Skip to main content

Advertisement

Log in

The Serum Endothelın-1 Level in Steatosıs and NASH, and Its Relatıon wıth Severıty of Lıver Fıbrosıs

  • Original Paper
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Endothelin-1 (ET-1) is known to play an important role in hepatic fibrosis. ET-1 is also a mediator that is elevated in conditions such as insulin resistance, hyperglycemia, oxidative stress, and endothelial cell dysfunction. In this study, we investigated whether ET-1 has a role in determining the severity of liver fibrosis in NASH. Also, the relation between ALT levels, obesity, diabetes, and AST/ALT ratio and fibrosis and ET-1 level was sought. A total of 92 patients were enrolled in the study. The patients were categorized into three groups: group 1, patients with elevated transaminase levels who were diagnosed as NASH by liver biopsy (n=40); group II, patients with only hepatosteatosis determined by biopsy but having elevated transaminase levels (n=12); and group III, patients with hepatosteatosis observed by ultrasonography, having normal transaminase levels (n=40). The serum ET-1 level was measured by an appropriate ELISA kit for all patients. Mean serum ET-1 level was statistically significantly higher in the NASH group compared to the other two groups (15.56±4.63 vs 6.75±2.46 and 5.74±2.34 μmol/L; P < 0.01). Mean serum ET-1 levels in NASH patients with grade I, grade II, and grade IV fibrosis were 14.06±0.92, 17.70±2.32, and 20.40±1.40 μmol/L, respectively. None of the patients were identified as grade III fibrosis. It was found that the serum ET-1 level showed a statistically significant increase as fibrosis severity increased in NASH patients (P < 0.05). In conclusion, the serum ET-1 level is higher in NASH patients compared to patients having only steatosis. There appears to be a correlation between severity of fibrosis and serum ET-1 level in NASH patients. It has been found that NASH patients having a twofold increase in their ALT levels had higher ET-1 levels and a more severe grade of fibrosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Falck-Ytter Y, Younossi ZM, Marchenissi G, Mc Cullough AJ (2001) Clinical features and natural history of non-alcoholic steatohepatitis syndrome. Semin Liver Dis 21(1):17–25

    Article  PubMed  CAS  Google Scholar 

  2. Ludwig J, Viggiano TR, McGill DB, Oh BJ (1980) Nonalcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease. Mayo Clin Proc 55:434–438

    PubMed  CAS  Google Scholar 

  3. Cassiman D, Libbrecht L, Desmet V, Denef C, Roskams T (2002) Hepatic stellate cell/myofibroblast subpopulations in fibrotic human and rat livers. J Hepatol 36:200–209

    Article  PubMed  Google Scholar 

  4. Geerts A (2001) History and heterogeneity of stellate cells, and role in normal liver function. Semin Liver Dis 21:311–336

    Article  PubMed  CAS  Google Scholar 

  5. Yanagisawa M, Inoue A, Ishikawa T, Kasuya Y, Kimura S, Kumagaye S, Nakajima K (1988) Primary structure, synthesis, and biological activity of rat endothelin, an endothelium-derived vasoconstrictor peptide. Proc Natl Acad Sci USA 85:6964–6967

    Article  PubMed  CAS  Google Scholar 

  6. Gandhi CR, Behal RH, Harvey SA, Nouchi TA, Olson MS (1992) Hepatic effects of endothelin. Receptor characterization and endothelin induced signal transduction in hepatocytes. Biochem J 287:897–904

    CAS  Google Scholar 

  7. Housset C, Rockey DC, Bissell DM (1993) Endothelin receptors in rat liver: lipocytes as a contractile target for endothelin 1. Proc Natl Acad Sci USA 90:9266–9270

    Article  PubMed  CAS  Google Scholar 

  8. Sanyal AJ, Campbell SC, Mirshahi F (2001) Non-alcoholic steatohepatitis: association of insulin resistance and mitochondrial abnormalities. Gastroenterology 120:1183–1192

    Article  PubMed  CAS  Google Scholar 

  9. Valdenaire O, Rohrbacher E, Mattei MG (1995) Organization of the gene encoding the human endothelin-converting enzyme (ECE-1). J Biol Chem 270:29794–29798

    Article  PubMed  CAS  Google Scholar 

  10. Rockey DC, John J, Chung A (1996) Endothelin antagonism in experimental hepatic fibrosis implications for endothelin in the pathogenesis of wound healing. J Clin Invest 98(6):381–1388

    Article  Google Scholar 

  11. Rockey DC, Housset CN, Friedman SL (1993) Activation-dependent contractility of rat hepatic lipocytes in culture and in vivo. J Clin Invest 92:1795–1804

    PubMed  CAS  Google Scholar 

  12. Shao R, Yan W, Rockey DC (1999) Regulation of endothelin-1 synthesis by endothelin-converting enzyme-1 during wound healing. J Biol Chem 274:3228–3234

    Article  PubMed  CAS  Google Scholar 

  13. Cho JJ, Hocher B, Herbst H, Jia J, Ruehl M, Hahn EG, Riecken EO (2000) An oral endothelin A receptor antagonist blocks collagen synthesis and depostion in advanced rat liver fibrosis. Gastroenterology 118:1169–1178

    Article  PubMed  CAS  Google Scholar 

  14. Rockey DC (2001) Cellular pathophysiology of portal hypertension and prospects for management with gene therapy. Clin Liver Dis 5:851–865

