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CN 22-1108/R
Volume 42 Issue 5
May  2026
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Article Navigation >  Journal of Clinical Hepatology  > 2026  >  42(5): 1067-1074

Value of serum intestinal fatty acid-binding protein in predicting short-term mortality after endoscopic hemostasis for esophagogastric variceal bleeding in patients with liver cirrhosis

DOI: 10.12449/JCH260511
  • 1.

    Department of Medical Laboratory，The Affiliated Hospital of Yanbian University，Yanji，Jilin 133000，China

  • 2.

    Medical School of Yanbian University，Yanji，Jilin 133000，China

  • 3.

    Department of Infectious Diseases，The Affiliated Hospital of Yanbian University，Yanji，Jilin 133000，China

  • 4.

    Department of Gastroenterology，The Affiliated Hospital of Yanbian University，Yanji，Jilin 133000，China

Research funding:

Applied Foundation Research Project of Yanbian University (YDKJ202327);

Science and Technology Research Project of Jilin Province Department of Education (JJKH20261280KJ)

More Information
  • Corresponding author: WU Zhengxie， 87599706@qq.com （ORCID： 0009-0008-8109-1253）
  • Received Date: 2026-01-06
  • Accepted Date: 2026-02-09
  • Published Date: 2026-05-25
    Abstract
  •   Objective  To investigate the value of intestinal fatty acid-binding protein （I-FABP） in predicting 6-week mortality in patients with liver cirrhosis after successful endoscopic hemostasis for esophagogastric variceal bleeding （EVB）.  Methods  A retrospective analysis was performed for the clinical data of 207 patients with liver cirrhosis who underwent successful endoscopic treatment for EVB （including ligation and sclerotherapy） in The Affiliated Hospital of Yanbian University from September 2020 to June 2025， with the endpoint of 6-week bleeding-related mortality. ELISA was used to measure the serum level of I-FABP on admission， and a stratified analysis was performed based on the quartiles of I-FABP measurements. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier survival analysis， Cox regression analysis， and restricted cubic spline （RCS） curve were used to investigate the association between I-FABP and mortality. Machine learning models were used to further quantify the impact of I-FABP on mortality. The integrated Brier score and an integrated cumulative/dynamic area under the curve were used to assess the importance of time-dependent variables， and the receiver operating characteristic （ROC） curve was used to assess the performance of the predictive model.  Results  During the study， 29 patients （14.0%） died within 6 weeks after successful endoscopic hemostasis， with a median time to death of 16 （8—26） days. The mortality group had a significantly higher serum level of I-FABP than the survival group （Z=-3.731， P<0.001）. The Kaplan-Meier survival analysis showed that there was a significant difference in 6-week mortality between the groups of patients based on I-FABP quartiles （χ2 =12.78， P=0.005）. The multivariable Cox regression analysis showed that an increase in I-FABP （hazard ratio=1.87， P=0.003） was an independent influencing factor for 6-week mortality. The RCS analysis showed a linear relationship between I-FABP and 6-week mortality （Pnon-linear=0.280， Poverall=0.029）. Machine learning models showed that there was a dynamic change in the importance of I-FABP over time， and Brier score loss and the loss of cumulative/dynamic area under the curve after permutation showed that I-FABP was an important variable affecting 6-week mortality rate.  Conclusion  I-FABP level is independently associated with the risk of 6-week mortality endoscopic hemostasis for EVB in patients with liver cirrhosis， and therefore， it can be used as a potential biomarker for poor short-term prognosis.

     

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