| Subject |
Endothelial Nitric Oxide Synthase Gene Polymorphism and Its Association With The Risk of Esophageal Varices in Patients With Liver Cirrhosis |
| Authors |
Ooda S.A., El-Hassafi M.Y., El-Biali M.A., Mokhtar M.M., Refai W.A. |
| Code |
2010 -
vol. 31,
No. 1,
Page. 36
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| Type |
Research Article
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| FILE #1 : 36-39_.pdf (148.0K), Down:1935, 2011-09-12 03:31:21 |
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Background: Esophageal varices (EV) is a frequent complication among
patients with liver cirrhosis. Nitric oxide (NO) and other vasoactive
molecules regulate the vascular tone in both the liver microcirculation and
the systemic and splanchnic circulation. Endothelial nitric oxide synthase
(eNOS) gene -which encodes NO- is polymorphic, and this polymorphism
has been associated with several cardiovascular diseases.
Objective: The aim of this work was to find a relationship between eNOS
gene polymorphism and serum nitrite/nitrate levels, degree of portal
hypertension, development of EV, and risk of EV bleeding among cirrhotic
patients.
Methods: This study was carried out on 75 patients with liver cirrhosis
and 50 healthy control subjects.
All subjects were subjected to measuring serum nitrite/nitrate levels as an
index of NO synthesis, and genotyping by polymerase chain reaction for
the eNOS 4/5 (intron 4) polymorphism. Ultrasound abdomen and Doppler
study of the portal venous system and upper gastrointestinal endoscopy
were done for all cirrhotic patients.
Results: Serum nitrite/nitrate levels were found to be significantly higher
in cirrhotic patients with EV than in cirrhotic patients without EV.
Higher serum nitrite/nitrate levels were found to be associated with larger
sized EV and correlated with risk of EV bleeding.
The prevalence of eNOS genotype 5/5 was significantly higher in cirrhotic
patients with than without EV.
Portal vein congestion index (PCI) was found to be higher in cirrhotic
patients of eNOS genotype 5/5.
eNOS genotype 5/5 was found to be associated with a higher serum
nitrite/nitrate levels in cirrhotic patients and healthy control subjects.
Genotype 5/5 was found to be associated with larger sized EV, advanced
EV red spot score, and advanced grade of gastric varices.
Conclusion: Our results support that we can identify cirrhotic patients at
higher risk of developing EV through identification of their eNOS
genotype.
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