A Alpha feto protein and high sensitive c-reactive protein levels in Iraqi liver cirrhosis patients Alpha feto protein and high sensitive c-reactive protein levels
Main Article Content
Keywords
Liver cirrhosis, alpha –fetoprotein, hs-CRP
Abstract
Background: Liver-related death globally is caused mainly by Cirrhosis. It is the final grade of intensive liver fibrosis, in which the hepatic architecture is changed.
Cirrhosis is a common worldwide disease and can be the end stage of several reasons , like obesity, non-alcoholic fatty liver , alcoholism, viral infection such as viral hepatitis , immunity disorders, bile duct obstruction , and metabolic diseases. Alpha-fetoprotein (AFP) is defined as a protein secreted by the germinal yolk cysit and liver. AFP used as a partition test for inherited disorders, chromosomal anomaly .hs-CRP have separated correlation with NAFLD. So, hs-CRP can be benefit as a good parameter for liver defect acerbity .
Subjects and Methods: thirty liver cirrhotic participants and thirty well being subjects as control (men and women).The specimen were possessed from Baghdad, Iraq were enrolled in this study. Blood and serum samples were obtained for the estimation of Hb and serum alpha–feto protein and hs –CRP levels.
Results: The pooled data of participants showed that hs-CRP and alph –fetoprotein concentration in cirrhotic subjects were significantly higher than control p<0.0001. There is no significant gender differences considering alpha fetoprotein with while hs CRP was higher in male when compared with female
Conclusion: This research show a significant high level of hs –CRP and alpha –fetoprotein in liver cirrhosis patients compared with the control subjects.
There is a nonsignificant gender differences concerning alpha –fetoprotein
With significant high level of hs- CRP in males compared with females
References
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Lancet GastroenterolHepatol. 2020; 5: 245-266.
4.Sharony R, Dayan D, Kidron D, Manor M, Berkovitz A, Biron-Shental T, Maymon R. Is the ratio of maternal serum to amniotic fluid AFP superior to serum levels as a predictor of pregnancy complications? Arch Gynecol Obstet. 2016 Apr;293(4):767-70. [PubMed]
5. Öztürk H, Erkaya S, Altınbaş S, Karadağ B, VanlıTonyalı N, Özkan D. The role of unexplained high serum alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG) levels in the second trimester to determine poor obstetric outcomes. Turk J Obstet Gynecol. 2014 Sep;11(3):142-147. [PMC free article] [PubMed]
6. Rood K, Stiller R. Hereditary persistence of alpha-fetoprotein: a rare cause for unexplained alpha-fetoprotein elevations in pregnancy. Conn Med. 2013 Jan;77(1):43-5
7.anLeeuwen DJ, Shumate CR. Space-occupying lesions of the liver. vanLeeuwen DJ, Reeders JWAJ, Ariyama J, eds. Imaging in Hepatobiliary and Pancreatic Disease: A Practical Clinical Approach. London: WB Saunders; 2000.
8. Kemmer N, Neff G, Kaiser T, Zacharias V, Thomas M, Tevar A, et al. An analysis of the UNOS liver transplant registry: high serum alpha-fetoprotein does not justify an increase in MELD points for suspected hepatocellular carcinoma. Liver Transpl. 2006 Oct. 12 (10):1519-22. [Medline].
9.Saffroy R, Pham P, Reffas M, Takka M, Lemoine A, Debuire B. New perspectives and strategy research biomarkers for hepatocellular carcinoma. ClinChem Lab Med. 2007. 45 (9):1169-79.
10. Alpert E: Human alpha,-fetoprotein. In Progress in Liver Diseases, ~015. Edited by H Popper, F Schaffner. New York, Grune& Stratton, 1976, p 337-349
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12.Sjöwall C, Cardell K, Boström EA, Bokarewa MI, Enocsson H, Ekstedt M, Lindvall L, Frydén A and Almer S: High prevalence of autoantibodies to C-reactive protein in patients with chronic C infection: Association with liver fibrosis and portal inflammation. Hum Immunol. 73:382–388. 2012.
