Meta-Analysis

肝硬化患者胱抑素C水平与全因死亡率的关系:一项荟萃分析

卷 31, 期 25, 2024

发表于: 02 January, 2024

页: [3977 - 3986] 页: 10

弟呕挨: 10.2174/0109298673247263231123114043

价格: $65

摘要

背景与目的:血胱抑素C水平已被引入作为一种有前景的生物标志物来检测肝硬化患者早期肾损伤。本荟萃分析的目的是研究肝硬化患者血胱抑素C水平与全因死亡率的关系。 方法:从研究开始到2022年11月15日,检索了PubMed、ScienceDirect和Embase数据库。观察性研究评估血胱抑素C水平在预测ACS患者全因死亡率中的价值。采用随机效应模型荟萃分析计算95%置信区间(CI)的综合危险风险(HR)。 结果:对1983例肝硬化患者进行了12项研究。高胱抑素C水平组与低胱抑素C水平组的全因死亡率合并调整后HR为3.59 (95% CI 2.39-5.39)。通过研究设计、患者特征、地理区域、样本量、随访时间等进行分层分析,进一步支持胱抑素C水平升高的预测值。 结论:胱抑素C水平升高是肝硬化患者生存不良的独立预测因子。检测血胱抑素C水平可能为肝硬化患者提供重要的预后信息。

