Albumin-Related Ratios Investigated in HBV-Associated Decompensated Cirrhosis
By LabMedica International staff writers Posted on 25 Mar 2022 |
Decompensated cirrhosis (DeCi) is a terminal liver disease characterized by various complications and associated with dramatically reduced survival. Liver transplantation is the most effective therapy for hepatitis B virus (HBV)-DeCi.
Serum albumin is considered a biomarker of malnutrition–inflammation syndrome, and there is emerging data that hypoalbuminemia is related to worse survival in intensive care unit patients. Albumin has multiple functions and plays important roles in liver disease severity, progression, and prognosis.
Clinical Laboratorians at The Second Affiliated Hospital Zhejiang University (Zhengzhou, China) enrolled a total of 161 HBV-DeCi patients. The main causes of admission were ascites (n = 120, 74.5%), gastrointestinal bleeding (n = 36, 22.5%), hepatorenal syndrome (n = 22, 14.0%), and encephalopathy (n = 10, 6.2%). Twenty-four patients (15.0%) had more than one feature of decompensation at presentation.
Laboratory variables (total bilirubin, total protein, albumin, blood urea nitrogen [BUN], creatinine, aspartate aminotransferase, alanine aminotransferase, C-reactive protein [CRP], white blood count [WBC], platelet count, hemoglobin, neutrophil count, plasma D-dimer, and international normalized ratio [INR]), and HBV-DNA levels, as well as hepatitis B e antigen status, were recorded at admission. Severity of liver disease and prognosis were assessed using the Model for End-Stage Liver Disease (MELD) score.
The investigators reported that a total of 29 (18.0%) patients had died 30 days after admission. The prognostic roles of C-reactive protein-to-albumin ratio (CAR), D-dimer-to-albumin ratio (DAR), prothrombin time-international normalized ratio-to-albumin ratio (PTAR), neutrophil count-to-albumin (NAR), and blood urea nitrogen-to-albumin ratio (BAR) in HBV-DeCi were different. CAR, PTAR, NAR, and BAR were significantly higher in non-survivors compared with survivors. However, DAR did not differ between the two groups. The predictive power of BAR was superior to that of the other four albumin-related biomarkers and similar to that of MELD score. On multivariate analysis, BAR and MELD score were identified as independent prognostic factors, and the combination of BAR and MELD score may improve the prognostic accuracy in HBV-DeCi.
The authors concluded that they had evaluated five albumin-related ratios (CAR, DAR, PTAR, NAR, and BAR) for the prediction of mortality in HBV-DeCi patients. Their study suggests that BAR can be a simple, effective, and useful prognostic tool to predict poor outcomes in HBV-DeCi patients and that use of a combination of BAR and MELD score can improve the prognostic accuracy. The study was published on March 17, 2022 in the Journal of Clinical Laboratory Analysis.
Related Links:
The Second Affiliated Hospital Zhejiang University
Latest Clinical Chem. News
- 3D Printed Point-Of-Care Mass Spectrometer Outperforms State-Of-The-Art Models
- POC Biomedical Test Spins Water Droplet Using Sound Waves for Cancer Detection
- Highly Reliable Cell-Based Assay Enables Accurate Diagnosis of Endocrine Diseases
- New Blood Testing Method Detects Potent Opioids in Under Three Minutes
- Wireless Hepatitis B Test Kit Completes Screening and Data Collection in One Step
- Pain-Free, Low-Cost, Sensitive, Radiation-Free Device Detects Breast Cancer in Urine
- Spit Test Detects Breast Cancer in Five Seconds
- Electrochemical Sensors with Next-Generation Coating Advances Precision Diagnostics at POC
- First-Of-Its-Kind Handheld Device Accurately Detects Fentanyl in Urine within Seconds
- New Fluorescent Sensor Array Lights up Alzheimer’s-Related Proteins for Earlier Detection
- Automated Mass Spectrometry-Based Clinical Analyzer Could Transform Lab Testing
- Highly Sensitive pH Sensor to Aid Detection of Cancers and Vector-Borne Viruses
- Non-Invasive Sensor Monitors Changes in Saliva Compositions to Rapidly Diagnose Diabetes
- Breakthrough Immunoassays to Aid in Risk Assessment of Preeclampsia
- Urine Test for Monitoring Changes in Kidney Health Markers Can Predict New-Onset Heart Failure
- AACC Releases Comprehensive Diabetes Testing Guidelines