Urinary L-FABP is a promising prognostic biomarker of ACLF and mortality in patients with decompensated cirrhosis

Background & aims: Decompensated cirrhosis (DC) is associated with high mortality, mainly owing to the development of acute-on-chronic liver failure (ACLF). Identifying the patients with DC who are at high risk of mortality and ACLF development is an unmet clinical need. Liver fatty acid-binding...

ver descrição completa

Detalhes bibliográficos
Autores: Juanola Mayos, Adrià, Graupera, Isabel, Elia, Chiara, Piano, Salvatore, Solé, Cristina, Carol, Marta, Pérez-Guasch, Martina, Bassegoda, Octavi, Escudé, Laia, Rubio, Ana Belén, Cervera, Marta, Napoleone, Laura, Avitabile, Emma, Ma, Ann T., Fabrellas i Padrès, Núria, Pose Méndez, Elisa, Morales Ruiz, Manuel, Jiménez Povedano, Wladimiro, Torres, Ferran, Crespo Conde, Gonzalo, Solà, Elsa, Ginès i Gibert, Pere
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Recursos:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/216456
Acesso em linha:https://hdl.handle.net/2445/216456
Access Level:acceso abierto
Palavra-chave:Anàlisi d'orina
Àcids grassos
Fetge
Cirrosi hepàtica
Marcadors bioquímics
Urine analysis
Fatty acids
Liver
Hepatic cirrhosis
Biochemical markers
id ES_c862ffcb3a99b576ca75e86512cff75b
oai_identifier_str oai:diposit.ub.edu:2445/216456
network_acronym_str ES
network_name_str España
repository_id_str
spelling Urinary L-FABP is a promising prognostic biomarker of ACLF and mortality in patients with decompensated cirrhosisJuanola Mayos, Adrià Graupera, IsabelElia, ChiaraPiano, SalvatoreSolé, CristinaCarol, MartaPérez-Guasch, MartinaBassegoda, OctaviEscudé, LaiaRubio, Ana BelénCervera, MartaNapoleone, LauraAvitabile, EmmaMa, Ann T.Fabrellas i Padrès, NúriaPose Méndez, ElisaMorales Ruiz, ManuelJiménez Povedano, WladimiroTorres, FerranCrespo Conde, GonzaloSolà, ElsaGinès i Gibert, PereAnàlisi d'orinaÀcids grassosFetgeCirrosi hepàticaMarcadors bioquímicsUrine analysisFatty acidsLiverHepatic cirrhosisBiochemical markersBackground & aims: Decompensated cirrhosis (DC) is associated with high mortality, mainly owing to the development of acute-on-chronic liver failure (ACLF). Identifying the patients with DC who are at high risk of mortality and ACLF development is an unmet clinical need. Liver fatty acid-binding protein (L-FABP) is expressed in several organs and correlates with liver and systemic inflammation. Herein, we aimed to assess the prognostic value of L-FABP in patients with DC. Methods: A prospective series of 444 patients hospitalized for DC was divided into 2 cohorts: study cohort (305 patients) and validation cohort (139 patients). L-FABP was measured in urine and plasma samples collected at admission. Neutrophil gelatinase-associated lipocalin (NGAL) was also measured in urine samples for comparison. Results: Urine but not plasma L-FABP correlated with 3-month survival on univariate analysis. On multivariate analysis, urine L-FABP and model for end-stage liver disease (MELD)-Na were the only independent predictors of prognosis. Urine L-FABP levels were higher in patients with ACLF than in those without and also predicted the development of ACLF, together with MELD-Na, during follow-up. In patients with ACLF, urine L-FABP correlated with liver, coagulation, and circulatory failure. Urine L-FABP levels were also increased in patients with acute kidney injury, particularly in those with acute tubular necrosis. The ability of urinary L-FABP to predict survival and ACLF development was confirmed in the validation cohort. Urine NGAL predicted outcome on univariate but not multivariate analysis. Conclusions: Urinary L-FABP levels are independently associated with the 3-month clinical course in patients with DC, in terms of mortality and ACLF development. Urinary L-FABP is a promising prognostic biomarker for patients with DC.Elsevier2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/216456Articles publicats en revistes (Biomedicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1016/j.jhep.2021.08.031Journal of Hepatology, 2022, vol. 76, num.1, p. 107-114https://doi.org/10.1016/j.jhep.2021.08.031cc-by-nc-nd (c) Juanola, Adrià et al., 2021http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/2164562026-05-27T06:46:51Z
dc.title.none.fl_str_mv Urinary L-FABP is a promising prognostic biomarker of ACLF and mortality in patients with decompensated cirrhosis
title Urinary L-FABP is a promising prognostic biomarker of ACLF and mortality in patients with decompensated cirrhosis
spellingShingle Urinary L-FABP is a promising prognostic biomarker of ACLF and mortality in patients with decompensated cirrhosis
Juanola Mayos, Adrià
Anàlisi d'orina
Àcids grassos
Fetge
Cirrosi hepàtica
Marcadors bioquímics
Urine analysis
