Combined MELD and blood lipid level in evaluating the prognosis of decompensated cirrhosis

Jiang, Ming; Liu, Fei; Xiong, Wu-Jun; Zhong, Li-Ye; Xu, Wen; Xu, Fei; Liu, Yanbing

doi:10.3748/wjg.v16.i11.1397

Cited by 35 publications

(34 citation statements)

References 14 publications

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“…Correlation between the CTP score in liver cirrhosis patients and lipid serum levels has been observed, suggesting that this parameter can be used to estimate the prognosis of liver cirrhosis patients (19) . Malignant neoplasia carriers present increased triglycerides, glycerol and free fatty acids serum levels as they loose adipose tissue, characterizing a state of lipolysis and lipid peripheral synthesis reduction (40) .…”

Section: Discussionmentioning

confidence: 99%

“…The triglyceride serum levels were within normality in most patients from both groups, though they presented lower mean values in group CI. Different results showing reduction in the triglyceride and total cholesterol levels in HCC patients have also been described (19,21) . Racial disparities and dietary differences are possible causes for the difference in lipid metabolism between the cited studies.…”

Section: Discussionmentioning

confidence: 99%

“…Malignant neoplasia carriers present increased triglycerides, glycerol and free fatty acids serum levels as they loose adipose tissue, characterizing a state of lipolysis and lipid peripheral synthesis reduction (40) . HCC development is also related to the reduction in triglycerides and total decrease of cholesterol serum levels, with negative correlation between the size of the tumor and the triglycerides levels (19) . Some authors have observed reductions in the total cholesterol or HDL serum levels in liver cirrhosis patients (14) and in HCC (19) .…”

Section: Discussionmentioning

confidence: 99%

“…HCC development is also related to the reduction in triglycerides and total decrease of cholesterol serum levels, with negative correlation between the size of the tumor and the triglycerides levels (19) . Some authors have observed reductions in the total cholesterol or HDL serum levels in liver cirrhosis patients (14) and in HCC (19) . Likewise, increased triglyceride levels in this population have been reported (40) .…”

Section: Discussionmentioning

confidence: 99%

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Biochemical Nutritional Profile of Liver Cirrhosis Patients With Hepatocellular Carcinoma

Port

Oliveira

Soldera

et al. 2014

Arq. Gastroenterol.

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-Context -Liver cirrhosis patients with hepatocellular carcinoma present nutritional alterations and metabolic disorders that negatively impact the prognosis. Objective -The objective is to identify alterations in the metabolism of macro and micronutrients among liver cirrhosis patients with and without hepatocellular carcinoma and their relation to the Child-Turcote-Pugh score and Barcelona Clinic Liver Cancer staging. Methods -Analytical transversal study, with 31 hepatocellular carcinoma patients and 48 liver cirrhosis patients. Laboratorial exams were carried out. The existence of an association between the biochemical parameters and the disease severity as well as the presence of hepatocellular carcinoma was assessed. Results -The metabolic-nutritional profile of liver cirrhosis patients caused by the hepatitis C virus and hepatocellular carcinoma showed alterations, specifically the lipid (total cholesterol, HDL and triglycerides), protein (albumin, creatinine and uric acid), iron (transferrin, iron and ferritin saturation), hematocrit and hemoglobin, zinc and B12 vitamin profiles. There is a relation between nutritional biochemical markers and the Child-Turcote-Pugh, as well as Barcelona Clinic Liver Cancer staging. Conclusion -Considering the existence of alterations in the metabolism of nutrients in liver cirrhosis patients with and without hepatocellular carcinoma, and also that conventional nutritional assessment methods present limitations for this population, the biochemical laboratorial exams are valid to complement the diagnosis of the nutritional state in a quick and practical manner.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Biochemical Nutritional Profile of Liver Cirrhosis Patients With Hepatocellular Carcinoma

Port

Oliveira

Soldera

et al. 2014

Arq. Gastroenterol.