关键词: 肝硬化、胱抑素C、全因死亡率、荟萃分析、置信区间(CI)、危险风险(HR)。

[1]
Fortea, J.I.; Crespo, J.; Puente, Á. Cirrhosis, a global and challenging disease. J. Clin. Med., 2022, 11(21), 6512.
[http://dx.doi.org/10.3390/jcm11216512] [PMID: 36362738]
[2]
Sepanlou, S.G.; Safiri, S.; Bisignano, C.; Ikuta, K.S.; Merat, S.; Saberifiroozi, M.; Poustchi, H.; Tsoi, D.; Colombara, D.V.; Abdoli, A.; Adedoyin, R.A.; Afarideh, M.; Agrawal, S.; Ahmad, S.; Ahmadian, E.; Ahmadpour, E.; Akinyemiju, T.; Akunna, C.J.; Alipour, V.; Almasi-Hashiani, A.; Almulhim, A.M.; Al-Raddadi, R.M.; Alvis-Guzman, N.; Anber, N.H.; Angus, C.; Anoushiravani, A.; Arabloo, J.; Araya, E.M.; Asmelash, D.; Ataeinia, B.; Ataro, Z.; Atout, M.M.W.; Ausloos, F.; Awasthi, A.; Badawi, A.; Banach, M.; Bejarano Ramirez, D.F.; Bhagavathula, A.S.; Bhala, N.; Bhattacharyya, K.; Biondi, A.; Bolla, S.R.; Boloor, A.; Borzì, A.M.; Butt, Z.A.; Cámera, L.L.A.A.; Campos-Nonato, I.R.; Carvalho, F.; Chu, D-T.; Chung, S-C.; Cortesi, P.A.; Costa, V.M.; Cowie, B.C.; Daryani, A.; de Courten, B.; Demoz, G.T.; Desai, R.; Dharmaratne, S.D.; Djalalinia, S.; Do, H.T.; Dorostkar, F.; Drake, T.M.; Dubey, M.; Duncan, B.B.; Effiong, A.; Eftekhari, A.; Elsharkawy, A.; Etemadi, A.; Farahmand, M.; Farzadfar, F.; Fernandes, E.; Filip, I.; Fischer, F.; Gebremedhin, K.B.B.; Geta, B.; Gilani, S.A.; Gill, P.S.; Gutirrez, R.A.; Haile, M.T.; Haj-Mirzaian, A.; Hamid, S.S.; Hasankhani, M.; Hasanzadeh, A.; Hashemian, M.; Hassen, H.Y.; Hay, S.I.; Hayat, K.; Heidari, B.; Henok, A.; Hoang, C.L.; Hostiuc, M.; Hostiuc, S.; Hsieh, V.C.; Igumbor, E.U.; Ilesanmi, O.S.; Irvani, S.S.N.; Jafari Balalami, N.; James, S.L.; Jeemon, P.; Jha, R.P.; Jonas, J.B.; Jozwiak, J.J.; Kabir, A.; Kasaeian, A.; Kassaye, H.G.; Kefale, A.T.; Khalilov, R.; Khan, M.A.; Khan, E.A.; Khater, A.; Kim, Y.J.; Koyanagi, A.; La Vecchia, C.; Lim, L-L.; Lopez, A.D.; Lorkowski, S.; Lotufo, P.A.; Lozano, R.; Magdy Abd El Razek, M.; Mai, H.T.; Manafi, N.; Manafi, A.; Mansournia, M.A.; Mantovani, L.G.; Mazzaglia, G.; Mehta, D.; Mendoza, W.; Menezes, R.G.; Mengesha, M.M.; Meretoja, T.J.; Mestrovic, T.; Miazgowski, B.; Miller, T.R.; Mirrakhimov, E.M.; Mithra, P.; Moazen, B.; Moghadaszadeh, M.; Mohammadian-Hafshejani, A.; Mohammed, S.; Mokdad, A.H.; Montero-Zamora, P.A.; Moradi, G.; Naimzada, M.D.; Nayak, V.; Negoi, I.; Nguyen, T.H.; Ofori-Asenso, R.; Oh, I-H.; Olagunju, T.O.; Padubidri, J.R.; Pakshir, K.; Pana, A.; Pathak, M.; Pourshams, A.; Rabiee, N.; Radfar, A.; Rafiei, A.; Ramezanzadeh, K.; Rana, S.M.M.; Rawaf, S.; Rawaf, D.L.; Reiner, R.C., Jr; Roever, L.; Room, R.; Roshandel, G.; Safari, S.; Samy, A.M.; Sanabria, J.; Sartorius, B.; Schmidt, M.I.; Senthilkumaran, S.; Shaikh, M.A.; Sharif, M.; Sharifi, A.; Shigematsu, M.; Singh, J.A.; Soheili, A.; Suleria, H.A.R.; Teklehaimanot, B.F.; Tesfay, B.E.; Vacante, M.; Vahedian-Azimi, A.; Valdez, P.R.; Vasankari, T.J.; Vu, G.T.; Waheed, Y.; Weldegwergs, K.G.; Werdecker, A.; Westerman, R.; Wondafrash, D.Z.; Wondmieneh, A.B.; Yeshitila, Y.G.; Yonemoto, N.; Yu, C.; Zaidi, Z.; Zarghi, A.; Zelber-Sagi, S.; Zewdie, K.A.; Zhang, Z-J.; Zhao, X-J.; Naghavi, M.; Malekzadeh, R. The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol. Hepatol., 2020, 5(3), 245-266.
[http://dx.doi.org/10.1016/S2468-1253(19)30349-8] [PMID: 31981519]
[3]
Juanola, A.; Ma, A.T.; Pose, E.; Ginès, P. Novel biomarkers of AKI in cirrhosis. Semin. Liver Dis., 2022, 42(4), 489-500.
[http://dx.doi.org/10.1055/a-1954-4136] [PMID: 36191596]
[4]
Wong, F.; O’Leary, J.G.; Reddy, K.R.; Garcia-Tsao, G.; Fallon, M.B.; Biggins, S.W.; Subramanian, R.M.; Thuluvath, P.J.; Kamath, P.S.; Patton, H.; Maliakkal, B.; Tandon, P.; Vargas, H.; Thacker, L.; Bajaj, J.S. Acute kidney injury in cirrhosis: Baseline serum creatinine predicts patient outcomes. Am. J. Gastroenterol., 2017, 112(7), 1103-1110.
