Vnitr Lek 2009, 55(5):468-473
Impact of basal prolactin levels on the prevalence of complications and the prognosis of patients with liver cirrhosis
- V. interná klinika Lekárskej fakulty UK a FNsP Bratislava, Slovenská republika, prednosta prof. MUDr. Juraj Payer, CSc.
Introduction:
Prolactin concentration was proved to be associated with complications of cirrhosis.
Methods:
This relationship was investigated on the group of 90 patients predominantly males with alcoholic cirrhosis. Basic clinical and laboratory data were collected at entry as well as complications of cirrhosis already present. Patients were followed for the mean of 434 days and events such as variceal bleeding, hepatorenal syndrome and death were recorded.
Results:
We found that 16.7% of patients had elevated serum prolactin levels, and had significantly higher Child-Pugh and MELD scores as well as higher ascites and encephalopathy stage. By comparing prolactin concentration quartiles we found complications of cirrhosis such as ascites, higher INR, jaundice and higher Child-Pugh and MELD scores more often with increasing prolactin concentrations. The most prominent was the relationship to hepatic encephalopathy (0 vs 31% between the 1st and 4th quartile, p < 0.05) to which the prolactin levels above 10.5 μg/l had a sensitivity of 92.9% and negative predictive value of 97%. Kaplan-Meier survival curve showed that patients in the 1st comparing to the 4th quartile had significantly higher survival rates (85.2 vs 50%, p = 0.046, hazard ratio = 0.2881). Prolactin levels > 11.91 μg/l had 80.8% sensitivity and 87.8% negative predictive value to predict death during the follow up period.
Conclusion:
Basal prolactin concentration could therefore be used as an alternative marker of hepatic encephalopathy and death in a selected subset of patients with cirrhosis.
Keywords: prolactin; cirrhosis; hepatic encephalopathy; survival
Received: September 16, 2008; Accepted: December 21, 2008; Published: May 1, 2009 Show citation
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