Serum cholesterol: could it be a sixth parameter of Child-Pugh scoring system in cirrhotics due to viral hepatitis?

Abstract

OBJECTIVE:

To determine the association of serum cholesterol levels with Child-Pugh class in patients with decompensated chronic liver disease due to viral hepatitis.

STUDY DESIGN:

Cross-sectional analytical study.

PLACE AND DURATION OF STUDY:

Jinnah Postgraduate Medical Centre, Karachi, Medical Unit-III, Ward-7 from June to December 2010.

METHODOLOGY:

Consecutive patients attending outpatient department or admitted in medical unit III were eligible if they had a diagnosis of cirrhosis secondary to viral hepatitis. Patients were excluded if alcoholic, diabetic, hypertensive, or with non-alcoholic fatty liver disease, autoimmune, metabolic, cardiovascular, cerebrovascular or kidney diseases and recent use of lipid-regulating drugs. Serum lipid profile was determined after an overnight fast of 12 hours. On the basis of serum total cholesterol, patients were divided into four groups; Group I with serum total cholesterol ² 100 mg/dl, Group II with level of 101-150 mg/dl, Group III with level of 151-200 mg/dl and Group IV with serum total cholesterol level of > 200 mg/dl. Hepatic dysfunction was categorized according to Child-Pugh scoring system. Chi-square and Spearman's correlation testing with p < 0.05 was accepted as significant.

RESULTS:

One hundred and fourteen patients met the inclusion criteria with a mean age of 40.32 ± 13.59 years. Among these 32 were females (28.1%) while 82 were males (71.9%). According to Child-Pugh class; 34 patients (29.8%) presented with Child-Pugh class A, 34 (29.8%) in class B and 46 (40.4%) were in class C. Serum cholesterol (total) and triglycerides had significant association with Child-Pugh class (p = 0.0001 and p = 0.004 respectively) suggesting that as severity of liver dysfunction increases; serum cholesterol and triglycerides levels decrease. Results also revealed that males were significantly more hypocholesterolemic than females (p = 0.006).

CONCLUSION:

Hypocholesterolemia is a common finding in decompensated chronic liver disease and has got significant association with Child-Pugh class. It may increase the reliability of Child-Pugh classification in assessment of severity and prognosis in chronic liver disease patients.

• Authors: Amanullah Abbasi, Abdul Rabb Bhutto, Nazish Butt, Keshav Lal, S M Munir
• Journal: Journal of the College of Physicians and Surgeons--Pakistan : JCPSP (J Coll Physicians Surg Pak) Vol. 22 Issue 8 Pg. 484-7 (Aug 2012) ISSN: 1681-7168 [Electronic] Pakistan
• PMID: 22868011 (Publication Type: Journal Article)

Chemical References

• Triglycerides
• Cholesterol

Topics

• Adult
• Cholesterol (blood)
• Cross-Sectional Studies
• Female
• Hepatitis, Viral, Human (blood, complications)
• Humans
• Liver Cirrhosis (blood, complications, virology)
• Liver Diseases (complications)
• Logistic Models
• Male
• Middle Aged
• Predictive Value of Tests
• Prognosis
• Severity of Illness Index
• Sex Distribution
• Triglycerides (blood)