Pretreatment gamma‐glutamyl transferase predicts mortality in patients with chronic hepatitis B treated with nucleotide/nucleoside analogs-Reference-Cited by-同舟云学术

Pretreatment gamma‐glutamyl transferase predicts mortality in patients with chronic hepatitis B treated with nucleotide/nucleoside analogs

Published:2023-10-27 Issue:2 Volume:40 Page:188-197
ISSN:1607-551X
Container-title:The Kaohsiung Journal of Medical Sciences
language:en
Short-container-title:The Kaohsiung J of Med Scie

Author:

Jang Tyng‐Yuan¹²^ORCID,Liang Po‐Cheng²,Jun Dae Won³,Jung Jang Han⁴,Toyoda Hidenori⁵,Wang Chih‐Wen²^ORCID,Yuen Man‐Fung⁶⁷,Cheung Ka Shing⁶,Yasuda Satoshi⁵,Kim Sung Eun⁸,Yoon Eileen L.³,An Jihyun⁹,Enomoto Masaru¹⁰,Kozuka Ritsuzo¹⁰,Chuma Makoto¹¹,Nozaki Akito¹¹,Ishikawa Toru¹²,Watanabe Tsunamasa¹³,Atsukawa Masanori¹⁴,Arai Taeang¹⁴,Hayama Korenobu¹⁴,Ishigami Masatoshi¹⁵,Cho Yong Kyun¹⁶,Ogawa Eiichi¹⁷,Kim Hyoung Su¹⁸,Shim Jae‐Jun¹⁹,Uojima Haruki²⁰,Jeong Soung Won²¹,Ahn Sang Bong²²,Takaguchi Koichi²³,Senoh Tomonori²³,Buti Maria²⁴,Vargas‐Accarino Elena²⁴,Abe Hiroshi²⁵,Takahashi Hirokazu²⁶²⁷,Inoue Kaori²⁶²⁷,Huang Jee‐Fu²²⁸,Chuang Wan‐Long²²⁸,Yeh Ming‐Lun²⁹^ORCID,Dai Chia‐Yen²²⁸,Huang Chung‐Feng²²⁸³⁰^ORCID,Nguyen Mindie H.³¹^ORCID,Yu Ming‐Lung²²⁸³²³³^ORCID

Affiliation:

1. Ph.D. Program in Environmental and Occupational Medicine, College of Medicine Kaohsiung Medical University and National Health Research Institutes Kaohsiung Taiwan

2. Hepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital Kaohsiung Taiwan

3. Department of Internal Medicine Hanyang University Hospital, Hanyang University College of Medicine Seoul South Korea

4. Division of Gastroenterology, Department of Internal Medicine Severance Hospital, Yonsei University College of Medicine Seoul Korea

5. Department of Gastroenterology and Hepatology Ogaki Municipal Hospital Gifu Japan

6. Department of Medicine School of Clinical Medicine, Queen Mary Hospital, The University of Hong Kong Hong Kong Hong Kong

7. State Key Laboratory of Liver Research The University of Hong Kong Hong Kong Hong Kong

8. Department of Internal Medicine Hallym University Sacred Heart Hospital, Hallym University College of Medicine Anyang South Korea

9. Department of Internal Medicine Hanyang University College of Medicine, Hanyang University Guri Hospital Guri South Korea

10. Department of Hepatology Graduate School of Medicine, Osaka Metropolitan University Osaka Japan

11. Gastroenterological Center Yokohama City University Medical Center Yokohama Japan

12. Department of Gastroenterology Saiseikai Niigata Hospital Niigata Japan

13. Division of Gastroenterology and Hepatology St. Marianna University School of Medicine Kawasaki Japan

14. Division of Gastroenterology and Hepatology Nippon Medical School Tokyo Japan

15. Department of Gastroenterology & Hepatology Nagoya University Graduate School of Medicine Nagoya Japan

16. Department of Internal Medicine Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Seoul South Korea

17. Department of General Internal Medicine Kyushu University Kyushu Japan

18. Department of Internal Medicine Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine Seoul South Korea

19. Department of Internal Medicine Kyung Hee University Hospital, Kyung Hee University School of Medicine Seoul South Korea

20. Department of Gastroenterology Internal Medicine, Kitasato University School of Medicine Sagamihara Japan

21. Department of Internal Medicine Soonchunhyang University Hospital, Soonchunhyang University College of Medicine Seoul South Korea

22. Department of Internal Medicine Nowon Eulji Medical Center, Eulji University College of Medicine Seoul South Korea

23. Department of Hepatology Kagawa Prefectural Central Hospital Kagawa Japan

24. Liver Unit Hospital Universitari Vall d'Hebron and CIBEREHD del Instituto Carlos III Barcelona Spain

25. Division of Gastroenterology and Hepatology Shinmatsudo Central General Hospital Chiba Japan

26. Liver Center Saga University Hospital Saga Japan

27. Division of Metabolism and Endocrinology, Faculty of Medicine Saga University Saga Japan

28. Faculty of Internal Medicine and Hepatitis Research Center, School of Medicine, College of Medicine, and Center for Cancer Research and Liquid Biopsy Kaohsiung Medical University Kaohsiung Taiwan

29. Kaohsiung Medical University Hospital Kaohsiung Taiwan

30. Translational Medicine College of Medicine, Kaohsiung Medical University, Kaohsiung, and Academia Sinica Kaohsiung Taiwan

31. Division of Gastroenterology and Hepatology, Department of Medicine Stanford University Medical Center Palo Alto California USA

32. School of Medicine, College of Medicine, National Sun Yat‐Sen University Kaohsiung Taiwan

33. Division of Hepato‐Gastroenterology, Department of Internal Medicine Kaohsiung Chang Gung Memorial Hospital Kaohsiung Taiwan

Abstract

AbstractElevated 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.

Funder

Kaohsiung Medical University

KMUH

Ministry of Health and Welfare

Publisher

Wiley

Subject

General Medicine

Link

https://onlinelibrary.wiley.com/doi/pdf/10.1002/kjm2.12771

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