Evidence map›Paper›PMID 41912988›Full record

Observational studyHepatology international2026

Distinct amino acid metabolic subtypes predict prognosis and stratify treatment response in acute-on-chronic liver failure: a multicenter prospective study.

Haocheng Zheng, Simiao Yu, Ting Zhou, Shuangnan Fu, Jingjing Zhang, Ning Zhang, Yijiang Liu, Yanyang Huang, Zhaoyun He, Jin Zhang and 3 more

Abstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Hepatology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Haocheng ZhengDepartment of Hepatology of Traditional Chinese Medicine, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, 100039, China.
Simiao YuDepartment of Hepatology of Traditional Chinese Medicine, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, 100039, China.
Ting ZhouSchool of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China.
Shuangnan FuDepartment of Hepatology of Traditional Chinese Medicine, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, 100039, China.
Jingjing ZhangDepartment of Hepatology of Traditional Chinese Medicine, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, 100039, China.
Ning ZhangDepartment of Hepatology of Traditional Chinese Medicine, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, 100039, China.
Yijiang LiuDepartment of Hepatology of Traditional Chinese Medicine, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, 100039, China.
Yanyang HuangDepartment of Hepatology of Traditional Chinese Medicine, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, 100039, China.
Zhaoyun HeDepartment of Hepatology of Traditional Chinese Medicine, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, 100039, China.
Jin ZhangDepartment of Hepatology of Traditional Chinese Medicine, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, 100039, China.
Pengcheng LiuDepartment of Hepatology of Traditional Chinese Medicine, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, 100039, China.
Man GongDepartment of Hepatology of Traditional Chinese Medicine, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, 100039, China. gongman302@163.com.
Chao ZhouDepartment of Hepatology of Traditional Chinese Medicine, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, 100039, China. zhouchao@301hospital.com.cn.

Funding

National Natural Science Foundation of China 82305067National Science and Technology Major Project of China during the 13th Five-Year Plan Period 2018ZX10725506-002
6 · The paper itself

Abstract

backgroundAcute-on-chronic liver failure (ACLF) exhibits high mortality and heterogeneity, demanding precise risk stratification. We aimed to identify metabolic subtypes and explore their association with prognosis and real-world artificial liver support (ALS) responsiveness.

methodsThis prospective, multicenter, observational cohort study enrolled 142 ACLF patients. Serum was collected at baseline, prior to ALS initiation. Patients were subtyped via metabolomics clustering. ALS exposure was analyzed using inverse probability of treatment weighting (IPTW) and Cox models to test for heterogeneity of treatment effect.

resultsTwo subtypes were identified (Cluster 1/2). Cluster 2 showed significantly higher 90 day mortality (p = 0.032) and severe amino acid metabolic reprogramming, particularly in branched-chain amino acid and glutamine pathways. Exploratory analysis suggested a differential association between ALS and survival across subtypes (interaction p = 0.12). ALS showed a weaker survival association in Cluster 2 after IPTW adjustment.

conclusionACLF patients possess distinct amino acid-based metabolic subtypes that are potent prognostic indicators. Baseline metabolic profiling can serve as a stratification tool to identify patients who may derive the greatest clinical benefit from ALS therapy, guiding personalized treatment strategies.

Indexed as

Acute-On-Chronic Liver FailureAmino AcidsAdultAgedFemaleHumansLiver, ArtificialMaleMetabolomicsMiddle AgedPrognosisProspective StudiesTreatment OutcomeAmino AcidsAcute on chronic liver failureAmino acidArtificial liver supportLiver failureMetabolomics

Identifiers

PMID41912988

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.