Risk Factor Analysis of Hepatic Encephalopathy and the Establishment of Diagnostic Model

Abstract

To identify laboratory diagnostic indicators of hepatic encephalopathy (HE), the present study established a HE diagnostic model to explore the diagnostic value of serum homocysteine, lactic acid, procalcitonin, and bile acid levels in HE identification. 371 patients with liver cirrhosis were selected as research objects, who were admitted to the Department of Hepatic Diseases, Affiliated Hospital of Northwest Minzu University from August 2019 to August 2020. The Spearman correlation results indicated that between lactic acid, procalcitonin, bile acid, serum homocysteine, and HE, the coefficients were -0.15, 0.41, 0.29, and -0.19, respectively. Univariate and multivariate analysis methods were adopted for inpatient analysis to identify the influencing factors of HE occurrence, and the diagnosis of the HE identification model was subsequently constructed. The univariate logistic regression showed that risk of developing HE increased as bile acid level ( P = 0.00434 ) and serum homocysteine ( P = 0.058 ) increased. Multivariate logistic regression diagnostic model of bile acid level and serum homocysteine revealed that the AUC value of the area under the ROC curve was 0.7201, indicating that the diagnostic model produced a satisfactory evaluation effect. The model formula referred logistic P = − 2.4544 + 0.0117 bile acid levels + 0.0198 serum homocysteine . In this study, the HE diagnostic model was established using logistic regression analysis, which could benefit patients in early HE differential diagnosis. Particularly, combined detection of serum homocysteine and bile acid levels was considered to be more significant.

Microbiota-gut-liver-brain axis and hepatic encephalopathy

“…In addition, α-ketoglutaramate, a metabolite in the process of glutamine transamination, has been proposed to be a useful biomarker for early prediction of HE [ 105 ] . Serum homocysteine and BA levels were also identified as promising markers for the diagnosis of HE [ 106 ] . Additionally, it is possible to target brain dysfunction as a potential diagnostic criterion in HE, as the brain default mode network based on resting-state functional magnetic resonance imaging (MRI) scanning was shown to be a valuable method to identify HE [ 107 ] .…”

“…Promising gut microbiota indicators to differentiate patients with higher HE progression risk from cirrhotic cohorts included: high populations of urease enzyme-producing bacteria such as Alcaligenaceae, Streptococcaceae, and Staphylococcus intermedius in fecal microbiota [100,101] ; low populations of butyric acid-producing bacteria such as Faecalibacterium prausnitzii in colonic mucosal samples; and low populations of Ruminococcus, Clostridium XIVb, Faecalibaterium, and Butyricoccus in stools [102][103][104] . In addition, α-ketoglutaramate, a metabolite in the process of glutamine transamination, has been proposed to be a useful biomarker for early prediction of HE [105] . Serum homocysteine and BA levels were also identified as promising markers for the diagnosis of HE [106] .…”

Hepatic encephalopathy post-TIPS: Current status and prospects in predictive assessment

“…Chen et al developed a diagnostic model for HE using serum homocysteine and bile acid levels, which demonstrated significant diagnostic value for HE. Future advances may include real-time dynamic models [103] . These tools will help physicians better understand the specific risk factors of each patient with HE, leading to individualized treatment plans.…”

Retracted: Risk Factor Analysis of Hepatic Encephalopathy and the Establishment of Diagnostic Model

“…This article has been retracted by Hindawi, as publisher, following an investigation undertaken by the publisher [1]. This investigation has uncovered evidence of systematic manipulation of the publication and peer-review process.…”