کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6088214 1207691 2015 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Liver, Pancreas and Biliary TractAdrenal function and microbial DNA in noninfected cirrhotic patients with ascites: Relationship and effect on survival
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی غدد درون ریز، دیابت و متابولیسم
پیش نمایش صفحه اول مقاله
Liver, Pancreas and Biliary TractAdrenal function and microbial DNA in noninfected cirrhotic patients with ascites: Relationship and effect on survival
چکیده انگلیسی

BackgroundThere are few data on clinical relevance of adrenal dysfunction and its relationship with occult microbial DNA in noninfected haemodynamically stable cirrhotic patients with ascites.AimsThe aim of this study was to evaluate prognostic role of adrenal dysfunction, microbial DNA, and their relationship.MethodsAdrenal function was assessed in 93 consecutive patients following a corticotropin stimulation test. Adrenal dysfunction was defined as: basal cortisol <10 μg/dl, delta cortisol <9 μg/dl, or peak cortisol <18 μg/dl. Microbial DNA was assessed in blood and ascites of 54 consecutive patients. Patients were followed up until liver transplantation or death.ResultsAdrenal dysfunction was not significantly associated with mortality, while the risk of death rose significantly with an increase in basal cortisol values (HR 1.13 per 1-μl/dl increase; 95% CI 1.01-1.26). Microbial DNA was independently associated with reduced survival (HR 8.05, 95% CI 1.57-41.2). In microbial DNA-positive patients a significant correlation was found between Model for End-Stage Liver Disease (MELD) score and basal cortisol values (Pearson's r = 0.5107; p = 0.018).ConclusionsMicrobial DNA and MELD score, but not adrenal function, were the best independent predictors of mortality in noninfected cirrhotic patients with ascites. High serum cortisol levels may be a systemic reaction to microbial translocation, increasing in parallel with deterioration of liver function.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Digestive and Liver Disease - Volume 47, Issue 8, August 2015, Pages 702-708
نویسندگان
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