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Detecting Minimal Hepatic Encephalopathy in an Endemic Country for Hepatitis B: The Role of Psychometrics and Serum IL-6

BACKGROUND & AIMS: It remains unknown what the prevalence of minimal hepatic encephalopathy is in Taiwan, a highly endemic country for chronic viral hepatitis infection. It is also unclear whether abnormal serum cytokine levels can be indicative of the presence of minimal hepatic encephalopathy....

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Autores principales: Tsai, Chia-Fen, Chu, Chi-Jen, Huang, Yi-Hsiang, Wang, Yen-Po, Liu, Pei-Yi, Lin, Han-Chieh, Lee, Fa-Yauh, Lu, Ching-Liang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4454579/
https://www.ncbi.nlm.nih.gov/pubmed/26039496
http://dx.doi.org/10.1371/journal.pone.0128437
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author Tsai, Chia-Fen
Chu, Chi-Jen
Huang, Yi-Hsiang
Wang, Yen-Po
Liu, Pei-Yi
Lin, Han-Chieh
Lee, Fa-Yauh
Lu, Ching-Liang
author_facet Tsai, Chia-Fen
Chu, Chi-Jen
Huang, Yi-Hsiang
Wang, Yen-Po
Liu, Pei-Yi
Lin, Han-Chieh
Lee, Fa-Yauh
Lu, Ching-Liang
author_sort Tsai, Chia-Fen
collection PubMed
description BACKGROUND & AIMS: It remains unknown what the prevalence of minimal hepatic encephalopathy is in Taiwan, a highly endemic country for chronic viral hepatitis infection. It is also unclear whether abnormal serum cytokine levels can be indicative of the presence of minimal hepatic encephalopathy. We aimed to standardize the tests of psychometric hepatic encephalopathy score and predictive value of proinflammatory cytokines in minimal hepatic encephalopathy in Taiwan. METHODS: 180 healthy subjects and 94 cirrhotic patients without a history of overt hepatic encephalopathy from a tertiary center were invited to participate in this cross-sectional study. Blood sampling for determination of serum levels of interleukin 6 and 18 and tumor necrosis factor-α was performed. Based on the normogram of psychometric hepatic encephalopathy score from healthy volunteers, patients with minimal hepatic encephalopathy were identified from the cirrhotic patients using the criterion of a psychometric hepatic encephalopathy score less than −4. RESULTS: In the healthy subjects, age and education were predictors of subtests of psychometric hepatic encephalopathy score. Minimal hepatic encephalopathy was identified in 27 (29%) cirrhotic patients. Serum interleukin 6 level (OR = 6.50, 95% CI = 1.64–25.76, P = 0.008) was predictive of the presence of minimal hepatic encephalopathy after multivariate analysis. CONCLUSIONS: The psychometric hepatic encephalopathy score can be a useful tool for detecting patients with minimal hepatic encephalopathy in Taiwan and around one third of cirrhotic outpatients fulfill this diagnosis. A high serum interleukin 6 level is predictive of the presence of minimal hepatic encephalopathy.
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spelling pubmed-44545792015-06-09 Detecting Minimal Hepatic Encephalopathy in an Endemic Country for Hepatitis B: The Role of Psychometrics and Serum IL-6 Tsai, Chia-Fen Chu, Chi-Jen Huang, Yi-Hsiang Wang, Yen-Po Liu, Pei-Yi Lin, Han-Chieh Lee, Fa-Yauh Lu, Ching-Liang PLoS One Research Article BACKGROUND & AIMS: It remains unknown what the prevalence of minimal hepatic encephalopathy is in Taiwan, a highly endemic country for chronic viral hepatitis infection. It is also unclear whether abnormal serum cytokine levels can be indicative of the presence of minimal hepatic encephalopathy. We aimed to standardize the tests of psychometric hepatic encephalopathy score and predictive value of proinflammatory cytokines in minimal hepatic encephalopathy in Taiwan. METHODS: 180 healthy subjects and 94 cirrhotic patients without a history of overt hepatic encephalopathy from a tertiary center were invited to participate in this cross-sectional study. Blood sampling for determination of serum levels of interleukin 6 and 18 and tumor necrosis factor-α was performed. Based on the normogram of psychometric hepatic encephalopathy score from healthy volunteers, patients with minimal hepatic encephalopathy were identified from the cirrhotic patients using the criterion of a psychometric hepatic encephalopathy score less than −4. RESULTS: In the healthy subjects, age and education were predictors of subtests of psychometric hepatic encephalopathy score. Minimal hepatic encephalopathy was identified in 27 (29%) cirrhotic patients. Serum interleukin 6 level (OR = 6.50, 95% CI = 1.64–25.76, P = 0.008) was predictive of the presence of minimal hepatic encephalopathy after multivariate analysis. CONCLUSIONS: The psychometric hepatic encephalopathy score can be a useful tool for detecting patients with minimal hepatic encephalopathy in Taiwan and around one third of cirrhotic outpatients fulfill this diagnosis. A high serum interleukin 6 level is predictive of the presence of minimal hepatic encephalopathy. Public Library of Science 2015-06-03 /pmc/articles/PMC4454579/ /pubmed/26039496 http://dx.doi.org/10.1371/journal.pone.0128437 Text en © 2015 Tsai et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Tsai, Chia-Fen
Chu, Chi-Jen
Huang, Yi-Hsiang
Wang, Yen-Po
Liu, Pei-Yi
Lin, Han-Chieh
Lee, Fa-Yauh
Lu, Ching-Liang
Detecting Minimal Hepatic Encephalopathy in an Endemic Country for Hepatitis B: The Role of Psychometrics and Serum IL-6
title Detecting Minimal Hepatic Encephalopathy in an Endemic Country for Hepatitis B: The Role of Psychometrics and Serum IL-6
title_full Detecting Minimal Hepatic Encephalopathy in an Endemic Country for Hepatitis B: The Role of Psychometrics and Serum IL-6
title_fullStr Detecting Minimal Hepatic Encephalopathy in an Endemic Country for Hepatitis B: The Role of Psychometrics and Serum IL-6
title_full_unstemmed Detecting Minimal Hepatic Encephalopathy in an Endemic Country for Hepatitis B: The Role of Psychometrics and Serum IL-6
title_short Detecting Minimal Hepatic Encephalopathy in an Endemic Country for Hepatitis B: The Role of Psychometrics and Serum IL-6
title_sort detecting minimal hepatic encephalopathy in an endemic country for hepatitis b: the role of psychometrics and serum il-6
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4454579/
https://www.ncbi.nlm.nih.gov/pubmed/26039496
http://dx.doi.org/10.1371/journal.pone.0128437
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