Pretreatment gamma-glutamyl transferase predicts mortality in patients with chronic hepatitis B treated with nucleotide/nucleoside analogs
© 2023 The Authors. The Kaohsiung Journal of Medical Sciences published by John Wiley & Sons Australia, Ltd on behalf of Kaohsiung Medical University..
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 <25, 25-75, and >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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:40 |
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| Enthalten in: |
The Kaohsiung journal of medical sciences - 40(2024), 2 vom: 09. Feb., Seite 188-197 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jang, Tyng-Yuan [VerfasserIn] |
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| Links: |
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| Themen: |
Alanine Transaminase |
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| Anmerkungen: |
Date Completed 05.02.2024 Date Revised 05.02.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1002/kjm2.12771 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM363774092 |
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| 520 | |a © 2023 The Authors. The Kaohsiung Journal of Medical Sciences published by John Wiley & Sons Australia, Ltd on behalf of Kaohsiung Medical University. | ||
| 520 | |a 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 <25, 25-75, and >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 | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Jung, Jang Han |e verfasserin |4 aut | |
| 700 | 1 | |a Toyoda, Hidenori |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Chih-Wen |e verfasserin |4 aut | |
| 700 | 1 | |a Yuen, Man-Fung |e verfasserin |4 aut | |
| 700 | 1 | |a Cheung, Ka Shing |e verfasserin |4 aut | |
| 700 | 1 | |a Yasuda, Satoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Sung Eun |e verfasserin |4 aut | |
| 700 | 1 | |a Yoon, Eileen L |e verfasserin |4 aut | |
| 700 | 1 | |a An, Jihyun |e verfasserin |4 aut | |
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| 700 | 1 | |a Arai, Taeang |e verfasserin |4 aut | |
| 700 | 1 | |a Hayama, Korenobu |e verfasserin |4 aut | |
| 700 | 1 | |a Ishigami, Masatoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Cho, Yong Kyun |e verfasserin |4 aut | |
| 700 | 1 | |a Ogawa, Eiichi |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Hyoung Su |e verfasserin |4 aut | |
| 700 | 1 | |a Shim, Jae-Jun |e verfasserin |4 aut | |
| 700 | 1 | |a Uojima, Haruki |e verfasserin |4 aut | |
| 700 | 1 | |a Jeong, Soung Won |e verfasserin |4 aut | |
| 700 | 1 | |a Ahn, Sang Bong |e verfasserin |4 aut | |
| 700 | 1 | |a Takaguchi, Koichi |e verfasserin |4 aut | |
| 700 | 1 | |a Senoh, Tomonori |e verfasserin |4 aut | |
| 700 | 1 | |a Buti, Maria |e verfasserin |4 aut | |
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