title: Pro-C5, a marker of true type V collagen formation and fibrillation, correlates with portal hypertension in patients with alcoholic cirrhosis.
abstract: OBJECTIVE
  The hepatic venous pressure gradient (HVPG) is an important but invasive diagnostic and prognostic marker in cirrhotic patients. The aim of the study was to evaluate a novel biochemical plasma marker of true type V collagen formation (Pro-C5) for describing HVPG.
  
  
  METHODS
  Ninety-four patients mainly with alcoholic cirrhosis and fourteen liver-healthy controls were included in a retrospective study. Relevant clinical and routine laboratory data and hemodynamics were determined. Plasma Pro-C5 was correlated to HVPG and liver function parameters. Furthermore, Pro-C5 was combined in a linear regression model.
  
  
  RESULTS
  Plasma Pro-C5 correlated to HVPG, indocyanine green clearance, sustained vascular resistance and mean arterial pressure (r = -0.68-0.33, p < 0.0001). A multiple regression analysis including Pro-C5, alanine aminotransferase, bilirubin and model for end-stage liver disease (MELD) improved the correlation to HVPG (r = 0.74, p < 0.0001). Plasma Pro-C5 was positively or negatively correlated to a number of routine liver function markers and MELD score (r = 0.27-0.68; p < 0.05-0.0001). Furthermore, plasma Pro-C5 could clearly separate patients with a HVPG <10 mmHg or HVPG ≥10 mmHg (p < 0.001, area under the curve (AUC) = 0.73), HVPG 10-<16 mmHg or HVPG ≥16 mmHg (p < 0.001, AUC = 0.68) and controls from diseased patients (p < 0.0001, AUC = 0.88). Finally, there was a clear relation to increasing Child score A-C and plasma Pro-C5 (ANOVA p < 0.001).
  
  
  CONCLUSIONS
  Plasma Pro-C5 reflects liver hemodynamics, liver function, disease stage and clinically significant portal hypertension (PH). A multimarker model in combination with clinical scores predicted HVPG and separated clinical relevant HVPG thresholds. Plasma Pro-C5 may be suitable for the noninvasive evaluation of PH in patients with cirrhosis.
authors: Nordic Bioscience, Fibrosis Biology and Biomarkers , Herlev , Denmark.
authors: Diana J
authors: DJ
authors: Leeming
authors: Sanne S
authors: SS
authors: Veidal
authors: Morten A
authors: MA
authors: Karsdal
authors: Mette Juul
authors: MJ
authors: Nielsen
authors: Jonel
authors: J
authors: Trebicka
authors: Troels
authors: T
authors: Busk
authors: Flemming
authors: F
authors: Bendtsen
authors: Aleksander
authors: A
authors: Krag
authors: Søren
authors: S
authors: Møller
mesh_terms: D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D019540:Area Under Curve; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D024062:Collagen Type V / Q000737:chemistry*; D003182:Complement C5 / Q000737:chemistry*; D058625:End Stage Liver Disease / Q000150:complications*; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis*; D016014:Linear Models; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D024062:Collagen Type V; D003182:Complement C5; D000410:Alanine Transaminase; D001663:Bilirubin
keywords: biochemical marker; cirrhosis; clinic; liver; noninvasive.; portal hypertension