Serum autotaxin is a parameter for the severity of liver cirrhosis and overall survival in patients with liver cirrhosis--a prospective cohort study.

<h4>Background</h4>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 s...

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Autores principales: Thomas Pleli, Daniel Martin, Bernd Kronenberger, Friederike Brunner, Verena Köberle, Georgios Grammatikos, Harald Farnik, Yolanda Martinez, Fabian Finkelmeier, Sandra Labocha, Nerea Ferreirós, Stefan Zeuzem, Albrecht Piiper, Oliver Waidmann
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Publicado: Public Library of Science (PLoS) 2014
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spelling oai:doaj.org-article:f85ff14292e741c48d9e01f2f8ef19b12021-11-25T06:07:04ZSerum autotaxin is a parameter for the severity of liver cirrhosis and overall survival in patients with liver cirrhosis--a prospective cohort study.1932-620310.1371/journal.pone.0103532https://doaj.org/article/f85ff14292e741c48d9e01f2f8ef19b12014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25062038/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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).<h4>Conclusion</h4>Serum ATX is an indicator for the severity of liver disease and the prognosis of cirrhotic patients.Thomas PleliDaniel MartinBernd KronenbergerFriederike BrunnerVerena KöberleGeorgios GrammatikosHarald FarnikYolanda MartinezFabian FinkelmeierSandra LabochaNerea FerreirósStefan ZeuzemAlbrecht PiiperOliver WaidmannPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 7, p e103532 (2014)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Thomas Pleli
Daniel Martin
Bernd Kronenberger
Friederike Brunner
Verena Köberle
Georgios Grammatikos
Harald Farnik
Yolanda Martinez
Fabian Finkelmeier
Sandra Labocha
Nerea Ferreirós
Stefan Zeuzem
Albrecht Piiper
Oliver Waidmann
Serum autotaxin is a parameter for the severity of liver cirrhosis and overall survival in patients with liver cirrhosis--a prospective cohort study.
description <h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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).<h4>Conclusion</h4>Serum ATX is an indicator for the severity of liver disease and the prognosis of cirrhotic patients.
format article
author Thomas Pleli
Daniel Martin
Bernd Kronenberger
Friederike Brunner
Verena Köberle
Georgios Grammatikos
Harald Farnik
Yolanda Martinez
Fabian Finkelmeier
Sandra Labocha
Nerea Ferreirós
Stefan Zeuzem
Albrecht Piiper
Oliver Waidmann
author_facet Thomas Pleli
Daniel Martin
Bernd Kronenberger
Friederike Brunner
Verena Köberle
Georgios Grammatikos
Harald Farnik
Yolanda Martinez
Fabian Finkelmeier
Sandra Labocha
Nerea Ferreirós
Stefan Zeuzem
Albrecht Piiper
Oliver Waidmann
author_sort Thomas Pleli
title Serum autotaxin is a parameter for the severity of liver cirrhosis and overall survival in patients with liver cirrhosis--a prospective cohort study.
title_short Serum autotaxin is a parameter for the severity of liver cirrhosis and overall survival in patients with liver cirrhosis--a prospective cohort study.
title_full Serum autotaxin is a parameter for the severity of liver cirrhosis and overall survival in patients with liver cirrhosis--a prospective cohort study.
title_fullStr Serum autotaxin is a parameter for the severity of liver cirrhosis and overall survival in patients with liver cirrhosis--a prospective cohort study.
title_full_unstemmed Serum autotaxin is a parameter for the severity of liver cirrhosis and overall survival in patients with liver cirrhosis--a prospective cohort study.
title_sort serum autotaxin is a parameter for the severity of liver cirrhosis and overall survival in patients with liver cirrhosis--a prospective cohort study.
publisher Public Library of Science (PLoS)
publishDate 2014
url https://doaj.org/article/f85ff14292e741c48d9e01f2f8ef19b1
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