Growth Differentiation Factor 15 Predicts Chronic Liver Disease Severity

( Eaum Seok Lee ),( Seok Hyun Kim ),( Hyun Jin Kim ),( Kyung Hee Kim ),( Byung Seok Lee ),( Bon Jeong Ku ) 대한간학회 2017 Gut and Liver Vol.11 No.2

Background/Aims: Growth differentiation factor 15 (GDF-15) belongs to the transforming growth factor-β superfamily. GDF-15 is emerging as a biomarker for several diseases. The aim of this study was to determine the clinical performances of GDF-15 for the prediction of liver fibrosis and severity in chronic liver disease. Methods: The serum GDF-15 levels were examined via enzyme immunoassay in 145 patients with chronic liver disease and 101 healthy individuals. The patients with chronic liver disease consisted of 54 patients with chronic hepatitis, 44 patients with compensated liver cirrhosis, and 47 patients with decompensated liver cirrhosis. Results: Of the patients with chronic liver diseases, the decompensated liver cirrhosis patients had an increased serum GDF-15 (3,483 ng/L) level compared with the patients with compensated liver cirrhosis (1,861 ng/L) and chronic hepatitis (1,232 ng/L). The overall diagnostic accuracies of GDF-15, as determined by the area under the receiver operating characteristic curves, were as follows: chronic hepatitis= 0.656 (>574 ng/L, sensitivity, 53.7%; specificity, 79.2%), compensated liver cirrhosis=0.886 (>760 ng/L, sensitivity, 75.6%; specificity, 92.1%), and decompensated liver cirrhosis= 0.984 (>869 ng/L, sensitivity, 97.9%; specificity, 94.1%). Conclusions: This investigation represents the first study to demonstrate the availability of GDF-15 in chronic liver disease. GDF-15 comprised a useful biomarker for the prediction of liver fibrosis and severity in chronic liver disease. (Gut Liver 2017;11:276-282)

만성 실질성 간질환 환자 혈청에서 Basic Fibroblast Growth Factor 및 Angiogenin 농도의 변동

백인규(In Kyu Paik),이숭환(Soong Hwan Lee),조윤주(Yun Ju Cho),이성희(Sung Hee Lee),김홍주(Hong Ju Kim),남승우(Seung Woo Nam),고희관(Hee Kwan Koh),이창범(Chang Beom Lee),박동일(Dong Il Park),조영중(Yong Jung Cho) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.6

Background/Aims: Liver fibrosis by the progression of the chronic process of the liver disease induces deformed microcirculations of the hepatic lobules and this eventually resulted in portal hypertension. Angiogenic stimulant factors are physiologically activated in order to repair the tissue damage. Overexpression of angiogenic factors, however, can stimulate neovascularization as in a formation of the hypervascular tumor that liberates uncontrolled overgrowing of the tumor cells. To elucidate the dynamic changes of the serum concentration of basic fibroblast growth factor(bFGF) and angiogenin in chronic liver diseases, this study is intended to employ an ELISA out of pathologically proven patients. Methods: Sera taken out of the 44 patients with chronic persistent hepatitis(5 cases), chronic active hepatitis(6 cases), liver cirrhosis(19 cases) and hepatocellular carcinoma(14 cases) were tested for bFGF and angiogenin employing Quantikine' ELISA Kits (R & D Systems Inc. Minneapolis, MN) that pathological diagnosis was proven )ater. The statistical analysis was evaluated by students t-test. Results: Serum mean value and standar<I error of bFGF concentration(pg/ml) was 11.851.98 in 19 cases of liver cirrhosis, 9.86+2.35 in 14 cases of hepatocellular carcinoma, 9.48+4.57 in 6 cases of chronic active hepatitis, and 8.29+2.63 in 5 cases of chronic persistent hepatitis. Mean value and standard error of angiogenin concentration (ng/ml) of the sera was 238.92+50.95 in 5 cases of chronic persistent hepatitis, 184.47+12.75 in 6 cases of chronic active bepatitis, 131.36+10.99 in 19 cases of liver cirrhosis, and 211.03+19.08 in 14 cases of hepatocellular carcinoma, respectively. Serum angiogenin concentration in liver cirrhosis was significantly lower than that in chronic persistent hepatitis(p=0.0033(I), and than that in chronic active hepatitis(p=0.018673). Angiogenin concentration in hepatocellular carcinoma was very significantly elevated, when compared with the level of the liver cirrhosis investigated (p=0.000569). Conclusions: These data suppoit that persistent inflammatory insults in chronic hepatitis were compensated by the elevation of angiogenin, but complete fibrosis as in liver cirrhosis showed the depressed level of angiogenin. Again, emerging of the hepatocellular carcinoma is accompanying with the elevated stitnuli of angiogenin for the neovascularization. In contrast, bFGF in this study was statistically not significant but may be related with fibrosis and reconstruction of microvascular system accompanying with progression of chronic parenchymal liver diseases to liver cirrhosis.(Korean J Gastroenterol 1996; 28:806-814)

