Related Experiment Videos
Development and validation of a GDF-15-albumin-CRP score for predicting Cachexia in Asian patients with decompensated
Shuangzhe Yao1, Binbin Peng1, Lingyu Ren1
1Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, China.
Background & Aims:
Cachexia is prevalent and prognostically adverse in decompensated cirrhosis. Diagnosis is challenging, especially in Asian populations, due to limitations of current criteria and scoring systems. This study aimed to develop and validate a biomarker-based model for predicting cachexia defined by the Asian Working Group for Cachexia (AWGC) in cirrhotic patients.
Methods:
In this retrospective cohort study, 420 patients with decompensated cirrhosis were enrolled (295 in the training cohort, 125 in the external validation cohort). Cachexia was diagnosed according to AWGC criteria. LASSO regression selected predictive serum biomarkers. A nomogram-derived GDF-15-Albumin-CRP score was constructed, and its performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration, and decision curve analysis (DCA).
Results:
In the training cohort, 158 patients (53.56%) had cachexia. LASSO regression identified serum growth differentiation factor-15 (GDF-15), albumin, and C-reactive protein (CRP) as the strongest predictors. The resulting GDF-15-Albumin-CRP score achieved an AUC of 0.736 (95% CI: 0.680-0.792) for cachexia prediction, significantly outperforming Child-Turcotte-Pugh (CTP), Model for End-Stage Liver Disease (MELD), and MELD-Na scores (all P < 0.05). DCA demonstrated clinical net benefit across a wide range of threshold probabilities. The score exhibited a strong risk gradient for cachexia (adjusted OR for the high- vs. low-risk group: 7.58; 95% CI: 2.68-21.46). External validation confirmed its performance (AUC = 0.723, 95% CI: 0.630-0.810).
Conclusions:
The GDF-15-Albumin-CRP score is a validated and clinically feasible tool predicting AWGC-defined cachexia in Asian cirrhotic patients, superior to traditional severity scores and potentially enabling earlier targeted intervention.
