Copeptin as a novel marker predicting prognosis of liver cirrhosis and its major complications

Figures & data

Table 1 Liver function tests among studied groups

		Group I		Group II		Group III	Group IV	Control	F test	P-value
		Compensated cirrhosis		Cirrhosis with GI hemorrhage due to PH		Cirrhosis with HRS	Cirrhosis with liver failure
Bilirubin (total) (mg/dL)	Range	0.5–1.9		0.8–8.4		0.5–10.8	0.7–3.57	0.5–1.66	4.789	0.003a
	Mean±SD	1.19±0.46		1.46±2.27		4.13±3.38	1.75±0.98	0.81±0.35
Tukey’s test	P1	P2	P3	P4	P5	P6	P7	P8	P9	P10
	0.566	0.010a	0.964	0.992	0.296	0.915	0.307	0.053	0.003a	0.804
ALT (U/L)	Range	25–44		18–77		13–125	11–70	15–40	1.176	0.334
	Mean±SD	34.9±7.50		37.4±18.32		38.5±33.41	38.6±17.88	22.86±7.27
Tukey’s test	P1	P2	P3	P4	P5	P6	P7	P8	P9	P10
	0.998	0.994	0.993	0.638	0.999	0.999	0.458	0.999	0.384	0.378
AST (U/L)	Range	31–89		27–120		10–220	26–180	10–42	2.170	0.088
	Mean±SD	54.3±24.66		61.6±34.62		62.8±59.92	77.3±45.49	28.6±9.03
Tukey’s test	P1	P2	P3	P4	P5	P6	P7	P8	P9	P10
	0.992	0.988	0.674	0.568	0.999	0.899	0.312	0.917	0.286	0.051
Albumin (g/dL)	Range	3–3.8		1.8–3.34		1.8–2.6	1.4–2.8	3.5–3.97	40.436	0.001a
	Mean±SD	3.41±0.26		2.71±0.42		2.22±0.27	2.26±0.48	3.75±0.19
Tukey’s test	P1	P2	P3	P4	P5	P6	P7	P8	P9	P10
	0.001a	0.001a	0.001a	0.197	0.018a	0.036a	0.001a	0.999	0.001a	0.001a

Notes: P1 (group I and group II), P2 (group I and group III), P3 (group I and group IV), P4 (group I and control), P5 (group II and group III), P6 (group II and group IV), P7 (group II and control), P8 (group III and group IV), P9 (group III and control), and P10 (group IV and control).

a Significant P-value <0.05.

Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; GI, gastrointestinal; HRS, hepatorenal syndrome; PH, portal hypertension.

Table 2 Child score among studied groups

Child score		Group				Total
		Group I	Group II	Group III	Group IV
		Compensated cirrhosis	Cirrhosis with GI hemorrhage due to PH	Cirrhosis with HRS	Cirrhosis with liver failure
A	N	10	1	0	0	11
	%	100.0%	10.0%	0.0%	0.0%	27.5%
B	N	0	5	4	6	15
	%	0.0%	50.0%	40.0%	60.0%	37.5%
C	N	0	4	6	4	14
	%	0.0%	40.0%	60.0%	40.0%	35.0%
Total	N	10	10	10	10	40
	%	100.0%	100.0%	100.0%	100.0%	100.0%
Chi-square	χ^2	36.689
	P-value	0.001*

Note:

* Statistically significant.

Abbreviations: GI, gastrointestinal; HRS, hepatorenal syndrome; PH, portal hypertension.

Table 3 Serum copeptin (pmol/L) among studied groups

Copeptin (pmol/L)	Group I		Group II		Group III		Group IV		Control
	Compensated cirrhosis		Cirrhosis with GI hemorrhage due to PH		Cirrhosis with HRS		Cirrhosis with liver failure
Range	4.2–10.6		16.1–28.5		10.2–17.5		7.6–14.8		2.0–7.2
Mean±SD	6.46±1.68		21.08±4.11		13.29±2.72		10.04±2.13		4.29±1.52
F test	63.863
P-value	0.001*
Tukey’s test
P1	P2	P3	P4	P5	P6	P7	P8	P9	P10
0.001*	0.001*	0.028*	0.352	0.001*	0.001*	0.001*	0.057	0.001*	0.001*

Notes: P1 (group I and group II), P2 (group I and group III), P3 (group I and group IV), P4 (group I and control), P5 (group II and group III), P6 (group II and group IV), P7 (group II and control), P8 (group III and group IV), P9 (group III and control), and P10 (group IV and control).

* Statistically significant.

Abbreviations: GI, gastrointestinal; HRS, hepatorenal syndrome; PH, portal hypertension.

Table 4 Linear correlation between copeptin and some parameters in studied groups

	Copeptin
	R	P
Creatinine	0.598	0.036*
Urea	0.685	0.003*
Bilirubin	0.220	0.125
Albumin	−0.863	0.001*
INR	0.730	0.002*
Na	−0.810	0.001*
Child score	0.898	0.001*
MELD	0.493	0.066

Note:

* Statistically significant.

Abbreviations: INR, international normalized ratio; MELD, Model for End-stage Liver Disease.

Figure 1 ROC of copeptin.

Abbreviation: ROC, receiver operating curve.

Table 5 Sensitivity and specificity of copeptin at a cutoff value of 7 pmol/L in diagnosis of different groups

	Sensitivity	Specificity	PPV	NPV
Group I	78	85	83	81
Group II	94	97	96	98
Group III	88	90	91	93
Group IV	82	83	89	87

Notes: Group I: compensated cirrhosis; Group II: cirrhosis with gastrointestinal (GI) hemorrhage due to portal hypertension; Group III: cirrhosis with HRS; Group IV: cirrhosis with liver cell failure. Group V (10 controls): Normal healthy individuals.

Abbreviations: PPV, positive predictive value; NPV, negative predictive value.