Department of Biochemistry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Rama IV Road, Patumwan, Bangkok 10330, Thailand.
World J Gastroenterol. 2010 Nov 21;16(43):5467-73. doi: 10.3748/wjg.v16.i43.5467.
To analyze plasma osteopontin levels and liver stiffness using transient elastography in postoperative biliary atresia (BA) children compared with healthy controls.
Thirty children with postoperative BA and 10 normal controls were enrolled. The patients were categorized into two groups according to their jaundice status. Plasma levels of osteopontin were determined using commercially available enzyme-linked immunosorbent assay. Liver stiffness was measured by using transient elastography (Fibroscan). Ten validated Fibroscan measurements were performed in each patient and control with the result expressed in kilopascals (kPa).
Plasma osteopontin was significantly elevated in BA children compared with that of healthy controls (47.0 ± 56.4 ng/mL vs 15.1 ± 15.0 ng/mL, P = 0.01). The liver stiffness measurement was markedly elevated in the patients with BA compared with that of controls (26.9 ± 24.6 kPa vs 3.9 ± 0.7 kPa, P = 0.001). Subgroup analysis showed that the BA patients with jaundice had more pronounced plasma osteopontin levels than those without jaundice (87.1 ± 61.6 ng/mL vs 11.9 ± 6.1 ng/mL, P = 0.001). Furthermore, the mean liver stiffness was significantly greater in the jaundiced BA patients compared with non-jaundiced patients (47.7 ± 21.8 kPa vs 8.7 ± 3.0 kPa, P = 0.001). Additionally, plasma osteopontin was positively related to serum total bilirubin (r = 0.64, P < 0.001). There was also a correlation between plasma osteopontin and liver stiffness values (r = 0.60, P < 0.001).
High plasma osteopontin positively correlated with degree of hepatic fibrosis and could be used as a biochemical parameter reflecting disease severity in postoperative BA children.
分析术后胆道闭锁(BA)患儿与健康对照者的血浆骨桥蛋白水平和肝脏硬度,采用瞬时弹性成像技术。
纳入 30 例术后 BA 患儿和 10 例正常对照者。根据患儿的黄疸状态将其分为两组。采用商用酶联免疫吸附试验测定骨桥蛋白的血浆水平。采用瞬时弹性成像(Fibroscan)测量肝脏硬度。对每位患者和对照者进行 10 次经验证的 Fibroscan 测量,结果以千帕斯卡(kPa)表示。
BA 患儿的血浆骨桥蛋白水平明显高于健康对照者(47.0±56.4ng/ml 比 15.1±15.0ng/ml,P=0.01)。BA 患儿的肝脏硬度测量值明显高于对照组(26.9±24.6kPa 比 3.9±0.7kPa,P=0.001)。亚组分析显示,有黄疸的 BA 患儿的血浆骨桥蛋白水平比无黄疸者更显著(87.1±61.6ng/ml 比 11.9±6.1ng/ml,P=0.001)。此外,黄疸性 BA 患儿的平均肝脏硬度明显大于非黄疸性患儿(47.7±21.8kPa 比 8.7±3.0kPa,P=0.001)。此外,血浆骨桥蛋白与血清总胆红素呈正相关(r=0.64,P<0.001)。血浆骨桥蛋白与肝脏硬度值之间也存在相关性(r=0.60,P<0.001)。
高血浆骨桥蛋白与肝纤维化程度呈正相关,可作为反映术后 BA 患儿疾病严重程度的生化指标。