Brief Article
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World J Gastroenterol. Nov 21, 2010; 16(43): 5467-5473
Published online Nov 21, 2010. doi: 10.3748/wjg.v16.i43.5467
Increased osteopontin and liver stiffness measurement by transient elastography in biliary atresia
Sittisak Honsawek, Maneerat Chayanupatkul, Voranush Chongsrisawat, Paisarn Vejchapipat, Yong Poovorawan
Sittisak Honsawek, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Rama IV Road, Patumwan, Bangkok 10330, Thailand
Maneerat Chayanupatkul, Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
Voranush Chongsrisawat, Yong Poovorawan, Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
Paisarn Vejchapipat, Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
Author contributions: Honsawek S designed the study, carried out the laboratory work, analyzed the data and wrote the manuscript; Chayanupatkul M collected the blood samples and assisted in the analysis of data; Chongsrisawat V, Vejchapipat P and Poovorawan Y examined all the patients and collected the clinical data.
Supported by Ratchadapiseksompotch Fund, Faculty of Medicine, Chulalongkorn University, Thailand Research Fund, and the Commission on Higher Education
Correspondence to: Sittisak Honsawek, MD, PhD, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Rama IV Road, Patumwan, Bangkok 10330, Thailand. sittisak.h@chula.ac.th
Telephone: +66-2-2564482 Fax: +66-2-2564482
Received: July 28, 2010
Revised: August 27, 2010
Accepted: September 4, 2010
Published online: November 21, 2010
Abstract

AIM: To analyze plasma osteopontin levels and liver stiffness using transient elastography in postoperative biliary atresia (BA) children compared with healthy controls.

METHODS: Thirty children with postoperative BA and 10 normal controls were enrolled. The patients were categorized into two groups according to their jaundice status. Plasma levels of osteopontin were determined using commercially available enzyme-linked immunosorbent assay. Liver stiffness was measured by using transient elastography (Fibroscan). Ten validated Fibroscan measurements were performed in each patient and control with the result expressed in kilopascals (kPa).

RESULTS: Plasma osteopontin was significantly elevated in BA children compared with that of healthy controls (47.0 ± 56.4 ng/mL vs 15.1 ± 15.0 ng/mL, P = 0.01). The liver stiffness measurement was markedly elevated in the patients with BA compared with that of controls (26.9 ± 24.6 kPa vs 3.9 ± 0.7 kPa, P = 0.001). Subgroup analysis showed that the BA patients with jaundice had more pronounced plasma osteopontin levels than those without jaundice (87.1 ± 61.6 ng/mL vs 11.9 ± 6.1 ng/mL, P = 0.001). Furthermore, the mean liver stiffness was significantly greater in the jaundiced BA patients compared with non-jaundiced patients (47.7 ± 21.8 kPa vs 8.7 ± 3.0 kPa, P = 0.001). Additionally, plasma osteopontin was positively related to serum total bilirubin (r = 0.64, P < 0.001). There was also a correlation between plasma osteopontin and liver stiffness values (r = 0.60, P < 0.001).

CONCLUSION: High plasma osteopontin positively correlated with degree of hepatic fibrosis and could be used as a biochemical parameter reflecting disease severity in postoperative BA children.

Keywords: Biliary atresia; Fibroscan; Jaundice; Liver stiffness; Osteopontin