Prystupa Andrzej, Kiciński Paweł, Luchowska-Kocot Dorota, Błażewicz Anna, Kurys-Denis Ewa, Niedziałek Jarosław, Sak Jarosław, Panasiuk Lech
Department of Internal Medicine, Medical University of Lublin, Lublin, Poland.
Department of Family Medicine, Medical University of Lublin, Lublin, Poland.
Ann Agric Environ Med. 2017 Sep 21;24(3):544-548. doi: 10.26444/aaem/76937. Epub 2017 Sep 16.
Liver cirrhosis is a disease involving the liver parenchyma, which is characterised by fibrosis and impaired architectonics of the parenchyma with regenerative nodules. The aim of the study was to determine the relationship between stage of alcoholic liver cirrhosis, concentrations of selenium, zinc and profibrotic and proangiogenic cytokines (FGF-19, ENG).
The study included 99 patients with alcoholic cirrhosis and 20 healthy subjects. Ion chromatography with UV/VIS detection was used for determination of zinc ions in the previously mineralized serum samples. The measurements of selenium were performed with the ContrAA700 high-resolution continuum source graphite tube atomic absorption spectrometer. ELISA was used to determine concentration of FGF-19 and ENG in serum samples.
Concentrations of zinc and selenium were significantly decreased in cirrhotic patients (p<0.001 for both). The highest concentration of FGF-19 was found in Child-Pugh stage C liver cirrhosis patients (806.9±650.3 pg/ml), and was significantly higher than observed in controls (p=0.005) and stage A patients (compensated cirrhosis) (p=0.02). The highest concentration of ENG was demonstrated in the control group (3.24±148 ng/ml) while the lowest in patients with decompensated cirrhosis (7.32±5.39 ng/ml and 7.92±4.18 ng/ml for stage B and C; p=0.03 and p=0.02, respectively). The use of the multiple-variable model demonstrated that the independent factors affecting the concentration of ENG were the concentration of bilirubin (p=0.02), INR (p=0.01) and duration of alcohol abuse (p=0.02). The independent determinants of FGF-19 concentrations were found to be the stage (severity) of liver cirrhosis (p=0.04) and INR (p=0.03).
Concentrations of zinc and selenium in serum of patients with alcoholic liver cirrhosis are not independently related to concentrations of FGF-19 and ENG.
肝硬化是一种累及肝实质的疾病，其特征为纤维化以及伴有再生结节的肝实质结构破坏。本研究的目的是确定酒精性肝硬化的阶段与硒、锌浓度以及促纤维化和促血管生成细胞因子（FGF - 19、ENG）之间的关系。
本研究纳入了99例酒精性肝硬化患者和20名健康受试者。采用配有紫外/可见检测的离子色谱法测定先前矿化血清样本中的锌离子。使用ContrAA700高分辨率连续光源石墨管原子吸收光谱仪进行硒的测量。采用酶联免疫吸附测定法（ELISA）测定血清样本中FGF - 19和ENG的浓度。
肝硬化患者的锌和硒浓度显著降低（两者均p<0.001）。在Child - Pugh C期肝硬化患者中发现FGF - 19的浓度最高（806.9±650.3 pg/ml），且显著高于对照组（p = 0.005）和A期患者（代偿期肝硬化）（p = 0.02）。对照组中ENG的浓度最高（3.24±148 ng/ml），而失代偿期肝硬化患者中最低（B期和C期分别为7.32±5.39 ng/ml和7.92±4.18 ng/ml；p分别为0.03和0.02）。多变量模型分析表明，影响ENG浓度的独立因素为胆红素浓度（p = 0.02）、国际标准化比值（INR）（p = 0.01）和酒精滥用持续时间（p = 0.02）。发现FGF - 19浓度的独立决定因素为肝硬化的阶段（严重程度）（p = 0.04）和INR（p = 0.03）。
酒精性肝硬化患者血清中的锌和硒浓度与FGF - 19和ENG的浓度无独立相关性。
