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Is neutrophil gelatinase associated lipocalin useful in hepatitis C virus infection?

World Journal of Hepatology 2016年第19期8卷 815-824页

作者： Alessio Strazzulla Giuseppe Coppolino Concetta Di Fatta Francesca Giancotti Giuseppina D'Onofrio Maria Concetta Postorino Maria Mazzitelli Selma Valerie Mammone Innocenza Gentile Laura Rivoli Eleonora Palella Tiziana Gravina Chiara Costa Vincenzo Pisani Vincenzo De Maria Giorgio Settimo Barreca Nadia Marascio Alfredo Focà Giorgio Fuiano elio gulletta Carlo Torti Infectious Diseases Unit Department of Medical and Surgical Sciences "Magna Graecia" University Nephrology and Dialysis Unit "Pugliese-Ciaccio" Hospital Clinical Pathology Unit Department of Health Sciences "Magna Graecia" University Hepatology Unit "Mater Domini" Teaching Hospital Nephrology Unit Department of Medical and Surgical Sciences "Magna Graecia" University Microbiology Unit Department of Health Sciences "Magna Graecia" University

AIM: To evaluate neutrophil gelatinase associated lipocalin(NGAL) in patients infected by hepatitis C virus(HCV) before and during treatment with directly acting antivirals(DAAs).METHODS: NGAL was measured in a group of patients with chronic HCV infection ranked, at baseline, by age, gender, anti-hypertensive therapy, HCV viral load, liver fibrosis stage and, either at baseline or after 1 year, estimated glomerular filtration rate(e GFR). Then, NGAL and e GFR evolutions were monitored in a subgroup of patients who started antiviral therapy with DAAs. Differences of median NGAL levels were evaluated through Wilcoxon-Mann-Whitney test for nonparametric data. Differences in dichotomous variables were evaluated through χ~2 test. At baseline, a univariate regression analysis was conducted to verify if NGAL values correlated with other quantitative variables [age, fibrosis four(FIB-4), AST to platelet ratio index(APRI), and e GFR]. RESULTS: Overall, 48 patients were enrolled, 8 of them starting HCV treatment. At baseline, statistically significant differences were found in median NGAL values only between patients with e GFR 118.11 ng/d L were compared with those of NGAL ≤ 118.11 ng/d L, not statistically significant differences were present for age, gender, chronic kidney disease classification and liver fibrosis(P > 0.05). Linear correlation was found between NGAL and both age(P = 0.0475) and e GFR(P = 0.0282) values. Not statistically significant predictions of NGAL at baseline were demonstrated for e GFR evolution 1 year later. Interestingly, in the 8 patients treated with DAAs, median NGAL significantly increased at week 12 compared to baseline(P = 0.0239).CONCLUSION: Our results suggest that NGAL should be further evaluated as an adjunct marker of kidney function in these patients.

关键词： Directly acting antivirals Hepatitis C virus Inflammation Neutrophil gelatinase lipocalin Tubular impairment

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