| Journal: | Annals of hepatology |
| Database: | PERIÓDICA |
| System number: | 000415685 |
| ISSN: | 1665-2681 |
| Authors: | Eslam, Mohammed1 Ampuero, Javier1 Jover, María1 Abd-Elhalim, Hesham2 Rincón, Diego3 Shatat, Mohammed2 Camacho, Inés1 Kamal, Amal2 Lo Iacono, Oreste3 Nasr, Zainb2 Grande, Lourdes1 Bañares, Rafael3 Khattab, Mahmoud A2 Romero Gómez, Manuel1 |
| Institutions: | 1Hospital Universitario de Valme, Unidad para el Manejo Clínico de Enfermedades Digestivas, Sevilla, Andalucía. España 2Minia University, Department of Internal Medicine, Minia. Egipto 3Hospital General Universitario Gregorio Marañón, Unidad Digestiva, Madrid. España |
| Year: | 2013 |
| Season: | Jul-Ago |
| Volumen: | 12 |
| Number: | 4 |
| Pages: | 420-430 |
| Country: | México |
| Language: | Inglés |
| Document type: | Artículo |
| Approach: | Analítico, descriptivo |
| English abstract | This study assessed the involvement of metabolic factors (anthropometric indices, insulin resistance (IR) and adipocytokines) in the prediction of portal hypertension, esophageal varices and risk of variceal bleeding in cirrhotic patients. Material and methods. Two prospective and retrospective cohorts of cirrhotic patients were selected (n = 357). The first prospective cohort (n = 280) enrolled consecutively in three centers, underwent upper gastrointestinal endoscopy, seeking evidence of esophageal varices. Clinical, anthropometric, liver function tests, ultrasonographic, and metabolic features were recorded at the time of endoscopy, patients were followed-up every 6 months until death, liver transplantation or variceal bleeding. The second retrospective cohort (n = 48 patients) had measurements of the hepatic venous pressure gradient (HVPG). Statistical analyses of the data were with the SPSS package. Results. The presence of esophageal varices was independently associated with lower platelet count, raised HOMA index and adiponectin levels. This relationship extended to subset analysis in patients with Child A cirrhosis. HOMA index and adiponectin levels significantly correlated with HVPG. Beside Child-Pugh class, variceal size and glucagonemia, HOMA index but not adiponectin and leptin plasma levels were associated with higher risk of variceal bleeding. Conclusion. In patients with cirrhosis, HOMA score correlates with HVPG and independently predict clinical outcomes. Three simple markers i.e. platelet count, IR assessed by HOMA-IR and adiponectin significantly predict the presence of esophageal varices in cirrhotic patients |
| Disciplines: | Medicina |
| Keyword: | Diagnóstico, Gastroenterología, Sistema cardiovascular, Hepatitis crónica, Hepatitis C, Hipertensión portal, Várices esofágicas, Conteo de plaquetas, Resistencia a la insulina, Adiponectina |
| Keyword: | Medicine, Cardiovascular system, Diagnosis, Gastroenterology, Chronic hepatitis, Hepatitis C, Portal hypertension, Esophageal varices, Platelet count, Insulin resistance, Adiponectin |
| Full text: | Texto completo (Ver PDF) |
