Serum autotaxin is a parameter for the severity of liver cirrhosis and overall survival in patients with liver cirrhosis--a prospective cohort study.
Serum autotaxin is a parameter for the severity of liver cirrhosis and overall survival in patients with liver cirrhosis--a prospective cohort study.
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DOI：
10.1371/journal.pone.0103532
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Waidmann O
中科院分区：
文献类型：
--
作者：
Pleli T;Martin D;Kronenberger B;Brunner F;Köberle V;Grammatikos G;Farnik H;Martinez Y;Finkelmeier F;Labocha S;Ferreirós N;Zeuzem S;Piiper A;Waidmann O
自分泌运动因子（ATX）及其产物溶血磷脂酸（LPA）被认为参与肝纤维化的发展，并且已在患有丙型肝炎病毒相关肝纤维化的患者中发现血清ATX水平升高。然而，全身ATX在肝硬化阶段的临床作用尚不清楚。本研究旨在探讨ATX血清水平与肝硬化严重程度及预后的关系。前瞻性入组肝硬化患者，并随访至死亡、肝移植或末次联系。通过酶联免疫吸附试验评估研究入选当天采集的血样的ATX含量。ATX水平与肝硬化的分期及并发症有关。通过单因素和多因素考克斯回归分析研究ATX的预后价值。LPA浓度通过液相色谱-串联质谱法测定。270例患者入组。与健康受试者相比，肝硬化受试者的ATX血清水平升高（0.814±0.42 mg/l vs. 0.258±0.40 mg/l，P<0.001）。血清ATX水平与Child-Pugh分期、终末期肝病模型（MELD）评分及LPA水平相关（r = 0.493，P = 0.027）。 肝性脑病（P = 0.006）、食管静脉曲张（P = 0.002）和门脉高压性胃病（P = 0.008）患者的ATX水平高于无这些并发症的患者。 低ATX水平是与较长总生存期独立相关的参数（风险比0.575，95%置信区间0.365-0.905，P = 0.017）。 血清ATX是肝病严重程度和肝病患者预后的指标。
Autotaxin (ATX) and its product lysophosphatidic acid (LPA) are considered to be involved in the development of liver fibrosis and elevated levels of serum ATX have been found in patients with hepatitis C virus associated liver fibrosis. However, the clinical role of systemic ATX in the stages of liver cirrhosis was unknown. Here we investigated the relation of ATX serum levels and severity of cirrhosis as well as prognosis of cirrhotic patients. Patients with liver cirrhosis were prospectively enrolled and followed until death, liver transplantation or last contact. Blood samples drawn at the day of inclusion in the study were assessed for ATX content by an enzyme-linked immunosorbent assay. ATX levels were correlated with the stage as well as complications of cirrhosis. The prognostic value of ATX was investigated by uni- and multivariate Cox regression analyses. LPA concentration was determined by liquid chromatography-tandem mass spectrometry. 270 patients were enrolled. Subjects with liver cirrhosis showed elevated serum levels of ATX as compared to healthy subjects (0.814±0.42 mg/l vs. 0.258±0.40 mg/l, P<0.001). Serum ATX levels correlated with the Child-Pugh stage and the MELD (model of end stage liver disease) score and LPA levels (r = 0.493, P = 0.027). Patients with hepatic encephalopathy (P = 0.006), esophageal varices (P = 0.002) and portal hypertensive gastropathy (P = 0.008) had higher ATX levels than patients without these complications. Low ATX levels were a parameter independently associated with longer overall survival (hazard ratio 0.575, 95% confidence interval 0.365–0.905, P = 0.017). Serum ATX is an indicator for the severity of liver disease and the prognosis of cirrhotic patients.
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影响因子：
6.5
作者：
Masuda, Akiko;Nakamura, Kazuhiro;Yatomi, Yutaka
通讯作者：
Yatomi, Yutaka
影响因子：
4
作者：
Jansen, S;Stefan, C;Bollen, M
通讯作者：
Bollen, M
影响因子：
3.7
作者：
Sisignano M;Angioni C;Ferreiros N;Schuh CD;Suo J;Schreiber Y;Dawes JM;Antunes-Martins A;Bennett DL;McMahon SB;Geisslinger G;Scholich K
通讯作者：
Scholich K
DOI：
10.1006/bbrc.1998.8983
发表时间：
1998-07-20
影响因子：
3.1
作者：
Ikeda, H;Yatomi, Y;Fujiwara, K
通讯作者：
Fujiwara, K
影响因子：
24.5
作者：
Cardenas, Andres;Gines, Pere
通讯作者：
Gines, Pere