Study on Primary Biliary Cholangitis (PBC) and Hypercholesterolemia

Patients with primary biliary cholangitis (PBC) often have hypercholesterolemia. However, its association with prognosis and lipid metabolism remains unclear.

Researchers have conducted a study aimed to investigate the prognostic value of baseline total cholesterol (TC) levels in PBC and characterized the lipid metabolism.

The study published in Clinical Gastroenterology and Hepatology has concluded that primary biliary cholangitis patients with baseline total cholesterol levels above 5.2 mmol/L have unique lipidome characteristics. These patients are at greater risk of poor clinical outcomes.

This study investigated the prognostic value of baseline total cholesterol (TC) levels in PBC and characterized lipid metabolism. The 531 PBC patients with no history of prior cirrhosis-related complications were divided into the derivation and validation cohorts (ratio of 7:3). Their complete clinical data were analyzed, with liver-related death, liver transplantation, and cirrhosis-related complications as endpoints. Untargeted lipidomics were performed on 89 patients and 28 healthy controls or HC.

Key Findings from the Study

• Baseline total cholesterol (TC) levels were independently associated with poor clinical outcomes, as demonstrated by adjusted C-statistics of 0.8035 and 0.8754 in the derivation and validation cohorts, respectively.
• The 5.2 mmol/L cut-off optimally divided patients into low- and high-risk groups.
• In low total cholesterol patients whose baseline total cholesterol level was < 200 mg/dL, the metabolism was similar to healthy controls.
• In high total cholesterol patients with a baseline total cholesterol level of more than 200 mg/dL, there was upregulated glycerophospholipid and sphingolipid metabolism.

According to our findings, individuals with primary biliary cholangitis (PBC) and baseline total cholesterol (TC) levels higher than 5.2 mmol/L exhibit distinct lipidome features and face an increased likelihood of unfavorable clinical results. The combination of total cholesterol and Globe score may provide a more accurate risk stratification of patients with PBC.

Reference

Zheng et al. Hypercholesterolemia is associated with dysregulation of lipid metabolism and poor prognosis in primary biliary cholangitis. Clinical Gastroenterology and Hepatology. https://doi.org/10.1016/j.cgh.2024.01.039