Animals ; Chronic Disease ; Endotoxemia ; blood ; etiology ; Endotoxins ; blood ; Escherichia coli ; Humans ; Liver Cirrhosis ; blood ; complications ; Liver Diseases ; blood ; complications

OBJECTIVETo determine the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and evaluate their relationships with cardiac structure and function and liver function in patients with cirrhosis.

METHODSFifty patients with cirrhosis underwent two-dimensional Doppler echocardiography. The cirrhotic patients were divided into groups according to Child-Pugh score:Child-Pugh class A, n=15; Child-Pugh class B, n=20; Child-Pugh class C, n=15. Cardiac dimensions and left and right ventricular functions were evaluated. In addition, the plasma NT-proBNP was detected in the 50 cirrhotic patients and 11 healthy controls.

RESULTSThe levels of plasma NT-proBNP was significantly higher in cirrhotic patients than in healthy controls (240.15+/-80.87 pg/mL vs.55.86+/-20.13 pg/mL, P=0.000).The Child-Pugh class A, B and C groups showed no differences for left ventricular diameter, right ventricular diameter, septal thickness, left ventricular wall thickness, E wave, A wave, aortic annulus diameter, and the value of E/A.However, the left atrial diameter was significantly lower in the A group than in the C group (29.83+/-3.76 mm vs.35.08+/-3.68 mm, P=0.015) and in the B group than in the C group (31.78+/-4.05 mm vs.35.08+/-3.68 mm, P=0.000); there was no significant difference between the A and B groups. The plasma NT-proBNP was significantly lower in the A group than the C group (189.20+/-20.25 pg/mL vs.300.13+/-34.96 pg/mL, P=0.000) and in the B group than in the C group (202.34+/-31.20 pg/mL vs.300.13+/-34.96 pg/mL, P=0.000); there was no significant difference between the A and B groups (P=0.302).The NT-proBNP level was positively correlated with the left atrial diameter and the left ventricular wall thickness (r=0.540, P=0.000 andr=0.309, P=0.029 respectively).In addition, the NT-proBNP showed correlation with Child-Turcotte-Pugh score (r=0.454, P=0.001), albumin level (r=-0.376, P=0.007) and total bilirubin level (r=0.283, P=0.047).

CONCLUSIONs Increased levels of plasma NT-proBNP are related to disease severity in patients with cirrhosis.Furthermore, cardiac dysfunction in patients with cirrhosis may be related to increased plasma levels of NT-proBNP.

Heart Diseases ; complications ; Humans ; Liver Cirrhosis ; complications ; physiopathology ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood

Autoantibodies ; blood ; Cholangitis, Sclerosing ; complications ; diagnosis ; Hepatitis, Autoimmune ; complications ; diagnosis ; Humans ; Liver Cirrhosis, Biliary ; complications ; diagnosis

Biomarkers ; blood ; Biopsy, Needle ; utilization ; Hepatitis C ; complications ; Humans ; Liver ; pathology ; Liver Cirrhosis ; diagnosis ; pathology

Carcinoma, Hepatocellular ; blood ; complications ; virology ; Glycomics ; Hepatitis B virus ; Hepatitis B, Chronic ; blood ; Humans ; Liver Cirrhosis ; blood ; complications ; virology ; Liver Neoplasms ; blood ; complications ; virology ; Neoplasm Staging

Animals ; Fatty Liver ; blood ; complications ; Liver Cirrhosis ; blood ; etiology ; Male ; Mice ; Mice, Inbred C57BL ; Serum ; chemistry ; Thiazolidinediones ; pharmacology

OBJECTIVETo determine the clinical value of hepatic fibrosis parameters and serum ferritin (SF) in obese children with nonalcoholic fatty liver disease.

METHODSOne hundred and one obese children aged 6-15 years and 30 healthy children aged 9-14 years were enrolled in the study. Body mass index (BMI), waist circumference (WC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), hepatic fibrosis parameters including hyaluronic acid (HA), laminin (LN), serum type III procollagen (PCIII) and type IV collagen (CIV), serum ferritin and hepatic B-ultrasonography were assessed. All subjects were divided into 4 subgroups: simple obese children (SOC), simple nonalcoholic fatty liver (SNAFL), nonalcoholic steatohepatitis (NASH) and control group. ALT, AST, hepatic fibrosis parameters and serum ferritin were compared in these four groups.

RESULTCompared with control group, the serum levels of HA and PCIII increased significantly in SOC group (P <0.05); Serum levels of HA, PCIII, SF, ALT and AST also elevated markedly in SNAFL group and NASH group compared with those in control group. PCIII, SF, ALT, AST increased stepwise as the disease developed from SOC to SNAFL and NASH (P <0.05). SF was correlated with PCIII, ALT and AST (r=0.33,0.63,0.69,P <0.05) and PCIII was well related to ALT and AST (r=0.55,0.56,P <0.05). There were only 6 cases with SF >301 microg/L among all obese children, they were all NASH. The average levels of HA, CIV, PCIII, ALT, AST of these 6 cases were significantly higher than those of other NASH children.

