Nutrition (Burbank, Los Angeles County, Calif.) · 2026
Lipocalin 2 is associated with malnutrition risk and poor prognosis of decompensated cirrhosis.
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Peng Binbin, Yang Ziyi, Ren Lingyu, Li Jia, Zhang Mingxin, Sun Chao
Аннотация
BACKGROUND: Lipocalin 2 (LCN2) plays a pivotal role in regulating metabolic homeostasis and appetite, which has been identified as a biomarker of nutritional syndromes, such as cachexia and anorexia. However, there is little evidence concerning its predictive/prognostic value in cirrhosis. We sought to assess the association between LCN2 and a spectrum of metrics reflecting malnutrition, functional decline, and prognostication.
METHODS: A total of 279 decompensated cirrhosis patients were enrolled (median age: 64 y, 46.2% females). We assessed malnutrition risk, functional decline, and body composition using the RFH-NPT scale, frailty index, handgrip strength, and computed tomography-derived parameters, respectively.
RESULTS: Our cohort was categorized into three groups according to the LCN2 tertile. Patients with the highest LCN2 tertile had more deteriorated disease severity and higher malnutrition risk. Multivariate logistic regression analysis indicated that LCN2 was a significant predictor of malnutrition risk, as defined by RFH-NPT. Furthermore, patients in the highest LCN2 tertile exhibited poorer long-term survival (log-rank test: P < 0.001). Increased LCN2 levels were independently associated with 1-y all-cause mortality after adjusting for age, gender, body mass index, CTP score, and malnutrition risk (HR = 2.54, 95% CI: 1.04, 6.21, P = 0.042). After further adjusting for eGFR and excluding patients with severe renal dysfunction, these associations were attenuated to borderline significance, while the overall trends remained consistent. However, no obvious association was observed between LCN2 and other metrics concerning functional decline and body composition abnormalities.
CONCLUSIONS: Circulating LCN2 is associated with malnutrition risk and poor prognosis in decompensated cirrhosis patients. Although these associations are partly affected by renal function, LCN2 may still serve as a potential predictive/prognostic biomarker concerning early detection and prognostication, with possible incremental gains to the conventional assessment.
METHODS: A total of 279 decompensated cirrhosis patients were enrolled (median age: 64 y, 46.2% females). We assessed malnutrition risk, functional decline, and body composition using the RFH-NPT scale, frailty index, handgrip strength, and computed tomography-derived parameters, respectively.
RESULTS: Our cohort was categorized into three groups according to the LCN2 tertile. Patients with the highest LCN2 tertile had more deteriorated disease severity and higher malnutrition risk. Multivariate logistic regression analysis indicated that LCN2 was a significant predictor of malnutrition risk, as defined by RFH-NPT. Furthermore, patients in the highest LCN2 tertile exhibited poorer long-term survival (log-rank test: P < 0.001). Increased LCN2 levels were independently associated with 1-y all-cause mortality after adjusting for age, gender, body mass index, CTP score, and malnutrition risk (HR = 2.54, 95% CI: 1.04, 6.21, P = 0.042). After further adjusting for eGFR and excluding patients with severe renal dysfunction, these associations were attenuated to borderline significance, while the overall trends remained consistent. However, no obvious association was observed between LCN2 and other metrics concerning functional decline and body composition abnormalities.
CONCLUSIONS: Circulating LCN2 is associated with malnutrition risk and poor prognosis in decompensated cirrhosis patients. Although these associations are partly affected by renal function, LCN2 may still serve as a potential predictive/prognostic biomarker concerning early detection and prognostication, with possible incremental gains to the conventional assessment.