Published online Oct 27, 2020. doi: 10.4254/wjh.v12.i10.850
Peer-review started: April 29, 2020
First decision: July 5, 2020
Revised: July 15, 2020
Accepted: August 24, 2020
Article in press: August 24, 2020
Published online: October 27, 2020
Hepatitis C virus (HCV) infection may affect lipid metabolism by enhancing the circulating levels of inflammatory cytokines. HCV may induce endothelial dysfunction.
We believe that there is a potential correlation between the changes in lipid profile, carotid intima-media thickness (CIMT) and ankle-brachial index with the severity of fibrosis, grades of esophageal varices (EVs), and fibrosis indices.
To identify predictive markers of vascular changes and endothelial dysfunction in HCV-related cirrhosis
HCV infected cirrhotic patients with and without EVs were evaluated by routine laboratory tests, including lipid profile assay, abdominal ultrasonography, carotid intima-media thickness (CIMT) by carotid Doppler, bedside ankle-brachial index (ABI), liver stiffness measurement, and upper gastrointestinal endoscopy and compared to the healthy control group. Logistic regression analysis was performed to identify variables independently associated with advanced fibrosis and endothelial dysfunction.
CIMT, low-density lipoproteins (LDL)/platelet ratio, ABI, and very LDL (VLDL) were predictive of advanced fibrosis, EVs and endothelial dysfunction. They were effective at cutoff values of 1.1 mm, 1, 0.94, and 16.5 mg/dL, respectively.
CIMT, ABI, VLDL, and LDL/platelet count ratio are good non-invasive predictors of advanced fibrosis, presence of EVs, and endothelial dysfunction in liver cirrhosis.
The proposed markers serve as non-invasive predictors of cirrhosis, EVs and endothelial dysfunction, and patients with advanced fibrosis and larger varices had higher CIMT and lower ABI consequently, they bear an increased cardiovascular risk added to the risk of variceal bleeding. The study was designed and validated in a single-center. External, prospective validation is required to determine the widespread applicability and utility of this model.