13.Rahul Kumar,1 Y C Porwal,1 Nishanth Dev,1 Priyadarshi Kumar,1 Sanjay Chakravarthy,1 and Ashok Kumawat- Association of high-sensitivity C-reactive protein (hs-CRP) with non-alcoholic fatty liver disease (NAFLD) in Asian Indians: A cross-sectional study.J Family Med Prim Care. 2020 Jan; 9(1): 390–394.
14.Relationship between Nonalcoholic Fatty Liver Disease and High Sensitivity C-Reactive Protein in Healthy Adults . Yunhyoung Choi1, Jung-Eun Oh1,*, Jin Lee1, Hwang-Sik Shin1. Korean J FamPract 2021; 11(1): 39-45
15.ukhpal Singh 1 , Abhishek Bansal 2 , * , PardeepKumaCRP Levels in Viral Hepatitis: A Meta-Analysis Study . nternational Journal of Infection: November 23, 2020 8 (1); 108958. 28. SAS. 2012. Statistical Analysis System, User's Guide.
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17. Pieri G, Agarwal B, Burroughs AK. C-reactive protein and bacterial infection in cirrhosis. Ann Gastroenterol 2014; 27: 113- 120.
18. Vincent Di Martino,CarolineCoutris,Jean-Paul Cervoni,.et al .Prognostic value of C-reactive protein levels in patients with cirrhosis .Liver Transplantation 2015;21:753-760
19.Chiang CH, Huang CC, Chan WL, Chen JW, Leu HB (2010) The severity of non-alcoholic fatty liver disease correlates with high sensitivity C-reactive protein value and is independently associated with increased cardiovascular risk in healthy population. ClinBiochem 43: 1399–1404. pmid:20846522
20.Genc H, Dogru T, Kara M, Tapan S, Ercin CN, Acikel C, et al. (2013) Association of plasma visfatin with hepatic and systemic inflammation in nonalcoholic fatty liver disease. Ann Hepatol 12: 548–555. pmid:23813132
21.Yao FY. Dramatic reduction of the alpha-fetoprotein level after lamivudine treatment of patients with chronic hepatitis B virus infection and cirrhosis. J ClinGastroenterol 2003; 36: 440-2.
22. Bae JS, Park SJ, Park KB, et al. Acute exacerbation of hepatitis in liver cirrhosis with very high levels of alpha-fetoprotein but no occurrence of hepatocellular carcinoma. Korean J Intern Med 2005; 20: 80-5.
23. Stein DF, Myaing M. Normalization of markedly elevated alphafetoprotein in a virologicnonresponder with HCV-related cirrhosis. Dig Dis Sci 2002; 47: 2686-90.
24. Cheema AW, Hirschtritt T, Van Thiel DH. Markedly elevated alpha-fetoprotein levels without hepatocellular carcinoma. Hepatogastroenterology 2004; 51: 1676-8. 5. Lee HS, Chung YH, Kim CY. Specificities of
25. Horváth 1, A Szegedi 1, A Folhoffer et al Serum alpha-fetoprotein (AFP) level in non-tumorous chronic liver diseases.Gastroenterol 2005; 43 – 44
26. Bloomer JR, Waldmann TA, McIntire KR, Klatskin G. alpha-fetoprotein in noneoplastic hepatic disorders. JAMA. 1975;233:38–41. [PubMed] [Google Scholar]
27. Dabeva MD, Laconi E, Oren R, Petkov PM, Hurston E, Shafritz DA. Liver regeneration and alpha-fetoprotein messenger RNA expression in the retrorsine model for hepatocyte transplantation. Cancer Res. 1998;58:5825–5834. [PubMed] [Google Scholar]
28. Goldstein NS, Blue DE, Hankin R, Hunter S, Bayati N, Silverman AL, Gordon SC. Serum alpha-fetoprotein levels in patients with chronic hepatitis C. Relationships with serum alanine aminotransferase values, histologic activity index, and hepatocyte MIB-1 scores. Am J ClinPathol. 1999;111:811–816.
