title: Serum autotaxin is a parameter for the severity of liver cirrhosis and overall survival in patients with liver cirrhosis--a prospective cohort study.
abstract: BACKGROUND
  Autotaxin (ATX) and its product lysophosphatidic acid (LPA) are considered to be involved in the development of liver fibrosis and elevated levels of serum ATX have been found in patients with hepatitis C virus associated liver fibrosis. However, the clinical role of systemic ATX in the stages of liver cirrhosis was unknown. Here we investigated the relation of ATX serum levels and severity of cirrhosis as well as prognosis of cirrhotic patients.
  
  
  METHODS
  Patients with liver cirrhosis were prospectively enrolled and followed until death, liver transplantation or last contact. Blood samples drawn at the day of inclusion in the study were assessed for ATX content by an enzyme-linked immunosorbent assay. ATX levels were correlated with the stage as well as complications of cirrhosis. The prognostic value of ATX was investigated by uni- and multivariate Cox regression analyses. LPA concentration was determined by liquid chromatography-tandem mass spectrometry.
  
  
  RESULTS
  270 patients were enrolled. Subjects with liver cirrhosis showed elevated serum levels of ATX as compared to healthy subjects (0.814±0.42 mg/l vs. 0.258±0.40 mg/l, P<0.001). Serum ATX levels correlated with the Child-Pugh stage and the MELD (model of end stage liver disease) score and LPA levels (r = 0.493, P = 0.027). Patients with hepatic encephalopathy (P = 0.006), esophageal varices (P = 0.002) and portal hypertensive gastropathy (P = 0.008) had higher ATX levels than patients without these complications. Low ATX levels were a parameter independently associated with longer overall survival (hazard ratio 0.575, 95% confidence interval 0.365-0.905, P = 0.017).
  
  
  CONCLUSIONS
  Serum ATX is an indicator for the severity of liver disease and the prognosis of cirrhotic patients.
authors: Medizinische Klinik 1, Schwerpunkt Gastroenterologie und Hepatologie, Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt, Germany.
authors: Thomas
authors: T
authors: Pleli
authors: Medizinische Klinik 1, Schwerpunkt Gastroenterologie und Hepatologie, Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt, Germany.
authors: Daniel
authors: D
authors: Martin
authors: Medizinische Klinik 1, Schwerpunkt Gastroenterologie und Hepatologie, Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt, Germany.
authors: Bernd
authors: B
authors: Kronenberger
authors: Medizinische Klinik 1, Schwerpunkt Gastroenterologie und Hepatologie, Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt, Germany.
authors: Friederike
authors: F
authors: Brunner
authors: Medizinische Klinik 1, Schwerpunkt Gastroenterologie und Hepatologie, Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt, Germany.
authors: Verena
authors: V
authors: Köberle
authors: Medizinische Klinik 1, Schwerpunkt Gastroenterologie und Hepatologie, Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt, Germany.
authors: Georgios
authors: G
authors: Grammatikos
authors: Medizinische Klinik 1, Schwerpunkt Gastroenterologie und Hepatologie, Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt, Germany.
authors: Harald
authors: H
authors: Farnik
authors: Medizinische Klinik 1, Schwerpunkt Gastroenterologie und Hepatologie, Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt, Germany.
authors: Yolanda
authors: Y
authors: Martinez
authors: Medizinische Klinik 1, Schwerpunkt Gastroenterologie und Hepatologie, Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt, Germany.
authors: Fabian
authors: F
authors: Finkelmeier
authors: pharmazentrum frankfurt/ZAFES, Institut für Klinische Pharmakologie, Universitätsklinikum Frankfurt, Frankfurt, Germany.
authors: Sandra
authors: S
authors: Labocha
authors: pharmazentrum frankfurt/ZAFES, Institut für Klinische Pharmakologie, Universitätsklinikum Frankfurt, Frankfurt, Germany.
authors: Nerea
authors: N
authors: Ferreirós
authors: Medizinische Klinik 1, Schwerpunkt Gastroenterologie und Hepatologie, Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt, Germany.
authors: Stefan
authors: S
authors: Zeuzem
authors: Medizinische Klinik 1, Schwerpunkt Gastroenterologie und Hepatologie, Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt, Germany.
authors: Albrecht
authors: A
authors: Piiper
authors: Medizinische Klinik 1, Schwerpunkt Gastroenterologie und Hepatologie, Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt, Germany.
authors: Oliver
authors: O
authors: Waidmann
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010727:Phosphoric Diester Hydrolases / Q000097:blood*; D011446:Prospective Studies; D016019:Survival Analysis; D000099189:Lysophospholipase D
chemical_list: D015415:Biomarkers; D010727:Phosphoric Diester Hydrolases; D000099189:Lysophospholipase D