Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya, Hyogo, Japan.
Ann Hepatol. 2013 May-Jun;12(3):471-8.
The relationships between the metabolic parameters and the endoscopic findings of esophageal varices have been poorly investigated. We investigated the association of the branched-chain amino acids to tyrosine ratio (BTR) with the severity of liver fibrosis and esophageal varices.
We studied hepatitis C virus (HCV)-positive chronic liver disease patients who had undergone liver biopsy (n = 149). The relationship between the BTR values and the liver fibrotic stage was investigated. We also studied whether the BTR value was associated with the presence and bleeding risk of varices in patients with HCV-related compensated cirrhosis.
The mean values of the BTR decreased with the progression of the fibrosis (METAVIR score: F0-1: 6.40 ± 1.19; F2: 5.85 ± 1.33; F3: 5.24 ± 0.97, F4: 4.78 ± 1.14). In the 58 patients with HCV-related compensated cirrhosis, the mean values of the BTR decreased with the severity of varices (patients without varices: 5.01 ± 1.15, patients with a low-risk varices: 4.42 ± 1.06, patients with a high-risk varices: 3.86 ± 1.02). The BTR value was significantly lower in the patients with varices than in those without varices (4.17 ± 1.07 vs. 5.01 ± 1.15, P < 0.01). The BTR value was also significantly lower in the patients with a high risk of hemorrhage than in those with a low risk (3.86 ± 1.02 vs. 4.78 ± 1.14, P < 0.01). Furthermore, the BTR value was the most significantly different parameter, with the smallest P-value among all the factors examined, including the platelet count and albumin level.
A decreased BTR value was found to be associated with the progression of liver fibrosis and severity of varices.
代谢参数与食管静脉曲张内镜检查结果之间的关系尚未得到充分研究。我们研究了支链氨基酸与酪氨酸比值（BTR）与肝纤维化和食管静脉曲张严重程度的关系。
我们研究了接受过肝活检的丙型肝炎病毒（HCV）阳性慢性肝病患者（n=149）。研究了 BTR 值与肝纤维化分期之间的关系。我们还研究了 BTR 值是否与 HCV 相关代偿性肝硬化患者静脉曲张的存在和出血风险相关。
BTR 值随纤维化程度的进展而降低（METAVIR 评分：F0-1：6.40±1.19；F2：5.85±1.33；F3：5.24±0.97，F4：4.78±1.14）。在 58 例 HCV 相关代偿性肝硬化患者中，BTR 值随静脉曲张严重程度的增加而降低（无静脉曲张患者：5.01±1.15，低危静脉曲张患者：4.42±1.06，高危静脉曲张患者：3.86±1.02）。静脉曲张患者的 BTR 值明显低于无静脉曲张患者（4.17±1.07 vs. 5.01±1.15，P<0.01）。高危出血风险患者的 BTR 值也明显低于低危出血风险患者（3.86±1.02 vs. 4.78±1.14，P<0.01）。此外，BTR 值是所有检查因素中差异最显著的参数，其 P 值最小。
BTR 值降低与肝纤维化进展和静脉曲张严重程度相关。
