Diagnostic significance of matrix metalloproteinases in predicting one-year mortality in liver cirrhosis

Aim of the investigation. To study the significance of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) in combination with markers of liver pathology in predicting one-year mortality in patients with liver cirrhosis. Materials and methods. Over the course of one year of follow-up, 159 patients with liver cirrhosis aged 26 to 64 years were examined. The primary endpoint was assessed: death from any cause. The blood levels of MMP-1, MMP-9, and TIMP-1 were determined by enzyme-linked immunosorbent assay. Results. One-year mortality was 8.5% and it was associated with parameters of Child-Pugh score ≥8 points, C-reactive protein ≥15.5 mg/l, ESR ³12 mm/hour, gammaglutamyltranspeptidase ≥124 u/l, prothrombin index ≤77%, albumin ≤30 g/l, MMP-1 ≥24.2 ng/ml, MMP-9 ≥331 ng/ml, TIMP-1/MMP-1 ≤19.4, TIMP-1/MMP-9 ≤2.4, with the presence of alcoholic etiology, inflammatory syndrome, ascites 2-3rd degree. According to multivariate regression analysis, the independent factors of one-year mortality in liver cirrhosis were Child-Pugh score and TIMP-1/MMR-9 ratio. The combination of these signs in predicting a lethal outcome had a sensitivity of 92.3% and a specificity of 84.3% (AUC 0.890). Conclusion. Thus, Child-Pugh score and TIMP-1/MMP-9 ratio are predictors of one-year mortality in patients with liver cirrhosis, which reflects the severity of liver damage and the development of complications, as well as due to the participation of MMP-9 in inflammation and vascular remodeling.