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1,5-Anhydroglucitol Predicts Mortality in Patients with HBV-Related Acute-on-chronic Liver Failure

Lingjian Zhang1, Yalei Zhao1, Zhongyang Xie1

  • 1State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.

Journal of Clinical and Translational Hepatology
|September 5, 2022
PubMed

Insights

Serum 1,5-anhydroglucitol (1,5AG) levels are significantly lower in non-survivors of Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). Lower 1,5AG indicates a poorer prognosis and can be used to predict mortality.

Area of Science:

  • Hepatology
  • Biochemistry
  • Clinical Diagnostics

Background:

  • Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is associated with high mortality.
  • 1,5-Anhydroglucitol (1,5AG) has shown activity in chronic liver disease.
  • The prognostic value of 1,5AG in HBV-ACLF remains to be elucidated.

Purpose of the Study:

  • To investigate the relationship between serum 1,5-anhydroglucitol (1,5AG) levels and prognosis in patients with HBV-ACLF.
  • To evaluate 1,5AG as a potential biomarker for predicting mortality in HBV-ACLF.

Main Methods:

  • Serum 1,5AG levels were measured in 333 HBV-ACLF patients, including those with and without diabetes.
  • Derivation and validation cohorts were established, with controls including patients with chronic hepatitis B, liver cirrhosis, and healthy individuals.
  • A novel predictive model (ACTIG) incorporating 1,5AG, age, total bilirubin, cholesterol, and INR was developed.

Main Results:

  • Serum 1,5AG levels were significantly lower in non-survivors compared to survivors in both derivation and validation cohorts.
  • 1,5AG demonstrated good predictive performance for 28-day mortality (AUC=0.811).
  • The ACTIG model showed superior predictive accuracy for 28-day mortality (AUC=0.914) compared to existing prognostic scores.

Conclusions:

  • Serum 1,5AG is a promising predictor of short-term mortality in HBV-ACLF patients.
  • The ACTIG model, utilizing 1,5AG, offers improved mortality prediction in HBV-ACLF.
  • Changes in 1,5AG distribution were observed in a mouse model of liver failure.
Abstract

Keywords:
1,5-anhydroglucitolAcute-on-chronic liver failurePrognosis

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