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Cholesterol esterification in plasma as a biomarker for liver function and prediction of mortality
BACKGROUND: Advanced stages of liver cirrhosis lead to a dramatically increased mortality. For valid identification of these patients suitable biomarkers are essential. The most important biomarkers for liver function are bilirubin and prothrombin time expressed as International Normalized Ratio (IN...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5397767/ https://www.ncbi.nlm.nih.gov/pubmed/28427335 http://dx.doi.org/10.1186/s12876-017-0614-9 |
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author | Kaiser, Thorsten Kinny-Köster, Benedict Bartels, Michael Berg, Thomas Scholz, Markus Engelmann, Cornelius Seehofer, Daniel Becker, Susen Ceglarek, Uta Thiery, Joachim |
author_facet | Kaiser, Thorsten Kinny-Köster, Benedict Bartels, Michael Berg, Thomas Scholz, Markus Engelmann, Cornelius Seehofer, Daniel Becker, Susen Ceglarek, Uta Thiery, Joachim |
author_sort | Kaiser, Thorsten |
collection | PubMed |
description | BACKGROUND: Advanced stages of liver cirrhosis lead to a dramatically increased mortality. For valid identification of these patients suitable biomarkers are essential. The most important biomarkers for liver function are bilirubin and prothrombin time expressed as International Normalized Ratio (INR). However, the influence of several anticoagulants on the prothrombin time limits its diagnostic value. Aim of this study was the evaluation of cholesterol esterification (CE) fraction (esterified cholesterol vs. total cholesterol) as an alternative biomarker for liver synthesis and mortality prediction. Under physiological conditions the CE fraction in blood is closely regulated by lecithin-cholesterol acyltransferase (LCAT) which is produced in the liver. METHODS: One hundred forty-two patients with liver disease clinically considered for orthotopic liver transplant for different indications were enrolled in the study. One patient was excluded because of the intake of a direct oral factor Xa inhibitor which has a strong impact on prothrombin time. RESULTS: Results of CE fraction were in good agreement with INR (R(2) = 0.73; p < 0.001). In patients who died or survived within three months mean CE fraction was 56% vs. 74% (p < 0.001) and mean INR was 2.0 vs. 1.3 (p < 0.001), respectively. The predictive value of CE fraction for three-month mortality risk was higher compared to INR (p = 0.04). Results for one-year mortality were comparable. CONCLUSIONS: The cholesterol esterification fraction is a valid biomarker for liver synthesis and allows reliable prediction of mortality. In contrast to INR, it is independent of anticoagulation and other analytical limitations of coagulation tests. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12876-017-0614-9) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5397767 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-53977672017-04-21 Cholesterol esterification in plasma as a biomarker for liver function and prediction of mortality Kaiser, Thorsten Kinny-Köster, Benedict Bartels, Michael Berg, Thomas Scholz, Markus Engelmann, Cornelius Seehofer, Daniel Becker, Susen Ceglarek, Uta Thiery, Joachim BMC Gastroenterol Research Article BACKGROUND: Advanced stages of liver cirrhosis lead to a dramatically increased mortality. For valid identification of these patients suitable biomarkers are essential. The most important biomarkers for liver function are bilirubin and prothrombin time expressed as International Normalized Ratio (INR). However, the influence of several anticoagulants on the prothrombin time limits its diagnostic value. Aim of this study was the evaluation of cholesterol esterification (CE) fraction (esterified cholesterol vs. total cholesterol) as an alternative biomarker for liver synthesis and mortality prediction. Under physiological conditions the CE fraction in blood is closely regulated by lecithin-cholesterol acyltransferase (LCAT) which is produced in the liver. METHODS: One hundred forty-two patients with liver disease clinically considered for orthotopic liver transplant for different indications were enrolled in the study. One patient was excluded because of the intake of a direct oral factor Xa inhibitor which has a strong impact on prothrombin time. RESULTS: Results of CE fraction were in good agreement with INR (R(2) = 0.73; p < 0.001). In patients who died or survived within three months mean CE fraction was 56% vs. 74% (p < 0.001) and mean INR was 2.0 vs. 1.3 (p < 0.001), respectively. The predictive value of CE fraction for three-month mortality risk was higher compared to INR (p = 0.04). Results for one-year mortality were comparable. CONCLUSIONS: The cholesterol esterification fraction is a valid biomarker for liver synthesis and allows reliable prediction of mortality. In contrast to INR, it is independent of anticoagulation and other analytical limitations of coagulation tests. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12876-017-0614-9) contains supplementary material, which is available to authorized users. BioMed Central 2017-04-20 /pmc/articles/PMC5397767/ /pubmed/28427335 http://dx.doi.org/10.1186/s12876-017-0614-9 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Kaiser, Thorsten Kinny-Köster, Benedict Bartels, Michael Berg, Thomas Scholz, Markus Engelmann, Cornelius Seehofer, Daniel Becker, Susen Ceglarek, Uta Thiery, Joachim Cholesterol esterification in plasma as a biomarker for liver function and prediction of mortality |
title | Cholesterol esterification in plasma as a biomarker for liver function and prediction of mortality |
title_full | Cholesterol esterification in plasma as a biomarker for liver function and prediction of mortality |
title_fullStr | Cholesterol esterification in plasma as a biomarker for liver function and prediction of mortality |
title_full_unstemmed | Cholesterol esterification in plasma as a biomarker for liver function and prediction of mortality |
title_short | Cholesterol esterification in plasma as a biomarker for liver function and prediction of mortality |
title_sort | cholesterol esterification in plasma as a biomarker for liver function and prediction of mortality |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5397767/ https://www.ncbi.nlm.nih.gov/pubmed/28427335 http://dx.doi.org/10.1186/s12876-017-0614-9 |
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