AUTOTAXIN, COPEPTIN AND CERULOPLASMIN AS MARKERS OF THE PROGRESSION OF ALCOHOLIC LIVER DISEASE
Abstract
Background. Alcoholic liver disease (ALD) covers a spectrum of progressively worsening liver diseases ranging from asymptomatic steatosis (80%) to hepatitis (10-35%), fibrosis and cirrhosis (10%) and is one of the most prevalent causes of liver disease-associated mortality. Objective. To detect the association between ceruloplasmin, copeptin and autotaxin levels and ALD, its severity and prognosis. Material and methods. An open case-control study was conducted with the case group including 92 ALD patients with signs of liver cirrhosis (LC) and the control group of 36 healthy volunteers. Copeptin, autotaxin and ceruloplasmin concentrations were determined by solid-phase enzyme-linked immunosorbent assay (ELISA) according to the manufacturer's instructions for the reagent kits. Results. The levels of copeptin and autotaxin in ALD patients were higher than in healthy volunteers (p <0,0001). Ceruloplasmin rose alongside with the severity of ALD according to Child-Pugh classification (p=0.006). Ceruloplasmin levels showed a positive correlation with cytolysis syndrome (with alanine aminotransferase and aspartate aminotransferase, p=0.009 and p=0.005, respectively) and severity of the liver disease (with total bilirubin; p=0.05). No marker demonstrated any association with key inflammatory markers except for autotaxin, which directly correlated with leukocyte count (p=0.002). Copeptin levels were statistically significantly lower in the group of patients with ALD and renal dysfunction as compared with those without renal dysfunction (p=0.03). No other associations between the levels of the markers and the presence of ALD complications were found (p>0.05). Conclusion. Elevated blood levels of autotaxin and copeptin in ALD patients are diagnostic for cirrhosis, while elevated ceruloplasmin values are associated with the severity of cirrhosis, as determined by the Child-Pugh scale.
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