29. McHutchison JG, Manns MP, Longo DL. Definition and management of anemia in patients infected with hepatitis C virus. Liver Int 2006;26:389-398.
30. Caldwell SH, Hoffman M, Lisman T, et al; Coagulation in Liver Disease Group. Coagulation disorders and hemostasis in liver disease: pathophysiology and critical assessment of current management. Hepatology 2006;44:1039-1046.
31. Pereira SP, Langley PG, Williams R. The management of abnormalities of hemostasis in acute liver failure. Semin Liver Dis 1996;16:403-414.
32. Gonzalez-Casas R, Garcia-Buey L, Jones EA, Gisbert JP, MorenoOtero R. Systematic review: hepatitis-associated aplastic anaemia—a syndrome associated with abnormal immunological function. Aliment PharmacolTher 2009;30:436-443
33.Maruyama S, Hirayama C, Yamamoto S, et al. Red blood cell status in alcoholic and non-alcoholic liver disease. J Lab Clin Med. 2001; 138(5): 332- 337.
34.Kalaitzakis E, Josefsson A, Castedal M, et al. Hepatic encephalopathy is related to anemia and fat-free mass depletion in liver transplant candidates with cirrhosis. Scand J Gastroenterol. 2013; 48(5): 577- 584.
35.deFranchis R, Baveno V. Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol. 2015; 63(3): 743- 752.
36.Lu YF, Li XQ, Han XY, Gong XG, Chang SW. Peripheral blood cell variations in cirrhotic portal hypertension patients with hypersplenism. Asian Pac J Trop Med. 2013; 6(8): 663- 666.
37.Lv Y, Yee Lau W, Wu H, et al. Causes of peripheral cytopenia in hepatitic cirrhosis and portal hypertensive splenomegaly. ExpBiol Med (Maywood). 2017; 242(7): 744- 749.
38.Yanli He, ... Lijuan Zhang, in Progress in Molecular Biology and Translational Science, 2019
39.AmitKheraMD, MSc⁎†Darren K.McGuireMD, MHSc(FACC)⁎.e talRace and Gender Differences in C-Reactive Protein Levels. Journal of the American College of Cardiology Volume 46, Issue 3, 2 August 2005, Pages 464-46.
2 Anthony PP, Ishak KG, Nayak NC, Poulsen HE, Scheuer PJ, Sobin LH. The morphology of cirrhosis. Recommendations on definition, nomenclature, and classification by a working group sponsored by the World Health Organization. J ClinPathol 1978; 31: 395–414.
3- SepanlouSG ,Safiri S , Bisignano C . et al.The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017.
Lancet GastroenterolHepatol. 2020; 5: 245-266.
4.Sharony R, Dayan D, Kidron D, Manor M, Berkovitz A, Biron-Shental T, Maymon R. Is the ratio of maternal serum to amniotic fluid AFP superior to serum levels as a predictor of pregnancy complications? Arch Gynecol Obstet. 2016 Apr;293(4):767-70. [PubMed]
5. Öztürk H, Erkaya S, Altınbaş S, Karadağ B, VanlıTonyalı N, Özkan D. The role of unexplained high serum alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG) levels in the second trimester to determine poor obstetric outcomes. Turk J Obstet Gynecol. 2014 Sep;11(3):142-147. [PMC free article] [PubMed]
6. Rood K, Stiller R. Hereditary persistence of alpha-fetoprotein: a rare cause for unexplained alpha-fetoprotein elevations in pregnancy. Conn Med. 2013 Jan;77(1):43-5
7.anLeeuwen DJ, Shumate CR. Space-occupying lesions of the liver. vanLeeuwen DJ, Reeders JWAJ, Ariyama J, eds. Imaging in Hepatobiliary and Pancreatic Disease: A Practical Clinical Approach. London: WB Saunders; 2000.
