Association Of Plasma Homocysteine Levels And Hepatitis B Cirrhosis

Objective:The damages of the liver induce the disorders of homocysteine(Hcy)metabolism and hyperhomocysteinemia(h Hcy).Moreover,Hcy accelerates the progression of liver disease by oxidative stress,resulting in cell damage.In this study,we aimed to investigate the relationship between plasma homocysteine concentration and Hepatitis B cirrhosis and provide new ideas for the prognosis and prevention of Hepatitis B cirrhosis.Methods: In a cross-sectional retrospective study,we analyzed a total of 474 hospitalized patients for Hepatitis B cirrhosis from June 2015 to August 2017.We also recorded Hcy levels,patients’ basic data and clinical data to calculate the scores of MELD and Child-Pugh.The incidence of cirrhosis complications(ascites,hepatic encephalopathy,esophageal and gastric variceal bleeding)is also recorded.By linear regression analysis,we determined the correlation between Hcy and MELD.By Spearman correlation(r)analysis,we determined the correlations between the complications of cirrhosis and other two factors,including Hcy and scores of MELD.We also determined the correlations between Hcy and the scores of Child-Pugh.Results: After quartering the plasma Hcy levels of the study population,we founded the fourth quartile was older and had a higher proportion of males and the history of drinking.The prevalence of hypertension and kidney disease was higher,with statistically significance.The plasma Hcy in hepatitis B cirrhosis was associated with higher ALT,CR,PT,INR,MELD score,Child-pugh score,and higher incidence of ascites,esophageal gastric varices bleeding,and hepatic encephalopathy.In linear regression,without correcting any variables,the study found that as the Hcy quintile increased,the MELD score increased,and the trend test was statistically significant(p<0.0001).Continuous variables found Hcy per One unit(1 mmol/l)was added and the MELD score was increased by 8.148 units,which was statistically significant.When the age and sex or age,sex,drinking,ALT,ALB,PT,LDLC were corrected,the study found that with the increase of Hcy quintile,the MELD score increased,and the trend test was statistically significant(p<0.0001).The plasma levels of Hcy were significantly correlated with the scores of Child pugh(Pearson’s r=0.0075,p=0.0087).The plasma levels of Hcy were significantly correlated with complications of liver cirrhosis,such as ascites(Pearson’s r=0.1300,p=0.0046),esophageal gastric varices bleeding(Pearson’s r=0.1173,p=0.0108),hepatic encephalopathy(Pearson’s r = 0.2615,p < 0.0001),which was statistically significant.Similarly,circulating score of MELD displayed a positive correlation with cirrhosis complications such as ascites(Spearman’s r=0.2947,p<0.001),esophageal gastric varices bleeding(Pearson’s r=0.2947,p<0.001),r=0.2084,p<0.001),hepatic encephalopathy(Pearson’s r = 0.2484,p <0.0001),whichwas statistically significant.Conclusions: In the cross-sectional study,in the middle-aged and elderly population plasma Hcy was positively correlated with the severity of Hepatitis B cirrhosis.