[http://dx.doi.org/10.1038/ajg.2017.122] [PMID: 28440305]
[5]
Wong, F. Acute kidney injury in liver cirrhosis: New definition and application. Clin. Mol. Hepatol., 2016, 22(4), 415-422.
[http://dx.doi.org/10.3350/cmh.2016.0056] [PMID: 27987536]
[6]
Yoo, J.J.; Kim, S.G.; Kim, Y.S.; Lee, B.; Lee, M.H.; Jeong, S.W.; Jang, J.Y.; Lee, S.H.; Kim, H.S.; Kim, Y.D.; Cheon, G.J. Estimation of renal function in patients with liver cirrhosis: Impact of muscle mass and sex. J. Hepatol., 2019, 70(5), 847-854.
[http://dx.doi.org/10.1016/j.jhep.2018.12.030] [PMID: 30630010]
[7]
Francoz, C.; Sola, E. Assessment of renal function in cirrhosis: Sarcopenia, gender and ethnicity matter. J. Hepatol., 2019, 70(5), 828-830.
[http://dx.doi.org/10.1016/j.jhep.2019.02.004] [PMID: 30833013]
[8]
Mussap, M.; Plebani, M. Biochemistry and clinical role of human cystatin C. Crit. Rev. Clin. Lab. Sci., 2004, 41(5-6), 467-550.
[http://dx.doi.org/10.1080/10408360490504934] [PMID: 15603510]
[9]
Shimizu-Tokiwa, A.; Kobata, M.; Io, H.; Kobayashi, N.; Shou, I.; Funabiki, K.; Fukui, M.; Horikoshi, S.; Shirato, I.; Saito, K.; Tomino, Y. Serum cystatin C is a more sensitive marker of glomerular function than serum creatinine. Nephron J., 2002, 92(1), 224-226.
[http://dx.doi.org/10.1159/000064453] [PMID: 12187109]
[10]
Seo, Y.S.; Jung, E.S.; An, H.; Kim, J.H.; Jung, Y.K.; Kim, J.H.; Yim, H.J.; Yeon, J.E.; Byun, K.S.; Kim, C.D.; Ryu, H.S.; Um, S.H. Serum cystatin C level is a good prognostic marker in patients with cirrhotic ascites and normal serum creatinine levels. Liver Int., 2009, 29(10), 1521-1527.
[http://dx.doi.org/10.1111/j.1478-3231.2009.02105.x] [PMID: 19725889]
[11]
Ahn, H.S.; Kim, Y.S.; Kim, S.G.; Kim, H.K.; Min, S.K.; Jeong, S.W.; Jang, J.Y.; Lee, S.H.; Kim, H.S.; Kim, B.S.; Park, J.M. Cystatin C is a good predictor of hepatorenal syndrome and survival in patients with cirrhosis who have normal serum creatinine levels. Hepatogastroenterology, 2012, 59(116), 1168-1173.
[PMID: 22057374]
[12]
Finkenstedt, A.; Dorn, L.; Edlinger, M.; Prokop, W.; Risch, L.; Griesmacher, A.; Graziadei, I.; Vogel, W.; Zoller, H. Cystatin C is a strong predictor of survival in patients with cirrhosis: Is a cystatin C -based MELD better? Liver Int., 2012, 32(8), 1211-1216.
[http://dx.doi.org/10.1111/j.1478-3231.2012.02766.x] [PMID: 22380485]
[13]
Maiwall, R.; Kumar, A.; Bhardwaj, A.; Kumar, G.; Bhadoria, A.S.; Sarin, S.K. Cystatin C predicts acute kidney injury and mortality in cirrhotics: A prospective cohort study. Liver Int., 2018, 38(4), 654-664.
[http://dx.doi.org/10.1111/liv.13600] [PMID: 28941301]
[14]
Seo, Y.S.; Park, S.Y.; Kim, M.Y.; Kim, S.G.; Park, J.Y.; Yim, H.J.; Jang, B.K.; Park, S.H.; Kim, J.H.; Suk, K.T.; Kim, J.D.; Kim, T.Y.; Cho, E.Y.; Lee, J.S.; Jung, S.W.; Jang, J.Y.; An, H.; Tak, W.Y.; Baik, S.K.; Hwang, J.S.; Kim, Y.S.; Sohn, J.H.; Um, S.H. Serum cystatin C level: An excellent predictor of mortality in patients with cirrhotic ascites. J. Gastroenterol. Hepatol., 2018, 33(4), 910-917.
[http://dx.doi.org/10.1111/jgh.13983] [PMID: 28910501]
[15]
Kim, T.H.; Lee, H.A.; Seo, Y.S.; Lee, Y.R.; Yim, S.Y.; Lee, Y.S.; Suh, S.J.; Jung, Y.K.; Kim, J.H.; An, H.; Yim, H.J.; Yeon, J.E.; Byun, K.S.; Um, S.H. Assessment and prediction of acute kidney injury in patients with decompensated cirrhosis with serum cystatin C and urine N-acetyl-β-D-glucosaminidase. J. Gastroenterol. Hepatol., 2019, 34(1), 234-240.
[http://dx.doi.org/10.1111/jgh.14387] [PMID: 30062791]
[16]
