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Serum level of taurine would be associated with the amelioration of minimal hepatic encephalopathy in cirrhotic patients
Author(s) -
Saito Masaya,
Hirano Hirotaka,
Yano Yoshihiko,
Momose Kenji,
Yoshida Masaru,
Azuma Takeshi
Publication year - 2016
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12565
Subject(s) - hepatic encephalopathy , medicine , taurine , gastroenterology , logistic regression , carnitine , confidence interval , receiver operating characteristic , prospective cohort study , area under the curve , cirrhosis , amino acid , chemistry , biochemistry
Aim A variety of treatment modalities including L‐carnitine have been tried for cirrhotic patients with minimal hepatic encephalopathy (MHE), which improved MHE for some patients, but were not effective for the other patients. We aimed to identify pre‐therapeutic independent factors to predict the amelioration of MHE after L‐carnitine treatment. Methods We performed a prospective cohort study on a total of 64 consecutive outpatients of cirrhotic patients who underwent blood biochemical examinations and neuropsychiatric (NP) test at Kobe University Hospital. MHE patients diagnosed by the NP test were p.o. administrated L‐carnitine for 3 months. The patients with and without MHE amelioration were compared, and the independent factors were statistically examined. Predictive scoring systems of the amelioration of MHE were established using multivariate logistic regression. Results The amelioration of MHE was found in 45.8% of MHE patients. Serum taurine before the treatment was the best predictive factor of the amelioration of MHE ( P = 0.046). The predictive model using serum taurine discriminated well between patients with and without the amelioration of MHE (area under the receiver–operator curve, 0.748; 95% confidence interval, 0.531–0.901). The predictive scores of the amelioration of MHE enable the patient‐specific probability to be easily looked up. Conclusion Serum taurine before L‐carnitine treatment was shown to be an independent factor associated with the amelioration of MHE 3 months after the treatment. The easy pre‐therapeutic prediction of MHE amelioration after L‐carnitine treatment would help in improving awareness of the selection of MHE patients with good response to L‐carnitine, thus being beneficial from a financial perspective.