Collazos J, Díaz F, Genollá J
Servicio de Medicina Interna, Hospital de Galdácano, Vizcaya, Spain.
Gut. 1993 Jul;34(7):974-6. doi: 10.1136/gut.34.7.974.
Laminin, a glycoprotein synthesised by Ito cells, has been considered a marker of fibrogenesis. The behaviour of laminin and clinical and laboratory data in 83 patients with cirrhosis were studied to find the factors associated with increases in this glycoprotein. There were increased concentrations of laminin in 62.7% of the patients (40% of the Child's A, 64.5% of the Child's B, and 75% of the Child's C categories). Significant differences in laminin concentrations were found between the Child's grades (p = 0.009) and between patients and controls (p < 0.0001). Correlations were found between laminin concentrations and mean corpuscular volume, aspartate aminotransferase, aspartate aminotransferase: alanine aminotransferase ratio, alkaline phosphatase activity, bilirubin and glycocholic acid concentrations, and hypoalbuminaemia--that is, variables related to liver insufficiency and alcohol intake. Moreover, patients with an alcohol intake higher than 100 g/day had higher laminin concentrations than those with a lower intake (p = 0.03). Conversely, there was no significant association with portal hypertension. Multivariate analysis showed that mean corpuscular volume, bilirubin concentrations, and hypoalbuminaemia were independently associated with laminin concentrations. Poor degradation associated with liver insufficiency seems to play an important part in the increase in serum laminin concentrations in these patients.
层粘连蛋白是一种由肝星状细胞合成的糖蛋白,一直被视为纤维生成的标志物。对83例肝硬化患者的层粘连蛋白行为以及临床和实验室数据进行了研究,以找出与这种糖蛋白增加相关的因素。62.7%的患者层粘连蛋白浓度升高(Child's A级患者中为40%,Child's B级患者中为64.5%,Child's C级患者中为75%)。在Child's分级之间(p = 0.009)以及患者与对照组之间(p < 0.0001)发现层粘连蛋白浓度存在显著差异。发现层粘连蛋白浓度与平均红细胞体积、天冬氨酸转氨酶、天冬氨酸转氨酶:丙氨酸转氨酶比值、碱性磷酸酶活性、胆红素和甘氨胆酸浓度以及低白蛋白血症之间存在相关性,即与肝功能不全和酒精摄入相关的变量。此外,酒精摄入量高于100克/天的患者层粘连蛋白浓度高于摄入量较低的患者(p = 0.03)。相反,与门静脉高压无显著关联。多变量分析表明,平均红细胞体积、胆红素浓度和低白蛋白血症与层粘连蛋白浓度独立相关。与肝功能不全相关的降解不良似乎在这些患者血清层粘连蛋白浓度升高中起重要作用。