Serum cholesterol predicts transplant-free survival in cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt

Ballester, María Pilar; Lluch, Paloma; Tosca, Joan; Capilla, Mercedes Ramón; Gómez, Concepción; Moreno, Oswaldo; Jordán-Iborra, Carlota; Sunsundegui, Patricia; Argemí, Josepmaria; Guijarro, Jorge; Mínguez, Miguel

doi:10.1016/j.dld.2021.04.035

Cited by 6 publications

(5 citation statements)

References 22 publications

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“…SM content of LDL and HDL particles is similar [13], and it is well known that cirrhosis is associated with lower serum lipid levels [18,28,47]. In females with liver cirrhosis, the three SM species found to be related to albumin also correlated with HDL.…”

Section: Discussionmentioning

confidence: 84%

Gender-Specific Differences in Serum Sphingomyelin Species in Patients with Hepatitis C Virus Infection—Sphingomyelin Species Are Related to the Model of End-Stage Liver Disease (MELD) Score in Male Patients

Peschel

Weigand

Grimm

et al. 2023

IJMS

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Hepatitis C virus (HCV) replication depends on cellular sphingomyelin (SM), but serum SM composition in chronic HCV infection has been hardly analyzed. In this work, 18 SM species could be quantified in the serum of 178 patients with chronic HCV infection before therapy with direct-acting antivirals (DAAs) and 12 weeks later, when therapy was completed. Six SM species were higher in the serum of females than males before therapy and nine at the end of therapy; thus, sex-specific analysis was performed. Type 2 diabetes was associated with lower serum levels of SM 36:2;O2 and 38:2;O2 in men. Serum SM species did not correlate with the viral load in both sexes. Of note, three SM species were lower in males infected with HCV genotype 3 in comparison to genotype 1 infection. These SM species normalized after viral cure. SM 38:1;O2, 40:1;O2, 41:1;O2, and 42:1;O2 (and, thus, total SM levels) were higher in the serum of both sexes at the end of therapy. In males, SM 39:1;O2 was induced in addition, and higher levels of all of these SM species were already detected at 4 weeks after therapy has been started. Serum lipids are related to liver disease severity, and in females 15 serum SM species were low in patients with liver cirrhosis before initiation of and after treatment with DAAs. The serum SM species did not correlate with the model of end-stage liver disease (MELD) score in the cirrhosis and the non-cirrhosis subgroups in females. In HCV-infected male patients, nine SM species were lower in the serum of patients with cirrhosis before DAA treatment and eleven at the end of the study. Most of the SM species showed strong negative correlations with the MELD score in the male cirrhosis patients before DAA treatment and at the end of therapy. Associations of SM species with the MELD score were not detected in the non-cirrhosis male subgroup. In summary, the current analysis identified sex-specific differences in the serum levels of SM species in HCV infection, in liver cirrhosis, and during DAA therapy. Correlations of SM species with the MELD score in male but not in female patients indicate a much closer association between SM metabolism and liver function in male patients.

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Section: Discussionmentioning

confidence: 84%

Gender-Specific Differences in Serum Sphingomyelin Species in Patients with Hepatitis C Virus Infection—Sphingomyelin Species Are Related to the Model of End-Stage Liver Disease (MELD) Score in Male Patients

Peschel

Weigand

Grimm

et al. 2023

IJMS

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“…Results showed a significant inverse correlation between lipid markers and prognostic criteria (MELD and Child-Pugh score). A previous study showed that in decompensated cirrhosis, LDL, HDL, TC, and TG level decreases with an increase in MELD score (Ballester et al, 2021). A study conducted by Mylavarapu et al reported that TC level was a significant independent predictor of mortality (Mylavarapu et al, 2022).…”

Section: Discussionmentioning

confidence: 95%

Association Between Lipid Profile of Cirrhotic Patients and Prognostic Scores

RAZA,

KHAN,

KHAN

et al. 2023

Biol Clin Sci Res J

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The retrospective study was conducted in the Hepatology & Medicine Department of the hospital from January 2022 to January 2023 to assess the association of the lipid profile of cirrhotic patients with scores including MELD and Child-Pugh. The study included patients aged > 18 years who had cirrhosis due to hepatitis C infection. Demographic data, biochemical parameters, and MELD and Child-Pugh scores of the participants were recorded. Data were analyzed using SPSS version 23.0. Results showed a statistically significant inverse correlation between lipid fractions and Child-Pugh score (P<0.001). The higher MELD score was correlated with lower TG (P=0.003), VLDL (P=0.030), LDL (P<0.001), HDL (P<0.001), and TC (P<0.001) levels. There is a significant association between MELD and Child-Pugh prognostic markers and reduced lipid profiles of cirrhotic patients. These results suggest using a lipid profile as a supplemental tool for evaluating liver disease.

