Role of HDL-C as a Predictor of Development of Complications in Patients with Stable Decompensated Cirrhosis

Abstract

Background: Chronic liver disease (CLD) is a major global health issue, with a growing number of cases and a significant impact on patient health and survival. The liver plays a crucial role in lipid metabolism, including synthesizing and regulating lipoproteins. The study was done to determine the development of more accurate predictive models for CLD progression, complementing existing tools such as the Model for End-Stage Liver Disease (MELD) and Child-Pugh scores.

Materials and methods: A prospective observational cohort study was conducted at the Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India. The study has been conducted for 15 months after obtaining ethical clearance, i.e., from December 2022 to March 2024. Ethical approval has been obtained from the Institutional Ethics Committee (IEC), IGIMS, Patna, Bihar, India under letter number 836/IEC/IGIMS/2022 dated 10 December 2022.

Results: The mean age ± standard deviation is 48.45 ± 13.72 years. The range is 15 to 75. Eighty-one males make up the study population, which is 81% male. Nineteen females represent 19% of the total. P-values were found to be significant at less than 0.05 at three months, six months, and twelve months in both CTP and MELD levels while correlating with HDL. The main complications that were observed were acute kidney injury, ascites, variceal bleeding, and SBP.

Conclusion: Serum HDL-C has emerged as a strong predictor of complication in patients with stable decompensated patients. It has the potential to become an essential part of management strategies, aiding in the prioritization of patients with decompensated CLD for liver transplantation. However, larger, multicenter prospective studies are necessary to validate these findings before recommending the routine use of HDL-C in clinical settings.

Keywords: Chronic liver disease, cirrhosis, High-density lipoprotein, Liver, ascites, Acute Kidney Injury