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Category: Volume 07 Issue 04 April 2019
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Title: Plasminogen Activator Inhibitor Type 1 in Patients with Alcoholic Liver Cirrhosis Associated with Non-alcoholic Fatty Liver Disease

Authors: Virstiuk Nataliia Hryhorivna, Matkovska Nataliia Romanivna

 DOI: https://dx.doi.org/10.18535/jmscr/v7i4.66

Abstract

The aim of the work was to study the changes of PAI-1 in patients with alcoholic liver cirrhosis (ALC) associated with non-alcoholic fatty liver disease (NAFLD), depending on the decompensation of the disease.

Material and Methods: 80 patients with ALC: 72 men and 8 women, aged 34 to 65 years were examined. Among them there were 38 patients with ALC (Group I) and 42 patients with ALC in combination with non-alcoholic fatty liver disease (NAFLD).

Results: An increase of PAI-1 content in the blood was found in patients with ALC, which increased with more pronounced decompensation of cirrhosis from A to B and C Child-Pugh Classes. The rate of PAI-1 was higher in a combination of ALC and NAFLD at all stages of the liver cirrhosis decompensation. The adverse effect of PAI-1 on the course of the ALC in combination with NAFLD according to correlation with the Child-Pugh score and the MELD index was revealed. We also interrelated the increasing content of PAI-1 in the blood of patients with ALC with concomitant NAFLD with indicators of immunoinflammatory system process (high-sensitivity C-reactive protein, tumour necrosis factor alpha), insulin resistance (immunoreactive insulin, HOMA-IR index) adipocytokines (leptin, adiponectin) endothelial dysfunction (asymmetric dimethylarinin).

Conclusion: Basing on the data of the study, it should be concluded that an increase in the content of PAI-1 adversely affects the course of the ALC with concomitant NAFLD, which substantiates the expediency of its use as a prognostic marker for such a cohort of patients.

Keywords: alcoholic liver cirrhosis, non-alcoholic fatty liver disease, plasminogen activator inhibitor type 1, decompensation, adipocytokines, endothelial dysfunction.

References

1.      Alkogol` naxvorobapechinky`. Adaptovan-aklinichnanastanova, zasnovananadokazax, [Elektronny` jresurs] (2014). Rezhy` mdostupu do resursu: http://moz.gov.ua/docfiles/dod_akn_dn_20140616_1.pdf.

