New prognostic factor for hepatitis B virus‐related decompensated cirrhosis: Ratio of monocytes to HDL‐cholesterol

Abstract

Hepatitis B virus (HBV) infection is an important health problem worldwide and HBV-infected patients can develop liver failure, liver cirrhosis, and hepatocellular carcinoma, resulting in an annual death toll of more than 1 million patients. 1,2 In China, HBV is the major cause of liver cirrhosis, and approximately 3% of HBV-infected patients with compensated cirrhosis develop decompensated cirrhosis (DeCi) each year, with a 5-year survival rate of only 15%. [3][4][5] Liver transplantation is an only reliable life-prolonging intervention for patients suffering from this condition. However, a shortage of donor livers and serious post-transplantation complications have limited its application. Therefore, identification of specific biomarkers that allow early assessment of prognosis of HBV-DeCi patients has gained importance in clinical practice.It is well known that the systemic inflammatory status plays an important role in the pathogenesis of HBV infection. Several studies have demonstrated that inflammation is relatively common in patients with advanced cirrhosis and associated with poor outcomes. 6,7 Monocyte-to-HDL-cholesterol (HDL-C) ratio (MHR) was a newly proposed inflammatory biomarker. 8 Recently, MHR was reported to be closely associated with coronary heart disease, [9][10][11] atrial fibrillation, 12,13 hypertension, 14 chronic kidney disease, 15 and cerebrovascular accidents. 16 However, no studies have investigated

Effect of Cytokeratin-18, C-peptide, MHR, and MACK-3 Biomarkers in Metabolic Dysfunction-Associated Fatty Liver Disease After Laparoscopic Sleeve Gastrectomy

“…Other studies reported significant elevation in liver disease patients as hepatitis B virus-related acute liver failure and hepatocellular carcinoma. 51 - 53 …”

Hepatocyte-Derived Prostaglandin E2-Modulated Macrophage M1-Type Polarization via mTOR-NPC1 Axis-Regulated Cholesterol Transport from Lysosomes to the Endoplasmic Reticulum in Hepatitis B Virus x Protein-Related Nonalcoholic Steatohepatitis

“…In this study, we found that by improving the disturbance of hepatic cholesterol accumulation and KC polarization balance, we were able to reduce inflammatory injury and ultimately rescue the HBx-associated NASH phenotype, suggesting that the dysregulation of cholesterol homeostasis and MC polarization can be used as biomarkers of HBx-associated NASH immune injury. Reduced high-density lipoprotein cholesterol (HDL-C) and an elevated monocyte-to-HDL-C ratio (MHR) are significantly associated with mortality in HBV patients and can be used as prognostic biomarkers [ 46 , 47 ]. There is a complex association between the polarized phenotype of macrophages and HBV infection, with M1 activation indicating a strong immune response to HBV infection and M2 indicating persistent HBV infection, which is associated with disease progression [ 48 ].…”

The Clinical Significance of Lipids/Lipoproteins Impairment in the Context of Cirrhosis: An Updated Review

“…An elevated monocyteto-HDL-C ratio has been shown to be predictive of increased mortality in HBV-related decompensated cirrhotic patients. 58 The potential mechanisms involve that the inflammation triggers monocyte release into the peripheral blood and produces pro-inflammatory molecules, leading to acceleration of inflammatory reactions and adverse outcomes. 59 Meanwhile, HDL-C serves as an anti-inflammatory lipoprotein by binding and neutralizing bac-terial lipopolysaccharides to facilitate their excretion.…”