Journal of Diagnostics Concepts & Practice >
Value of vWF-related indicators in the diagnosis of liver cirrhosis progression in patients with hepatitis B
Received date: 2024-04-07
Online published: 2024-12-25
Objective To evaluate the correlation between von Willebrand factor (vWF) and its related indicators and the progression of liver cirrhosis in patients with hepatitis B and explore the diagnostic value of vWF-related indicators in assisting the diagnosis of decompensated liver cirrhosis in patients with hepatitis B.Methods A total of 91 hepatitis B patients hospitalized in the Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, from December 2020 to March 2021, were included. According to the diagnostic criteria for liver cirrhosis, the patients were divided into three groups: chronic hepatitis B group (31 cases), compensated hepatitis B cirrhosis group (18 cases), and decompensated hepatitis B cirrhosis group (42 cases). The vWF antigen level (vWF: Ag), vWF collagen binding activity (vWF: CB), and vWF propeptide (vWFpp) were measured by ELISA. The vWF: CB/ vWF: Ag ratio was used to reflect the distribution of vWF multimers of different molecular weights. The vWFpp/vWF: Ag ratio was used to reflect the clearance rate of vWF in vivo. The ratio of vWF: Ag/platelet count was used to calculate the VITRO score. The SPSS 26.0 software was used for intergroup comparison, correlation analysis, and to assess the diagnostic performance of each indicator for decompensated hepatitis B cirrhosis.Results The levels of plasma vWF: Ag, vWF: CB, vWFpp, and vWFpp/vWF: Ag were significantly higher in the decompensated hepatitis B cirrhosis group than in the compensated group. However, there were no significant differences in the ratio of vWF: CB/vWF: Ag and VITRO scores between the two groups. The vWF: Ag, vWF: CB and vWFpp showed moderate positive correlations with Child-Pugh score in patients with chronic hepatitis B, with r values of 0.604, 0.593, and 0.711, respectively (P<0.05). When the cut-off value of vWFpp was set over 305.5%, its diagnostic efficacy for decompensated hepatitis B cirrhosis was highest, with a sensitivity of 78.6%, specificity of 93.9%, positive predictive value of 91.7%, negative predictive value of 83.6%, diagnostic accuracy of 86.8%, and area under the curve of 0.899.Conclusion The levels of vWF: Ag and vWFpp in plasma are well correlated with Child-Pugh liver function classification in patients with chronic hepatitis B, and can be used to assist in the diagnosis of decompensated liver cirrhosis of chronic hepatitis B, guiding patient treatment.
YANG Mingkang , LIU Yu , XU Guanqun , WANG Jianbiao , WANG Xuefeng , LIANG Qian . Value of vWF-related indicators in the diagnosis of liver cirrhosis progression in patients with hepatitis B[J]. Journal of Diagnostics Concepts & Practice, 2024 , 23(06) : 574 -579 . DOI: 10.16150/j.1671-2870.2024.06.003
[1] | ASRANI S K, DEVARBHAVI H, EATON J, et al. Burden of liver diseases in the world[J]. J Hepatol, 2019, 70(1):151-171. |
[2] | XIAO J, WANG F, WONG N K, et al. Global liver di-sease burdens and research trends: Analysis from a Chinese perspective[J]. J Hepatol, 2019, 71(1):212-221. |
[3] | 陈文辉, 陈昆仑, 钱兴旺, 等. 2013-2019年河南省肝脏疾病住院患者疾病谱变化[J]. 中国临床研究, 2023, 36(3):425-429. |
CHEN W H, CHEN K L, QIAN X W, et al. Spectrum changes of liver disease in Henan province from 2013 to 2019[J]. Chin J Clin Res, 2023, 36(3):425-429. | |
[4] | LENTING P J, CHRISTOPHE O D, DENIS C V. von Willebrand factor biosynthesis, secretion, and clearance: connecting the far ends[J]. Blood, 2015, 125(13):2019-2028. |