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show abstract

“…The importance of a circulating cholesterol supply for liver regeneration is exemplified following liver resection, where declining serum cholesterol coincides with intrahepatic cholesterol accumulation. In parallel, a serum total cholesterol concentration of below 2.8 mmol/L (108 mg/dL) in decompensated liver cirrhosis is associated with reduced transplant-free survival [55] . Additionally, among patients with non-cholestatic cirrhosis who underwent LT, a recipient serum total cholesterol level of below 1.8 mmol/L (69 mg/dL) at LT was associated with reduced post-LT graft outcome, independent of relevant donor, graft, and pre-operative recipient variables [56] .…”

Section: Regenerationmentioning

confidence: 99%

Cholesterol metabolism in cholestatic liver disease and liver transplantation: From molecular mechanisms to clinical implications

Nemes¹,

Åberg²,

Gylling³

et al. 2016

WJH

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The aim of this review is to enlighten the critical roles that the liver plays in cholesterol metabolism. Liver transplantation can serve as gene therapy or a source of gene transmission in certain conditions that affect cholesterol metabolism, such as low-density-lipoprotein (LDL) receptor gene mutations that are associated with familial hypercholesterolemia. On the other hand, cholestatic liver disease often alters cholesterol metabolism. Cholestasis can lead to formation of lipoprotein X (Lp-X), which is frequently mistaken for LDL on routine clinical tests. In contrast to LDL, Lp-X is non-atherogenic, and failure to differentiate between the two can interfere with cardiovascular risk assessment, potentially leading to prescription of futile lipid-lowering therapy. Statins do not effectively lower Lp-X levels, and cholestasis may lead to accumulation of toxic levels of statins. Moreover, severe cholestasis results in poor micellar formation, which reduces cholesterol absorption, potentially impairing the cholesterol-lowering effect of ezetimibe. Apolipoprotein B-100 measurement can help distinguish between atherogenic and non-atherogenic hypercholesterolemia. Furthermore, routine serum cholesterol measurements alone cannot reflect cholesterol absorption and synthesis. Measurements of serum non-cholesterol sterol biomarkers -such as cholesterol precursor sterols, plant sterols, and cholestanol -may help with the comprehensive assessment of cholesterol metabolism. An adequate cholesterol supply is essential for liver-regenerative capacity. Low preoperative and perioperative serum cholesterol levels seem to predict mortality in liver cirrhosis and after liver transplantation. Thus, accurate lipid profile evaluation is highly important in liver disease and after liver transplantation.

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Metabolomic and transcriptomic profiling of hepatocellular carcinomas in Hras12V transgenic mice

et al. 2017

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Activation of the Ras/MAPK pathway is prevalently involved in the occurrence and development of hepatocellular carcinoma (HCC). However, its effects on the deregulated cellular metabolic processes involved in HCC in vivo remain unknown. In this study, a mouse model of HCC induced by hepatocyte‐specific expression of the Hras12V oncogene was investigated using an integrative analysis of metabolomics and transcriptomics data. Consistent with the phenotype of abundant lipid droplets in HCC, the lipid biosynthesis in HCC was significantly enhanced by (1) a sufficient supply of acetyl‐CoA from enhanced glycolysis and citrate shuttle activity; (2) a sufficient supply of NADPH from enhanced pentose phosphate pathway (PPP) activity; (3) upregulation of key enzymes associated with lipid biosynthesis; and (4) downregulation of key enzymes associated with bile acid biosynthesis. In addition, glutathione (GSH) was significantly elevated, which may result from a sufficient supply of 5‐oxoproline and L‐glutamate as well as an enhanced reduction in the process of GSSG being turned into GSH by NADPH. The high level of GSH along with elevated Bcl2 and Ucp2 expression may contribute to a normal level of reactive oxygen species (ROS) in HCC. In conclusion, our results suggest that the lipid metabolism, glycolysis, PPP, tricarboxylic acid (TCA) cycle, citrate shuttle activity, bile acid synthesis, and redox homeostasis in the HCC induced by ras oncogene are significantly perturbed, and these altered metabolic processes may play crucial roles in the carcinogenesis, development, and pathological characteristics of HCC.

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Combined MELD and blood lipid level in evaluating the prognosis of decompensated cirrhosis

Abstract: MELD >or= 18 and TC

Cited by 35 publications

References 14 publications

Biochemical Nutritional Profile of Liver Cirrhosis Patients With Hepatocellular Carcinoma

Biochemical Nutritional Profile of Liver Cirrhosis Patients With Hepatocellular Carcinoma

Cholesterol metabolism in cholestatic liver disease and liver transplantation: From molecular mechanisms to clinical implications

Metabolomic and transcriptomic profiling of hepatocellular carcinomas in Hras12V transgenic mice

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