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Osteopontin: A non-invasive parameter of portal hypertension and prognostic marker of cirrhosis

World Journal of Gastroenterology 2016年第12期22卷 3441-3450页

作者： Radan Bruha Marie Jachymova jaromir petrtyl Karel Dvorak Martin Lenicek Petr Urbanek Tomislav Svestka Libor Vitek 4~(th) Department of Internal Medicine 1~(st) Faculty of Medicine and General University Hospital Charles University in Prague Institute of Clinical Biochemistry and Laboratory Diagnostics 1~(st) Faculty of Medicine Charles University in Prague Department of Internal Medicine Central Military Hospital and 1~(st) Faculty of Medicine Charles University in Prague

AIM: To investigate the relationship between osteopontin plasma concentrations and the severity of portal hypertension and to assess osteopontin prognostic value.METHODS: A cohort of 154 patients with confirmed liver cirrhosis(112 ethylic, 108 men, age 34-72 years)were enrolled in the study. Hepatic venous pressure gradient(HVPG) measurement and laboratory and ultrasound examinations were carried out for all patients. HVPG was measured using a standard catheterization method with the balloon wedge technique. Osteopontin was measured using the enzyme-linked immunosorbent assay(ELISA) method in plasma. Patients were followed up with a specific focus on mortality. The control group consisted of 137 healthy age- and sex- matched individuals.RESULTS: The mean value of HVPG was 16.18 ± 5.6 mm Hg. Compared to controls, the plasma levels of osteopontin in cirrhotic patients were significantly higher(P 10 mm Hg and 65% for those with HVPG ≤ 10 mm Hg(P = 0.0086, odds ratio(OR), 2.92, 95% confidence interval(CI): 1.09-7.76). Osteopontin showed a similar prognostic value to HVPG. Patients with osteopontin values above 80 ng/m L had significantly lower cumulative survival compared to those with osteopontin ≤ 80 ng/m L(37% vs 56%, P = 0.00035; OR = 2.23, 95%CI: 1.06-4.68).CONCLUSION: Osteopontin is a non-invasive parameter of portal hypertension that distinguishes patients with clinically significant portal hypertension. It is a strong prognostic factor for survival.

关键词： Cirrhosis Complications of cirrhosis Hepatic venous pressure gradient Osteopontin Portal hypertensio

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