Abstract :
Introduction: Chronic liver disease (CLD) may be accompanied by portal hypertension (PHT). Nitric oxide (NO) disturbance seems to play a key role in the pathogenesis of CLD and PHT. The aim of this study was to clarify the correlation between chronic liver disease stages, esophageal varices presence and nitric oxide disturbance.
Method: The study was conducted on 51 patients divided according to Child-Pugh Classification (CPC)(A = 16, B = 15, C = 10) and a control group of 15 healthy volunteers. All patients included were subjected to full clinical assessment, routine laboratory investigation and upper endoscopy. Serum nitrate and nitrite levels were determined by single step nitrate reductase enzymatic assay and Greiss’s reaction colorimetric assay.
Results: Nitrate and nitrite levels in CLD patients were higher (3.02 ± 0.370 and 0.97 ± 0.14 μmol/L) than those in the control group (1.5 ± 0.47 and 0.38 ± 0.01 μmol/L; p = 0.15 and p <0.001), respectively. Higher levels of serum nitrite were detected in more advance stages of chronic liver disease (CPC class A 0.38 ± 0.18 μmol/mL, class B 0.64 ± 0.12 μmol/mL, class C 2.8 ± 0.43 μmol/L, p <0.01). No significant difference of nitrate and nitrite levels was found between cirrhosis patients with (2.28 ± 0.42 and 0.6 ± 0.12 μmol/L) and without (2.23± 0.46 and 0.53 ± 0.09 μmol/L) esophageal varices (p = 0.107 and p = 0.089), respectively.
Conclusion: Serum nitrate and nitrite levels can be used as markers of chronic liver disease. The levels of these metabolites increase in advanced liver disease, with no correlation with the presence of esophageal varices.
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file/Thai-Journal-of-gastroenterology-vol-12-no-1-591339.pdf