만성간질환에서의 혈청 procollagen 1/3 propeptides 농도비 측정의 의의

유용걸(Yong Keol Yoo),이숭환(Soong Hwan Lee),김병훈(Byoung Hun Kim),조영중(Young Jung Cho),백인규(In Kyu Paik),유병무(Byeong Moo Yoo),이오영(Oh Young Lee),한동수(Dong Soo Han),손주현(Joo Hyun Sohn),최호순(Ho Soon Choi),이동후(Dong Ho 대한소화기학회 1996 대한소화기학회지 Vol.28 No.6

Background/Aims: Most of Ihe chronic liver diseases of variable etiologies are accompanied by a pathobiochemical reaction So-called fibrosis. Liver fibrosis was recently recognized as all the complexity of dynamic changes of the hepatic extracellular matrix(ECM). And ECM consists of four major components: collagen, glycoprotein such as fibronectin and laminin, proteoglycan, and elastin. Among these, collagen I and III are the representatives of disproportion of synthesis and degradation in conjunction with fibrogenesis. To elucidate the clinical significance of procollagen propeptide I(PICP) and III(PIIINP) measurements among the sera out of patients with chronic liver diseases, radioimmunoassay 4vas employed in this investigation. Methods: Sera tested were obtained from pathologically-proven 54 patients; 4 cases of fatty liver, 11 cases of chronic persistent hepatitis, 13 cases df chronic active hepatitis, 15 cases of liver cirrhosis and 11 cases of hepatocellular carcinoma. All:the patients except 4 cases of fatty liver were shown positivity of HBsAg. PICP and PIIINP radioimmunoassay kits(Farmos Diagnostica, Oulunsalo, Finland)were purchased for this study. ResOlts: PICP concentration (mean+standard error) was highest in liver cirrhosis (280.06>39,83 pg/L). PICP in liver cirrhosis was significantly elevated in cornparison to that (109.30+14.58) in fatty:liver(p=0.045), that (122.22>10.26) in chronic persistent hepatitis (p=0.003), and that (158.59>21.58) in chronic active hepatitis(p=0.016), PICP in hepatocellular carcinoma was decreased to 1'94.05+ 29.89. Similarly, PIIINP concentration revealed highest level in liver cirrhosis(17.29+3.58 pg/L). This value was significantly higher than that of chronic persistent hepatitis(5.12+0.59)(p=0.008). Contrarily to these results, concentration ratio of PICP/PIIINP was high in fatty liver (29.27>6.29) and chronic persistent hepatitis (25.04+2.00), These value were statistically higher than that of chronic active hepatitis (17.632.67) (p=0.043). PICP/PIIINP ratio in liver cirrhosis (21.58+3.29) showed no statistical difference. Conclusions: On the basis of these data, it is suggested that the elevation of PICP and PIIINP in the sera of the patients with chronic liver diseases means emerging the liver cirrhosis. And the ratio of these markers can be helpful in differential diagnosis of chronic liver diseases. (Korean J Gastroenterol 1996; 28:815-823)

A study of the awareness of chronic liver diseases among Korean adults

전대원,조용균,손주현,이창형,김석현,은종렬 대한간학회 2011 Clinical and Molecular Hepatology(대한간학회지) Vol.17 No.2

Background/Aims:Chronic liver disease is closely associated with lifestyle, and public enlightenment of the lifestyle factors is important in reducing prevalence of chronic liver disease. The KASL (Korean Association for the Study of the Liver) conducted a survey of basic information and epidemiological data regarding chronic liver diseases. Methods:A survey of chronic liver disease involving a total of 2,794 respondents was conducted. The respondents included patients and their guardians, visitors for health check-ups, and online pollees who completed a questionnaire on the awareness of fatty liver or chronic liver disease. Results:Of the entire cohort, 854 (39.7%) said they have had or still have fatty liver or an elevated transaminase level (>40 IU/L), but only 23.4% of the respondents had visited a hospital. It was found that 35% of healthy subjects and 45% of patients and their guardians misunderstood hepatitis B as the hereditary disesase. Furthermore, 26% of the subjects responded that patients with inactive hepatitis B do not require regular follow-up. While 17.9% answered that it is not too late to test for liver cancer when symptoms arise, 38.8% believed that liver transplant in liver cancer patients has a low success rate and is thus not recommended. Conclusions:Despite the inundation of information and widespread media advertising, the awareness of chronic liver disease is unsatisfactory among Korean adults. Systematic nationwide studies are needed to obtain data and information regarding the prevalence of chronic liver disease and patterns of use of the health-care system.