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“…Moreover, the diversion of portal blood flow into the systemic circulation decreases hepatic perfusion and deteriorates hepatic function. As such, biomarkers reflecting hepatic synthetic capacities, such as serum cholesterol and cholinesterase, were identified as predictors of post‐TIPS mortality, independent of the MELD score 90,91 . Another major consequence of portal‐systemic diversion is the increase in cardiac preload and the development of cardiac decompensation and pulmonary hypertension 92,93 .…”

Section: Other Prognostic Tools and Potential Biomarkersmentioning

confidence: 99%

“…As such, biomarkers reflecting hepatic synthetic capacities, such as serum cholesterol and cholinesterase, were identified as predictors of post-TIPS mortality, independent of the MELD score. 90,91 Another major consequence of portal-systemic diversion is the increase in cardiac preload and the development of cardiac decompensation and pulmonary hypertension. 92,93 Billey et al 94 identified several parameters that were significantly associated with cardiac decompensation after TIPS placement, including laboratory results (BNP and NT-pro BNP) and echocardiographic indices (E/A, E/e' ratio, and left ventricular ejection fraction).…”

Section: Potential Prognostic Biomarkersmentioning

confidence: 99%

A comprehensive review of prognostic scoring systems to predict survival after transjugular intrahepatic portosystemic shunt placement

Yang

Xiong

2022

Portal Hypertension & Cirrhosis

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Patient prognosis after transjugular intrahepatic portosystemic shunt (TIPS) placement is relatively poor and highly heterogeneous; therefore, a prognostic scoring system is essential for survival prediction and risk stratification. Conventional scores include the Child-Turcotte-Pugh (CTP) and model for end-stage liver disease (MELD) scores. The CTP score was created empirically and displayed a high correlation with post-TIPS survival. However, the inclusion of subjective parameters and the use of discrete cut-offs limit its utility. The advantages of the MELD score include its statistical validation and objective and readily available predictors that contribute to its broad application in clinical practice to predict post-TIPS outcomes. In addition, multiple modifications of the MELD score, by incorporating additional predictors (e.g., MELD-Sodium and MELD-Sarcopenia scores), adjusting coefficients (recalibrated MELD score), or combined (MELD 3.0), have been proposed to improve the prognostic ability of the standard MELD score. Despite several updates to conventional scores, a prognostic score has been proposed (based on contemporary data) specifically for outcome prediction after TIPS placement. However, this novel score (the Freiburg index of post-TIPS survival, FIPS) exhibited inconsistent discrimination in external validation studies, and its superiority over conventional scores remains undetermined. Additionally, several tools display potential for application in specific TIPS indications (e.g., bilirubin-platelet grade for refractory ascites), and biomarkers of systemic inflammation, nutritional status, liver disease progression, and cardiac decompensation may provide additional value, but require further validation. Future studies should consider the effect of TIPS placement when exploring predictors, as TIPS is a pathophysiological approach that substantially alters systemic hemodynamics and ameliorates bacterial translocation and malnutrition. K E Y W O R D S Child-Turcotte-Pugh (CTP) score, Freiburg index of post-TIPS survival (FIPS), model for endstage liver disease score (MELD), portal hypertension, prognosis, transjugular intrahepatic portosystemic shunt Key points • Multiple prognostic scores have been applied to predict post-transjugular intrahepatic portosystemic shunt (TIPS) survival, including conventional scores (e.g., Child-Turcotte-Pugh, a model for end-stage liver disease [MELD] and MELD-sodium scores) and scores based on contemporary data (e.g., MELD 3.0 and Freiburg index of post-TIPS survival score). • Novel prognostic biomarkers, especially those of systemic inflammation, nutritional status, liver disease severity, and cardiac decompensation could provide additional prognostic value for existing scoring systems.

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Serum cholesterol predicts transplant-free survival in cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt

Cited by 6 publications

References 22 publications

Gender-Specific Differences in Serum Sphingomyelin Species in Patients with Hepatitis C Virus Infection—Sphingomyelin Species Are Related to the Model of End-Stage Liver Disease (MELD) Score in Male Patients

Gender-Specific Differences in Serum Sphingomyelin Species in Patients with Hepatitis C Virus Infection—Sphingomyelin Species Are Related to the Model of End-Stage Liver Disease (MELD) Score in Male Patients

Association Between Lipid Profile of Cirrhotic Patients and Prognostic Scores

A comprehensive review of prognostic scoring systems to predict survival after transjugular intrahepatic portosystemic shunt placement

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