ADAMTS-13: A Prognostic Biomarker for Portal Vein Thrombosis in Japanese Patients with Liver Cirrhosis
Abstract
:1. Introduction
2. Results
2.1. Comparison of Clinical Characteristics
2.2. Plasma ADAMTS-13:AC and vWF:Ag Levels
2.3. Predictors of PVT in Patients with LC
2.4. Kaplan–Meier Survival Curve Comparisons of Patients According to Optimal Cutoff Levels of ADAMTS-13:AC for PVT Diagnosis in LC
2.5. Correlations of Coagulation and Fibrinolysis Parameters with ADAMTS-13:AC and vWF:Ag
2.6. ADAMTS-13:AC Levels for Different Etiologies
3. Materials and Methods
3.1. Patients
3.2. Determination of ADAMTS-13:AC and vWF:Ag
3.3. Statistical Analyses
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Total (n = 66) | PVT Group (n = 33) | Non-PVT Group (n = 33) | p Value |
---|---|---|---|---|
Age (years) | 70.0 ± 8.8 | 70.0 ± 9.3 | 70.0 ± 8.4 | 0.95 |
Sex (M/F) | 40/23 | 20/13 | 20/13 | 1.0 |
Etiology (HBV/HCV/Alcohol/MASH/Others) | 7/25/13/7/14 | 6/12/7/2/6 | 1/13/6/5/8 | 0.26 |
Albumin (g/dL) | 3.2 ± 0.6 | 3.2 ± 0.55 | 3.3 ± 0.65 | 0.22 |
Prothrombin time (PT)-international normalized ratio | 1.22 ± 0.22 | 1.22 ± 0.16 | 1.21 ± 0.27 | 0.89 |
PT (%) | 72.1 ± 18 | 69 ± 15 | 74 ± 22 | 0.26 |
Total bilirubin (mg/dL) | 2.1 ± 2.1 | 1.3 ± 1.1 | 3.4 ± 3.3 | 0.40 |
C-reactive protein (mg/dL) | 0.65 ± 0.33 | 0.61 ± 0.34 | 0.69 ± 0.39 | 0.70 |
AST (IU/L) | 53 ± 31 | 52 ± 37 | 54 ± 22 | 0.80 |
ALT (IU/L) | 42 ± 37 | 39 ± 37 | 44 ± 22 | 0.64 |
γ-glutamyl transpeptidase (IU/L) | 80 ± 33 | 78 ± 35 | 83 ± 35 | 0.69 |
Urea nitrogen (mg/dL) | 19.3 ± 11.9 | 20.3 ±11.2 | 18.3 ± 12.7 | 0.52 |
Creatinine (mg/dL) | 1.02 ± 0.90 | 1.19 ± 1.14 | 0.82 ± 0.43 | 0.10 |
Platelet (×104/μL) | 9.6 ± 5.5 | 9.5 ± 5.0 | 9.7 ± 6.1 | 0.91 |
α-fetoprotein (ng/mL) | 5.5 ± 1.9 | 5.6 ± 1.9 | 5.5 ± 1.8 | 0.98 |
Child–Pugh grade (A/B/C) | 26/28/12 | 13/14/6 | 13/14/6 | 1.0 |
Child–Purgh score | 7.2 ± 1.9 | 7.5 ± 2.0 | 6.9 ± 1.9 | 0.27 |
Ascites (presence/absence) | 35/31 | 13/20 | 12/21 | 0.80 |
Esophago gastric varices (presence/absence) | 34/32 | 19/14 | 15/18 | 0.46 |
Transient elastography-based liver stiffness measurement (Kpa) | 22.0 ± 3.9 | 23.5 ± 7.2 | 20.8 ± 5.4 | 0.09 |
Fibrinogen degradation products (μg/mL) | 18.0 ± 16.7 | 21.4 ± 19.7 | 14.3 ± 11.9 | 0.11 |
D-dimer (μg/mL) | 8.4 ± 7.6 | 9.9 ± 8.6 | 6.1 ± 6.0 | 0.10 |
Yerdel grade 1/2/3 | 28/4/1 | 28/4/1 | - | - |
ADAMTS-13:AC (%) | 30.5 ± 7.2 | 19.8 ± 8.3 | 62 ± 15.3 | <0.001 |
vWF:Ag (%) | 300 ± 81 | 278 ± 87 | 323 ± 75 | 0.15 |
Survival (alive/death) | 53/13 | 33/8 | 33/5 | 0.35 |
Observation period (days) | 1033 ± 147 | 1002 ± 165 | 1064 ± 129 | 0.45 |
Variables | Univariate Analysis | Multivariate Analysis | ||||
---|---|---|---|---|---|---|
Odds Ratio | 95% Confidence Interval | p Value | Odds Ratio | 95% Confidence Interval | p Value | |
ADAMTS-13:AC < 18.8 | 1.56 | 1.10–2.34 | 0.0052 | 1.67 | 1.21–3.00 | 0.002 |