Hemorheological Alteration in Patients Clinically Diagnosed with Chronic Liver Diseases

장보현,한지원,성필수,장정원,배시현,최종영,조영이,윤승규 대한의학회 2016 Journal of Korean medical science Vol.31 No.12

Since liver function is changed by chronic liver diseases, chronic liver disease can lead to different hemorheological alterations during the course of the progression. This study aims to compare alterations in whole blood viscosity in patients with chronic liver disease, focusing on the gender effect. Chronic liver diseases were classified into three categories by patient’s history, serologic markers, and radiologic findings: nonalcoholic fatty liver disease (NAFLD) (n = 63), chronic viral hepatitis B and C (n = 50), and liver cirrhosis (LC) (n = 35). Whole blood viscosity was measured by automated scanning capillary tube viscometer, while liver stiffness was measured by transient elastography using FibroScan®. Both systolic and diastolic whole blood viscosities were significantly lower in patients with LC than NAFLD and chronic viral hepatitis (P < 0.001) in male patients, but not in female patients. In correlation analysis, there were inverse relationships between both systolic and diastolic whole blood viscosity and liver stiffness (systolic: r = −0.25, diastolic: r = −0.22). Whole blood viscosity was significantly lower in male patients with LC than NAFLD or chronic viral hepatitis. Our data suggest that whole blood viscosity test can become a useful tool for classifying chronic liver disease and determining the prognosis for different types of chronic liver diseases.

Original Article : A study of the awareness of chronic Liver diseases among Korean adults

( Dae Won Jun ),( Yong Kyun Cho ),( Joo Hyun Sohn ),( Chang Hyeong Lee ),( Seok Hyun Kim ),( Jong Ryul Eun ) 대한간학회 2011 Clinical and Molecular Hepatology(대한간학회지) Vol.17 No.2

Background/Aims: Chronic liver disease is closely associated with lifestyle, and public enlightenment of the lifestyle factors is important in reducing prevalence of chronic liver disease. The KASL (Korean Association for the Study of the Liver) conducted a survey of basic information and epidemiological data regarding chronic liver diseases. Methods: A survey of chronic liver disease involving a total of 2,794 respondents was conducted. The respondents included patients and their guardians, visitors for health check-ups, and online pollees who completed a questionnaire on the awareness of fatty liver or chronic liver disease. Results: Of the entire cohort, 854 (39.7%) said they have had or still have fatty liver or an elevated transaminase level (>40 IU/L), but only 23.4% of the respondents had visited a hospital. It was found that 35% of healthy subjects and 45% of patients and their guardians misunderstood hepatitis B as the hereditary disesase. Furthermore, 26% of the subjects responded that patients with inactive hepatitis B do not require regular follow-up. While 17.9% answered that it is not too late to test for liver cancer when symptoms arise, 38.8% believed that liver transplant in liver cancer patients has a low success rate and is thus not recommended. Conclusions: Despite the inundation of information and widespread media advertising, the awareness of chronic liver disease is unsatisfactory among Korean adults. Systematic nationwide studies are needed to obtain data and information regarding the prevalence of chronic liver disease and patterns of use of the health-care system.

Hemorheological Alteration in Patients Clinically Diagnosed with Chronic Liver Diseases

Jang, Bohyun,Han, Ji Won,Sung, Pil Soo,Jang, Jeong Won,Bae, Si Hyun,Choi, Jong Young,Cho, Young I,Yoon, Seung Kew The Korean Academy of Medical Sciences 2016 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.31 No.12

<P>Since liver function is changed by chronic liver diseases, chronic liver disease can lead to different hemorheological alterations during the course of the progression. This study aims to compare alterations in whole blood viscosity in patients with chronic liver disease, focusing on the gender effect. Chronic liver diseases were classified into three categories by patient’s history, serologic markers, and radiologic findings: nonalcoholic fatty liver disease (NAFLD) (n = 63), chronic viral hepatitis B and C (n = 50), and liver cirrhosis (LC) (n = 35). Whole blood viscosity was measured by automated scanning capillary tube viscometer, while liver stiffness was measured by transient elastography using FibroScan®. Both systolic and diastolic whole blood viscosities were significantly lower in patients with LC than NAFLD and chronic viral hepatitis (<I>P</I> < 0.001) in male patients, but not in female patients. In correlation analysis, there were inverse relationships between both systolic and diastolic whole blood viscosity and liver stiffness (systolic: <I>r</I> = −0.25, diastolic: <I>r</I> = −0.22). Whole blood viscosity was significantly lower in male patients with LC than NAFLD or chronic viral hepatitis. Our data suggest that whole blood viscosity test can become a useful tool for classifying chronic liver disease and determining the prognosis for different types of chronic liver diseases.</P>

