Liver fibrosis index-based nomograms for identifying esophageal varices in patients with chronic hepatitis B related cirrhosis

doi:10.3748/wjg.v26.i45.7204

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastroenterol. Dec 7, 2020; 26(45): 7204-7221
Published online Dec 7, 2020. doi: 10.3748/wjg.v26.i45.7204

Table 1 Patient’s clinical characteristics of the training and validation cohort

Variable	Training cohort (n = 123)	Validation cohort (n = 184)	P value
Clinical parameter
Age (yr)	54.05 ± 12.02	54.54 ± 12.25	0.727
Male (%)	96 (78.05)	147 (79.89)	0.697
BMI (kg/m²)	22.97 ± 3.24	22.91 ± 3.41	0.877
SBP (mmHg)	129.29 ± 20.62	129.03 ± 20.56	0.914
DBP (mmHg)	71.77 ± 12.16	71.41 ± 11.76	0.796
Child-Pugh class A (%)	58 (47.15)	86 (46.74)	0.943
Degree of EV (Q1, Q3)	2 (0, 3)	2 (0, 3)	0.873
0 (%)	32 (26.02)	48 (26.09)
1 (%)	16 (13.01)	26 (14.13)
2 (%)	21 (17.07)	25 (13.59)
3 (%)	54 (43.90)	85 (46.19)
Laboratory test
TBil (µmol/L)	19.00 (12.00, 31.00)	18.50 (12.00, 31.00)	0.943
DBil (µmol/L)	9.00 (5.00, 16.00)	9.00 (5.00, 17.00)	0.766
TP (g/L)	65.80 ± 10.03	66.05 ± 9.95	0.831
Albumin (g/L)	32.85 ± 7.11	33.14 ± 7.14	0.726
ALT (IU/L)	27.00 (20.00, 47.00)	27.50 (20.25, 47.00)	0.850
AST (IU/L)	38.00 (28.00, 70.00)	41.00 (28.00, 70.75)	0.734
ALP (IU/L)	94.00 (74.00, 131.00)	99.00 (73.00, 140.00)	0.728
GGT (IU/L)	51.00 (24.00, 126.00)	50.00 (29.25, 126.75)	0.865
INR	1.36 (1.17, 1.54)	1.36 (1.17, 1.54)	0.994
PLT (× 10⁹/L)	82.00 (53.00, 140.00)	84.00 (56.00, 139.00)	0.760
MPV (fl)	11.50 (10.50, 12.50)	11.30 (10.40, 12.30)	0.301
PDW (fl)	14.90 (12.60, 17.30)	14.65 (12.70, 17.18)	0.760
Ultrasound parameter
HAD (mm)	3.46 ± 0.56	3.47 ± 0.57	0.914
HAPV (cm/s)	50.35 ± 12.23	50.51 ± 13.33	0.915
PVD (mm)	12.30 ± 1.54	12.05 ± 1.61	0.186
MPVV (cm/s)	19.11 ± 5.28	19.93 ± 5.59	0.196
SAD (mm)	5.05 ± 1.00	5.00 ± 0.98	0.678
SAPV (cm/s)	55.89 ± 15.38	55.91 ± 16.03	0.990
SVD (mm)	9.61 ± 1.82	9.59 ± 1.70	0.899
MSVV (cm/s)	22.22 ± 4.93	22.69 ± 5.20	0.428
ST (mm)	44.47 ± 9.36	44.61 ± 9.68	0.900
SD (mm)	110.88 ± 23.73	112.27 ± 25.39	0.629
SPI	2.96 ± 1.75	2.92 ± 1.96	0.871
LFI	3.74 ± 0.69	3.72 ± 0.68	0.886

BMI: Body mass index; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; EV: Esophageal varices; Q1: 1^st quartile; Q3: 3^rd quartile; TBil: Total bilirubin; DBil: Direct bilirubin; TP: Total protein; ALT: Alanine transaminase; AST: Aspartic transaminase; ALP: Alkaline phosphatase; GGT: Gamma-glutamyl transpeptidase; INR: International normalized ratio; PLT: Platelet count; MPV: Mean platelet volume; PDW: Platelet distribution width; HAD: Hepatic artery diameter; HAPV: Hepatic artery peak velocity; PVD: Portal vein diameter; MPVV: Mean portal vein velocity; SAD: Splenic artery diameter; SAPV: Splenic artery peak velocity; SVD: Splenic vein diameters; MSVV: Mean splenic vein velocity; ST: Spleen thick; SD: Spleen diameter; SPI: Splenic portal index; LFI: Liver fibrosis index.

Table 2 Univariate and multivariate logistic regression analyses for esophageal varices risk in patients with chronic hepatitis B related cirrhosis in the training cohort

