학술논문
Pretreatment gamma‐glutamyl transferase predicts mortality in patients with chronic hepatitis B treated with nucleotide/nucleoside analogs
Document Type
Report
Author
Jang, Tyng‐Yuan; Liang, Po‐Cheng; Jun, Dae Won; Jung, Jang Han; Toyoda, Hidenori; Wang, Chih‐Wen; Yuen, Man‐Fung; Cheung, Ka Shing; Yasuda, Satoshi; Kim, Sung Eun; Yoon, Eileen L.; An, Jihyun; Enomoto, Masaru; Kozuka, Ritsuzo; Chuma, Makoto; Nozaki, Akito; Ishikawa, Toru; Watanabe, Tsunamasa; Atsukawa, Masanori; Arai, Taeang; Hayama, Korenobu; Ishigami, Masatoshi; Cho, Yong Kyun; Ogawa, Eiichi; Kim, Hyoung Su; Shim, Jae‐Jun; Uojima, Haruki; Jeong, Soung Won; Ahn, Sang Bong; Takaguchi, Koichi; Senoh, Tomonori; Buti, Maria; Vargas‐Accarino, Elena; Abe, Hiroshi; Takahashi, Hirokazu; Inoue, Kaori; Huang, Jee‐Fu; Chuang, Wan‐Long; Yeh, Ming‐Lun; Dai, Chia‐Yen; Huang, Chung‐Feng; Nguyen, Mindie H.; Yu, Ming‐Lung
Source
The Kaohsiung Journal of Medical Sciences. February, 2024, Vol. 40 Issue 2, p188, 10 p.
Subject
Language
English
ISSN
1607-551X
Abstract
Elevated serum gamma‐glutamyl transferase (GGT) levels are associated with chronic hepatitis B (CHB)‐related hepatocellular carcinoma. However, their role in predicting mortality in patients with CHB treated with nucleotide/nucleoside analogs (NAs) remains elusive. Altogether, 2843 patients with CHB treated with NAs were recruited from a multinational cohort. Serum GGT levels before and 6 months (Month‐6) after initiating NAs were measured to explore their association with all‐cause, liver‐related, and non‐liver‐related mortality. The annual incidence of all‐cause mortality was 0.9/100 person‐years over a follow‐up period of 17,436.3 person‐years. Compared with patients who survived, those who died had a significantly higher pretreatment (89.3 vs. 67.4 U/L, p = 0.002) and Month‐6‐GGT levels (62.1 vs. 38.4 U/L, p < 0.001). The factors associated with all‐cause mortality included cirrhosis (hazard ratio [HR]/95% confidence interval [CI]: 2.66/1.92–3.70, p < 0.001), pretreatment GGT levels (HR/CI: 1.004/1.003–1.006, p < 0.001), alanine aminotransferase level (HR/CI: 0.996/0.994–0.998, p = 0.001), and age (HR/CI: 1.06/1.04–1.07, p < 0.001). Regarding liver‐related mortality, the independent factors included cirrhosis (HR/CI: 4.36/2.79–6.89, p < 0.001), pretreatment GGT levels (HR/CI: 1.006/1.004–1.008, p < 0.001), alanine aminotransferase level (HR/CI: 0.993/0.990–0.997, p = 0.001), age (HR/CI: 1.03/1.01–1.05, p < 0.001), and fatty liver disease (HR/CI: 0.30/0.15–0.59, p = 0.001). Pretreatment GGT levels were also independently predictive of non‐liver‐related mortality (HR/CI: 1.003/1.000–1.005, p = 0.03). The results remained consistent after excluding the patients with a history of alcohol use. A dose‐dependent manner of 75 percentile of pretreatment GGT levels was observed with respect to the all‐cause mortality (trend p < 0.001). Pretreatment serum GGT levels predicted all‐cause, liver‐related, and non‐liver‐related mortality in patients with CHB treated with NAs.
Abbreviations INTRODUCTION Hepatitis B virus (HBV) infection affects approximately 300 million people worldwide. Owing to the growing burden of HBV‐related death, it remains a major threat to global public health.[sup.1] [...]
Abbreviations INTRODUCTION Hepatitis B virus (HBV) infection affects approximately 300 million people worldwide. Owing to the growing burden of HBV‐related death, it remains a major threat to global public health.[sup.1] [...]