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Sphingosine-1-phosphate levels tied to 3-month, 1-year mortality in end-stage liver disease

one month ago

Prognosis in end-stage liver disease has highly significant association with plasma levels of sphingosine-1-phosphate (S1P), such that patients with low circulating S1P levels have lower 3-month and 1-year survival compared with those who have high S1P levels, a new study shows.

The study included 95 citrated plasma samples from patients who were assessed for orthotopicliver transplantation (OLT). Those who were receiving vitamin K antagonists or rivaroxaban as oral anti-coagulation therapies were excluded.

Hydrophilic interaction chromatography and liquid chromatography-mass spectrometry were used to process and quantify the levels of S1P, sphinganine-1-phosphate (SA1P) and sphingosine (SPH).

At the 3-month and 1-year follow-up, 9.5 (n=9)and 20 percent(n=19) of patients, respectively, died without OLT. Moreover, 10.5 percent (n=10) received OLT within 1 year.

The survival ratespredicted by S1P were 93.8, 83.1 and 57.1 percent for the third, second and first analyte concentration tertiles, respectively. Comparing the first to the second and third tertiles, the hazard ratios (HR) were 2.99 (95 percent CI,1.05 to 8.49; p=0.04)and 8.87 (1.98 to 39.78; p=0.004), respectively.

Survival rates for SA1P were 94.4, 80.2 and 64.5 percent for the third, second and first analyte concentration tertiles respectively. Only the comparison of the first to the third tertile yielded a significant HR (4.50; 1.24 to 16.40; p=0.023). No significant HRs were calculated for SPH.

Moreover, only S1P was the significant predictor of 3-month (HR, 0.94; 0.91 to 0.98; p=0.005) and 1-year (HR, 0.96; 0.94 to 0.99; p=0.002) mortality rates, according to the Cox regression analysis.

Finally, after controlling for platelet counts and haemoglobin and SA1P levels, S1P remained a significant predictor of 3-month (p<0.001) and 1-year (p<0.001) mortality, according to multivariate cox regression analysis.

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Most Read Articles
Saras Ramiya, one year ago
According to a meta-analysis of 22 randomized controlled trials, corticosteroids alone or in combination with pentoxifylline or N-acetylcysteine improve 28-day survival among patients with severe alcoholic hepatitis.
Jackey Suen, one year ago
Researchers from the Chinese University of Hong Kong (CUHK) have identified a seven-microRNA (miRNA) signature, which may be used to predict survival in patients with hepatocellular carcinoma (HCC). [PLos ONE 2015, doi:10.1371/journal.pone.0128628]
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