International Journal of General Medicine (Aug 2022)

Serum Nitric Oxide Level Serves as a Potential Prognostic Biomarker in ACLF Patients

  • Wang F,
  • Tai M,
  • He Y,
  • Tian Z

Journal volume & issue
Vol. Volume 15
pp. 6713 – 6723

Abstract

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Fei Wang,1,* Minghui Tai,1,* Yajuan He,1 Zhen Tian1,2 1Department of Ultrasound, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China; 2Department of Infectious Diseases, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhen Tian, Department of Ultrasound, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277 Yanta Road (w), Xi’an, 710061, People’s Republic of China, Tel +86 186 8290 3901, Fax +86 029 85234641, Email [email protected] and Aim: Fewer than 50% of patients with acute-on-chronic liver failure (ACLF) recover spontaneously, and without liver transplantation, ACLF is associated with high death rates. Nitric oxide (NO) has a role in the pathogenesis of various liver disorders. We investigated if serum NO level could be used as a biomarker to predict the severity and prognosis of patients with ACLF.Methods: Between January 2018 and September 2020, a retrospective cohort of 120 ACLF patients, as well as healthy and cirrhotic controls, was investigated. The serum NO levels were measured using a commercial ELISA kit, and Kaplan–Meier survival analysis was conducted.Results: ACLF patients had significantly higher serum NO levels than healthy and cirrhotic controls. Multivariate analysis indicated that the serum NO level (HR=1.078, 95% CI 1.031– 1.126, P 53.5 μmol/L was associated with a significant increase in the risk of mortality or liver transplantation. A combination of serum NO level and MELD score to assess the severity and prognosis of ACLF patients showed enhanced performance.Conclusion: Based on serum NO levels at the time of hospital admission, ACLF patients may be divided into high-risk and low-risk groups. The combination of serum NO level and MELD score is more closely linked to the patient’s outcome than either value alone. This method might be used to evaluate patient prognoses and select candidates for liver transplantation.Keywords: acute on chronic liver failure, autophagy, nitric oxide, reactive oxygen species, prediction

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