Hemorheological Alteration in Patients Clinically Diagnosed with Chronic Liver Diseases

( Ji Won Han ),( Bo Hyun Jang ),( Pil Soo Sung ),( Kwang Il Seo ),( Jeong Won Jang ),( Si Hyun Bae ),( Jong Young Choi ),( Seung Kew Yoon ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

Aims: Blood viscosity is predominantly determined by hematocrit, plasma viscosity, and the aggregation of red blood cells. We investigated the level of whole blood viscosity in patients with chronic liver diseases (CLD). Methods: A total of 320 patients whose whole blood viscosity (WBV) had been measured between August 2015 and April 2016 at Seoul St. Mary’s Hospital were retrospectively reviewed. Plasma WBV was measured using a scanning capillary tube viscometer at a high shear rate (systolic) and a low shear rate (diastolic). Among them, 151 patients were clinically diagnosed with CLD based on clinical in- formation and imaging study. We investigated the CBC, blood chemistry, and lipid profiles of these patients. Reference values for whole blood viscosity of normal controls were adapted from a previous report (Jung et al. Clinical Biochemistry 2014;47:489-493). Results: Chronic liver diseases were categorized into 3 groups : fatty liver (n=46), chronic hepatitis (n=70) and liver cirrhosis (n=35). Systolic blood viscosities (SBV) of plasma whole blood viscosity were 5.25 centipoise (cP), 5.03cP, 4.44cP in fatty liver, chronic hepatitis and liver cirrhosis, respectively. Diastolic blood viscosities (DBV) were 16.65 cP, 15.98 cP, 13.81 cP in fatty liver, chronic hepatitis and liver cirrhosis, respectively. These results indicated that the levels of blood viscosity were increased in CLD compared with healthy control. Regarding the blood viscosity according to the etiology of CLD, those were significantly lower in HBV- and HCV-related CLDs than NAFLD and alcoholic liver disease. Among CLDs, the level of the WBV in liver cirrhosis was the lowest (P<0.05). Conclusions: The level of whole blood viscosity of patients with chronic liver diseases was higher than that of normal controls. These result suggest that blood viscosity test may be useful tool to predict the prognosis of chronic liver diseases.

만성 간질환 환자에서 콜히친 약리효과와 T1-201 간문맥 스캔 단락지수와의 관련성

윤창옥,강문수,변재원,고동희,김동욱,최윤영,강주섭,이민호,곽민정 大韓臨床藥理學會 2001 臨床藥理學會誌 Vol.9 No.1

Development and psychometric evaluation of a chronic liver disease-specific quality of life questionnaire

Lee, Eun-Hyun,Cheong, Jae Youn,Cho, Sung Won,Hahm, Ki-Baik,Kim, Hak Yang,Park, Jong-Jae,Lee, Dong Ho,Kim, Seong Kook,Choi, Seok Reyol,Lee, Soo Teik,Moon, Seong Mi Blackwell Publishing Asia 2008 Journal of Gastroenterology and Hepatology Vol.23 No.2

<P>Abstract</P><P>Background and Aims: </P><P>There has been no reliable and valid instrument to measure health-related quality of life for Asian patients with chronic liver disease. The aim of the present study was to develop and evaluate a chronic liver disease-specific quality of life (CLD-QOL) questionnaire for Korean patients with chronic liver disease.</P><P>Methods: </P><P>Content-validated items were evaluated psychometrically in 271 patients with chronic liver disease recruited from seven university hospitals in Korea. The participants were asked to complete a preliminary questionnaire comprising the content-validated items and the Short Form-36 Health Survey. The Child–Pugh classification was used to classify the severity of liver cirrhosis.</P><P>Results: </P><P>Factor analysis extracted a five-factor solution from 27 preliminary items, which were generated by an expert panel and a pilot study, but factor and a multidimensional scaling analysis revealed that four items were not loaded significantly on any factor, suggesting that the four items might be heterogeneous. After deletion of these four items, a multiscaling analysis strongly supported item convergence and discriminant validity. The CLD-QOL was associated significantly with the Child–Pugh classification and the type of patient status (inpatient/outpatient) and was moderately correlated with the subscales of the Short Form-36 Health Survey. The values of Cronbach's alpha for the subscales of the novel CLD-QOL questionnaire were all greater than 0.70.</P><P>Conclusions: </P><P>The novel CLD-QOL questionnaire we developed is an easily applicable tool that exhibits excellent psychometric properties for Korean patients with chronic liver disease. It is recommended for the CLD-QOL to apply for Asian patients with chronic liver disease.</P>