Cortisol in Peripheral Blood Predicts the Severity and Prognosis in Patients with Liver Failure at 90 Days

Abstract

Objective:To investigate the cortisol level in peripheral blood in evaluating the severity and prognosis of patients with liver failure. Methods: A total of 211 inpatients with liver failure were enrolled in Beijing You 'an Hospital affiliated with Capital Medical University, from September 2018 to January 2020. They were divided into three groups according to the severity of liver failure: early-stage liver failure, medium-stage liver failure and end-stage liver failure. In all patients, peripheral venous blood was gathered to detect the level of peripheral cortisol and related biochemical indexes. Logistic regression was used to screen the risk factors affecting the prognosis of patients at 90 days. A receiver operating curve (ROC) was used to reflect the value of cortisol on the prognosis of patients at 90 days. A model for end-stage liver disease (MELD) was accessed. Results: Among these 211 patients with liver failure, aged from 19 to 70 years, the average level of cortisol was 351.26 ± 129.78 nmol/L for 101 cases with early-stage liver failure, 281.05 ± 81.31 nmol/L for 58 cases with medium-stage liver failure, and 189.21 ± 89.27 nmol/L for 52 cases with end-stage liver failure (P < 0.05). The level of cortisol in the survival group and the non-survival group was 339.26 ± 121.19 nmol/L and 192.71 ± 67.23 nmol/L, respectively (P < 0.05). The results of logistics regression analysis showed that the odds ratio (OR) and 95% confidence intervals (CI) of cortisol were 1.025 and 1.013-1.038 nmol/L (P < 0.05). MELD results showed that patients with higher MELD scores had lower cortisol content. Conclusion:The level of cortisol is correlated with the severity of liver failure and decreases with the aggravation of liver failure, suggesting that the level of cortisol could be used as one of the indicators to evaluate the prognosis in patients with liver failure at 90 days.

Serum cortisol and prolactin levels as prognostic markers for complications of liver cirrhosis

“…In the current research, prolactin and cortisol levels were an independent risk factor, while PV Diameter, MELD score, Child Score, and Ascities were independent variables impacting the prognosis of patients with liver failure at 90 days. Binary logistic regression analysis, as reported by Zhang et al [16] , revealed that cortisol level and MELD score were independent risk factors. Levels below this cut off were associated with increased mortality and morbidity, and this was similar to a study by Zhang et al [16] in which the cut-off values for the prediction of mortality were identified for cortisol levels (252.3 nmol/L equal to 105 ng\dl).…”

“…Binary logistic regression analysis, as reported by Zhang et al [16] , revealed that cortisol level and MELD score were independent risk factors. Levels below this cut off were associated with increased mortality and morbidity, and this was similar to a study by Zhang et al [16] in which the cut-off values for the prediction of mortality were identified for cortisol levels (252.3 nmol/L equal to 105 ng\dl). In this study, the sensitivity and specificity for mortality based on cortisol AM level cut off 40ng/dl was 92,80, and the sensitivity and specificity for mortality based on cortisol PM level cut off 25 ng/dl was 88,80, respectively.…”

The Effects of Walnuts and Academic Stress on Mental Health, General Well-Being and the Gut Microbiota in a Sample of University Students: A Randomised Clinical Trial

“…Interestingly, our study found a significant moderate negative correlation between cortisol levels and bilirubin levels at visit 1 and visit 2, but a significant positive correlation at visit 3 (Figure 9), although bilirubin levels were within a healthy range. This relationship may warrant further study since cortisol levels have been negatively associated with chronic liver disease and depression is common in such patients [69,70]. Regarding α-amylase, a negative correlation with both total protein and total cholesterol was evident at visit 2, but not at visit 1 and visit 3 (Figure 9).…”