Plasma viscosity changes in patients with liver cirrhosis.
OBJECTIVE
Plasma viscosity (PV) is a major determinant of capillary blood flow through the microcirculation, which, if impaired, can result in potentially important clinical sequelae. The objectives of this study were to investigate the alterations of PV values in different stages of cirrhosis, and to determine if any change in PV correlates with Child score or Model for End-Stage Liver Disease (MELD) score or has any prognostic significance.


METHODS
The study included 92 patients with cirrhosis and 28 healthy volunteers. Upper endoscopic and ultrasonographic examinations of the patients were obtained. Serum biochemistry fibrinogen, complete blood count, C-reactive protein (CRP), and lipid profile were performed. PV was determined using a rotational viscosimeter.


RESULTS
PV decreased with the progression in Child scores (Child A: 1.46 +/- 0.20 mPa-s, Child B: 1.33 +/- 0.21 mPa-s, Child C: 1.12 +/- 0.15 mPa-s), (P < 0.001). A similar change was detected between the MELD score and PV (P < 0.001). There was a positive correlation between the total protein, albumin and plasma viscosity in the control group, but a similar relationship was not found in cirrhotic patients. History of hepatic encephalopathy (30 of 92 patients) was independently associated with decreased PV (P = 0.003).


CONCLUSIONS
We observed that increasing Child and MELD scores were significantly associated with lower PV levels irrespective of biochemical and hematologic values. These observations support the concept that hemorheologic changes in cirrhotic patients might be either the cause or the result of a pathophysiological process, and it may not be easy to distinguish between these two possibilities.
Gokturk
Huseyin Savas
HS
Department of Gastroenterology, Baskent University Faculty of Medicine, Konya, Turkey.
Demir
Mehmet
M
Ozturk
Nevin Akcaer
NA
Unler
Gulhan Kanat
GK
Kulaksizoglu
Sevsen
S
Kozanoglu
Ilknur
I
Serin
Ender
E
Yilmaz
Ugur
U
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity / Q000502:physiology*; D001798:Blood Proteins / Q000032:analysis; D016022:Case-Control Studies; D005260:Female; D006501:Hepatic Encephalopathy / Q000503:physiopathology; D006801:Humans; D008103:Liver Cirrhosis / Q000145:classification / Q000503:physiopathology*; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D012709:Serum Albumin / Q000032:analysis
D001798:Blood Proteins; D012709:Serum Albumin