CONCLUSIONAmong all hepatic fibrosis parameters, serum PCIII level is an early and sensitive indicator of NAFLD and is correlated with the disease progress. SF may be also involved in early injury of fatty liver and the process of NAFLD.

Adolescent ; Biomarkers ; blood ; Child ; Collagen Type III ; blood ; Fatty Liver ; blood ; etiology ; Female ; Ferritins ; blood ; Humans ; Liver Cirrhosis ; blood ; etiology ; Male ; Obesity ; blood ; complications

Biomarkers ; blood ; Diagnostic Techniques, Digestive System ; Elasticity ; Hepatitis C, Chronic ; complications ; Humans ; Liver ; pathology ; Liver Cirrhosis ; diagnosis ; etiology

OBJECTIVETo compare the clinical features of children with different clinical forms of congenital hepatic fibrosis (CHF), and provides a description of the characteristics of childhood CHF.

METHODSSixty children with CHF between January 2002 and June 2015 were enrolled, including 26 children with portal hypertensive CHF (PH CHF), 3 children with cholangitic CHF, 30 children with combined portal hypertensive and cholangitic CHF (mixed CHF), and 1 child with latent forms of CHF. The medical data of 26 children with PH CHF and 30 children with mixed CHF, including gender, age, clinical manifestations, physical signs, laboratory tests and imaging characteristics, were retrospectively studied.

RESULTSFever, jaundice and hepatomegaly were more frequently noted in children with mixed CHF than in those with PH CHF (P<0.05). Splenomegaly and liver cirrhosis occurred more often in children with CHF, but there was no significant difference in the incidences of splenomegaly and liver cirrhosis between the children with PH CHF and mixed CHF. The plasma prothrombin activity, white blood cell counts, platelet counts, mean platelet volume, serum levels of alanine transaminase, aspartate transaminase, alkaline phosphatase, γ-glutamyl transferase, leucine aminopeptidase, and total bile acids in children with mixed CHF were higher than in those with PH CHF (P<0.05). The decreased international normalized ratio and lower serum albumin levels were more frequently observed in children with mixed CHF than in those with PH CHF (P<0.05).

CONCLUSIONSPH and mixed CHF are common forms in childhood CHF. The children with the two forms of PH usually manifest portal hypertension such as cirrhosis and hepatosplenomegaly. The liver damage may be common in children with mixed CHF.

Adolescent ; Alkaline Phosphatase ; blood ; Child ; Female ; Genetic Diseases, Inborn ; complications ; diagnosis ; Humans ; Liver Cirrhosis ; complications ; diagnosis ; Male ; Splenomegaly ; etiology

OBJECTIVETo study the relationship between the plasma homocysteine (HCY) level and the polymorphism of N(5), N(10)-methylenetetrahydrofolate reductase (MTHFR) gene C667T in liver cirrhosis.

METHODS112 normal subjects and 87 liver cirrhosis patients were recruited in the study. Their plasma HCY levels were measured using high performance liquid chromatography with fluorescence detection and polymorphisms of their MTHFR gene were analyzed using PCR-RFLP.

RESULTSThe mean level of plasma HCY was significantly higher in patients with liver cirrhosis (21.71+/-4.86) micromol/L than that in healthy individuals (8.34+/-3.59) micromol/L. There were three kinds of MTHFR genotypes: +/+ (TT, homozygous mutation), +/- (CT, heterozygous mutation) and -/- (CC, wild type). The frequencies of the three genotypes were as follows: +/+, 29.9%; +/-, 52.9%; -/-, 17.2% in cirrhosis patients and +/+, 19.6%; +/-, 33.9%; -/-, 46.4% in normal subjects. The frequency of homozygous or heterozygous mutation was significantly higher in cirrhosis patients than that in the normal control. Moreover, plasma homocysteine level was markedly higher in patients with MTHFR genetic mutation than those without mutation.

CONCLUSIONSHyperhomocysteinemia may be an independent risk factor for liver cirrhosis. MTHFR is the main enzyme related to homocysteine metabolism. The genetic mutation of MTHFR C667T is possibly an important mechanism of hyperhomocysteinemia in liver cirrhosis. The level of plasma homocysteine may be an early indicator for liver cirrhosis.

Female ; Homocysteine ; blood ; Humans ; Hyperhomocysteinemia ; complications ; genetics ; Liver Cirrhosis ; complications ; genetics ; Male ; Methylenetetrahydrofolate Dehydrogenase (NAD+) ; genetics ; Point Mutation ; Polymorphism, Genetic