[Serum laminin in chronic alcoholic liver disease: its value in the estimation of the degree of fibrosis].
OBJECTIVE
To determine the clinical and prognostic value of serum laminin in chronic alcoholic liver disease and to discern whether laminin, alone or in combination with serum N-terminal type III collagen propeptide, and/or biochemical parameters, is useful in estimating the histomorphometrically determined amount of fibrosis.


METHODS
Prospective.


METHODS
121 (80 of them cirrhotics), 107 followed up for a variable periods ranging from 1 to 1440 days.


RESULTS
Serum laminin was higher in cirrhotic patients belonging to Child's C group and, in cirrhotic patients, it significantly correlated with Pugh's score (r = 0.32, p < 0.01), prothrombin activity (r = 0.23, p < 0.05), serum albumin (r = -0.35, p < 0.001) and bilirubin (r = 0.30, p < 0.01), and also with the degree of fibrosis (r = 0.49, p < 0.001). Serum laminin over 3.5 U/ml were associated to higher mortality rates in the total population (Log rank test = 4.9, p = 0.022), but not in cirrhotics. Stepwise multiple regression analysis showed that laminin is useless in the estimation of liver fibrosis in cirrhotics, although in non-cirrhotic alcoholics, serum laminin together with alkaline phosphatase and GGT roughly estimates the amount of liver fibrosis (r = 0.72, p < 0.001, standard error = 7.29).


CONCLUSIONS
Laminin is not useful in estimating the total amount of fibrosis neither in prognostic assessment of cirrhotics. However, serum laminin-values over 3.5 U/ml were associated with higher mortality rates in patients with chronic alcoholic liver disease, and serum laminin together with alkaline phosphatase and GGT correlated with the amount of fibrosis in the non-cirrhotic subgroup.
González Reimers
E
E
Departmento de Medicina Intema. Hospital Universitario de Canarias. La Laguna (Tenerife).
Santolaria Fernández
F
F
Rodríguez Rodríguez
E
E
Rodríguez Moreno
F
F
Milena Abril
A
A
Martínez-Riera
A
A
García-Castro
C
C
D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002908:Chronic Disease; D004796:Clinical Enzyme Tests; D003094:Collagen / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D007797:Laminin / Q000097:blood*; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis; D008108:Liver Diseases, Alcoholic / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011516:Prothrombin / Q000032:analysis; D012044:Regression Analysis; D012709:Serum Albumin / Q000032:analysis; D013997:Time Factors; D005723:gamma-Glutamyltransferase / Q000097:blood
D007797:Laminin; D012709:Serum Albumin; D011516:Prothrombin; D003094:Collagen; D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase; D001663:Bilirubin