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Original scientific paper

Correlation of Endothelin-1 Concentration and Angiotensin-Converting Enzyme Activity with the Staging of Liver Fibrosis

Duško Kardum
Damir Fabijanić
Anita Lukić
Željko Romić
Mladen Petrovečki
Zoran Bogdanović
Klara Jurić
Marija Urek-Crnčević
Marko Banić

Full text: english pdf 151 Kb

page 413-418

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Increased serum angiotensin-converting enzyme (SACE) activity and serum concentration of endothelin-1 (ET-1)
were found in liver cirrhosis. We investigated a correlation between the different stages of liver fibrosis and SACE activity
and serum ET-1 concentration. Seventy patients with pathohistologically established chronic liver disease were divided
in three groups according to Ishak criteria for liver fibrosis: minimal fibrosis (Ishak score 0–1, n=20), medium fibrosis
(Ishak score 2–5, n=20) and cirrhosis (Ishak score 6, n=30). SACE activity and ET-1 concentration were
determined using commercial ELISA kits. SACE activity and ET-1 concentrations were proportional to the severity of
disease, the highest being in patients with liver cirrhosis. Maximal increase in SACE activity was found between minimal
and medium fibrosis while maximal increase in ET-1 concentration was revealed between medium fibrosis and cirrhosis.
The analysis of the Receiver Operating Characteristic (ROC) curve for SACE activity suggested a cut-off value to
separate minimal from medium fibrosis at 59.00 U/L (sensitivity 100%, specificity 64.7%). The cut-off value for serum
ET-1 concentration to separate medium fibrosis from cirrhosis was 12.4 pg/mL (sensitivity 96.8%, specificity 94.4%). A
positive correlation between SACE activity and ET-1 concentration was registered (Spearman’s ñ=0.438, p=0.004). Both
SACE activity and ET-1 concentration were increased in all stages of liver fibrosis. Cut-off points for SACE activity and
ET-1 concentration could be a biochemical marker for the progression of fibrosis. Positive correlation between SACE activity
and ET-1 concentration might indicate their interaction in the development of liver cirrhosis.


fibrosis, liver, cirrhosis, angiotensin converting enzyme, endothelin

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