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Plasma concentration of diamine oxidase (DAO) predicts 1-month mortality of acute-on-chronic hepatitis B liver failure

The plasma DAO level of survivals [14.0 (7.1; 26.5) ng/mL] was significantly lower than the nonsurvivals [58.6 (32.5; 121.3) ng/mL, P < .001]. The plasma DAO level, hepatic encephalopathy, spontaneous bacterial peritonitis and model for end-stage liver disease (MELD) score were independent factors associated with the 1-month mortality for ACHBLF.

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 2018 Sep;484:164-170. doi: 10.1016/j.cca.2018.05.050. Epub 2018 May 26.

Li FC1, Li YK2, Fan YC1, Wang K3.

Author information

1 Department of Hepatology, Qilu Hospital of Shandong University, Wenhuaxi Road 107#, Jinan 250012, China; Institute of Hepatology, Shandong University, Wenhuaxi Road 107#, Jinan 250012, China.
2 Department of Nuclear Medicine, Qilu Hospital of Shandong University, Wenhuaxi Road 107#, Jinan 250012, China.
3 Department of Hepatology, Qilu Hospital of Shandong University, Wenhuaxi Road 107#, Jinan 250012, China; Institute of Hepatology, Shandong University, Wenhuaxi Road 107#, Jinan 250012, China. Electronic address: wangdoc876@126.com.

Abstract

BACKGROUND:

Acute-on-chronic hepatitis B liver failure (ACHBLF) has high 1-month mortality but it is difficult to predict. This present study was aimed to determine the diagnostic value of plasma diamine oxidase (DAO) in predicting the 1-month mortality of ACHBLF.

METHODS:

A total of 106 consecutive newly diagnosed ACHBLF patients were retrospectively collected. The plasma expression of DAO was determined using enzyme-linked immunosorbent assay (ELISA).

RESULTS:

The plasma DAO level of survivals [14.0 (7.1; 26.5) ng/mL] was significantly lower than the nonsurvivals [58.6 (32.5; 121.3) ng/mL, P < .001]. The plasma DAO level, hepatic encephalopathy, spontaneous bacterial peritonitis and model for end-stage liver disease (MELD) score were independent factors associated with the 1-month mortality for ACHBLF. The cut-off point of 15.2 ng/mL for plasma DAO level with sensitivity of 95.45%, specificity of 62.5%, 22.6 for MELD score with sensitivity of 90.91%, specificity of 67.5%, 0.07 for DAO plus MELD with sensitivity of 87.88%, specificity of 80% were selected to discriminate 1-month morality of ACHBLF. Furthermore, DAO plus MELD score showed high AUROC than MELD score for predicting 1-month (0.916 vs. 0.843, P < .01).

CONCLUSIONS:

The plasma DAO level plus MELD > 0.07 predicts poor 1-month mortality of ACHBLF.

PMID: 29842857 DOI: 10.1016/j.cca.2018.05.050