Relationship of Serum Brain Natriuretic Peptide Levels with Severity of Chronic Liver Disease

Aims: To determine mean serum B-type natriuretic peptide (BNP) levels and their relationship with the severity of disease in patients with chronic liver disease (CLD).

Study Design: Descriptive cross-sectional study

Place and Duration of Study: Department of Medicine, Unit-2, Jinnah Hospital, Lahore, from 5th August 2015 to 4th February 2016.

Methodology: A study was done on 80 patients of Chronic liver disease. Under aseptic conditions, venous blood samples were obtained from cases at the time of presentation along with asking some questions related to disease and measure their weight and height. Serum albumin and BNP levels (outcome variable) were measured by using standard chemical analyzer in laboratory. Association between BNP levels with patients’ personal and disease factors of patients were analyzed by SPSS 21.

Results: Mean age of the patients was 55.4±10.43 years. Out of 80 patients, 48 (60%) were male. Mean BMI was 21.89±5.45 kg/m2, mean duration of CLD was 11.23±5.22 years and mean serum albumin and BNP was 3.18±1.05 g/dl and 393.13±289.36 pg/ml respectively. Upper gastro-intestinal bleeding observed in 22 (27.5%) patients, ascites was present in 60 (75%). Child Pugh class-A observed in 19 (23.8%) patients, class-B in 30 (37.5%) patients and class-C found in 31 (38.8%) patients. Serum BNP level was positively related with history of upper GI bleed (p=0.000), ascites (p=0.000) and Child Pugh classification (p=0.000) and negatively related with albumin level (p=0.000).

Conclusion: Elevated serum brain natriuretic peptide correlate with severity of chronic liver disease in cirrhotic patients. The use of this marker in cirrhotic patients should be cautiously interpreted for cardiomyopathy.