| High-density lipoprotein cholesterol as an indicator of liver function and prognosis in noncholestatic cirrhotics. | |
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MedLine Citation:
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PMID: 15765449 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND AIMS: The liver plays a central role in production and degradation of lipoproteins. Declining lipoprotein cholesterol may reflect deteriorating liver function. METHODS: We reviewed the records of 248 veterans with noncholestatic cirrhosis followed in our clinics or referred for liver transplantation between January 1, 1997 and October 31, 2002 (analysis period) and confirmed our findings prospectively in 165 noncholestatic cirrhotic veterans newly referred for liver transplantation between November 1, 2002 and May 1, 2004 (validation period). RESULTS: In the analysis group, albumin, bilirubin, INR, and Model for End-Stage Liver Disease (MELD) score correlated strongly with high-density lipoprotein (HDL) cholesterol, weakly but significantly with total cholesterol and very-low-density lipoprotein cholesterol (VLDL), and poorly with low-density lipoprotein cholesterol (LDL). Transplant-free mortality at 90, 180, and 365 days was 17/201 (8.5%), 19/173 (11.0%), and 38/119 (31.9%), respectively. Death at all 3 time points was associated with significantly lower initial levels of HDL, VLDL, and total cholesterol, but not LDL cholesterol. Of the lipoproteins, HDL was the best predictor of survival at 180 and 365 days (concordance statistics .86+/-.05 and .78+/-.05, respectively). By multivariate logistic regression, HDL cholesterol and MELD score were independent predictors of survival at 6 and 12 months. By Cox regression, HDL cholesterol below 30 mg/dL was associated with 3.4-fold increase in the hazard ratio for cirrhotic death. In the validation period, HDL cholesterol was confirmed to be significantly associated with death or transplantation at 6 or 12 months. CONCLUSIONS: HDL cholesterol in noncholestatic cirrhotic patients is a liver function test and an indicator of prognosis. |
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Authors:
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Adil Habib; Anastasios A Mihas; Souheil G Abou-Assi; Leslie M Williams; Edith Gavis; W Michael Pandak; Douglas M Heuman |
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Publication Detail:
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Type: Journal Article; Validation Studies |
Journal Detail:
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Title: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association Volume: 3 ISSN: 1542-3565 ISO Abbreviation: Clin. Gastroenterol. Hepatol. Publication Date: 2005 Mar |
Date Detail:
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Created Date: 2005-03-14 Completed Date: 2005-06-28 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 101160775 Medline TA: Clin Gastroenterol Hepatol Country: United States |
Other Details:
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Languages: eng Pagination: 286-91 Citation Subset: IM |
Affiliation:
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Department of Medicine, Virginia Commonwealth University Health Systems, Richmond, Virginia, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Biological Markers Cholesterol / blood Cholesterol, HDL / blood* Female Humans Liver Cirrhosis / blood, diagnosis*, surgery Liver Function Tests Liver Transplantation Male Outcome Assessment (Health Care) Prognosis Prospective Studies Retrospective Studies Survival Analysis |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Cholesterol, HDL; 57-88-5/Cholesterol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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