Fibrin degradation product ≥ 1.0 | 1.030 | 0.992–1.07 | 0.119 | 0.97 | 0.723–1.89 | 0.81 |
D-dimer ≥ 4.9 | 1.060 | 0.986–1.15 | 0.111 | 1.05 | 0.561–1.98 | 0.65 |
Creatinine ≥ 0.72 | 3.140 | 0.6510–15.10 | 0.154 | |||
Child–Pugh score ≥ 6.0 | 1.160 | 0.8930–1.51 | 0.266 |
Model | Threshold | Sensitivity | Specificity | PPV | NPV | AUC of ROC (95% CI) |
---|---|---|---|---|---|---|
ADAMTS13:AC | 18.8 | 0.818 | 0.97 | 0.965 | 0.842 | 0.913 (0.806-1) |
Variables | ADAMS13 ≥ 18.8% (n = 17) | ADAMS13 < 18.8% (n = 16) | p Value |
---|---|---|---|
Age (years) | 70.8 ± 8.5 | 69.3 ± 6.1 | 0.57 |
Sex (M/F) | 12/5 | 11/5 | 0.97 |
Etiology (HBV/HCV/Alcohol/NASH/Others) | 3/7/3/0/4 | 3/5/4/2/2 | 0.98 |
Albumin (g/dL) | 2.9 ± 0.6 | 3.3 ± 0.5 | 0.023 |
Prothrombin time (PT)-international normalized ratio | 1.2 ± 0.2 | 1.2 ± 0.14 | 0.30 |
PT (%) | 69 ± 15 | 70 ± 15 | 0.42 |
Total bilirubin (mg/dL) | 1.5 ± 0.93 | 2.3 ± 1.7 | 0.71 |
C-reactive protein (mg/dL) | 0.57 ± 0.35 | 0.72 ± 0.43 | 0.56 |
AST (IU/L) | 45 ± 17 | 59 ± 26 | 0.93 |
ALT (IU/L) | 30 ± 17 | 49 ± 22 | 0.88 |
γ-glutamyl transpeptidase (IU/L) | 77 ± 33 | 79 ± 26 | 0.93 |
Urea nitrogen (mg/dL) | 21 ± 15 | 19 ± 5.6 | 0.78 |
Creatinine (mg/dL) | 1.4 ± 1.3 | 1.0 ± 0.3 | 0.33 |
Platelet (×104/μL) | 10.7 ± 5.3 | 8.0 ± 3.1 | 0.48 |
α-fetoprotein(ng/mL) | 5.7 ± 1.9 | 4.8 ± 1.4 | 0.27 |
Child–Pugh grade (A/B/C) | 7/6/4 | 6/8/2 | 0.54 |
Child–Pugh score | 7.6 ± 2.2 | 7.3 ± 1.7 | 0.17 |
Ascites (presence/absence) | 8/9 | 9/7 | 0.62 |
Esophago gastric varices (presence/absence) | 9/8 | 10/6 | 0.57 |
Transient elastography-based liver stiffness measurement (Kpa) | 22.7 ± 6.2 | 23.8 ± 5.9 | 0.61 |
FDP (μg/mL) | 22 ± 16 | 20 ± 18 | 0.80 |
D-dimer (μg/mL) | 10.1 ± 7.3 | 9.6 ± 9.1 | 0.85 |
Yerdel grade 1/2/3 | 15/2/0 | 13/2/1 | 0.52 |
vWF | 331 ± 253 | 291 ± 147 | 0.255 |
Survival (alive/death) | 16/1 | 9/7 | 0.011 |
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Suzuki, J.; Namisaki, T.; Takya, H.; Kaji, K.; Nishimura, N.; Shibamoto, A.; Asada, S.; Kubo, T.; Iwai, S.; Tomooka, F.; et al. ADAMTS-13: A Prognostic Biomarker for Portal Vein Thrombosis in Japanese Patients with Liver Cirrhosis. Int. J. Mol. Sci. 2024, 25, 2678. https://doi.org/10.3390/ijms25052678
Suzuki J, Namisaki T, Takya H, Kaji K, Nishimura N, Shibamoto A, Asada S, Kubo T, Iwai S, Tomooka F, et al. ADAMTS-13: A Prognostic Biomarker for Portal Vein Thrombosis in Japanese Patients with Liver Cirrhosis. International Journal of Molecular Sciences. 2024; 25(5):2678. https://doi.org/10.3390/ijms25052678
Chicago/Turabian StyleSuzuki, Junya, Tadashi Namisaki, Hiroaki Takya, Kosuke Kaji, Norihisa Nishimura, Akihiko Shibamoto, Shohei Asada, Takahiro Kubo, Satoshi Iwai, Fumimasa Tomooka, and et al. 2024. "ADAMTS-13: A Prognostic Biomarker for Portal Vein Thrombosis in Japanese Patients with Liver Cirrhosis" International Journal of Molecular Sciences 25, no. 5: 2678. https://doi.org/10.3390/ijms25052678