Torner, M.; Mangal, A.; Scharnagl, H.; Jansen, C.; Praktiknjo, M.; Queck, A.; Gu, W.; Schierwagen, R.; Lehmann, J.; Uschner, F.E.; Graf, C.; Strassburg, C.P.; Fernandez, J.; Stojakovic, T.; Woitas, R.; Trebicka, J. Sex specificity of kidney markers to assess prognosis in cirrhotic patients with TIPS. Liver Int., 2020, 40(1), 186-193.
[http://dx.doi.org/10.1111/liv.14230] [PMID: 31448496]
[17]
Padia, G.; Mahajan, B.; Kumar, A.; Sonika, U.; Dahale, A.S.; Sachdeva, S.; Dalal, A.; George, R. Cystatin C and interleukin-6 for prognosticating patients with acute decompensation of cirrhosis. JGH Open, 2021, 5(4), 459-464.
[http://dx.doi.org/10.1002/jgh3.12516] [PMID: 33860096]
[18]
Jo, S.K.; Yang, J.; Hwang, S.M.; Lee, M.S.; Park, S.H. Role of biomarkers as predictors of acute kidney injury and mortality in decompensated cirrhosis. Sci. Rep., 2019, 9(1), 14508.
[http://dx.doi.org/10.1038/s41598-019-51053-8] [PMID: 31601879]
[19]
Abd El Wahab, A.M.; Awadeen, A.; Mansour, M.M.; Shemies, R. The diagnostic and prognostic utility of serum cystatin C and angiopoietin 2 in patients with liver cirrhosis complicated by acute kidney injury. Ther. Apher. Dial., 2022.
[PMID: 36181409]
[20]
Moher, D; Liberati, A; Tetzlaff, J; Altman, DG Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Ann. Intern. Med., 2009, 151(4), 264-9.
[21]
Wells, G.; Shea, B.; O’Connell, D.; Peterson, J.; Welch, V.; Losos, M. The Newcastle–Ottawa Scale (NOS) for assessing the quality if nonrandomized studies in meta-analyses. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
[22]
Fahmy, O.; Fahmy, U.A.; Alhakamy, N.A.; Khairul-Asri, M.G. Single-port versus multiple-port robot-assisted radical prostatectomy: A systematic review and meta-analysis. J. Clin. Med., 2021, 10(24), 5723.
[http://dx.doi.org/10.3390/jcm10245723] [PMID: 34945018]
[23]
Aumpan, N; Limprukkasem, T; Pornthisarn, B; Vilaichone, RK; Chonprasertsuk, S; Bhanthumkomol, P Plasma Cystatin C level is a prognostic marker of morbidity and mortality in hospitalized decompensated cirrhotic patients. J. Med. Invest., 2021, 68(3.4), 302-8.
[24]
Grant, R.L. Converting an odds ratio to a range of plausible relative risks for better communication of research findings. BMJ, 2014, 348(jan24 1), f7450.
[http://dx.doi.org/10.1136/bmj.f7450] [PMID: 24464277]
[25]
Begg, C.B.; Mazumdar, M. Operating characteristics of a rank correlation test for publication bias. Biometrics, 1994, 50(4), 1088-1101.
[http://dx.doi.org/10.2307/2533446] [PMID: 7786990]
[26]
Egger, M.; Smith, G.D.; Schneider, M.; Minder, C. Bias in meta-analysis detected by a simple, graphical test. BMJ, 1997, 315(7109), 629-634.
[http://dx.doi.org/10.1136/bmj.315.7109.629] [PMID: 9310563]
[27]
Wu, J.; Wu, Q.; Wu, M.; Mao, W. Serum cystatin C predicts mortality in HBV-related decompensated cirrhosis. BioMed Res. Int., 2019, 2019, 1-6.
[http://dx.doi.org/10.1155/2019/7272045] [PMID: 30949507]
[28]
Mauro, E.; Crespo, G.; Martinez-Garmendia, A.; Gutierrez-Acevedo, M.N.; Diaz, J.M.; Saidman, J.; Bermudez, C.; Ortiz-Patron, J.; Garcia-Olveira, L.; Zalazar, F.; Narvaez, A.; Spina, J.C.; Orta, R.; Savluk, L.; Piano, S.; Marciano, S.; Gadano, A. Cystatin C and sarcopenia predict acute on chronic liver failure development and mortality in patients on the liver transplant waiting list. Transplantation, 2020, 104(7), e188-e198.
[http://dx.doi.org/10.1097/TP.0000000000003222] [PMID: 32150034]
[29]
Suksamai, A.; Chaiprasert, A.; Chirapongsathorn, S. Serum cystatin C as a predictor of 90-day mortality among patients admitted with complications of cirrhosis. JGH Open, 2021, 5(5), 607-613.
[http://dx.doi.org/10.1002/jgh3.12543] [PMID: 34013062]
[30]
