Increased plasma malondialdehyde in patients with viral cirrhosis and its relationships to plasma nitric oxide, endotoxin, and portal pressure.
OBJECTIVE
Increased oxidative stress is involved in the development of portal hypertension in cirrhosis. Our study aimed to assess the relationship between oxidative stress and hemodynamic parameters in cirrhotic patients.


METHODS
Forty-two patients with viral cirrhosis and 24 normal controls were enrolled. Measurements of plasma levels of malondialdehyde (MDA), nitrite/nitrate (NOx), endotoxin, and activities of superoxide dismutase (SOD) were carried out in all subjects. Systemic and splanchnic hemodynamic measurements were carried out in cirrhotic patients.


RESULTS
Plasma levels of MDA, endotoxin, and NOx were significantly higher in cirrhotic patients than in normal controls (900 +/- 751 versus 226 +/- 16 nM, P < 0.01; 62.0 +/- 26.0 versus 14.8 +/- 4.1 pg/mL, P < 0.01; 50.5 +/- 22.6 versus 15.0 +/- 9.2 nM, P < 0.01, respectively). Activities of SOD were significantly decreased in cirrhotic patients compared with in normal controls (2.62 +/- 0.7 versus 6.8 +/- 0.4 U/mL). Further, plasma levels of MDA in cirrhotic patients were significantly positively associated with hepatic venous pressure gradient (HVPG) (r = 0.35; P = 0.025), wedge hepatic venous pressure (WHVP) (r = 0.42; P = 0.007), and hepatic sinusoid resistance (HSR) (r = 0.33; P = 0.033). Plasma MDA levels also correlated positively with plasma endotoxin (r = 0.71, P < 0.001) and NOx (r = 0.55, P < 0.001) levels in the cirrhotic patients. Multiregression analysis showed that the independent and strongest factors to predict HVPG, WHVP, and HSR are plasma levels of NOx, MDA, and endotoxin, respectively.


CONCLUSIONS
This study suggests a close interaction among MDA, endotoxin, and NOx and that these substances are also associated with hemodynamic derangement in cirrhosis.
Lee
Kuei-Chuan
KC
Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Yang
Ying-Ying
YY
Wang
Ying-Wen
YW
Lee
Fa-Yauh
FY
Loong
Che-Chuan
CC
Hou
Ming-Chih
MC
Lin
Han-Chieh
HC
Lee
Shou-Dong
SD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D018450:Disease Progression; D004731:Endotoxins / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006975:Hypertension, Portal / Q000097:blood / Q000175:diagnosis*; D008103:Liver Cirrhosis / Q000097:blood* / Q000503:physiopathology / Q000821:virology; D008297:Male; D008315:Malondialdehyde / Q000097:blood*; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood*; D018384:Oxidative Stress / Q000502:physiology; D017082:Portal Pressure / Q000502:physiology; D012372:ROC Curve; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013482:Superoxide Dismutase / Q000097:blood*; D055815:Young Adult
D015415:Biomarkers; D004731:Endotoxins; D009569:Nitric Oxide; D008315:Malondialdehyde; D013482:Superoxide Dismutase