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    Metabolomic biomarkers are associated with mortality in patients with cirrhosis caused by primary biliary cholangitis or primary sclerosing cholangitis

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    Author
    Mindikoglu, A.L.
    Seliger, S.L.
    Raufman, J.-P.
    Date
    2020
    Journal
    Future Science OA
    Publisher
    Future Medicine Ltd.
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.2144/fsoa-2019-0124
    Abstract
    Aim: To assess the ability of signature metabolites alone, or in combination with the model for end-stage liver disease-Na (MELD-Na) score to predict mortality in patients with cirrhosis caused by primary biliary cholangitis or primary sclerosing cholangitis. Materials & methods: Plasma metabolites were detected using ultrahigh-performance liquid chromatography/tandem mass spectrometry in 39 patients with cirrhosis caused by primary biliary cholangitis or primary sclerosing cholangitis. Mortality was predicted using Cox proportional hazards regression and time-dependent receiver operating characteristic curve analyses. Results: The top five metabolites with significantly greater accuracy than the MELD-Na score (area under the receiver operating characteristic curve [AUROC] = 0.7591) to predict 1-year mortality were myo-inositol (AUROC = 0.9537), N-Acetylputrescine (AUROC = 0.9018), trans-Aconitate (AUROC = 0.8880), erythronate (AUROC = 0.8345) and N6-carbamoylthreonyladenosine (AUROC = 0.8055). Several combined MELD-Na-metabolite models increased the accuracy of predicted 1-year mortality substantially (AUROC increased from 0.7591 up to 0.9392). Conclusion: Plasma metabolites have the potential to enhance the accuracy of mortality predictions, minimize underestimates of mortality in patients with cirrhosis and low MELD-Na scores, and promote equitable allocation of donor livers. Copyright 2020 The authors.
    Sponsors
    National Institutes of Health, NIH P30DK056338, 17RDM005, P30DK084567; Agilent Technologies: 0300016016; Cancer Prevention and Research Institute of Texas, CPRIT: R01DK111522, RP170005, RP170295.
    Keyword
    biomarker
    cirrhosis
    liver transplantation
    MELD-Na score
    metabolite
    metabolomics
    mortality
    myo-inositol
    primary biliary cholangitis
    primary sclerosing cholangitis
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85079152538&doi=10.2144%2ffsoa-2019-0124&partnerID=40&md5=d04a775279b5f24dad9e89535cd4a51a; http://hdl.handle.net/10713/12029
    ae974a485f413a2113503eed53cd6c53
    10.2144/fsoa-2019-0124
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