Variable	Univariate analysis			Multivariate analysis
Variable	OR	95%CI	P value	OR	95%CI	P value
Clinical parameter
Age (yr)	1.038	1.001-1.076	0.043
Gender (Female = 0, Male = 1)	0.994	0.375-2.633	0.990
BMI (kg/m²)	1.031	0.907-1.171	0.643
SBP (mmHg)	1.005	0.985-1.025	0.657
DBP (mmHg)	0.985	0.953-1.018	0.367
Child-Pugh class	7.990	2.979-21.426	< 0.001	7.705	2.169-27.370	0.002
(Child A = 1, Child B/C = 2)
Laboratory test
TBil (µmol/L)	1.001	0.988-1.013	0.930
DBil (µmol/L)	0.998	0.981-1.016	0.831
TP (g/L)	0.976	0.936-1.018	0.255
Albumin (g/L)	0.932	0.877-0.990	0.022
ALT (IU/L)	0.992	0.984-1.000	0.052
AST (IU/L)	0.997	0.990-1.003	0.294
ALP (IU/L)	1.009	0.999-1.018	0.065
GGT (IU/L)	0.998	0.995-1.000	0.081
INR	20.331	2.870-144.037	0.003
PLT (× 10⁹/L)	0.990	0.985-0.995	< 0.001	0.992	0.984-1.000	0.044
MPV (fl)	1.373	0.999-1.887	0.051
PDW (fl)	1.128	0.981-1.297	0.092
Ultrasound parameter
HAD (mm)	1.619	0.786-3.335	0.192
HAPV (cm/s)	1.017	0.984-1.051	0.318
PVD (mm)	1.505	1.121-2.021	0.006
MPVV (cm/s)	0.915	0.845-0.991	0.029
SAD (mm)	0.935	0.629-1.390	0.740
SAPV (cm/s)	0.995	0.970-1.021	0.711
SVD (mm)	1.086	0.860-1.372	0.489
MSVV (cm/s)	1.073	0.977-1.180	0.142
ST (mm)	1.312	1.178-1.462	< 0.001
SD (mm)	1.036	1.012-1.059	0.003
SPI	4.183	2.044-8.559	< 0.001	3.895	1.630-9.308	0.002
LFI	7.067	2.938-16.995	< 0.001	3.603	1.336-9.719	0.011

The bold P values represent P < 0.05. OR: Odds ratio; 95%CI: 95% Confidence interval; BMI: Body mass index; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; TBil: Total bilirubin; DBil: Direct bilirubin; TP: Total protein; ALT: Alanine transaminase; AST: Aspartic transaminase; ALP: Alkaline phosphatase; GGT: Gamma-glutamyl transpeptidase; INR: International normalized ratio; PLT: Platelet count; MPV: Mean platelet volume; PDW: Platelet distribution width; HAD: Hepatic artery diameter; HAPV: Hepatic artery peak velocity; PVD: Portal vein diameter; MPVV: Mean portal vein velocity; SAD: Splenic artery diameter; SAPV: Splenic artery peak velocity; SVD: Splenic vein diameters; MSVV: Mean splenic vein velocity; ST: Spleen thick; SD: Spleen diameter; SPI: Splenic portal index; LFI: Liver fibrosis index.

Table 3 Univariate and multivariate logistic regression analyses for esophageal varices severity in patients with chronic hepatitis B related cirrhosis in the training cohort

Variable	Univariate analysis			Multivariate analysis
Variable	OR	95%CI	P value	OR	95%CI	P value
Clinical parameter
Age (yr)	0.997	0.967-1.027	0.833
Gender (Female = 0, Male = 1)	0.898	0.372-2.168	0.811
BMI (kg/m²)	1.011	0.904-1.132	0.844
SBP (mmHg)	1.001	0.983-1.019	0.928
DBP (mmHg)	0.992	0.962-1.022	0.584
Child-Pugh class	5.161	2.344-11.361	< 0.001	5.436	2.112-13.990	< 0.001
(Child A = 1, Child B/C = 2)
Laboratory test
TBil (µmol/L)	1.000	0.989-1.012	0.937
DBil (µmol/L)	0.996	0.980-1.012	0.643
TP (g/L)	0.978	0.942-1.015	0.246
Albumin (g/L)	0.987	0.937-1.038	0.605
ALT (IU/L)	0.994	0.986-1.001	0.109
AST (IU/L)	0.997	0.991-1.003	0.282
ALP (IU/L)	1.001	0.995-1.007	0.637
GGT (IU/L)	0.997	0.995-1.000	0.064
INR	10.764	2.342-49.469	0.002
PLT (× 10⁹/L)	0.994	0.989-0.999	0.016
MPV (fl)	1.399	1.050-1.865	0.022	1.479	1.043-2.098	0.028
PDW (fl)	1.036	0.920-1.166	0.564
Ultrasound parameter
HAD (mm)	1.327	0.693-2.541	0.393
HAPV (cm/s)	1.025	0.995-1.057	0.108
PVD (mm)	1.465	1.126-1.906	0.004	1.397	1.021-1.912	0.037
MPVV (cm/s)	0.964	0.899-1.033	0.301
SAD (mm)	0.973	0.678-1.396	0.880
SAPV (cm/s)	1.000	0.977-1.024	0.985
SVD (mm)	1.109	0.900-1.366	0.332
MSVV (cm/s)	1.062	0.979-1.151	0.148
ST (mm)	1.146	1.077-1.218	< 0.001
SD (mm)	1.030	1.010-1.049	0.003
SPI	1.644	1.193-2.265	0.002	1.463	1.030-2.079	0.034
LFI	4.184	2.080-8.416	< 0.001	3.089	1.442-6.617	0.004

Citation: Xu SH, Wu F, Guo LH, Zhang WB, Xu HX. Liver fibrosis index-based nomograms for identifying esophageal varices in patients with chronic hepatitis B related cirrhosis. World J Gastroenterol 2020; 26(45): 7204-7221
URL: https://www.wjgnet.com/1007-9327/full/v26/i45/7204.htm
DOI: https://dx.doi.org/10.3748/wjg.v26.i45.7204