Altered metal metabolism in patients with HCV-related cirrhosis and hepatic encephalopathy

作者：Marano Massimo^*; Gentilucci Umberto Vespasiani; Altamura Claudia; Siotto Mariacristina; Squitti Rosanna; Bucossi Serena; Quintiliani Livia; Migliore Simone; Greco Federico; Scarciolla Laura; Quattrocchi Carlo Cosimo; Picardi Antonio; Vernieri Fabrizio

来源：Metabolic Brain Disease, 2015, 30(6): 1445-1452.

DOI：10.1007/s11011-015-9721-x

• Iron
• Copper
• Ammonia
• Ceruloplasmin
• Transferrin
• Wilson's disease

Dysfunctional metal homeostasis contributes to oxidative stress and neuronal damage. These have been implicated in hepatic encephalopathy pathogenesis. To investigate whether altered metal metabolism is associated with hepatic encephalopathy. Twenty-one controls and 34 HCV-cirrhotic patients (ENC/NEC patients according to presence/absence of previous overt episodes of hepatic encephalopathy) and a control group were studied. Serum iron, copper, ceruloplasmin, ceruloplasmin activity, transferrin, and ceruloplasmin/transferrin ratio were determined. Neuropsychological tests were performed by the repeatable battery of neuropsychological status. Magnetic resonance assessed basal ganglia volumes and metal deposition (pallidal index and T2*). Cirrhotic patients performed worse than controls at cognitive tests, especially ENC patients,. At biochemical analysis copper concentrations, ceruloplasmin activity and transferrin levels were lower in ENC than in NEC patients and controls (p < 0.05 and p < 0.01, respectively). Ceruloplasmin/transferrin ratio was higher in ENC compared to NEC patients (p < 0.05), and controls (p < 0.01). By brain magnetic resonance, ENC patients showed reduced caudate and globus pallidus volumes compared to controls (p < 0.05), and ENC and NEC patients an increased pallidal index compared to controls (p < 0.01). In ENC patients, ceruloplasmin activity correlated with caudate volume and pallidal index (rho = 0.773 and rho = -0.683, p < 0.05). Altered metal metabolism likely contributes to cirrhotic hepatic encephalopathy.

• 出版日期2015-12
• 单位中国人民解放军空军预警学院