Fatty acids
Liver
Hepatic cirrhosis
Biochemical markers
title_short Urinary L-FABP is a promising prognostic biomarker of ACLF and mortality in patients with decompensated cirrhosis
title_full Urinary L-FABP is a promising prognostic biomarker of ACLF and mortality in patients with decompensated cirrhosis
title_fullStr Urinary L-FABP is a promising prognostic biomarker of ACLF and mortality in patients with decompensated cirrhosis
title_full_unstemmed Urinary L-FABP is a promising prognostic biomarker of ACLF and mortality in patients with decompensated cirrhosis
title_sort Urinary L-FABP is a promising prognostic biomarker of ACLF and mortality in patients with decompensated cirrhosis
dc.creator.none.fl_str_mv Juanola Mayos, Adrià
Graupera, Isabel
Elia, Chiara
Piano, Salvatore
Solé, Cristina
Carol, Marta
Pérez-Guasch, Martina
Bassegoda, Octavi
Escudé, Laia
Rubio, Ana Belén
Cervera, Marta
Napoleone, Laura
Avitabile, Emma
Ma, Ann T.
Fabrellas i Padrès, Núria
Pose Méndez, Elisa
Morales Ruiz, Manuel
Jiménez Povedano, Wladimiro
Torres, Ferran
Crespo Conde, Gonzalo
Solà, Elsa
Ginès i Gibert, Pere
author Juanola Mayos, Adrià
author_facet Juanola Mayos, Adrià
Graupera, Isabel
Elia, Chiara
Piano, Salvatore
Solé, Cristina
Carol, Marta
Pérez-Guasch, Martina
Bassegoda, Octavi
Escudé, Laia
Rubio, Ana Belén
Cervera, Marta
Napoleone, Laura
Avitabile, Emma
Ma, Ann T.
Fabrellas i Padrès, Núria
Pose Méndez, Elisa
Morales Ruiz, Manuel
Jiménez Povedano, Wladimiro
Torres, Ferran
Crespo Conde, Gonzalo
Solà, Elsa
Ginès i Gibert, Pere
author_role author
author2 Graupera, Isabel
Elia, Chiara
Piano, Salvatore
Solé, Cristina
Carol, Marta
Pérez-Guasch, Martina
Bassegoda, Octavi
Escudé, Laia
Rubio, Ana Belén
Cervera, Marta
Napoleone, Laura
Avitabile, Emma
Ma, Ann T.
Fabrellas i Padrès, Núria
Pose Méndez, Elisa
Morales Ruiz, Manuel
Jiménez Povedano, Wladimiro
Torres, Ferran
Crespo Conde, Gonzalo
Solà, Elsa
Ginès i Gibert, Pere
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Anàlisi d'orina
Àcids grassos
Fetge
Cirrosi hepàtica
Marcadors bioquímics
Urine analysis
Fatty acids
Liver
Hepatic cirrhosis
Biochemical markers
topic Anàlisi d'orina
Àcids grassos
Fetge
Cirrosi hepàtica
Marcadors bioquímics
Urine analysis
Fatty acids
Liver
Hepatic cirrhosis
Biochemical markers
description Background & aims: Decompensated cirrhosis (DC) is associated with high mortality, mainly owing to the development of acute-on-chronic liver failure (ACLF). Identifying the patients with DC who are at high risk of mortality and ACLF development is an unmet clinical need. Liver fatty acid-binding protein (L-FABP) is expressed in several organs and correlates with liver and systemic inflammation. Herein, we aimed to assess the prognostic value of L-FABP in patients with DC. Methods: A prospective series of 444 patients hospitalized for DC was divided into 2 cohorts: study cohort (305 patients) and validation cohort (139 patients). L-FABP was measured in urine and plasma samples collected at admission. Neutrophil gelatinase-associated lipocalin (NGAL) was also measured in urine samples for comparison. Results: Urine but not plasma L-FABP correlated with 3-month survival on univariate analysis. On multivariate analysis, urine L-FABP and model for end-stage liver disease (MELD)-Na were the only independent predictors of prognosis. Urine L-FABP levels were higher in patients with ACLF than in those without and also predicted the development of ACLF, together with MELD-Na, during follow-up. In patients with ACLF, urine L-FABP correlated with liver, coagulation, and circulatory failure. Urine L-FABP levels were also increased in patients with acute kidney injury, particularly in those with acute tubular necrosis. The ability of urinary L-FABP to predict survival and ACLF development was confirmed in the validation cohort. Urine NGAL predicted outcome on univariate but not multivariate analysis. Conclusions: Urinary L-FABP levels are independently associated with the 3-month clinical course in patients with DC, in terms of mortality and ACLF development. Urinary L-FABP is a promising prognostic biomarker for patients with DC.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/216456
url https://hdl.handle.net/2445/216456
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1016/j.jhep.2021.08.031
Journal of Hepatology, 2022, vol. 76, num.1, p. 107-114
https://doi.org/10.1016/j.jhep.2021.08.031
dc.rights.none.fl_str_mv cc-by-nc-nd (c) Juanola, Adrià et al., 2021
http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc-nd (c) Juanola, Adrià et al., 2021
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv Articles publicats en revistes (Biomedicina)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869419281228234752
score 15,812429

Registos relacionados