8. Kemmer N, Neff G, Kaiser T, Zacharias V, Thomas M, Tevar A, et al. An analysis of the UNOS liver transplant registry: high serum alpha-fetoprotein does not justify an increase in MELD points for suspected hepatocellular carcinoma. Liver Transpl. 2006 Oct. 12 (10):1519-22. [Medline].
9.Saffroy R, Pham P, Reffas M, Takka M, Lemoine A, Debuire B. New perspectives and strategy research biomarkers for hepatocellular carcinoma. ClinChem Lab Med. 2007. 45 (9):1169-79.
10. Alpert E: Human alpha,-fetoprotein. In Progress in Liver Diseases, ~015. Edited by H Popper, F Schaffner. New York, Grune& Stratton, 1976, p 337-349
11.Andreozzi P, Viscogliosi G, Colella F, Subic M, Cipriani E, Marigliano B, Verrusio W, Servello A, Ettorre E and Marigliano V: Predictors of liver fibrosis in patients with non-alcoholic fatty liver disease. The role of metabolic syndrome, insulin-resistance and inflammation. RecentiProg Med. 103:570–574. 2012.(In Italian).
12.Sjöwall C, Cardell K, Boström EA, Bokarewa MI, Enocsson H, Ekstedt M, Lindvall L, Frydén A and Almer S: High prevalence of autoantibodies to C-reactive protein in patients with chronic C infection: Association with liver fibrosis and portal inflammation. Hum Immunol. 73:382–388. 2012.
13.Rahul Kumar,1 Y C Porwal,1 Nishanth Dev,1 Priyadarshi Kumar,1 Sanjay Chakravarthy,1 and Ashok Kumawat- Association of high-sensitivity C-reactive protein (hs-CRP) with non-alcoholic fatty liver disease (NAFLD) in Asian Indians: A cross-sectional study.J Family Med Prim Care. 2020 Jan; 9(1): 390–394.
14.Relationship between Nonalcoholic Fatty Liver Disease and High Sensitivity C-Reactive Protein in Healthy Adults . Yunhyoung Choi1, Jung-Eun Oh1,*, Jin Lee1, Hwang-Sik Shin1. Korean J FamPract 2021; 11(1): 39-45
15.ukhpal Singh 1 , Abhishek Bansal 2 , * , PardeepKumaCRP Levels in Viral Hepatitis: A Meta-Analysis Study . nternational Journal of Infection: November 23, 2020 8 (1); 108958. 28. SAS. 2012. Statistical Analysis System, User's Guide.
16.Statistical. Version 9.1th ed. SAS. Inst. Inc. Cary. N.C.
17. Pieri G, Agarwal B, Burroughs AK. C-reactive protein and bacterial infection in cirrhosis. Ann Gastroenterol 2014; 27: 113- 120.
18. Vincent Di Martino,CarolineCoutris,Jean-Paul Cervoni,.et al .Prognostic value of C-reactive protein levels in patients with cirrhosis .Liver Transplantation 2015;21:753-760
19.Chiang CH, Huang CC, Chan WL, Chen JW, Leu HB (2010) The severity of non-alcoholic fatty liver disease correlates with high sensitivity C-reactive protein value and is independently associated with increased cardiovascular risk in healthy population. ClinBiochem 43: 1399–1404. pmid:20846522
20.Genc H, Dogru T, Kara M, Tapan S, Ercin CN, Acikel C, et al. (2013) Association of plasma visfatin with hepatic and systemic inflammation in nonalcoholic fatty liver disease. Ann Hepatol 12: 548–555. pmid:23813132
21.Yao FY. Dramatic reduction of the alpha-fetoprotein level after lamivudine treatment of patients with chronic hepatitis B virus infection and cirrhosis. J ClinGastroenterol 2003; 36: 440-2.
22. Bae JS, Park SJ, Park KB, et al. Acute exacerbation of hepatitis in liver cirrhosis with very high levels of alpha-fetoprotein but no occurrence of hepatocellular carcinoma. Korean J Intern Med 2005; 20: 80-5.
23. Stein DF, Myaing M. Normalization of markedly elevated alphafetoprotein in a virologicnonresponder with HCV-related cirrhosis. Dig Dis Sci 2002; 47: 2686-90.