  1. Ambrosino P, Tarantino L, Di Minno G, et al. The risk of venous thromboembolism in patients with cirrhosis. A systematic review and meta-analysis. Thromb Haemost 2017; 117:139.
  2. American Association for the Study of Liver Diseases (2014).Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases. J. Hepatol. 61: 642-659. Doi:nlm.nih.gov/pubmed/25015420.
  3. Blasi A. Coagulopathy in liver disease: Lack of an assessment tool. World J Gastroenterol. 2015 Sep 21; 21(35): 10062–10071. doi: 3748/wjg.v21.i35.10062
  4. Davis JPE, Northup PG, Caldwell SH, Intagliata NM. Viscoelastic Testing in Liver Disease. Ann Hepatol 2018; 17:205.
  5. Dirkmann D. The Hemostatic System in Patients with Cirrhosis, Monitoring of Coagulation and Management of Bleeding. In book: Critical Care for Potential Liver Transplant Candidates. 2019. DOI: 10.1007/978-3-319-92934-7_7
  6. EASL Clinical Practical Guidelines: Management of AlcoholicLiver Disease, 2012 /Journal of Hepatology. –2012. –57. – P.399-420. Doi: http://www.spg.pt/wp-content/uploads/2015/11/2012-ALD.pdf
  7. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. J Hepatol 2018, 69 (2): 406-460. DOI:https://doi.org/10.1016/j.jhep.2018.03.024
  8. EASL–EASD–EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease (2016) Journalof Hepatology64(6):1388-1402
  9. Fisher C, Patel VC, Stoy SH, et al. Balanced haemostasis with both hypo- and hyper-coagulable features in critically ill patients with acute-on-chronic-liver failure. J Crit Care 2018; 43:54.
  10. Fuentes A, Gordon-Burroughs S, Hall JB, et al. Comparison of anti-Xa and activated partial thromboplastin time monitoring for heparin dosing in patients with cirrhosis. Ther Drug Monit 2015; 37:40.
  11. Hum J, Shatzel JJ, Jou JH, Deloughery TG. The efficacy and safety of direct oral anticoagulants vs traditional anticoagulants in cirrhosis. Eur J Haematol 2017; 98:393.
  12. Intagliata NM, Henry ZH, Maitland H, et al. Direct Oral Anticoagulants in Cirrhosis Patients Pose Similar Risks of Bleeding When Compared to Traditional Anticoagulation. Dig Dis Sci 2016; 61:1721.
  13. Intagliata NM, Maitland H, Caldwell SH. Direct oral anticoagulants in cirrhosis. Curr Treat Options Gastroenterol 2016; 14:247.
  14. Intagliata NM, Maitland H, Northup PG, Caldwell SH. Treating thrombosis in cirrhosis patients with new oral agents: ready or not? Hepatology 2015; 61:738.
  15. Kalambokis GN, Oikonomou A, Christou L, et al. von Willebrand factor and procoagulant imbalance predict outcome in patients with cirrhosis and thrombocytopenia. J Hepatol 2016; 65:921.
  16. Lisman T, Bos S, Intagliata NM. Mechanisms of enhanced thrombin-generating capacity in patients with cirrhosis. J Thromb Haemost 2018; 16:1128.
  17. Luyendyk JP, Schoenecker JG, Flick MJ.The multifaceted role of fibrinogen in tissue injury and inflammation. 2019 Feb 7; 133(6):511-520. Epub 2018 Dec 6.
  18. Ng KJ, Lee YK, Huang MY, et al. Risks of venous thromboembolism in patients with liver cirrhosis: a nationwide cohort study in Taiwan. J ThrombHaemost 2015; 13:206.
  19. Qamar A, Vaduganathan M, Greenberger NJ, Giugliano RP. Oral Anticoagulation in Patients With Liver Disease. J Am Coll Cardiol 2018; 71:2162.
  20. Shatzel J, Dulai PS, Harbin D, et al. Safety and efficacy of pharmacological thromboprophylaxis for hospitalized patients with cirrhosis: a single-center retrospective cohort study. J Thromb Haemost 2015; 13:1245.
  21. Sinegre T, Duron C, Lecompte T, et al. Increased factor VIII plays a significant role in plasma hyper coagulability phenotype of patients with cirrhosis. J Thromb Haemost 2018; 16:1132.
  22.  Stepanov YuM, Gravirovs` ka NG (2012) Dy`namikazaxvoryuvanosti ta poshy` renostiosnovny` xxvoroborganivtravlennya v Ukrayini za 5 ostannixrokiv.  Gastroenterologiya: mizhvid. Zbirny`k, Dnipro: Zhurfond, 46: 3-12.
  1. Stine JG, Shah NL, Argo CK, et al. Increased risk of portal vein thrombosis in patients with cirrhosis due to nonalcoholic steatohepatitis. Liver Transpl 2015; 21:1016.
  2. Transplant Direct. 2018 Nov; 4(11):e403. Epub 2018 Oct 26.
  3. Verbeek TA, Stine JG, Saner FH, Bezinover D.Hypercoagulability in End-stage Liver Disease: Review of Epidemiology, Etiology, and Management.
  4. Xobzej MK, Xarchenko NV, Lishhy`shy`na OM ta in (2014) Unifikovany` jklinichny` jprotokol "Alkogol`ny` jsteatogepaty`t". Nakaz MOZ Ukrayiny` # 826 vid 06.08.2014 roku [Elektronny`jresurs]. Rezhy`mdostupu: http://mtd.dec.gov.ua/images/dodatki/2014_826Gepatyty/2014_826_YKPMD_AG.pdf
  5. Xobzej MK, Xarchenko NV, Lishhy`shy`na OM ta in (2014) Unifikovany` jklinichny` jprotokol "Nealkogol` ny`j steatogepaty`t". Nakaz MOZ Ukrayiny` # 826 vid 06.11.2014 roku [Elektronny` jresurs]. Rezhy`m dostupu: http://moz.gov.ua/docfiles/dn_20141106_0826_dod_ukp_nsg.pdf

Corresponding Author

Matkovska Nataliia Romanivna

Department of Therapy and Family Practice of postgraduate study faculty, SHEE "Ivano-Frankivsk National Medical University", Ivano-Frankivsk, Ukraine

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