Low T3 syndrome is associated with poor prognosis in patients with hepatitis B virus-related acute-on-chronic liver failure

ABSTRACT

Background

Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a critical disease with high mortality risk. Low triiodothyronine syndrome (LT3S) is associated with various severe acute and chronic diseases. We investigated the relationship between LT3S and poor prognosis in patients with HBV-ACLF.

Research design and methods

A total of 198 patients with HBV-ACLF were enrolled between January 2018 and March 2019. We screened for independent risk factors for 28-day mortality using univariate and multivariate logistic regression analyses. Spearman’s correlation analysis was used to evaluate the correlation between LT3S and the poor prognostic parameters of HBV-ACLF.

Results

LT3S was an independent risk factor for 28-day mortality in HBV-ACLF patients (odds ratio: 4.035, 95% confidence interval 1.117–14.579; p = 0.033). The death group had a lower serum FT3 level (Z-value = 2639.000, p < 0.001). Serum FT3 levels were negatively correlated with age, C-reactive protein, international normalized ratio, and neutrophil count but positively correlated with lymphocyte count. A negative correlation between FT3 and various prognostic scores was observed, indicating that a low FT3 level was closely related to a poor prognosis.

Conclusions

LT3S was an independent risk factor for 28-day mortality and was correlated with poor prognosis in patients with HBV-ACLF.

KEYWORDS:

• Hepatitis B virus-related acute-on-chronic liver failure
• low triiodothyronine syndrome
• mortality
• prognosis
• retrospective

Author contributions

Y Xiong and Z Xia contributed equally to this work. J Huang, Y Xiong and Z Xia were involved in the conception and design; Y Xiong and L Yang participated in data collection; Y Xiong and Z Xia analysed and interpreted the data; Y Xiong drafted the paper and J Huang revised it critically. All authors read and agreed the published version of the manuscript.

Declaration of interests

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.

Reviewer disclosures

Peer reviewers on this manuscript have received an honorarium from Expert Review of Gastroenterology & Hepatology for their review work but have no other relevant financial relationships to disclose.

Additional information

Funding

This work was supported by the Chinese National Science and Technology Major Project (No. 2017ZX10203201).