STUDY OF COPEPTIN AS A NEW BIOMARKER IN THE EVALUATION OF DECOMPENSATED LIVER CIRRHOSIS

Introduction: Liver cirrhosis is the terminal phase of a vast number of chronic hepatic diseases. It is classified into compensated and decompensated stages according to occurrence of complications. Portal hypertension is a severe consequence of cirrhosis. It results from increased vascular resistance and release of endotoxins and cytokines which trigger splanchnic arterial vasodilation which activates the RAAS. This ends in the release of arginine vasopressin (AVP) which is difficult to be measured because of its small size and short half-life. Copeptin, the C-terminal part of the AVP precursor, is produced from the posterior pituitary along with AVP in equimolar levels. Being stable makes it a sensitive surrogate marker for AVP release.Aim of the work: This study aimed to evaluate copeptin’s level as a marker predicting decompensated liver cirrhosis and its use as a prognostic marker.Patients and Methods: The study was conducted on 90 subjects admitted to Alexandria main university hospital who were divided into three groups: Group I (n=35) compensated cirrhotic patients, Group II (n=35) decompensated cirrhotic patients and Group III (n=20) apparently healthy individuals. Serum copeptin was measured by ELISA. Candidates underwent detailed clinical evaluation and laboratory investigations which included CBC, renal function tests and liver profile; alanine transaminase (ALT), aspartate transaminase (AST), prothrombin time, INR, serum albumin, total serum protein, serum bilirubin (total and direct). Liver disease severity was assessed by Child-Pugh, MELD and MELD-Na scores.