Details

Autor(en) / Beteiligte

• Angelico, Francesco
• Ginanni Corradini, Stefano
• Pastori, Daniele
• Fargion, Silvia
• Fracanzani, Anna Ludovica
• Angelico, Mario
• Bolondi, Luigi
• Tozzi, Giulia
• Pujatti, Pietro Luigi
• Labbadia, Giancarlo
• Corazza, Gino Roberto
• Averna, Maurizio
• Perticone, Francesco
• Croce, Giuseppe
• Persico, Marcello
• Bucci, Tommaso
• Baratta, Francesco
• Polimeni, Licia
• Del Ben, Maria
• Violi, Francesco

Titel

Severe reduction of blood lysosomal acid lipase activity in cryptogenic cirrhosis: A nationwide multicentre cohort study

Ist Teil von

• Atherosclerosis, 2017-07, Vol.262, p.179-184

Ort / Verlag

Ireland: Elsevier B.V

Erscheinungsjahr

2017

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Background and aims Blood lysosomal acid lipase (LAL) is reduced in non-alcoholic steatohepatitis, which is the major cause of cryptogenic cirrhosis (CC); few data on LAL activity in CC do exist. We investigated LAL activity in a cohort of patients with liver cirrhosis. Methods This is a multicentre cohort study including 274 patients with liver cirrhosis of different aetiology from 19 centres of Internal Medicine, Gastroenterology and Hepatology distributed throughout Italy. Blood LAL activity (nmol/spot/h) was measured with dried blood spot extracts using Lalistat 2. Results Overall, 133 patients had CC, and 141 patients had cirrhosis by other causes (61 viral, 53 alcoholic, 20 alcoholic + viral, 7 autoimmune). Mean age was 64.2 ± 13.4 years, and 28.5% were women. Patients with CC were older compared to other aetiology-cirrhosis, with a lower Child-Turcotte-Pugh (CTP, p =0.003) and MELD ( p =0.009) score, and a higher prevalence of cardio-metabolic risk factors and previous ischemic events. In the whole cohort, median LAL activity value was 0.58 nmol/spot/h, 0.49 and 0.65 in the groups of CC and known-aetiology cirrhosis, respectively ( p =0.002). The difference remained significant after adjustment for white blood cells count ( p =0.001). Multivariable linear regression analysis showed that CC ( vs. known aetiology, Beta = −0.144, p =0.018), platelet count (Beta = 0.398, p < 0.001) and CTP score (Beta = −0.133, p =0.022) were associated with log-LAL activity. Similar results were found using MELD as covariate. Conclusions We found a marked reduction of LAL activity in patients with cryptogenic cirrhosis compared to the other known aetiologies. A prospective study will clarify the role of LAL in chronic liver diseases.