title: Correlation of endothelin-1 concentration and angiotensin-converting enzyme activity with the staging of liver fibrosis.
abstract: Increased serum angiotensin-converting enzyme (SACE) activity and serum concentration of endothelin-1 (ET-1) were found in liver cirrhosis. We investigated a correlation between the different stages of liver fibrosis and SACE activity and serum ET-1 concentration. Seventy patients with pathohistologically established chronic liver disease were divided in three groups according to Ishak criteria for liver fibrosis: minimal fibrosis (Ishak score 0-1, n =20), medium fibrosis (Ishak score 2-5, n=20) and cirrhosis (Ishak score 6, n=30). SACE activity and ET-1 concentration were determined using commercial ELISA kits. SACE activity and ET-1 concentrations were proportional to the severity of disease, the highest being in patients with liver cirrhosis. Maximal increase in SACE activity was found between minimal and medium fibrosis while maximal increase in ET-1 concentration was revealed between medium fibrosis and cirrhosis. The analysis of the Receiver Operating Characteristic (ROC) curve for SACE activity suggested a cut-off value to separate minimal from medium fibrosis at 59.00 U/L (sensitivity 100%, specificity 64.7%). The cut-off value for serum ET-1 concentration to separate medium fibrosis from cirrhosis was 12.4 pg/mL (sensitivity 96.8%, specificity 94.4%). A positive correlation between SACE activity and ET-1 concentration was registered (Spearman's ñ = 0.438, p = 0.004). Both SACE activity and ET-1 concentration were increased in all stages of liver fibrosis. Cut-off points for SACE activity and ET-1 concentration could be a biochemical marker for the progression of fibrosis. Positive correlation between SACE activity and ET-1 concentration might indicate their interaction in the development of liver cirrhosis.
authors.affiliation: University of Zagreb, Dubrava University Hospital, Department of Gastroenterology and Hepatology, Zagreb, Croatia.
authors.forename: Dusko
authors.initials: D
authors.lastname: Kardum
authors.forename: Damir
authors.initials: D
authors.lastname: Fabijanić
authors.forename: Anita
authors.initials: A
authors.lastname: Lukić
authors.forename: Zeljko
authors.initials: Z
authors.lastname: Romić
authors.forename: Mladen
authors.initials: M
authors.lastname: Petrovecki
authors.forename: Zoran
authors.initials: Z
authors.lastname: Bogdanović
authors.forename: Klara
authors.initials: K
authors.lastname: Jurić
authors.forename: Marija
authors.initials: M
authors.lastname: Urek-Crncević
authors.forename: Marko
authors.initials: M
authors.lastname: Banić
mesh_terms: D000328:Adult; D000368:Aged; D019332:Endothelin-1 / Q000097:blood*; D004789:Enzyme Activation / Q000502:physiology; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000201:enzymology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000097:blood*; D011446:Prospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D019332:Endothelin-1; C488034:ACE protein, human; D007703:Peptidyl-Dipeptidase A