The diagnostic value of serum insulin-like growth factor binding protein-7 levels in patients with hepatitis B-related cirrhosis complicated with acute kidney injury

Abstract

Abstract: Objective To evaluate the diagnostic value of serum insulin-like growth factor binding protein-7 (IGFBP-7) levels in patients with hepatitis B-related cirrhosis complicated by acute kidney injury (AKI). Methods The study included 132 patients with hepatitis B-related cirrhosis treated in Suzhou Integrated Traditional Chinese and Western Medicine Hospital from January 2018 to January 2023. Patients who developed AKI were assigned to the observation group (n=40), while those without AKI constituted the control group (n=92). Basic data including gender, age, etiology and underlying diseases were collected from both groups of patients. Blood and urine samples were collected within 72 hours of enrollment to measure serum levels of total bilirubin (TBil), creatinine (Scr), blood urea nitrogen (BUN), cystatin C (CysC), and β2-microglobulin (β2-MG), as well as IGFBP-7 levels in both serum and urine. Logistic regression analysis was used to identify risk factors for AKI in patients with hepatitis B-related cirrhosis, and the diagnostic value of IGFBP-7 levels in serum and urine for assessing AKI was evaluated using Receiver operating characteristic (ROC) curve method. Results In the observation group, the levels of serum TBil, Scr, BUN, CysC, β2-MG, and IGFBP-7 were respectively 40.03 ± 6.32 μmol/L, 110.42 ± 23.36 μmol/L, 14.53 ± 3.23 mmol/L, 1.57 ± 0.42 mg/L, 2.77 ± 0.46 mg/L, and 12.12 ± 3.76 μg/L. The level of IGFBP-7 in urine was 28.09 ± 4.52 μg/L, all of which were higher than those in the control group (P< 0.05). Multifactorial analysis indicated that higher levels of Scr, BUN, CysC, and IGFBP-7 are associated with an increased risk of acute kidney injury (AKI) in patients (P<0.05). The ROC curve analysis revealed that the accuracy of serum IGFBP-7 in assessing the risk of AKI in patients with hepatitis B virus-induced cirrhosis was 0.857, which increased to 0.978 when combined with the measurement of urinary IGFBP-7 levels. Conclusion Elevated serum IGFBP-7 levels are closely related to the occurrence of AKI in patients with hepatitis B-related cirrhosis, and combined measurement of serum and urine IGFBP-7 levels provides higher diagnostic accuracy.

Key words: Insulin-like growth factor binding protein-7, Hepatitis B, Cirrhosis, Acute kidney injury, Diagnostic efficacy

MA Xiao-min, JIANG Ye-zhou, CHEN Guo-fei. The diagnostic value of serum insulin-like growth factor binding protein-7 levels in patients with hepatitis B-related cirrhosis complicated with acute kidney injury[J]. Chinese Hepatolgy, 2025, 30(8): 1061-1065.

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