24. Cheema AW, Hirschtritt T, Van Thiel DH. Markedly elevated alpha-fetoprotein levels without hepatocellular carcinoma. Hepatogastroenterology 2004; 51: 1676-8. 5. Lee HS, Chung YH, Kim CY. Specificities of
25. Horváth 1, A Szegedi 1, A Folhoffer et al Serum alpha-fetoprotein (AFP) level in non-tumorous chronic liver diseases.Gastroenterol 2005; 43 – 44
26. Bloomer JR, Waldmann TA, McIntire KR, Klatskin G. alpha-fetoprotein in noneoplastic hepatic disorders. JAMA. 1975;233:38–41. [PubMed] [Google Scholar]
27. Dabeva MD, Laconi E, Oren R, Petkov PM, Hurston E, Shafritz DA. Liver regeneration and alpha-fetoprotein messenger RNA expression in the retrorsine model for hepatocyte transplantation. Cancer Res. 1998;58:5825–5834. [PubMed] [Google Scholar]
28. Goldstein NS, Blue DE, Hankin R, Hunter S, Bayati N, Silverman AL, Gordon SC. Serum alpha-fetoprotein levels in patients with chronic hepatitis C. Relationships with serum alanine aminotransferase values, histologic activity index, and hepatocyte MIB-1 scores. Am J ClinPathol. 1999;111:811–816.
29. McHutchison JG, Manns MP, Longo DL. Definition and management of anemia in patients infected with hepatitis C virus. Liver Int 2006;26:389-398.
30. Caldwell SH, Hoffman M, Lisman T, et al; Coagulation in Liver Disease Group. Coagulation disorders and hemostasis in liver disease: pathophysiology and critical assessment of current management. Hepatology 2006;44:1039-1046.
31. Pereira SP, Langley PG, Williams R. The management of abnormalities of hemostasis in acute liver failure. Semin Liver Dis 1996;16:403-414.
32. Gonzalez-Casas R, Garcia-Buey L, Jones EA, Gisbert JP, MorenoOtero R. Systematic review: hepatitis-associated aplastic anaemia—a syndrome associated with abnormal immunological function. Aliment PharmacolTher 2009;30:436-443
33.Maruyama S, Hirayama C, Yamamoto S, et al. Red blood cell status in alcoholic and non-alcoholic liver disease. J Lab Clin Med. 2001; 138(5): 332- 337.
34.Kalaitzakis E, Josefsson A, Castedal M, et al. Hepatic encephalopathy is related to anemia and fat-free mass depletion in liver transplant candidates with cirrhosis. Scand J Gastroenterol. 2013; 48(5): 577- 584.
35.deFranchis R, Baveno V. Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol. 2015; 63(3): 743- 752.
36.Lu YF, Li XQ, Han XY, Gong XG, Chang SW. Peripheral blood cell variations in cirrhotic portal hypertension patients with hypersplenism. Asian Pac J Trop Med. 2013; 6(8): 663- 666.
37.Lv Y, Yee Lau W, Wu H, et al. Causes of peripheral cytopenia in hepatitic cirrhosis and portal hypertensive splenomegaly. ExpBiol Med (Maywood). 2017; 242(7): 744- 749.
38.Yanli He, ... Lijuan Zhang, in Progress in Molecular Biology and Translational Science, 2019
39.AmitKheraMD, MSc⁎†Darren K.McGuireMD, MHSc(FACC)⁎.e talRace and Gender Differences in C-Reactive Protein Levels. Journal of the American College of Cardiology Volume 46, Issue 3, 2 August 2005, Pages 464-46.
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Aug 24, 2022
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Abbas, W. (2022). A Alpha feto protein and high sensitive c-reactive protein levels in Iraqi liver cirrhosis patients: Alpha feto protein and high sensitive c-reactive protein levels . Journal of Population Therapeutics and Clinical Pharmacology, 29(03). https://doi.org/10.47750/jptcp.2022.905
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