Benefits of Liver Volume and Serum Zinc Level Assessment for the Screening of Covert Hepatic Encephalopathy in Patients with Child–Pugh Class A Cirrhosis
<b>Background/Objectives</b>: Covert hepatic encephalopathy (CHE) is associated with decreased quality of life. Detection of Child–Pugh class A is necessary for its early diagnosis. This study aimed to establish a simple diagnostic method of CHE in patients with Child–Pugh class A. <b...
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2024-12-01
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| author | Masanori Fukushima Hisamitsu Miyaaki Ryu Sasaki Yasuhiko Nakao Masafumi Haraguchi Kosuke Takahashi Eisuke Ozawa Satoshi Miuma Kazuhiko Nakao |
| author_facet | Masanori Fukushima Hisamitsu Miyaaki Ryu Sasaki Yasuhiko Nakao Masafumi Haraguchi Kosuke Takahashi Eisuke Ozawa Satoshi Miuma Kazuhiko Nakao |
| author_sort | Masanori Fukushima |
| collection | DOAJ |
| description | <b>Background/Objectives</b>: Covert hepatic encephalopathy (CHE) is associated with decreased quality of life. Detection of Child–Pugh class A is necessary for its early diagnosis. This study aimed to establish a simple diagnostic method of CHE in patients with Child–Pugh class A. <b>Methods</b>: One hundred patients with liver cirrhosis without overt hepatic encephalopathy and sixty-eight with liver cirrhosis and Child–Pugh class A who visited our institution were enrolled. CHE was diagnosed using number connection test B in the neuropsychiatric test (NPT). Clinical data were compared. <b>Results</b>: The liver volume/body surface area ratio (LV/BSA) was associated with CHE in patients with all-cause and Child–Pugh class A liver cirrhosis. Multiple logistic regression analysis revealed that low LV/BSA and low serum zinc (Zn) levels were significantly associated with CHE in Child–Pugh class A liver cirrhosis. The best cutoff values in the receiver operating characteristic curve analysis showed that the complication rate of CHE was 54.8% in patients with LV/BSA < 620 mL/m<sup>2</sup>, which was 2.9 times higher than that in patients with larger liver volume. Referring to the cutoff values for LV/BSA and Zn (<70 µg/dL), in cases with LV/BSA < 620 mL/m<sup>2</sup> and Zn < 70 µg/dL, 64.2% had CHE, whereas in cases with LV/BSA ≥ 620 mL/m<sup>2</sup> and Zn ≥ 70 µg/dL, 94.5% did not have CHE. <b>Conclusions</b>: Liver volume can be used as a risk assessment tool for CHE. LV/BSA and serum Zn levels are considered effective diagnostic tools for CHE, serving as alternatives to NPT in patients with Child–Pugh class A liver cirrhosis. |
| format | Article |
| id | doaj-art-90d5d575aa6c43d2bcd2382550048561 |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj-art-90d5d575aa6c43d2bcd23825500485612025-01-10T13:16:29ZengMDPI AGDiagnostics2075-44182024-12-011512310.3390/diagnostics15010023Benefits of Liver Volume and Serum Zinc Level Assessment for the Screening of Covert Hepatic Encephalopathy in Patients with Child–Pugh Class A CirrhosisMasanori Fukushima0Hisamitsu Miyaaki1Ryu Sasaki2Yasuhiko Nakao3Masafumi Haraguchi4Kosuke Takahashi5Eisuke Ozawa6Satoshi Miuma7Kazuhiko Nakao8Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City 852-8501, Nagasaki, JapanDepartment of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City 852-8501, Nagasaki, JapanDepartment of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City 852-8501, Nagasaki, JapanDepartment of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City 852-8501, Nagasaki, JapanDepartment of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City 852-8501, Nagasaki, JapanDepartment of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City 852-8501, Nagasaki, JapanDepartment of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City 852-8501, Nagasaki, JapanDepartment of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City 852-8501, Nagasaki, JapanDepartment of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City 852-8501, Nagasaki, Japan<b>Background/Objectives</b>: Covert hepatic encephalopathy (CHE) is associated with decreased quality of life. Detection of Child–Pugh class A is necessary for its early diagnosis. This study aimed to establish a simple diagnostic method of CHE in patients with Child–Pugh class A. <b>Methods</b>: One hundred patients with liver cirrhosis without overt hepatic encephalopathy and sixty-eight with liver cirrhosis and Child–Pugh class A who visited our institution were enrolled. CHE was diagnosed using number connection test B in the neuropsychiatric test (NPT). Clinical data were compared. <b>Results</b>: The liver volume/body surface area ratio (LV/BSA) was associated with CHE in patients with all-cause and Child–Pugh class A liver cirrhosis. Multiple logistic regression analysis revealed that low LV/BSA and low serum zinc (Zn) levels were significantly associated with CHE in Child–Pugh class A liver cirrhosis. The best cutoff values in the receiver operating characteristic curve analysis showed that the complication rate of CHE was 54.8% in patients with LV/BSA < 620 mL/m<sup>2</sup>, which was 2.9 times higher than that in patients with larger liver volume. Referring to the cutoff values for LV/BSA and Zn (<70 µg/dL), in cases with LV/BSA < 620 mL/m<sup>2</sup> and Zn < 70 µg/dL, 64.2% had CHE, whereas in cases with LV/BSA ≥ 620 mL/m<sup>2</sup> and Zn ≥ 70 µg/dL, 94.5% did not have CHE. <b>Conclusions</b>: Liver volume can be used as a risk assessment tool for CHE. LV/BSA and serum Zn levels are considered effective diagnostic tools for CHE, serving as alternatives to NPT in patients with Child–Pugh class A liver cirrhosis.https://www.mdpi.com/2075-4418/15/1/23covert hepatic encephalopathyliver cirrhosisliver volumezinc |
| spellingShingle | Masanori Fukushima Hisamitsu Miyaaki Ryu Sasaki Yasuhiko Nakao Masafumi Haraguchi Kosuke Takahashi Eisuke Ozawa Satoshi Miuma Kazuhiko Nakao Benefits of Liver Volume and Serum Zinc Level Assessment for the Screening of Covert Hepatic Encephalopathy in Patients with Child–Pugh Class A Cirrhosis Diagnostics covert hepatic encephalopathy liver cirrhosis liver volume zinc |
| title | Benefits of Liver Volume and Serum Zinc Level Assessment for the Screening of Covert Hepatic Encephalopathy in Patients with Child–Pugh Class A Cirrhosis |
| title_full | Benefits of Liver Volume and Serum Zinc Level Assessment for the Screening of Covert Hepatic Encephalopathy in Patients with Child–Pugh Class A Cirrhosis |
| title_fullStr | Benefits of Liver Volume and Serum Zinc Level Assessment for the Screening of Covert Hepatic Encephalopathy in Patients with Child–Pugh Class A Cirrhosis |
| title_full_unstemmed | Benefits of Liver Volume and Serum Zinc Level Assessment for the Screening of Covert Hepatic Encephalopathy in Patients with Child–Pugh Class A Cirrhosis |
| title_short | Benefits of Liver Volume and Serum Zinc Level Assessment for the Screening of Covert Hepatic Encephalopathy in Patients with Child–Pugh Class A Cirrhosis |
| title_sort | benefits of liver volume and serum zinc level assessment for the screening of covert hepatic encephalopathy in patients with child pugh class a cirrhosis |
| topic | covert hepatic encephalopathy liver cirrhosis liver volume zinc |
| url | https://www.mdpi.com/2075-4418/15/1/23 |
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