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ABSTRACT
Introduction: The Baveno VI consensus recommended the use of noninvasive predictors to identify patients at high risk of esophageal varices (EV) in whom endoscopic evaluation is most needed. Kallistatin is a protein molecule synthesized by the liver, and its level declines with the deterioration of liver functions. We aim to explore the role of kallistatin as a predictor of esophageal varices.
Methods: This case–control study included 70 cirrhotic patients (35 patients with EV and 35 patients without EV). The laboratory investigations and upper GI endoscopy were performed, and the serum kallistatin level was measured in all patients.
Results: The mean level of serum kallistatin was significantly lower in patients with varices (12.2 ± 5.6 vs 16.9 ± 4.8 µg/ml, p = 0.009). It also shows a significant decline in patients with large varices. Kallistatin can predict the presence of EV and large EV at cut off values of 15.8 and 8.9 µg/ml, respectively, with sensitivity and specificity of 71.4% and 54.3% for EV and 50% and 94.8% for large EV.
Discussion: Kallistatin is a promising marker that can be used to predict the presence of esophageal varices especially when they are large and risky.
Ethical regulations
The study design was reviewed and approved by the institutional review board.
Disclosure statement
No potential conflict of interest was reported by the authors.
Additional information
Notes on contributors
Osama M. Sobhey
Osama M. Sobhey, Master degree in tropical medicine, resident of gastroenterology and hepatology in AlAhrar eductional hospital in Zagazig, specialist of gastroenetrology and hepatology.
Amal A. Jouda
Amal A. Jouda, PhD in tropical medicine, assistant professor of tropical medicine, faculty of medicine, Zagazig University, consultant of gastroenterology and hepatology, member of the Egyptian society of study of endoscopy and hepatogastroenterology.
Ashraf Metwally
Ashraf Metwally, PhD in tropical medicine, assistant professor of tropical medicine Faculty of medicine Zagazig University, diploma in hospital management from Sadat Academy of Management Sciences, consultant of gastroenetrology and hepatology, member of the Egyptian society of study of endoscopyn and heptogastroenetrology.
Nagwa M. Shawky
Nagwa M. Shawky, PhD in clinical pathology, professor and former head of clinical pathology department Faculty of medicine Zagazig University, consultant of clinical pathology in zagazig University hospitals.
Mohammad N. Elkhashab
Mohammad N. Elkhashab, PhD in tropical medicine, professor and former head of tropical medicine department, Faculty of medicine zagazig University, member of the Egyptian society of study of endoscopy and hepatogastroenetrology, consultant of gastroeneterology and hepatology, editor in chief of the afro-Egyptian journal of infectious and endemic diseases.