Serum NT-proCNP Concentrations Are Elevated in Patients With Chronic Liver Diseases and Associated With Complications and Unfavorable Prognosis of Cirrhosis

Clin Biochem. 2012 Apr;45(6):429-35. doi: 10.1016/j.clinbiochem.2012.01.009. Epub 2012 Jan 18.

Abstract

Objectives: C-type natriuretic peptide (CNP) might be an important regulator of vasodilatation, fluid and sodium balance in liver cirrhosis. We aimed at assessing its regulation and prognostic relevance in liver disease patients.

Design and methods: We analyzed NT-proCNP serum levels in 193 patients with chronic liver diseases and 43 healthy controls.

Results: Serum NT-proCNP concentrations were significantly elevated in liver disease patients compared to healthy controls, with highest levels in established hepatic cirrhosis, independent of disease etiology. NT-proCNP was associated with complications of liver diseases and portal hypertension, namely ascites, esophageal varices and hepatic encephalopathy. Circulating NT-proCNP correlated inversely with renal function. Importantly, elevated NT-proCNP levels were identified as a predictor of mortality or necessity for transplantation. NT-proCNP levels >2 pmol/L indicated adverse prognosis (sensitivity 66.7%, specificity 72.8%, RR 5.4 [95%-CI 2.6-11.2]).

Conclusions: Serum NT-proCNP is elevated in advanced liver diseases and has prognostic value in cirrhotic patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biliary Tract Diseases / blood
  • Biliary Tract Diseases / complications
  • Biliary Tract Diseases / mortality
  • Biomarkers / blood
  • Cohort Studies
  • Cytokines / blood
  • End Stage Liver Disease / blood*
  • End Stage Liver Disease / diagnosis
  • End Stage Liver Disease / etiology
  • End Stage Liver Disease / mortality
  • Female
  • Hepatitis, Viral, Human / blood
  • Hepatitis, Viral, Human / complications
  • Hepatitis, Viral, Human / mortality
  • Humans
  • Hypertension, Portal / blood
  • Hypertension, Portal / etiology
  • Kaplan-Meier Estimate
  • Liver Cirrhosis / blood*
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / etiology
  • Liver Cirrhosis / mortality
  • Liver Diseases, Alcoholic / blood
  • Liver Diseases, Alcoholic / complications
  • Liver Diseases, Alcoholic / mortality
  • Male
  • Middle Aged
  • Natriuretic Peptide, C-Type / blood*
  • Prognosis
  • Protein Precursors / blood*
  • ROC Curve
  • Severity of Illness Index
  • Young Adult

Substances

  • Biomarkers
  • Cytokines
  • Protein Precursors
  • Natriuretic Peptide, C-Type