Luo, J.; Wang, L.P.; Hu, H.F.; Zhang, L.; Li, Y.L.; Ai, L.M.; Mu, H.Y.; Kun-Wang Cystatin C and cardiovascular or all-cause mortality risk in the general population: A meta-analysis. Clin. Chim. Acta, 2015, 450, 39-45.
[http://dx.doi.org/10.1016/j.cca.2015.07.016] [PMID: 26192218]
[31]
Yang, S.; Song, L.; Zhao, L.; Dong, P.; Lai, L.; Wang, H. Predictive value of cystatin C in people with suspected or established coronary artery disease: A meta-analysis. Atherosclerosis, 2017, 263, 60-67.
[http://dx.doi.org/10.1016/j.atherosclerosis.2017.05.025] [PMID: 28599259]
[32]
Sun, Y.; Lu, Q.; Cheng, B.; Tao, X. Prognostic value of cystatin C in patients with acute coronary syndrome: A systematic review and meta-analysis. Eur. J. Clin. Invest., 2021, 51(3), e13440.
[http://dx.doi.org/10.1111/eci.13440] [PMID: 33128232]
[33]
Karvellas, C.J.; Durand, F.; Nadim, M.K. Acute kidney injury in cirrhosis. Crit. Care Clin., 2015, 31(4), 737-750.
[http://dx.doi.org/10.1016/j.ccc.2015.06.009] [PMID: 26410141]
[34]
Markwardt, D.; Holdt, L.; Steib, C.; Benesic, A.; Bendtsen, F.; Bernardi, M.; Moreau, R.; Teupser, D.; Wendon, J.; Nevens, F.; Trebicka, J.; Garcia, E.; Pavesi, M.; Arroyo, V.; Gerbes, A.L. Plasma cystatin C is a predictor of renal dysfunction, acute-on-chronic liver failure, and mortality in patients with acutely decompensated liver cirrhosis. Hepatology, 2017, 66(4), 1232-1241.
[http://dx.doi.org/10.1002/hep.29290] [PMID: 28545169]
[35]
Francoz, C.; Glotz, D.; Moreau, R.; Durand, F. The evaluation of renal function and disease in patients with cirrhosis. J. Hepatol., 2010, 52(4), 605-613.
[http://dx.doi.org/10.1016/j.jhep.2009.11.025] [PMID: 20185192]
[36]
Shlipak, M.G.; Katz, R.; Cushman, M.; Sarnak, M.J.; Stehman-Breen, C.; Psaty, B.M.; Siscovick, D.; Tracy, R.P.; Newman, A.; Fried, L. Cystatin-C and inflammatory markers in the ambulatory elderly. Am. J. Med., 2005, 118(12), 1416.e25-1416.e31.
[http://dx.doi.org/10.1016/j.amjmed.2005.07.060] [PMID: 16378798]
[37]
Mahassadi, A.K.; Konang, J.N.; Kissi, H.Y.; Afum-Adjei Awuah, A.; Bangoura, A.D.; Doffou, S.A.; Attia, A.K. Systemic inflammatory response syndrome and model for end-stage liver disease score accurately predict the in-hospital mortality of black African patients with decompensated cirrhosis at initial hospitalization: A retrospective cohort study. Clin. Exp. Gastroenterol., 2018, 11, 143-152.
[http://dx.doi.org/10.2147/CEG.S140655] [PMID: 29670387]
[38]
Yang, D.; Xie, Y.; Pan, H.; Huang, Y.; Dai, Y.; Tong, Y.; Chen, M. Clinical characteristics and prognostic factors of liver cirrhosis patients with systemic inflammatory response syndrome. Hepatol. Res., 2017, 47(11), 1174-1185.
[http://dx.doi.org/10.1111/hepr.12886] [PMID: 28249358]
[39]
Ladero, J.M.; Cárdenas, M.C.; Ortega, L.; González-Pino, A.; Cuenca, F.; Morales, C.; Lee-Brunner, A. Serum cystatin C: A non-invasive marker of liver fibrosis or of current liver fibrogenesis in chronic hepatitis C? Ann. Hepatol., 2012, 11(5), 648-651.
[http://dx.doi.org/10.1016/S1665-2681(19)31437-1] [PMID: 22947524]
[40]
Torre, A.; Aguirre-Valadez, J.M.; Arreola-Guerra, J.M.; García-Flores, O.R.; García-Juárez, I.; Cruz-Rivera, C.; Correa-Rotter, R.; Niño-Cruz, J.A. Creatinine versus cystatin C for estimating GFR in patients with liver cirrhosis. Am. J. Kidney Dis., 2016, 67(2), 342-344.
[http://dx.doi.org/10.1053/j.ajkd.2015.09.022] [PMID: 26530874]
[41]
Carrier, P.; Debette-Gratien, M.; Essig, M.; Loustaud-Ratti, V. Beyond serum creatinine: which tools to evaluate renal function in cirrhotic patients? Hepatol. Res., 2018, 48(10), 771-779.
[http://dx.doi.org/10.1111/hepr.13224] [PMID: 29954046]

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