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

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.

• Authors: Ayse L Mindikoglu, Cristian Coarfa, Antone R Opekun, Vijay H Shah, Juan P Arab, Konstantinos N Lazaridis, Nagireddy Putluri, Chandrashekar R Ambati, Matthew J Robertson, Sridevi Devaraj, Prasun K Jalal, Abbas Rana, John A Goss, Thomas C Dowling, Matthew R Weir, Stephen L Seliger, Jean-Pierre Raufman, David W Bernard, John M Vierling
• Journal: Future science OA (Future Sci OA) Vol. 6 Issue 2 Pg. FSO441 (Dec 17 2019) ISSN: 2056-5623 [Print] England
• PMID: 32025330 (Publication Type: Journal Article)
• Copyright: © 2019 The authors.