Metabolomic biomarkers are associated with mortality in patients with cirrhosis caused by primary biliary cholangitis or primary sclerosing cholangitis
JournalFuture Science OA
PublisherFuture Medicine Ltd.
MetadataShow full item record
AbstractAim: 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.
SponsorsNational Institutes of Health, NIH P30DK056338, 17RDM005, P30DK084567; Agilent Technologies: 0300016016; Cancer Prevention and Research Institute of Texas, CPRIT: R01DK111522, RP170005, RP170295.
primary biliary cholangitis
primary sclerosing cholangitis
Identifier to cite or link to this itemhttps://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