TY - JOUR
T1 - ACE I allele is associated with more severe portal hypertension in patients with liver cirrhosis: A pilot study
AU - Annicchiarico, Brigida Eleonora
AU - Santonocito, Concetta
AU - Siciliano, Massimo
AU - Scapaticci, Margherita
AU - Guarino, Donatella
AU - Di Stasi, Carmine
AU - Riccioni, Maria Elena
AU - Di Stasio, Enrico
AU - Capoluongo, Ettore Domenico
AU - Gasbarrini, Antonio
PY - 2018
Y1 - 2018
N2 - Background: In liver cirrhosis, the renin-angiotensin-aldosterone system is involved in the pathogenesis of portal hypertension. Its effector, angiotensin II, is generated by angiotensin-converting enzyme (ACE). Serum ACE levels are affected by I/D polymorphism of its gene, with alleles I and D being associated, respectively, with lesser and greater activity of the enzyme. In cirrhotic patients carrying the ACE I allele, an increased risk for gastro-oesophageal varices was observed. Aim: The aim of our study was to evaluate whether ACE I/D polymorphism influenced portal pressure. Methods: Fifty-one consecutive cirrhotic patients were divided based on ACE genotype (DD, ID, and II). Kidney and liver function tests, upper endoscopy, and hepatic venous pressure gradient measurement (HVPG) were performed in all patients. Results: The presence of the ACE I allele was associated with a higher HVPG value (18.7 ± 6.4 vs 10.3 ± 6.3 mmHg; P < .001), higher frequency of large gastrooesophageal varices (59.3% vs 25.0%; P < .05), and higher frequency of variceal bleeding (63.0% vs 29.2%; P < .05). No significant differences were found between patients with and those without the ACE I allele regarding Child-Pugh score, MELD score, ascites, and hepatic encephalopathy. Conclusion: ACE I/D polymorphism seems to influence the severity of portal hypertension and the risk of variceal bleeding in liver cirrhosis, regardless of the severity of liver disease.
AB - Background: In liver cirrhosis, the renin-angiotensin-aldosterone system is involved in the pathogenesis of portal hypertension. Its effector, angiotensin II, is generated by angiotensin-converting enzyme (ACE). Serum ACE levels are affected by I/D polymorphism of its gene, with alleles I and D being associated, respectively, with lesser and greater activity of the enzyme. In cirrhotic patients carrying the ACE I allele, an increased risk for gastro-oesophageal varices was observed. Aim: The aim of our study was to evaluate whether ACE I/D polymorphism influenced portal pressure. Methods: Fifty-one consecutive cirrhotic patients were divided based on ACE genotype (DD, ID, and II). Kidney and liver function tests, upper endoscopy, and hepatic venous pressure gradient measurement (HVPG) were performed in all patients. Results: The presence of the ACE I allele was associated with a higher HVPG value (18.7 ± 6.4 vs 10.3 ± 6.3 mmHg; P < .001), higher frequency of large gastrooesophageal varices (59.3% vs 25.0%; P < .05), and higher frequency of variceal bleeding (63.0% vs 29.2%; P < .05). No significant differences were found between patients with and those without the ACE I allele regarding Child-Pugh score, MELD score, ascites, and hepatic encephalopathy. Conclusion: ACE I/D polymorphism seems to influence the severity of portal hypertension and the risk of variceal bleeding in liver cirrhosis, regardless of the severity of liver disease.
KW - ACE polymorphism
KW - Gastro-esophageal varices
KW - Gastroenterology
KW - Hepatic venous pressure gradient
KW - Hepatology
KW - ACE polymorphism
KW - Gastro-esophageal varices
KW - Gastroenterology
KW - Hepatic venous pressure gradient
KW - Hepatology
UR - http://hdl.handle.net/10807/129412
UR - http://www.elsevier.com/wps/find/journalbibliographicinfo.cws_home/623449/description#bibliographicinfo
U2 - 10.1016/j.dld.2018.08.005
DO - 10.1016/j.dld.2018.08.005
M3 - Article
SN - 1590-8658
VL - 51
SP - 293
EP - 296
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
ER -