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2003 ; 9
(10
): 2325-7
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Adrenomedullin in cirrhotic and non-cirrhotic portal hypertension
#MMPMID14562402
Tahan V
; Avsar E
; Karaca C
; Uslu E
; Eren F
; Aydin S
; Uzun H
; Hamzaoglu HO
; Besisik F
; Kalayci C
; Okten A
; Tozun N
World J Gastroenterol
2003[Oct]; 9
(10
): 2325-7
PMID14562402
show ga
AIM: Adrenomedullin (ADM) is a potent vasodilator peptide. ADM and nitric oxide
(NO) are produced in vascular endothelial cells. Increased ADM level has been
linked to hyperdynamic circulation and arterial vasodilatation in cirrhotic
portal hypertension (CPH). The role of ADM in non-cirrhotic portal hypertension
(NCPH) is unknown. plasma ADM levels were studied in patients with NCPH,
compensated and decompensated cirrhosis in order to determine its contribution to
portal hypertension (PH) in these groups. METHODS: There were 4 groups of
subjects. Group 1 consisted of 27 patients (F/M: 12/15) with NCPH due to portal
and/or splenic vein thrombosis (mean age: 41+/-12 years), group 2 consisted of 14
patients (F/M: 6/8) with compensated (Child-Pugh A) cirrhosis (mean age: 46+/-4),
group 3 consisted of 16 patients (F/M: 6/10) with decompensated (Child-Pugh C)
cirrhosis (mean age: 47+/-12). Fourteen healthy subjects (F/M: 6/8) (mean age:
44+/-8) were used as controls in Group 4. ADM level was measured by ELISA. NO was
determined as nitrite/nitrate level by chemoluminescence. RESULTS: ADM level in
Group 1 (236+/-61.4 pg/mL) was significantly higher than that in group 2
(108.4+/-28.3 pg/mL) and group 4 (84.1+/-31.5 pg/mL) (both P<0.0001) but was
lower than that in Group 3 (324+/-93.7 pg/mL) (P=0.002). NO level in group 1
(27+/-1.4 micromol/L) was significantly higher than that in group 2 (19.8+/-2.8
micromol/L) and group 4 (16.9+/-1.6 micromol/L) but was lower than that in Group
3 (39+/-3.6 micromol/L) (for all three P<0.0001). A strong correlation was
observed between ADM and NO levels (r=0.827, P<0.0001). CONCLUSION:
Adrenomedullin and NO levels were high in both non-cirrhotic and cirrhotic portal
hypertension and were closely correlated, Adrenomedullin and NO levels increased
proportionally with the severity of cirrhosis, and were significantly higher than
those in patients with NCPH. Portal hypertension plays an important role in the
increase of ADM and NO. Parenchymal damage in cirrhosis may contribute to the
increase in these parameters.
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