Study of the Relation between Endothelial Nitric Oxide Synthase G894T Gene Variants and Occurrence of Type II Hepatorenal Syndrome

Document Type : Original Article

Authors

1 Tropical Medicine Department , Faculty of Medicine, Menoufia University,Egypt.

2 Medical Biochemistry and Molecular Biology Department , Faculty of Medicine ,Menoufia University,Egypt.

3 Gastroenterology resident, Kafr Elshigh Hospital, Kafr Elshigh ,Egypt.

Abstract

Background  and study aim: The progress of hepatorenal syndrome (HRS) in hepatic patients is not yet understood. Nitric oxide level, through its impact on haemodynamic circulation, may be engaged in the progress of the disease. Our study expected to clarify the possible role of eNOS G894T in decompensated liver cirrhosis and HRS and its relationship with nitrite level.
Methods: Study included 80 cirrhotic patients (40 decompensated cirrhotic and 40 HRS) and 40 healthy participants as controls. Renal and liver function tests, CBC, serum electrolytes, plasma nitrite and eNOS G894T by real-time PCR were surveyed.
Results: There were higher frequencies of TT and GT genotypes of eNOS G894T versus GG in both cirrhotic (22.5% and 50% respectively) and HRS (30% and 45% respectively) than in controls (10% and 30%) (P=0.007). T allele was more prevalent than G allele in cirrhotic (47.5%) and HRS (52.5%) patients compared to controls (25.0%) (P=0.001). TT and GT genotypes increase risk of cirrhosis by OR 4.909 [95% CI: 1.24 – 19.46] and OR 3.636 [95% CI: 1.32 – 9.99] and HRS OR7.200 [95% CI: 1.86 – 27.77] and 3.600[95% CI: 1.27 – 10.7] respectively. T allele can increase risk of cirrhosis by OR 2.714 [95% CI: 1.39 – 5.30] and HRS OR 3.316 [95% CI: 1.70 – 6.48]. Clear connections were observed between TT genotype and lower plasma nitrite level (P<0.001).
Conclusion: Mutant variants of eNOS G894T gene in cirrhotic and HRS patients from controls could partially explain the progress to decompensation and HRS in liver cirrhosis.

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