• Postgraduate medicine · Aug 2021

    Association of lipid profile with decompensation, liver dysfunction, and mortality in patients with liver cirrhosis.

    • Ruirui Feng, Xiaozhong Guo, Yun Kou, Xiangbo Xu, Cen Hong, Wenwen Zhang, Yang An, Cyriac Abby Philips, Andrea Mancuso, and Xingshun Qi.
    • Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, Liaoning, P.R. China.
    • Postgrad Med. 2021 Aug 1; 133 (6): 626-638.

    Background And AimsLipid metabolism is often disrupted in liver cirrhosis. The present study aimed to evaluate the impact of lipid profile on decompensation events, severity of liver dysfunction, and death in patients with liver cirrhosis.MethodsIn a cross-sectional study, 778 patients with lipid profile data were enrolled, and then were divided into 240 and 538 patients with and without liver cirrhosis, respectively. In a cohort study, 314 cirrhotic patients with lipid profile data, who were prospectively followed, were enrolled. Lipid profile included total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-c), low-density lipoprotein-cholesterol (LDL-c), triglycerides (TG), and lipoprotein(a).ResultsIn the cross-sectional study, cirrhotic patients with decompensation events had significantly lower levels of TC and lipoprotein(a) than those without; and cirrhotic patients with Child-Pugh class B and C had significantly lower levels of TC, HDL-c, LDL-c, and lipoprotein(a) than those with Child-Pugh class A. In the cohort study, there was an inverse association of survival with TC, HDL-c, and lipoprotein(a) levels; after adjusting for MELD score, TC (Hazard Ratio [HR] = 1.703, P = 0.034) and HDL-c (HR = 2.036, P = 0.005), but not lipoprotein(a) (HR = 1.377, P = 0.191), remained a significant predictor of death; when TC, HDL-c, lipoprotein(a), and MELD score were included in the multivariate Cox regression analysis, HDL-c (HR = 1.844, P = 0.024) was the only independent predictor of death.ConclusionsDecreased levels in specific components of lipid profile indicate more decompensation events, worse liver function, and reduced survival in liver cirrhosis. MELD score combined with HDL-c should be promising for the assessment of outcomes of cirrhotic patients.

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