Severe reduction of blood lysosomal acid lipase activity in cryptogenic cirrhosis: A nationwide multicentre cohort study

LAL-Cirrhosis Collaborative Research Group

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND AND AIMS: Blood lysosomal acid lipase (LAL) is reduced in non-alcoholic steatohepatitis, which is the major cause of cryptogenic cirrhosis (CC); few data on LAL activity in CC do exist. We investigated LAL activity in a cohort of patients with liver cirrhosis.

METHODS: This is a multicentre cohort study including 274 patients with liver cirrhosis of different aetiology from 19 centres of Internal Medicine, Gastroenterology and Hepatology distributed throughout Italy. Blood LAL activity (nmol/spot/h) was measured with dried blood spot extracts using Lalistat 2.

RESULTS: Overall, 133 patients had CC, and 141 patients had cirrhosis by other causes (61 viral, 53 alcoholic, 20 alcoholic + viral, 7 autoimmune). Mean age was 64.2 ± 13.4 years, and 28.5% were women. Patients with CC were older compared to other aetiology-cirrhosis, with a lower Child-Turcotte-Pugh (CTP, p=0.003) and MELD (p=0.009) score, and a higher prevalence of cardio-metabolic risk factors and previous ischemic events. In the whole cohort, median LAL activity value was 0.58 nmol/spot/h, 0.49 and 0.65 in the groups of CC and known-aetiology cirrhosis, respectively (p=0.002). The difference remained significant after adjustment for white blood cells count (p=0.001). Multivariable linear regression analysis showed that CC (vs. known aetiology, Beta = -0.144, p=0.018), platelet count (Beta = 0.398, p < 0.001) and CTP score (Beta = -0.133, p=0.022) were associated with log-LAL activity. Similar results were found using MELD as covariate.

CONCLUSIONS: We found a marked reduction of LAL activity in patients with cryptogenic cirrhosis compared to the other known aetiologies. A prospective study will clarify the role of LAL in chronic liver diseases.

Original languageEnglish
Pages (from-to)179-184
Number of pages6
JournalAtherosclerosis
Volume262
DOIs
Publication statusPublished - Jul 2017

Keywords

  • Aged
  • Biomarkers/blood
  • Chi-Square Distribution
  • Comorbidity
  • Cross-Sectional Studies
  • Down-Regulation
  • Dried Blood Spot Testing
  • Female
  • Humans
  • Italy/epidemiology
  • Linear Models
  • Liver Cirrhosis/blood
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Platelet Count
  • Prevalence
  • Risk Factors
  • Sterol Esterase/blood

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