    Article  PubMed  CAS  Google Scholar 

  15. Sakurai T, Yanagisawa M, Masaki T (1992) Molecular characterization of endothelin receptors. Trends Pharmacol Sci 13:103–108

    Article  PubMed  CAS  Google Scholar 

  16. Mallat A, Fouassier L, Preaux AM, Gal CS, Raufaste D, Rosenbaum J, Dhumeaux D, Jouneaux C, Mavier P, Lotersztajn S (1995) Growth inhibitory properties of endothelin-1 in human hepatic myofibroblastic Ito cells. An endothelin B receptor-mediated pathway. J Clin Invest 96:42–49

    CAS  Google Scholar 

  17. Hu RM, Levin ER, Pedram A (1993) Insulin stimulates production and secretion of endothelin from bovine endothelial cells. Diabetes 42:351–358

    Article  PubMed  CAS  Google Scholar 

  18. Tard ES, Giles WH, Dietz WH (2002) Prevalence of the metabolic syndrome among US adults: findings from the Third National Health and Nutrition Examination Survey. JAMA 287:356–359

    Article  Google Scholar 

  19. Gore RM (1994) Diffuse liver disease. In: Gore RM, Levine MS, Laufer I (eds) Textbook of gastrointestinal radiology. Saunders, Philadelphia, pp 1968–2017

    Google Scholar 

  20. Brunt EM (2001) Nonalcoholic steatohepatitis: definition and pathology. Semin Liver Dis 21:3–16

    Article  PubMed  CAS  Google Scholar 

  21. Fong DG, Nehra V, Lindor K (2000) Metabolic and nutritional considerations in nonalcoholic fatty liver. Hepatology 32:3–10

    Article  PubMed  CAS  Google Scholar 

  22. Marchesini G, Brizi M, Morselli-Labate AM (1999) Association of nonalcoholic fatty liver disease with insulin resistance. Am J Med 107:450–455

    Article  PubMed  CAS  Google Scholar 

  23. Angulo P (1999) Independent predictors of liver fibrosis in patients with NASH. Hepatology 30:1356–1362

    Article  PubMed  CAS  Google Scholar 

  24. Bacon BR, Farahvash MJ, Janney CG, Neuschwander Tetri BA (1994) Nonalcoholic steatohepatitis: an expanded clinical entity. Gastroenterology 107:1103–1109

    PubMed  CAS  Google Scholar 

  25. Stephenson K, Harvey SA, Akıncı SB, Olson MS (1995) Endothelin association with the cultured rat Kupffer cell: characterization and regulation. Hepatology 22:896–905

    PubMed  CAS  Google Scholar 

  26. Hattori Y, Kasai K, Nakamura T, Emoto T, Shimoda S (1991) Effects of glucose and insulin on immunoreactive endothelin-1 release from cultured porcine aortic endothelial cells. Metabolism 40:165–169

    Article  PubMed  CAS  Google Scholar 

  27. Yamauchi T, Ohnaka K, Takayanagi R, Umeda F, Nawata H (1990) Enhanced secretion of endothelin-1 by elevated glucose levels from cultured bovine aortic endothelial cells. FEBS Lett 267:16–18

    Article  PubMed  CAS  Google Scholar 

  28. Donatelli M, Colletti I, Bucalo ML, Russo V, Verga S (1994) Plasma endothelin levels in NIDDM patients with macroangiopathy. Diabetes Res 25:159–164

    PubMed  CAS  Google Scholar 

  29. Ferri C, De Mattia G (1995) The effect of insulin on endothelin-1 (ET-1) secretion in human cultured endothelial cell. Metabolism 44:689–690

    Article  PubMed  CAS  Google Scholar 

  30. Schleiffer T, Nagel D, Franz H, Falk M, Valentiner I, Wildburg G, Stark M, Brass H (1994) Endothelin and atrial natriuretic peptid in non-insulindependent diabetic versus non-diabetic patients on chronic hemodialysis. Renal Fail 16:747–758

    CAS  Google Scholar 

  31. Dixon JB, Bhathal PS, O'Brien PE (2001) Nonalcoholic fatty liver disease: Predictors of nonalcoholic steatohepatitis and liver fibrosis in the severely obese. Gastroenterology 121:91–100

    Article  PubMed  CAS  Google Scholar 

  32. Muzzi A, Leandro G, Rubbia-Brandt L, James R, Keiser O, Malinverni R, Dufour JF, Helbling B, Hadengue A, Gonvers JJ, Mullhaupt B, Cerny A, Mondelli MU, Negro F (2005) Insulin resistance is associated with liver fibrosis in non-diabetic chronic hepatitis C patients. J Hepatol 42(1):41–46

    Article  PubMed  CAS  Google Scholar 

  33. Younossi ZM, Gramlich T, Matteoni CA, Boparai N, McCullough AJ (2004) Nonalcoholic fatty liver disease in patients with type 2 diabetes. Clin Gastroenterol Hepatol 2(3):262–265

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Bulent Degertekin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Degertekin, B., Ozenirler, S., Elbeg, S. et al. The Serum Endothelın-1 Level in Steatosıs and NASH, and Its Relatıon wıth Severıty of Lıver Fıbrosıs. Dig Dis Sci 52, 2622–2628 (2007). https://doi.org/10.1007/s10620-006-9147-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-006-9147-8

Keywords

Navigation