1.Clinical Implications of the Serum Apelin Level on Portal Hypertension and Prognosis of Liver Cirrhosis.
Yoo Li LIM ; Eunhee CHOI ; Yoon Ok JANG ; Youn Zoo CHO ; Yong Seok KANG ; Soon Koo BAIK ; Sang Ok KWON ; Moon Young KIM
Gut and Liver 2016;10(1):109-116
BACKGROUND/AIMS: Levels of serum apelin (s-apelin), an endogenous ligand for angiotensin-like receptor 1, have been shown to be related to hepatic fibrosis and hemodynamic abnormalities in preclinical studies. We investigated the clinical implications of s-apelin as a noninvasive prognostic biomarker for chronic liver disease (CLD). METHODS: From January 2009 to December 2012, 215 CLD patients were enrolled and underwent clinical data collection, hepatic venous pressure gradient (HVPG) measurement, and liver biopsy. s-apelin was detected with a human total apelin enzyme-linked immunosorbent assay kit. All patients were prospectively observed during the median follow-up period of 23.0±12.9 months for decompensation and mortality. RESULTS: A total of 42 patients (19.5%) died during the follow-up period. s-apelin was significantly correlated with measurements of liver stiffness (R2=0.263, p<0.001) and collagen proportional area (R2=0.213, p<0.001) measured from liver biopsy tissue and HVPG (R2=0.356, p<0.001). In a multivariate analysis using a Cox regression hazard model, s-apelin was a weakly significant predictor of decompensation (hazard ratio [HR], 1.002; p<0.001) and mortality (HR, 1.003; p<0.001). CONCLUSIONS: s-apelin showed a significant relationship with CLD severity. However, its significance as a noninvasive biomarker for disease severity and prognosis was weak.
Adult
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Biomarkers/blood
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Biopsy
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Enzyme-Linked Immunosorbent Assay
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Female
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Follow-Up Studies
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Humans
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Hypertension, Portal/*blood/complications/mortality
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Intercellular Signaling Peptides and Proteins/*blood
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Liver/blood supply/pathology
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Liver Cirrhosis/*blood/etiology/mortality/pathology
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Male
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Middle Aged
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Portal Pressure
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Prognosis
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Proportional Hazards Models
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Prospective Studies