Abstract: Objective To investigate the predictive value of high density lipoprotein cholesterol (HDL-C) for the prognosis of patients with non-cholestatic cirrhosis. Methods 684 patients with liver cirrhosis who met the inclusion criteria in the first affiliated hospital of Soochow University from January 2017 to December 2020 were enrolled in this study. The results of blood routine, biochemical routine, coagulation routine tests and other related auxiliary examination on the first day of admission were collected. the Model for end-stage liver disease (MELD) score, MELD-Na score and Integration of albumin-bilirubin (ALBI) score were calculated and the performance of HDL-C and other scores to predict the prognosis of patients with cirrhosis were compared. Results Within the 684 patients with liver cirrhosis, 94 patients died and 590 survived during hospitalization. The level of HDL-C in death group was 0.3 (0.1-0.7) mmol/L, which is significantly lower than that in non-death group 0.9 (0.6-1.2) mmol /L (U=12 869.0, P<0.001). Multivariate logistic regression analysis showed that an increased age, white blood cell count, and creatinine level and the decreased HDL-C level were risk factors for poor prognosis of liver cirrhosis (P<0.05). The receiver operating characteristic curves (AUROC) of HDL-C level, MELD score, MELD-Na score and ALBI score were 0.768 (95 % CI: 0.768-0.819), 0.751 ( 95 % CI: 0.691-0.810), 0.747 ( 95 % CI: 0.686-0.807) and 0.715 (95 % CI: 0.659-0.770), respectively. The AUROC of HDL-C combined with MELD score was 0.803 (95% CI: 0.753-0.852), and the sensitivity and specificity were 74.5% and 74.2%, respectively. Conclusion HDL-C is a powerful predictor for the prognosis of patients with cirrhosis and the predictive ability of HDL-C combined with MELD score was significantly higher than that of single index.

Key words: High density lipoprotein cholesterol, Liver cirrhosis, MELD score, MELD-Na score, ALBI score, prognosis