Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology · 2026
Serum hypoxia-inducible factor-1α levels in compensated and decompensated liver cirrhosis: Association with disease severity and MELD score.
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Hasanova K A, Asgarova T A, Bayramov N Y, Ibrahimova A A
Аннотация
BACKGROUND AND STUDY AIMS: Liver cirrhosis represents the end stage of chronic liver disease and carries high morbidity and mortality. Hypoxia-inducible factor-1α (HIF-1α) is a key regulator of cellular adaptation to hypoxia. This cross-sectional study evaluated serum HIF-1α levels in compensated and decompensated liver cirrhosis, their association with clinical and biochemical parameters, and their independent association with the presence of decompensation.
PATIENTS AND METHODS: This cross-sectional study included 31 patients with decompensated cirrhosis (DC), 39 with compensated cirrhosis (CC), and 20 healthy controls. Serum HIF-1α was measured by ELISA (Sunlong Biotech, Catalog No. SL0905Hu; range 8-500 pg/mL; sensitivity 4.5 pg/mL). Disease severity was assessed using the MELD score. Statistical analyses included the Mann-Whitney U test, Spearman correlation, multivariate logistic regression, and ROC curve analysis with bootstrap 95% confidence intervals.
RESULTS: Serum HIF-1α was significantly higher in DC (313.5 pg/mL; IQR 264.2-359.0) than CC (165.0 pg/mL; IQR 128.5-208.0) and controls (70.3 pg/mL; IQR 68.1-92.8) (p < 0.001). HIF-1α correlated positively with AST, ALP, ALT, bilirubin, and MELD score, and negatively with albumin (all p < 0.05). On multivariate logistic regression, HIF-1α remained an independent predictor of decompensation after adjustment for bilirubin and albumin (OR = 1.035; 95% CI: 1.016-1.054; p < 0.001; Nagelkerke R2 = 0.812; accuracy 90.0%). ROC analysis showed excellent diagnostic performance (AUC = 0.925; bootstrap 95% CI: 0.861-0.975; cut-off 215.5 pg/mL; sensitivity 93.5%; specificity 79.5%).
CONCLUSION: Serum HIF-1α is significantly elevated in liver cirrhosis, particularly in decompensated disease, and is independently associated with decompensation status. In this single-center cohort without an independent validation set, HIF-1α shows preliminary promise for discriminating compensated from decompensated cirrhosis; its predictive and diagnostic utility requires confirmation in larger, multicenter, prospectively validated cohorts.
PATIENTS AND METHODS: This cross-sectional study included 31 patients with decompensated cirrhosis (DC), 39 with compensated cirrhosis (CC), and 20 healthy controls. Serum HIF-1α was measured by ELISA (Sunlong Biotech, Catalog No. SL0905Hu; range 8-500 pg/mL; sensitivity 4.5 pg/mL). Disease severity was assessed using the MELD score. Statistical analyses included the Mann-Whitney U test, Spearman correlation, multivariate logistic regression, and ROC curve analysis with bootstrap 95% confidence intervals.
RESULTS: Serum HIF-1α was significantly higher in DC (313.5 pg/mL; IQR 264.2-359.0) than CC (165.0 pg/mL; IQR 128.5-208.0) and controls (70.3 pg/mL; IQR 68.1-92.8) (p < 0.001). HIF-1α correlated positively with AST, ALP, ALT, bilirubin, and MELD score, and negatively with albumin (all p < 0.05). On multivariate logistic regression, HIF-1α remained an independent predictor of decompensation after adjustment for bilirubin and albumin (OR = 1.035; 95% CI: 1.016-1.054; p < 0.001; Nagelkerke R2 = 0.812; accuracy 90.0%). ROC analysis showed excellent diagnostic performance (AUC = 0.925; bootstrap 95% CI: 0.861-0.975; cut-off 215.5 pg/mL; sensitivity 93.5%; specificity 79.5%).
CONCLUSION: Serum HIF-1α is significantly elevated in liver cirrhosis, particularly in decompensated disease, and is independently associated with decompensation status. In this single-center cohort without an independent validation set, HIF-1α shows preliminary promise for discriminating compensated from decompensated cirrhosis; its predictive and diagnostic utility requires confirmation in larger, multicenter, prospectively validated cohorts.