Glycated Albumin to Glycated Hemoglobin Ratio in Patients with a High Risk Esophageal Varices

Abstract

C irrhosis is the end stage of chronic damage to the liver. Portal hypertension commonly accompanies liver cirrhosis with the development of OV and PHG as major complications. Gastroesophgeal variceal hemorrhage is a major complication of portal hypertension resulting from liver cirrhosis. Oesophageal variceal bleeding is one of the most dreaded complications of cirrhosis because of its high mortality. The prevalence of varices in patients with cirrhosis is approximately 60-80%. The incidence of OV increases by nearly 5% per year, and the rate of progression from small to large varices is approximately 5 to 10 % per year. The mortality rate from variceal bleeding is about 17-57 % but when patients are treated optimally in hospital it is found to be only 20%. The American Association for the Study of Liver Disease and the Baveno V Consensus Conference on portal hypertension recommended that all cirrhotic patients should be screened for the presence of OV when liver cirrhosis is diagnosed. Endoscopy is an invasive procedure and secondly the cost effectiveness of this approach is also questionable. As only 9-36% patients with cirrhosis are found to have varices on screening endoscopy. It may be more cost-effective to routinely screen patients at high risk for the presence of varices so as to reduce the increasing burden and procedure cost of endoscopy units. The aim of this work is to assess the value of GA/HbA1c ratio as a non-invasive predictor of OV and its risk of bleeding and comparing it with other different non-invasive predictors.