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Hyaluronic acid and aspartate aminotransferase levels normalized by liver function can reflect sinusoidal impairment in chronic liver disease
Author(s) -
Testa Emanuela,
Malfatti Federica,
Milazzo Sara,
Cordiviola Cinzia,
Cotellessa Tiziana,
Marabotto Elisa,
Giannini Edoardo,
Ceppa Paola,
Mamone Mario,
Risso Domenico,
Testa Roberto
Publication year - 2006
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2006.01251.x
Subject(s) - cirrhosis , gastroenterology , medicine , hyaluronic acid , fibrosis , liver disease , chronic hepatitis , liver function , chronic liver disease , liver function tests , immunology , virus , anatomy
Background/Aim: To evaluate the relationship between hyaluronic acid/aminopyrine breath test (HA/ABT) ratio and fibrosis score in chronic hepatitis, and between HA/ABT and clinical staging (child‐turcotte‐pugh'score, CTP; and model for end stage liver disease, MELD) in cirrhosis, as well as to evaluate the aspartate aminotransferase (AST)/ABT in relation to the HA/ABT. Methods: We studied 48 patients with histologically proven chronic hepatitis C (CHC) and 35 patients with compensated cirrhosis (CIR). Results: HA/ABT and AST/ABT showed a more significant correlation with the fibrosis score than HA or ABT or AST alone in the 48 CHC patients: r =0.568 ( P <0.0001), r =0.610 ( P <0.0001), r =0.450 ( P =0.0021), r =−0.449 ( P =0.0021), and r =0.472( P =0.0012), respectively. Progressive liver damage (fibrosis 1–2 vs fibrosis 3–6 vs cirrhosis) was significantly ( P <0.05) reflected by both HA/ABT (mean±SEM: 4.0±0.9 vs 18.1±4.2 vs 149.9±33.1) and AST/ABT (6.3±1.8 vs 12.7±1.6 vs 42.1±14.6). A strong relationship was found between HA/ABT and AST/ABT ( r =0.755 P <0.0001). In cirrhotic patients, the most significant relationship was observed between HA/ABT and CTP r =0.483 and P =0.0049, and MELD r =0.523 and P =0.0023. Conclusion: Considering that HA levels in chronic hepatitis depend on the progressive impairment of sinusoidal endothelial cells (SEC), related to progressive fibrosis, HA/ABT ratio would seem to be the most specific reflection of progressive impairment of the SEC. AST/ABT could be used as a possible surrogate of HA in identifying SEC impairment in chronic hepatitis.