Association of lipid profile with decompensation, liver dysfunction, and mortality in patients with liver cirrhosis

ABSTRACT

Background and Aims

Lipid metabolism is often disrupted in liver cirrhosis. The present study aimed to evaluate the impact of lipid profile on decompensation events, severity of liver dysfunction, and death in patients with liver cirrhosis.

Methods

In a cross-sectional study, 778 patients with lipid profile data were enrolled, and then were divided into 240 and 538 patients with and without liver cirrhosis, respectively. In a cohort study, 314 cirrhotic patients with lipid profile data, who were prospectively followed, were enrolled. Lipid profile included total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-c), low-density lipoprotein-cholesterol (LDL-c), triglycerides (TG), and lipoprotein(a).

Results

In the cross-sectional study, cirrhotic patients with decompensation events had significantly lower levels of TC and lipoprotein(a) than those without; and cirrhotic patients with Child-Pugh class B and C had significantly lower levels of TC, HDL-c, LDL-c, and lipoprotein(a) than those with Child-Pugh class A. In the cohort study, there was an inverse association of survival with TC, HDL-c, and lipoprotein(a) levels; after adjusting for MELD score, TC (Hazard Ratio [HR] = 1.703, P = 0.034) and HDL-c (HR = 2.036, P = 0.005), but not lipoprotein(a) (HR = 1.377, P = 0.191), remained a significant predictor of death; when TC, HDL-c, lipoprotein(a), and MELD score were included in the multivariate Cox regression analysis, HDL-c (HR = 1.844, P = 0.024) was the only independent predictor of death.

Conclusions

Decreased levels in specific components of lipid profile indicate more decompensation events, worse liver function, and reduced survival in liver cirrhosis. MELD score combined with HDL-c should be promising for the assessment of outcomes of cirrhotic patients.

KEYWORDS:

• Liver cirrhosis
• lipid
• dyslipidemia
• decompensation
• death

Supplementary material

Supplemental data for this article can be accessed here.

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Conceptualization: XQ; Methodology: RF, YK, XX, CH, and XQ; Formal analysis: RF, XX, CH, and XQ; Investigation: RF, CH, and XQ; Data curation: RF, YK, XX, CH, and XQ; Writing–original draft: RF, YK, XX, and XQ; Writing–review and editing: RF, YK, XX, CH, WZ, YA, CAP, AM, XG, and XQ; Supervision: XQ, XG; Project administration: XQ, XG. All authors have made an intellectual contribution to the manuscript and approved the submission.

Acknowledgments

We are indebted to our study team, including Wenchun Bao, Feifei Hou, Zeqi Guo, Jingqiao Zhang, Xinmiao Zhou, Miaomiao Li, Cen Hong, Ruirui Feng, and Yanglan He, of whom all had worked for our study group for establishing and updating the database which prospectively enrolled the patients treated by Dr. Xingshun Qi. We are also indebted to our study team, including Han Deng, Ran Wang, Xiangbo Xu, Zhaohui Bai, Qianqian Li, Kexin Zheng, Le Wang, Fangfang Yi, Yanyan Wu, Li Luo, Mengyuan Peng, Yue Yin, and Shixue Xu, of whom all had worked for our study group for establishing and updating the database which prospectively and consecutively enrolled cirrhotic patients.

Declaration of interest

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was partially supported by the Science and Technology Project Foundation of Shenyang (19-112-4-005) and Science and Technology Plan Project of Liaoning Province (2,020,020,267-JH2/103).