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Soluble CD163 Is a Predictor of Mortality in Patients With Decompensated Cirrhosis
Yue Zhang1, Chenkai Huang1, Yuan Nie1
1Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
Insights
Soluble CD163 (sCD163) effectively predicts outcomes in decompensated cirrhosis patients. Adding sCD163 to existing scores significantly improves prognostic accuracy for short-term and long-term survival.
Area of Science:
- Hepatology
- Biomarker Discovery
- Clinical Prognostics
Background:
- Soluble CD163 (sCD163), a macrophage-expressed protein, is linked to liver cirrhosis severity.
- Its potential as a prognostic biomarker in decompensated cirrhosis requires investigation.
Purpose of the Study:
- To evaluate the predictive value of sCD163 for patient outcomes in decompensated cirrhosis.
- To assess if sCD163 improves existing clinical scoring systems.
Main Methods:
- Prospective observational study of 345 decompensated cirrhosis patients.
- Plasma sCD163 levels measured by ELISA; patients followed for 6 months.
- Logistic regression and ROC analysis used to assess sCD163's predictive performance.
Main Results:
- Higher sCD163 levels in non-survivors; positive correlation with CTP, MELD, and ALBI scores.
- sCD163 independently predicted 28-day, 3-month, and 6-month mortality (AUROCs > 0.81).
- Incorporating sCD163 into CTP, MELD, and ALBI scores significantly enhanced their prognostic accuracy (P < 0.001).
Conclusions:
- sCD163 serves as a valuable prognostic biomarker for both short-term and long-term outcomes in decompensated cirrhosis.
- The integration of sCD163 into current clinical scoring systems offers improved predictive capabilities.
Abstract:
Background: Soluble CD163 (sCD163) is a scavenger receptor membrane protein expressed almost exclusively on Kupffer cells and other macrophages. It was found to be associated with the severity of liver cirrhosis. The aim of the present study was to determine whether the novel biomarker sCD163 predicts outcomes in patients with decompensated cirrhosis. Materials and Methods: A single-center, observational, prospective study with 345 decompensated cirrhosis patients was conducted in the Gastroenterology Department between January 2017 and December 2020. Their plasma samples were tested by enzyme-linked immunosorbent assay (ELISA) for sCD163 within 24 hours of admission. These patients were followed up at 28 days, 3 months and 6 months. The independent risk factors were identified with uni- and multivariate logistic regression analyses. We evaluated the predictive performance of the new scoring system (including sCD163) and the original scoring system. Results: The sCD163 level was significantly higher in non-surviving patients than in surviving patients. Positive associations were found between sCD163 levels and the Child-Turcotte-Pugh (CTP), Model for End-Stage Liver Disease (MELD) and albumin-bilirubin (ALBI) scores. Logistic regression confirmed that sCD163 was an independent risk factor for 28-day, 3-month, and 6-month mortality. The areas under the receiver operating characteristic curves (AUROCs) of the use of sCD163 for the prediction of 28-day, 3-month, and 6-month mortality were relatively higher (AUROCs: 0.856; 0.823 and 0.811, respectively). The AUROCs of the new scores obtained by adding sCD163 to the original scoring systems (CTP + sCD163, MELD + sCD163 and ALBI + sCD163) showed that the new scoring systems had better predictive performance than the original scoring systems at all time points (P < 0.001). Conclusion: sCD163 is a prognostic predictor of short-term and long-term outcomes in decompensated cirrhosis patients. Accordingly, the addition of sCD163 to the original clinical scoring systems improved their prognostic performance.
