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

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