Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 14, 2017; 23(14): 2613-2624
Published online Apr 14, 2017. doi: 10.3748/wjg.v23.i14.2613
Serum omentin and vaspin levels in cirrhotic patients with and without portal vein thrombosis
Michał Kukla, Marek Waluga, Michał Żorniak, Agnieszka Berdowska, Piotr Wosiewicz, Tomasz Sawczyn, Rafał J Bułdak, Marek Ochman, Katarzyna Ziora, Tadeusz Krzemiński, Marek Hartleb
Michał Kukla, Marek Waluga, Michał Żorniak, Piotr Wosiewicz, Marek Hartleb, Department of Gastroenterology and Hepatology, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
Agnieszka Berdowska, Department of Microbiology and Biotechnology, Jan Długosz University, 42-200 Częstochowa, Poland
Tomasz Sawczyn, Department of Physiology, Medical University of Silesia in Katowice, 41-800 Zabrze, Poland
Rafał J Bułdak, Department of Biochemistry in Zabrze, Medical University of Silesia in Katowice, 41-800 Zabrze, Poland
Marek Ochman, Department of Cardiac Surgery and Transplantation, Silesian Center for Heart Diseases, 41-800 Zabrze, Poland
Katarzyna Ziora, Department of Pediatrics, Medical University of Silesia in Katowice, 41-800 Zabrze, Poland
Tadeusz Krzemiński, Department of Pharmacology, Medical University of Silesia in Katowice, 41-800 Zabrze, Poland
Author contributions: Kukla M contributed to study design, data collection, data interpretation, manuscript preparation, literature search, funds collection, critical revisions related to important intellectual content of the manuscript; Waluga M contributed to data collection, data interpretation, manuscript preparation, literature search, funds collection, critical revisions related to important intellectual content of the manuscript; Żorniak M contributed to data collection, manuscript preparation; Berdowska A contributed to statistical analysis; Wosiewicz P contributed to literature search, data collection; Sawczyn T and Bułdak RJ contributed to data interpretation, data collection; Ochman M contributed to manuscript preparation, funds collection; Ziora K contributed to data interpretation, literature search; Krzemiński T contributed to data collection; Hartleb M contributed to data interpretation, manuscript preparation, literature search, funds collection, critical revisions related to important intellectual content of the manuscript.
Supported by Medical University of Silesia- Contract, No. KNW1-090/N/6/0.
Institutional review board statement: The study was reviewed and approved by Department of Science of Medical University of Silesia in Katowice.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Michał Kukla, MD, PhD, Department of Gastroenterology and Hepatology, Medical University of Silesia in Katowice, Medyków14 street, 40-752 Katowice, Poland. kuklamich@poczta.onet.pl
Telephone: +48-327894401 Fax: +48-327894402
Received: September 11, 2016
Peer-review started: September 12, 2016
First decision: November 21, 2016
Revised: February 24, 2017
Accepted: March 15, 2017
Article in press: March 15, 2017
Published online: April 14, 2017
Abstract
AIM

To investigate serum omentin and vaspin levels in cirrhotic patients; and to assess the relationship of these levels with hemostatic parameters, metabolic abnormalities, cirrhosis severity and etiology.

METHODS

Fifty-one cirrhotic patients (17 with portal vein thrombosis) were analyzed. Serum omentin and vaspin levels were measured with commercially available direct enzyme-linked immunosorbent assays (ELISAs). To assess platelet activity, the following tests were performed using a MULTIPLATE®PLATELET FUNCTION ANALYZER: (1) an ADP-induced platelet activation test; (2) a cyclooxygenase dependent aggregation test (ASPI test); (3) a von Willebrand factor and glycoprotein Ib-dependent aggregation (using ristocetin) test (RISTO test); and (4) a test for thrombin receptor-activating peptide-6 induced activation of the thrombin receptor, which is sensitive to IIb/IIIa receptor antagonists.

RESULTS

Omentin, but not vaspin, serum concentrations were significantly decreased in patients with portal vein thrombosis (PVT) (P = 0.01). Prothrombin levels were significantly increased in patients with PVT (P = 0.01). The thrombin receptor activating peptide (TRAP) test results were significantly lower in the PVT group (P = 0.03). No significant differences in adipokines serum levels were found regarding the etiology or severity of liver cirrhosis assessed according to the Child-Pugh or Model of End-Stage Liver Disease (MELD) scores. There was a significant increase in the TRAP (P = 0.03), ASPI (P = 0.001) and RISTO high-test (P = 0.02) results in patients with lower MELD scores. Serum omentin and vaspin levels were significantly down-regulated in patients without insulin resistance (P = 0.03, P = 0.02, respectively). A positive relationship between omentin and vaspin levels were found both when all of the patients were analyzed (r = 0.41, P = 0.01) and among those with PVT (r = 0.94, P < 0.001).

CONCLUSION

Serum omentin levels are increased in patients without PVT. Cirrhosis origin and grade do not affect omentin and vaspin levels. The analyzed adipokines do not influence platelet activity.

Keywords: Omentin, Vaspin, Cirrhosis, Adipokine, Portal vein thrombosis, Portal hypertension

Core tip: Accumulating data suggest that obesity and insulin resistance are related to a more rapid progression of chronic liver diseases, the development of cirrhosis and its complications. Some adipokines have been suggested to contribute to the complicated pathophysiology of hepatic injury and repair. Ongoing research has revealed alterations in the levels and expression of various adipokines in cirrhosis. Portal vein thrombosis (PVT) has been considered to be a complication of more advanced liver cirrhosis. The data regarding novel adipokines in liver cirrhosis is scare and ambiguous. The current study evaluated the serum concentrations of omentin and vaspin in patients with liver cirrhosis of different origins and stages with and without PVT. The relationships of these measures with disease severity and etiology, platelet activity, hemostatic parameters and potential complications were also assessed. The study included 51 patients with cirrhosis of different etiologies (alcohol in 30 patients, hepatitis C virus infection in 15, autoimmune hepatitis in 6). Seventeen these patients manifested portal vein thrombosis confirmed by contrast-enhanced computed tomography.