Juanola, AdriàGraupera, IsabelElia, ChiaraPiano, SalvatoreSolé, CristinaCarol, MartaPérez-Guasch, MartinaBassegoda, OctaviEscudé, LaiaRubio, Ana BelénCervera, MartaNapoleone, LauraAvitabile, EmmaMa, Ann T.Fabrellas i Padrès, NúriaPose Méndez, ElisaMorales Ruiz, ManuelJiménez Povedano, WladimiroTorres, FerranCrespo Conde, GonzaloSolà, ElsaGinès i Gibert, Pere2024-11-132024-11-132022-01-010168-8278https://hdl.handle.net/2445/216456Background & aims: Decompensated cirrhosis (DC) is associated with high mortality, mainly owing to the development of acute-on-chronic liver failure (ACLF). Identifying the patients with DC who are at high risk of mortality and ACLF development is an unmet clinical need. Liver fatty acid-binding protein (L-FABP) is expressed in several organs and correlates with liver and systemic inflammation. Herein, we aimed to assess the prognostic value of L-FABP in patients with DC. Methods: A prospective series of 444 patients hospitalized for DC was divided into 2 cohorts: study cohort (305 patients) and validation cohort (139 patients). L-FABP was measured in urine and plasma samples collected at admission. Neutrophil gelatinase-associated lipocalin (NGAL) was also measured in urine samples for comparison. Results: Urine but not plasma L-FABP correlated with 3-month survival on univariate analysis. On multivariate analysis, urine L-FABP and model for end-stage liver disease (MELD)-Na were the only independent predictors of prognosis. Urine L-FABP levels were higher in patients with ACLF than in those without and also predicted the development of ACLF, together with MELD-Na, during follow-up. In patients with ACLF, urine L-FABP correlated with liver, coagulation, and circulatory failure. Urine L-FABP levels were also increased in patients with acute kidney injury, particularly in those with acute tubular necrosis. The ability of urinary L-FABP to predict survival and ACLF development was confirmed in the validation cohort. Urine NGAL predicted outcome on univariate but not multivariate analysis. Conclusions: Urinary L-FABP levels are independently associated with the 3-month clinical course in patients with DC, in terms of mortality and ACLF development. Urinary L-FABP is a promising prognostic biomarker for patients with DC.8 p.application/pdfengcc-by-nc-nd (c) Juanola, Adrià et al., 2021http://creativecommons.org/licenses/by-nc-nd/4.0/Anàlisi d'orinaÀcids grassosFetgeCirrosi hepàticaMarcadors bioquímicsUrine analysisFatty acidsLiverHepatic cirrhosisBiochemical markersinfo:eu-repo/semantics/article7179852024-11-13info:eu-repo/semantics/openAccess34530063