International Journal of General Medicine (Jan 2022)

Evaluation of Predisposing Metabolic Risk Factors for Portopulmonary Hypertension in Patients with NASH Cirrhosis

  • Türker F,
  • Sahın T,
  • Oral A,
  • Koçak E,
  • Çavuşoğlu Türker B,
  • Niğdelioğlu A,
  • Ataoğlu HE

Journal volume & issue
Vol. Volume 15
pp. 859 – 865

Abstract

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Fatih Türker,1 Tolga Sahın,2 Alihan Oral,2 Erdem Koçak,3 Betül Çavuşoğlu Türker,4 Adil Niğdelioğlu,2 Hayriye Esra Ataoğlu1 1University of Health Sciences, Haseki Health Training and Research Hospital, Internal Medicine Clinic, İstanbul, Turkey; 2Demiroglu Bilim University, Florence Nightingale Hospital Internal Medicine Clinic, İstanbl, Turkey; 3Istinye University, Liv Hospital Vadi Istanbul, Gastroenterology, İstanbul, Turkey; 4University of Health Sciences, Taksim Health Training and Research Hospital, Internal Medicine Clinic, İstanbul, TurkeyCorrespondence: Fatih Türker, Aksaray, Dr. Adnan Adıvar Cd, No: 9, İstanbul, Tel +0905364721656, Fax +0212 453 20 00, Email [email protected]: Metabolic parameters are important for the development of portopulmonary hypertension (PoPH) during nonalcoholic steatohepatitis (NASH)-associated cirrhosis. This study evaluated patients with NASH-associated cirrhosis to determine metabolic risk factors for portopulmonary hypertension.Patients and Methods: Data on 171 patients (120 men and 51 women) with NASH-associated cirrhosis who were seen in Florence Nightingale Hospital’s gastroenterology Clinic from 2009 to 2018 was obtained from the Hospital database. A pulmonary artery systolic pressure > 35 mmHg was defined as PH (pulmonary hypertension) according to standard transthoracic echocardiography. Portal hypertension was diagnosed from clinical symptoms and dilated portal veins shown by abdominal ultrasound or computed tomography (CT). Pulmonary patients with portal hypertension were diagnosed with portopulmonary hypertension (PoPH).Results: A total of 171 patients with NASH-associated cirrhosis were included in this study. Of these, 43 patients had PoPH. These patients had increased TSH (p=0.004), bilirubin (p=0.023) and triglyceride (p=0.048) levels, higher MELD scores (p=0.018) and decreased hemoglobin (p=0.05). MELD score and hemoglobin, total bilirubin, TSH, and triglyceride levels were all included in a multivariate logistic regression model and TSH levels were independently associated with increased risk of PoPH.Conclusion: Increased TSH is an independent risk factor for PoPH.Keywords: pulmonary hypertension, portopulmonary hypertension, NASH cirrhosis

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