title: Osteopontin: A non-invasive parameter of portal hypertension and prognostic marker of cirrhosis.
abstract: OBJECTIVE
  To investigate the relationship between osteopontin plasma concentrations and the severity of portal hypertension and to assess osteopontin prognostic value.
  
  
  METHODS
  A cohort of 154 patients with confirmed liver cirrhosis (112 ethylic, 108 men, age 34-72 years) were enrolled in the study. Hepatic venous pressure gradient (HVPG) measurement and laboratory and ultrasound examinations were carried out for all patients. HVPG was measured using a standard catheterization method with the balloon wedge technique. Osteopontin was measured using the enzyme-linked immunosorbent assay (ELISA) method in plasma. Patients were followed up with a specific focus on mortality. The control group consisted of 137 healthy age- and sex- matched individuals.
  
  
  RESULTS
  The mean value of HVPG was 16.18 ± 5.6 mmHg. Compared to controls, the plasma levels of osteopontin in cirrhotic patients were significantly higher (P < 0.001). The plasma levels of osteopontin were positively related to HVPG (P = 0.0022, r = 0.25) and differed among the individual Child-Pugh groups of patients. The cut-off value of 80 ng/mL osteopontin distinguished patients with significant portal hypertension (HVPG above 10 mmHg) at 75% sensitivity and 63% specificity. The mean follow-up of patients was 3.7 ± 2.6 years. The probability of cumulative survival was 39% for patients with HVPG > 10 mmHg and 65% for those with HVPG ≤ 10 mmHg (P = 0.0086, odds ratio (OR), 2.92, 95% confidence interval (CI): 1.09-7.76). Osteopontin showed a similar prognostic value to HVPG. Patients with osteopontin values above 80 ng/mL had significantly lower cumulative survival compared to those with osteopontin ≤ 80 ng/mL (37% vs 56%, P = 0.00035; OR = 2.23, 95%CI: 1.06-4.68).
  
  
  CONCLUSIONS
  Osteopontin is a non-invasive parameter of portal hypertension that distinguishes patients with clinically significant portal hypertension. It is a strong prognostic factor for survival.
authors.affiliation: Radan Bruha, Jaromir Petrtyl, Karel Dvorak, Tomislav Svestka, 4 Department of Internal Medicine, 1 Faculty of Medicine and General University Hospital, Charles University in Prague, 12808 Prague, Czech Republic.
authors.forename: Radan
authors.initials: R
authors.lastname: Bruha
authors.affiliation: Radan Bruha, Jaromir Petrtyl, Karel Dvorak, Tomislav Svestka, 4 Department of Internal Medicine, 1 Faculty of Medicine and General University Hospital, Charles University in Prague, 12808 Prague, Czech Republic.
authors.forename: Marie
authors.initials: M
authors.lastname: Jachymova
authors.affiliation: Radan Bruha, Jaromir Petrtyl, Karel Dvorak, Tomislav Svestka, 4 Department of Internal Medicine, 1 Faculty of Medicine and General University Hospital, Charles University in Prague, 12808 Prague, Czech Republic.
authors.forename: Jaromir
authors.initials: J
authors.lastname: Petrtyl
authors.affiliation: Radan Bruha, Jaromir Petrtyl, Karel Dvorak, Tomislav Svestka, 4 Department of Internal Medicine, 1 Faculty of Medicine and General University Hospital, Charles University in Prague, 12808 Prague, Czech Republic.
authors.forename: Karel
authors.initials: K
authors.lastname: Dvorak
authors.affiliation: Radan Bruha, Jaromir Petrtyl, Karel Dvorak, Tomislav Svestka, 4 Department of Internal Medicine, 1 Faculty of Medicine and General University Hospital, Charles University in Prague, 12808 Prague, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Lenicek
authors.affiliation: Radan Bruha, Jaromir Petrtyl, Karel Dvorak, Tomislav Svestka, 4 Department of Internal Medicine, 1 Faculty of Medicine and General University Hospital, Charles University in Prague, 12808 Prague, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Urbanek
authors.affiliation: Radan Bruha, Jaromir Petrtyl, Karel Dvorak, Tomislav Svestka, 4 Department of Internal Medicine, 1 Faculty of Medicine and General University Hospital, Charles University in Prague, 12808 Prague, Czech Republic.
authors.forename: Tomislav
authors.initials: T
authors.lastname: Svestka
authors.affiliation: Radan Bruha, Jaromir Petrtyl, Karel Dvorak, Tomislav Svestka, 4 Department of Internal Medicine, 1 Faculty of Medicine and General University Hospital, Charles University in Prague, 12808 Prague, Czech Republic.
authors.forename: Libor
authors.initials: L
authors.lastname: Vitek
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D053495:Osteopontin / Q000097:blood*; D017082:Portal Pressure; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C506895:SPP1 protein, human; D053495:Osteopontin
keywords: Cirrhosis; Complications of cirrhosis; Hepatic venous pressure gradient; Osteopontin; Portal hypertension; Prognosis; Survival prediction