Kukla Michał, Waluga Marek, Żorniak Michał, Berdowska Agnieszka, Wosiewicz Piotr, Sawczyn Tomasz, Bułdak Rafał J, Ochman Marek, Ziora Katarzyna, Krzemiński Tadeusz, Hartleb Marek
Michał Kukla, Marek Waluga, Michał Żorniak, Piotr Wosiewicz, Marek Hartleb, Department of Gastroenterology and Hepatology, Medical University of Silesia in Katowice, 40-752 Katowice, Poland.
World J Gastroenterol. 2017 Apr 14;23(14):2613-2624. doi: 10.3748/wjg.v23.i14.2613.
To investigate serum omentin and vaspin levels in cirrhotic patients; and to assess the relationship of these levels with hemostatic parameters, metabolic abnormalities, cirrhosis severity and etiology.
Fifty-one cirrhotic patients (17 with portal vein thrombosis) were analyzed. Serum omentin and vaspin levels were measured with commercially available direct enzyme-linked immunosorbent assays (ELISAs). To assess platelet activity, the following tests were performed using a MULTIPLATEPLATELET FUNCTION ANALYZER: (1) an ADP-induced platelet activation test; (2) a cyclooxygenase dependent aggregation test (ASPI test); (3) a von Willebrand factor and glycoprotein Ib-dependent aggregation (using ristocetin) test (RISTO test); and (4) a test for thrombin receptor-activating peptide-6 induced activation of the thrombin receptor, which is sensitive to IIb/IIIa receptor antagonists.
Omentin, but not vaspin, serum concentrations were significantly decreased in patients with portal vein thrombosis (PVT) ( = 0.01). Prothrombin levels were significantly increased in patients with PVT ( = 0.01). The thrombin receptor activating peptide (TRAP) test results were significantly lower in the PVT group ( = 0.03). No significant differences in adipokines serum levels were found regarding the etiology or severity of liver cirrhosis assessed according to the Child-Pugh or Model of End-Stage Liver Disease (MELD) scores. There was a significant increase in the TRAP ( = 0.03), ASPI ( = 0.001) and RISTO high-test ( = 0.02) results in patients with lower MELD scores. Serum omentin and vaspin levels were significantly down-regulated in patients without insulin resistance ( = 0.03, = 0.02, respectively). A positive relationship between omentin and vaspin levels were found both when all of the patients were analyzed ( = 0.41, = 0.01) and among those with PVT ( = 0.94, < 0.001).
Serum omentin levels are increased in patients without PVT. Cirrhosis origin and grade do not affect omentin and vaspin levels. The analyzed adipokines do not influence platelet activity.
研究肝硬化患者血清网膜素和内脏脂肪素水平；并评估这些水平与止血参数、代谢异常、肝硬化严重程度及病因之间的关系。
分析51例肝硬化患者（17例伴有门静脉血栓形成）。采用市售直接酶联免疫吸附测定法（ELISA）检测血清网膜素和内脏脂肪素水平。为评估血小板活性，使用多功能血小板功能分析仪进行以下检测：（1）ADP诱导的血小板活化试验；（2）环氧化酶依赖性聚集试验（ASPI试验）；（3）血管性血友病因子和糖蛋白Ib依赖性聚集（使用瑞斯托霉素）试验（RISTO试验）；（4）凝血酶受体激活肽-6诱导的凝血酶受体激活试验，该试验对IIb/IIIa受体拮抗剂敏感。
门静脉血栓形成（PVT）患者的网膜素血清浓度显著降低（P = 0.01），而内脏脂肪素血清浓度无显著变化。PVT患者的凝血酶原水平显著升高（P = 0.01）。PVT组的凝血酶受体激活肽（TRAP）试验结果显著降低（P = 0.03）。根据Child-Pugh或终末期肝病模型（MELD）评分评估的肝硬化病因或严重程度，脂肪因子血清水平无显著差异。MELD评分较低的患者，其TRAP（P = 0.03）、ASPI（P = 0.001）和RISTO高值试验（P = 0.02）结果显著升高。无胰岛素抵抗的患者血清网膜素和内脏脂肪素水平显著下调（分别为P = 0.03，P = 0.02）。分析所有患者时，网膜素和内脏脂肪素水平呈正相关（P = 0.41，P = 0.01）；在PVT患者中也呈正相关（P = 0.94，P < 0.001）。
无PVT的患者血清网膜素水平升高。肝硬化的起源和分级不影响网膜素和内脏脂肪素水平。所分析的脂肪因子不影响血小板活性。
