Alpha-hydroxybutyrate dehydrogenase as a biomarker for predicting systemic lupus erythematosus with liver injury

Purpose: To explore potential biomarkers for identifying systemic lupus erythematosus (SLE) with liver injury.

Methods: This retrospective study examined the records of 158 SLE cases. The Apriori algorithm of association rules was employed to identify laboratory indexes related to liver injury in SLE patients.

Results: The ratio of albumin to globulin; levels of alpha-hydroxybutyrate dehydrogenase (α-HBDH), calcium, hemoglobin, urine protein, total cholesterol; absolute value of lymphocytes; red cell distribution width and hematocrit were identified by the Apriori algorithm from SLE-related liver injury patients. α-HBDH was identified as an independent risk factor for SLE-related liver injury. There were more SLE patients with liver injury in high-α-HBDH group than in low-α-HBDH group (64.63% vs. 21.05%; P < 0.001). In high-α-HBDH group, levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and gamma-glutamyl transpeptidase (GGT), and the AST/ALT ratio were significantly higher, and albumin and complement 3 (C3) were markedly lower. Moreover, α-HBDH level was significantly higher in the SLE-related liver injury patients than in the non-SLE-related liver injury patients. In addition, α-HBDH was positively correlated with levels of AST and LDH, the AST/ALT ratio, and the SLE Disease Activity Index 2000, and it was negatively correlated with albumin and C3. The optimal cutoff value of α-HBDH for distinguishing SLE patients with and without liver injury was 258.50 U/L, which provided a 60.94% sensitivity and a 94.67% specificity.

Conclusion: α-HBDH could be used to evaluate the disease activity of SLE-related liver injury, and it may be a potential biomarker for diagnosing SLE-related liver injury.