[5] | MANDORFER M, SCHWABL P, PATERNOSTRO R, et al. Von Willebrand factor indicates bacterial translocation, inflammation, and procoagulant imbalance and predicts complications independently of portal hypertension severity[J]. Aliment Pharmacol Ther, 2018, 47(7):980-988. |
[6] | PAN Y, GUO R, LV Y, et al. The role of von Willebrand factor antigen in predicting survival of patients with HBV-related cirrhosis[J]. Can J Gastroenterol Hepatol, 2022, 2022:9035971. |
[7] | VAN DEN BOOM B P, STAMOULI M, TIMON J, et al. Von Willebrand factor is an independent predictor of short-term mortality in acutely ill patients with cirrhosis[J]. Liver Int, 2023, 43(12):2752-2761. |
[8] | 中华医学会肝病学分会. 肝硬化诊治指南[J]. 中华肝脏病杂志, 2019, 27(11):846-865. |
Chinese Society of Hepatology, Chinese Medical Association. Chinese guidelines on the management of liver cirrhosis[J]. Chin J Hepatol, 2019, 27(11):846-865. | |
[9] | LIANG Q, QIN H, DING Q, et al. Molecular and clinical profile of VWD in a large cohort of Chinese population: application of next generation sequencing and CNVplex? technique[J]. Thromb Haemost, 2017, 117(8):1534-1548. |
[10] | 刘春晖, 戴力维, 于海涛. 乙型肝炎病毒相关慢加急性肝衰竭合并急性肾损伤预测模型的初步构建[J]. 中国临床研究, 2024, 37(5):751-755. |
LIUI C H, DAI L W, YV H T. Preliminary construction of a prediction model for HBV-related acute-on-chronic liver failure combined with acute kidney injury[J]. Chin J Clin Res, 2024, 37(5):751-755. | |
[11] | CURAKOVA RISTOVSKA E, GENADIEVA-DIMITROVA M. Prognostic value of von-Willebrand factor in patients with liver cirrhosis and its relation to other prognostic indicators[J]. World J Hepatol, 2022, 14(4):812-826. |
[12] | JACHS M, HARTL L, SIMBRUNNER B, et al. Decreasing von Willebrand factor levels upon nonselective beta blocker therapy indicate a decreased risk of further decompensation, acute-on-chronic liver failure, and death[J]. Clin Gastroenterol Hepatol, 2022, 20(6):1362-1373.e6. |
[13] | HAMETNER S, FERLITSCH A, FERLITSCH M, et al. The VITRO score (von willebrand factor antigen/thrombocyte ratio) as a new marker for clinically significant portal hypertension in comparison to other non-invasive parameters of fibrosis including ELF test[J]. PLoS One, 2016, 11(2):e0149230. |
[14] | 庄焱. 血管性血友病因子抗原与VITRO评分对乙型肝炎肝硬化预后的预测价值[J]. 陕西医学杂志, 2023, 52(8):1059-1062. |
ZHUANG Y. The predictive value of von Willebrand factor antigen and VITRO score for the prognosis of hepatitis B cirrhosis[J]. Shanxi Med J, 2023, 52(8):1059-1062. | |
[15] | 刘杰玉, 冯义朝. 多种肝衰竭预后模型的对比分析[J]. 临床肝胆病杂志, 2014(10):1082-1086. |
LIU J Y, FENG Y C. Analysis of prognostic models for liver failure[J]. J Clin Hepatol, 2014(10):1082-1086. | |
[16] | 陈亚利, 许姗姗, 张晶. vWF 及 ADAMTS13在肝脏疾病中的意义[J]. 肝脏, 2016, 21(4):316-319. |
CHEN Y L, XV S S, ZHANG J. The significance of vWF and ADAMTS13 in liver diseases[J]. Chin Hepatol, 2016, 21(4):316-319. | |
[17] | ZHOU W C, ZHANG Q B, QIAO L. Pathogenesis of liver cirrhosis[J]. World J Gastroenterol, 2014, 20(23):7312-7324. |
[18] | TRIPODI A. Hemostasis in acute and chronic liver disease[J]. Semin Liver Dis, 2017, 37(1):28-32. |
[19] | NOSSENT A Y, VAN MARION V, VAN TILBURG N H, et al. von Willebrand factor and its propeptide: the influence of secretion and clearance on protein levels and the risk of venous thrombosis[J]. J Thromb Haemost, 2006, 4(12):2556-2562. |
[20] | PALYU E, HARSFALVI J, TORNAI T, et al. Major changes of von Willebrand factor multimer distribution in cirrhotic patients with stable disease or acute decompensation[J]. Thromb Haemost, 2018, 118(8):1397-1408. |
[21] | LIANG Q, PARKER E T, DEAN G, et al. Nanobody activator improves sensitivity of the von Willebrand factor activity assay to multimer size[J]. J Thromb Haemost, 2024, 22(7):2052-2058. |
/
〈 |
|
〉 |