Table 3. . Performance of model for end-stage liver disease-Na-metabolite models versus model for end-stage liver disease-Na score to predict 1-year mortality in patients with cirrhosis caused by primary biliary cholangitis or primary sclerosing cholangitis.

MELD-Na Score		Plasma metabolites	Hazard ratio for MELD-Na score†	p-value for hazard ratio for MELD-Na score	Hazard ratio for metabolite†	p-value for hazard ratio for metabolite	Time-dependent AUROC (at year)‡	AUROCC 95% confidence limits (lower)§	AUROCC 95% confidence limits (upper)§
MELD-Na score	+	Myo-inositol	1.091	0.1104	3.139	0.0356	0.9392	0.5804	1.0000
MELD-Na score	+	N6-Acetyllysine	1.204	0.0026	0.508	0.2777	0.9023	0.7442	1.0000
MELD-Na score	+	N-Acetylalanine	1.052	0.4350	0.078	0.0423	0.8653	0.1290	1.0000
MELD-Na score	+	Gamma-Glutamylphenylanine	1.163	0.0021	0.530	0.5244	0.8574	0.1634	1.0000
MELD-Na score	+	Adenosine	1.181	0.0018	0.722	0.0948	0.8569	0.5918	1.0000
MELD-Na score	+	N-Acetylputrescine	1.135	0.0162	2.422	0.0461	0.8426	0.6578	1.0000
MELD-Na score	+	N6-Carbamoylthreonyladenosine	1.091	0.1253	8.962	0.0050	0.8279	0.6246	1.0000
MELD-Na score	+	Erythronate	1.083	0.1803	4.269	0.0468	0.8193	0.6705	0.9681
MELD-Na score	+	3-Ureidopropionate	1.190	0.0008	0.312	0.2005	0.8190	0.3470	1.0000
MELD-Na score	+	N2,N2-Dimethylguanosine	1.105	0.0915	14.670	0.0064	0.8055	0.5803	1.0000
MELD-Na score	+	N1-Methyladenosine	1.135	0.0246	5.320	0.0632	0.7975	0.3781	1.0000
MELD-Na score	+	N-Acetylvaline	1.172	0.0020	0.724	0.3344	0.7900	0.5956	0.9844
MELD-Na score	+	S-Adenosylhomocysteine (SAH)	1.185	0.0017	3.375	0.1941	0.7889	0.3442	1.0000
MELD-Na score	+	Glucuronate	1.081	0.1663	3.402	0.0138	0.7826	0.5927	0.9724
MELD-Na score	+	Dimethylarginine (SDMA + ADMA)¶	1.124	0.0355	3.257	0.0665	0.7802	0.5775	0.9829
MELD-Na score	+	Creatinine	1.209	0.0011	5.045	0.0157	0.7748	0.2986	1.0000
MELD-Na score	+	Trans-aconitate	1.149	0.0267	1.112	0.7862	0.7741	0.6183	0.9300
MELD-Na score	+	Picolinate	1.154	0.0035	2.130	0.2150	0.7741	0.5740	0.9743
MELD-Na score	+	Cystathionine	1.124	0.0398	1.418	0.3167	0.7674	0.5597	0.9750
MELD-Na score	+	Adenine	1.177	0.0012	1.425	0.1446	0.7671	0.5667	0.9676
MELD-Na score	+	Xylitol	1.138	0.0097	2.081	0.3330	0.7671	0.3421	1.0000
MELD-Na score	+	N-Acetylserine	1.169	0.0023	1.219	0.5192	0.7662	0.5989	0.9335
MELD-Na score	+	Cytidine	1.152	0.0049	1.872	0.1996	0.7594	0.5354	0.9834
MELD-Na score	+	Pseudouridine	1.164	0.0018	0.597	0.4666	0.7594	0.5467	0.9721
MELD-Na score			1.162	0.0020			0.7591	0.5553	0.9628
MELD-Na score	+	N4-Acetylcytidine	1.168	0.0074	1.040	0.8623	0.7442	0.5877	0.9007
MELD-Na score	+	N-Formylmethionine	1.146	0.0075	2.062	0.4006	0.7440	0.5339	0.9541
MELD-Na score	+	3-(4-Hydroxyphenyl)lactate	1.098	0.1204	1.932	0.1702	0.7440	0.5479	0.9400
MELD-Na score	+	7-Methylguanine	1.168	0.0020	2.651	0.3461	0.7365	0.4934	0.9796
MELD-Na score	+	3-Methoxytyramine Sulfate	1.159	0.0026	1.255	0.7981	0.7365	0.3450	1.0000
MELD-Na score	+	1-Methylhistidine	1.137	0.0107	1.758	0.0530	0.7358	0.5320	0.9395
MELD-Na Score	+	Phenyllactate	1.146	0.0071	2.881	0.3779	0.7213	0.0924	1.0000
MELD-Na score	+	4-Acetamidobutanoate	1.142	0.0216	1.934	0.0168	0.7126	0.5147	0.9106
MELD-Na score	+	3-Methoxtyrosine	1.105	0.0707	0.319	0.1265	0.6883	0.4361	0.9405

Bold font highlights the MELD-Na score.

^†Metabolites were expressed on a log2 scale - hazard ratios represent the risk of death associated with one log₂ unit increment.

^‡Data were sorted by AUROC (largest to smallest), then by p-value (smallest to largest).

^§CIs that did not include 0.50 were considered significant (e.g., 95% CIs for the AUROC of MELD-Na-myo-inositol model was significant because it did not include 0.50). Several models that combined MELD-Na score with a plasma metabolite predicted 1-year mortality with significantly greater accuracy (AUROC) compared with the accuracy (AUROC) of the MELD-Na score alone.

^¶SDMA; ADMA.

ADMA: Asymmetric dimethylarginine; AUROC: Area under the receiver operating characteristic; MELD-Na: Model for end-stage liver disease-Na; SDMA: Symmetric dimethylarginine.