Predictive ability of liver-fatty acid binding protein for all-cause mortality in patients with hepatic encephalopathy: A prospective observational study

Abstract

Purpose: We investigated the ability of serum and urine Liver-Fatty Acid Binding Protein levels to predict mortality in patients with hepatic encephalopathy and/or compensated cirrhosis. Materials and methods: We enrolled 48 patients with cirrhosis (19 hepatic encephalopathy, 29 compensated cirrhosis) and 20 control individuals. Serum and urine Liver-Fatty Acid Binding Protein levels were determined. Patients were prospectively followed for three months. Results: Cox regression analyses showed that urine liver- fatty acid binding protein levels, Model for End-Stage Liver Disease-Sodium scores, and Child-Turcot-Pugh scores were independent predictors of mortality. Receiver operating characteristic curve analyses showed that serum levels of liver- fatty acid binding protein (>8057.5 ng/L), urine liver-fatty acid binding protein (>9892.5 ng/L), and ammonia (>65.5 µg/dL), as well as the Model for End-Stage Liver Disease-Sodium (>21.5) and Child-Turcot-Pugh (>10.5) scores, predict mortality in patients with hepatic encephalopathy. Similarly, the areas under the curve for serum liver-fatty acid binding protein (AUC, 0.701), urine liver- fatty acid binding protein (0.692), and serum ammonia (0.898) levels, as well as Model for End-Stage Liver Disease-Sodium (0.934) and Child-Turcot-Pugh (0.966) scores predicted mortality in patients with hepatic encephalopathy. Conclusion: Liver-Fatty Acid Binding Protein levels predict mortality in patients with hepatic encephalopathy.

Amaç: Hepatik ensefalopati ve/veya kompanze sirozu olan hastalarda serum ve idrar Liver- Fatty Acid Binding Protein seviyelerinin mortaliteyi öngörme kabiliyetini araştırdık. Gereç ve yöntem: Bu çalışmaya 48 siroz hastası (19 hepatik ensefalopati, 29 kompanze siroz) ve kontrol grubuna ise 20 kişi dahil edildi. Serum ve idrar Liver-Fatty Acid Binding Protein seviyeleri ölçüldü. Hastalar prospektif olarak üç ay takip edildi. Bulgular: Cox regresyon analizi, idrar Liver-Fatty Acid Binding Protein seviyeleri, Model for End-Stage Liver Disease-Sodium skoru, and Child-Turcot-Pugh skoru mortalitenin bağımsız belirleyicileri olduğunu gösterdi. "Receiver operating characteristic curve" analizleri, serum liver-fatty acid binding protein (>8057.5 ng/L), idrar liver- fatty acid binding protein (>9892.5 ng/L), and serum amonyak seviyeleri (>65.5 µg/dL), Model for End-Stage Liver Disease-Sodium (>21.5) ve Child-Turcot-Pugh (>10.5) skorları hepatic ensefalopatii hastalarda mortaliteyi öngördüğü gösterildi. Benzer olarak, eğri altında kalan alana bakıldığında, serum liver-fatty acid binding protein (AUC, 0.701), idrar liver- fatty acid binding protein (0.692), and serum amonyak (0.898) seviyeleri, ek olarak Model for End-Stage Liver Disease-Sodium (0.934) ve Child-Turcot-Pugh (0.966) skorları hepatic ensefalopatili hastalarda mortaliteyi öngördüğü gösterildi. Sonuç: Liver-Fatty Acid Binding Protein seviyeleri hepatic ensefalopatili hastalarda mortaliteyi predikte eder.