Elevated Serum Interleukin 6 Is Associated With High Risk of First Non-bleeding Decompensation in Patients With Compensated Cirrhosis.

BACKGROUND/AIM: The transition from compensated to decompensated cirrhosis indicates a poor prognosis, and decompensated symptoms are subclassified as bleeding and non-bleeding. This study aimed to investigate the association between serum systemic inflammation marker levels and the development of the first bleeding and non-bleeding decompensation in patients with compensated cirrhosis.

PATIENTS AND

METHODS

This retrospective study included 214 patients with compensated liver cirrhosis. The baseline serum C-reactive protein, interleukin 6, procalcitonin, and serum amyloid A protein levels were measured. Factors associated with the first decompensation were assessed using the Cox proportional hazards model. The probability of first decompensation was evaluated using Kaplan-Meier analysis and the log-rank test.

RESULTS

In the study cohort, 167 (78%) patients showed elevation of one or more systemic inflammation markers. During a median follow-up of 3.6 years, 28 and 35 patients developed first bleeding and non-bleeding decompensation, respectively. The multivariate Cox proportional hazards model identified that nonviral etiology and low platelet count were significantly associated with bleeding decompensation and nonviral etiology, albumin-bilirubin grade, and serum interleukin 6 level with non-bleeding decompensation. Kaplan-Meier analyses showed that patients with high serum interleukin 6 levels (≥10 pg/ml) showed significantly higher probability of first non-bleeding decompensation than those with low serum interleukin 6 levels, but probability of bleeding decompensation was not different between them.

CONCLUSION

Serum pro-inflammatory cytokine interleukin 6 predicts the risk of first non-bleeding decompensation but not bleeding decompensation in patients with compensated cirrhosis.