Ascitic non-HDL-C/HDL-C ratio:a novel prognostic marker in liver cirrhosis

Background and study aim: Laboratory tests were developed on ascitic fluid for assessing causes, mechanisms, and prognosis of the diseases. This study aimed to evaluate the prognostic value of ascitic lipids in cirrhosis with special consideration to the non-high-density lipoprotein cholesterol (HDL-C) and its related ratios. Methods: This cross-sectional study included 120 cirrhotic patients with ascites. Ascitic fluid analysis for lipid contents and calculations of ratios were done. Ascitic lipid contents and ratios are used to assess liver disease severity and predict the mortality in different Child-Pugh groups. Results: Regarding Child-Pugh score, ascitic cholesterol, and HDL-C showed significantly higher levels in group C when compared to groups A and B.  Ascitic non-HDL-C and ascitic non-HDL-C/ HDL-C ratio had a statistically significant increasing trend among Child-Pugh groups. Serum-ascites cholesterol gradient showed no significant difference among Child-Pugh groups (p>0.05). Ascitic non-HDL-C/ HDL-C ratio had the highest positive linear correlation with cirrhosis severity scores (p<0.0001). High ascitic non-HDL-C/ HDL-C ratio patients had a higher mortality rate when compared to those with a lower ratio (38.5% versus 9.5%). Conclusion: Ascitic non-HDL-C/HDL-C ratio was more beneficial than non-HDL-C in cirrhosis severity prediction. Also, it could predict the cirrhotic patients' survival. So, Ascitic non-HDL-C/HDL-C ratio seems to be an excellent prognostic marker for cirrhosis.