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Plasma Nogo-A and placental growth factor levels are associated with portal hypertension in patients with liver cirrhosis

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World Journal of Gastroenterology 2019年第23期25卷 2935-2946页

作者： Sigita Gelman Violeta Salteniene Andrius Pranculis Jurgita Skieceviciene Romanas Zykus dalius petrauskas Limas Kupcinskas Ali Canbay Alexander Link Juozas Kupcinskas Department of Gastroenterology Medical AcademyLithuanian University of Health SciencesKaunas 44307Lithuania Institute for Digestive Research Medical AcademyLithuanian University of Health SciencesKaunas 44307Lithuania Department of Radiology Medical AcademyLithuanian University of Health SciencesKaunas 44307Lithuania Institute for Digestive Research and Department of Gastroenterology Medical AcademyLithuanian University of Health SciencesKaunas 44307Lithuania Department of Gastroenterology Hepatology and Infectious Diseases Otto-von-Guericke UniversityMagdeburg 39106Germany

BACKGROUND Clinically significant portal hypertension(CSPH) and severe portal hypertension(SPH) increase the risk for decompensation and life-threatening complications in liver cirrhosis. Pathologic angiogenesis might contribute to the formation of these conditions. Placental growth factor(PlGF) and Nogo-A protein are biomarkers of pathological angiogenesis, but data on their role in liver cirrhosis and portal hypertension is scarce.AIM To determine plasma levels of PlGF and Nogo-A in patients with liver cirrhosis,CSPH, SPH and potential to predict portal hypertension.METHODS A cohort of 122 patients with hepatitis C virus and/or alcohol-induced liver cirrhosis with characterized hepatic venous pressure gradient(HVPG) were included in the study. Demographic data, medical history, Child-Turcotte-Pugh and Model of End Stage liver disease score, clinical chemistry, liver stiffnessvalues were recorded on the day of the procedure prior HVPG measurement. The degree of portal hypertension was determined by the invasive HVPG measurement. Nogo-A and PlGF plasma levels were evaluated using enzyme linked immunosorbent assay. The control group consisted of 30 healthy age-and sex-matched individuals.RESULTS Peripheral PlGF levels were higher and Nogo-A levels were lower in patients with liver cirrhosis(23.20 vs 9.85;P < 0.0001 and 2.19 vs 3.12;P = 0.004 respectively). There was a positive linear correlation between peripheral levels of PlGF and HVPG(r = 0.338, P = 0.001) and negative linear correlation between the peripheral Nogo-A levels and HVPG(r =-0.267, P = 0.007). PlGF levels were higher in CSPH and SPH(P = 0.006;P < 0.0001) whereas Nogo-A levels were lower(P = 0.01;P < 0.033). Area under the curve for the diagnosis of CSPH for PlGF was 0.68(P = 0.003) and for Nogo-A-0.67(P = 0.01);for SPH 0.714(P <0.0001) and 0.65(P = 0.014) respectively. PlGF levels were higher and Nogo-A levels were lower in patients with esophageal varices(P < 0.05). PlGF cut-off value of 25 pg/mL distinguished patients with CSPH at 55.7% sensitivit

关键词： Liver cirrhosis Portal hypertension Angiogenesis Placental growth factor Nogo-A Hepatic venous pressure gradient

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Disease-specific health-related quality of life and its determinants in liver cirrhosis patients in Lithuania

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World Journal of Gastroenterology 2006年第48期12卷 7792-7797页

作者： Jolanta Sumskiene Linas Sumskas dalius petrauskas Limas Kupcinskas Department of Gastroenterology Kaunas University of Medicine A.Mickeviciaus street 9 Kaunas LT-44307 Lithuania Institute for Biomedical Research of Kaunas University of Medicine Eiveniu street 4 Kaunas LT-50009 Lithuania

AIM: To evaluate disease-specific quality of life (QOL) in liver cirrhosis patients and to compare it with those of a healthy population. Also an important objective was to assess whether QOL in liver cirrhosis patients differs by age and gender, by type and severity of disease. METHODS: The case group of 131 liver cirrhosis patients was selected. The control group of 262 was enrolled from a healthy population according to the scheme of case-control study. Clinical, demographic, laboratory data were collected. QOL was measured with a specific chronic liver disease questionnaire (CLDQ), which was translated and validated in Lithuanian. QOL scores were compared between groups by age, gender, type and severity of disease. Cronbach’s alpha statistics calculation was used for evaluation of internal consistency reliability. Student’s t test or ANOVA were used for evaluation hypothesis about probability equation. RESULTS: QOL was significantly lower in liver cirrhosis patients than in healthy population (59.5 ± 18.3 vs 85.3 ± 12.3, P < 0.001). The significant QOL differences between case and control groups were observed in domains of worry and abdominal symptoms, the smaller differences-in emotional functions and systematic symptom domains. Significantly worse QOL was in observed patients with increased clinical severity of the disease measured by Child-Pugh class. Age, gender and etiology of disease had an insignificant effect on QOL in cirrhotic patients. CONCLUSION: QOL was significantly impaired in all CLDQ domains in liver cirrhosis patients. Increase in severity of disease was the major factor associated with poorer QOL.

关键词：生活质量立陶宛肝硬化病理机制

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