohol	42 (30.4)	68 (36.0)
Hepatitis C	50 (36.2)	78 (41.3)
Hepatitis B	6 (4.3)	8 (4.2)
Cryptogenic	14 (10.1)	15 (7.9)
Other	26 (18.8)	20 (10.6)
Previous decompensation	104 (75.4)	120 (63.5)
Active alcoholism	5 (3.6)	68 (36.0)
Propranolol	87(63.0)	74 (40.2)
PPI	69 (50.0)	43 (23.4)
Complication at evaluation
Ascites	28 (20.3)	92 (48.7)
Hepatic encephalopathy	14 (10.1)	112 (59.3)
Gastrointestinal bleeding	0	99 (52.4)
Bacterial infection	0	50 (26.6)
ACLF	0	45 (23.8)
Laboratory data
Leucocyte count (× 109), median	4.90	7.20
Sodium (meq/L), median	138	135
Creatinine (mg/dL), median	0.90	1.1
INR, median	1.20	1.41
Albumin (g/dL), mean ± SD	3.44 ± 0.46	2.35 ± 0.69
CRP (mg/L), median	3.5	10.05
Total bilirubin (mg/dL), median	1.00	2.10
IGFBP-3 (mcg/mL), median	1.69	0.94
Child-Pugh classification
A	92 (66.7)	23 (12.2)
B	43 (31.2)	91 (48.1)
C	3 (2.2)	75 (39.7)
MELD score, mean ± SD	9.84 ± 2.28	16.32 ± 6.53

PPI: Proton-pump inhibitors; ACFL: Acute-on-chronic liver failure; INR: International normalized ratio; CRP: C-reactive protein; IGFBP-3: Insulin-like growth factor-binding protein 3; MELD: Model for end-stage liver disease.

Table 2 Factors associated with mortality or liver transplantations among patients with stable cirrhosis n (%)

	Survivors (n = 111)	Death/liver transplantation (n = 27)	P value
Age (yr), mean ± SD	54.33 ± 12.11	50.67 ± 13.91	0.173
Male gender	79 (71.2)	18 (66.7)	0.646
Etiology of cirrhosis
Alcohol	34 (30.6)	8 (29.6)	0.919
Hepatitis C	42 (37.8)	8 (29.6)	0.426
Hepatitis B	4 (3.6)	2 (7.4)	0.334
Cryptogenic	10 (9.0)	4 (14.8)	0.475
Other	21 (18.9)	5 (18.5)	0.962
Previous hospitalization	73 (65.8)	24 (88.9)	0.018
Active alcoholism	3 (2.7)	2 (7.4)	0.252
Propranolol	67 (60.4)	20 (74.1)	0.185
PPI	54 (48.6)	15 (55.6)	0.520
Complication at evaluation
Ascites	19 (17.1)	9 (33.3)	0.060
Hepatic encephalopathy	8 (7.2)	6 (22.2)	0.032
Previous ascites	47 (42.3)	19 (70.4)	0.009
Laboratory data
Leucocyte count (× 109), median	4.93	4.83	0.548
Sodium (meq/L), median	138.00	136.00	0.022
Creatinine (mg/dL), median	0.9	0.8	0.480
INR, median	1.16	1.27	< 0.001
Albumin (g/dL), mean ± SD	3.52 ± 0.44	3.11 ± 0.39	< 0.001
CRP (mg/L), median	3.5	4.51	0.014
Total bilirubin (mg/dL), median	0.9	1.8	< 0.001
IGFBP-3 (mcg/mL), median	1.74	1.44	0.027
Child-Pugh B/C	27 (24.3)	19 (70.4)	< 0.001
MELD score, mean ± SD	9.32 ± 1.97	11.98 ± 2.24	< 0.001

PPI: Proton-pump inhibitors; INR: International normalized ratio; CRP: C-reactive protein; IGFBP-3: Insulin-like growth factor-binding protein 3; MELD: Model for end-stage liver disease.

Table 3 Factors associated with 30-d mortality among patients hospitalized for acute decompensation of cirrhosis n (%)

	Survivors (n = 143)	Deaths (n = 46)	P value
Age (yr), mean ± SD	53.61 ± 11.54	53.49 ± 11.75	0.952
Male gender	101 (70.6)	37 (80.4)	0.192
Etiology of cirrhosis
Alcohol	47 (32.9)	21 (49.7)	0.116
Hepatitis C	61 (42.7)	17 (37.0)	0.495
Hepatitis B	6 (4.2)	2 (4.3)	1.000
Cryptogenic	14 (9.8)	1 (2.2)	0.123
Other	15 (10.5)	5 (10.9)	1.000
Previous decompensation	88 (61.5)	32 (69.6)	0.325
Active alcoholism	45 (31.5)	23 (50.0)	0.023
Complication at evaluation
Ascites	57 (39.9)	35 (76.1)	< 0.001
Hepatic encephalopathy	73 (51.0)	39 (84.8)	< 0.001
Gastrointestinal bleeding	81 (56.6)	18 (39.1)	0.039
Bacterial infection	28 (19.6)	22 (48.9)	< 0.001
ACLF	16 (11.2)	29 (63.0)	< 0.001
Laboratory data
Leucocyte count (× 109), median	6.59	8.46	0.005
Sodium (meq/L), median	136.00	134.00	0.011
Creatinine (mg/dL), median	1.00	1.80	< 0.001
INR, median	1.38	1.60	< 0.001
Albumin (g/dL), mean ± SD	2.47 ± 0.70	1.98 ± 0.51	< 0.001
CRP (mg/L), median	8.40	24.8	0.002
Total bilirubin (mg/dL), median	1.51	3.10	< 0.001
IGFBP-3 (mcg/mL), median	1.05	0.63	< 0.001
Child-Pugh C	41 (28.7)	34 (73.9)	< 0.001
MELD score, mean ± SD	14.35 ± 5.00	22.44 ± 6.95	< 0.001
Vital signs
MAP (mmHg), mean ± SD	85.11 ± (13.95)	80.33 ± (15.27)	0.053
Heart rate (BPM), mean ± SD	81.27 ± 19.19	88.66 ± 16.40	0.022
SpO2/FiO2 ratio, median	461.9	442.86	< 0.001

INR: International normalized ratio; CRP: C-reactive protein; IGFBP-3: Insulin-like growth factor-binding protein 3; MELD: Model for end-stage liver disease; MAP: Mean arterial pressure; SpO₂/FiO₂: Oxygen saturation to fraction of inspired oxygen ratio; ACLF: Acute-on-chronic liver failure.