胆红素在早期诊断中起关键作用。预后,和预防肝脏疾病。非结合胆红素(UCB)需要通过肝脏葡萄糖醛酸化转化为水溶性形式,产生单葡糖醛酸(BMG)或二葡糖醛酸胆红素(BDG)用于胆汁排泄。本研究旨在评估胆红素分子物种UCB的作用,BMG,和BDG-在诊断和理解慢性急性肝衰竭(ACLF)患者肝硬化的发病机制中,代偿期肝硬化(LC)患者,和健康的个体。该研究包括ACLF和不同病因的代偿LC患者,以及健康的控制。我们收集了实验室和临床数据以确定严重程度并评估死亡率。我们从血清样本中提取胆红素来测量UCB,BMG,和BDG使用液相色谱-质谱(LC-MS)。通过监测质量电荷(m/z)比进行胆红素的定量。在评估的74名患者中,45有ACLF,11有LC,18人是健康个体。在ACLF患者中,胆红素的分子种类水平为UCB19.69μmol/L,BMG47.71μmol/L,BDG2.120μmol/L对于代偿性肝硬化患者,UCB水平为11.29μmol/L,BMG1.49μmol/L,和BDG0.055μmol/L,在健康的个体中,UCB为6.42μmol/L,BMG0.52μmol/L,BDG0.028μmol/L该研究显示,与代偿性肝硬化和健康对照相比,ACLF患者的胆红素明显升高,强调肝功能障碍的进展。BMG和BDG水平与常用炎症标志物的相关性表明ACLF中胆红素代谢与全身性炎症之间存在关系。
Bilirubin plays a key role in early diagnosis, prognosis, and prevention of liver diseases. Unconjugated bilirubin (UCB) requires conversion to a water-soluble form through liver glucuronidation, producing monoglucuronide (BMG) or diglucuronide bilirubin (BDG) for bile excretion. This study aimed to assess the roles of bilirubin\'s molecular species-UCB, BMG, and BDG-in diagnosing and understanding the pathogenesis of liver cirrhosis in patients with acute-on-chronic liver failure (ACLF), compensated liver cirrhosis (LC) patients, and healthy individuals. The study included patients with ACLF and compensated LC of diverse etiologies, along with healthy controls. We collected laboratory and clinical data to determine the severity and assess mortality. We extracted bilirubin from serum samples to measure UCB, BMG, and BDG using liquid chromatography-mass spectrometry (LC-MS). The quantification of bilirubin was performed by monitoring the mass charge (m/z) ratio. Of the 74 patients assessed, 45 had ACLF, 11 had LC, and 18 were healthy individuals. Among ACLF patients, the levels of molecular species of bilirubin were UCB 19.69 μmol/L, BMG 47.71 μmol/L, and BDG 2.120 μmol/L. For compensated cirrhosis patients, the levels were UCB 11.29 μmol/L, BMG 1.49 μmol/L, and BDG 0.055 μmol/L, and in healthy individuals, the levels were UCB 6.42 μmol/L, BMG 0.52 μmol/L, and BDG 0.028 μmol/L. The study revealed marked elevations in the bilirubin species in individuals with ACLF compared to those with compensated cirrhosis and healthy controls, underscoring the progression of liver dysfunction. The correlation of BMG and BDG levels with commonly used inflammatory markers suggests a relationship between bilirubin metabolism and systemic inflammation in ACLF.