Serum-ascites albumin gradients in nonalcoholic liver disease

Kajani, Mirza; Yoo, Young-Kul; Alexander, J. A.; Gavaler, Judith S.; Stauber, Rudolf; Dindzans, Vincents J.; Thiel, David H. Van

doi:10.1007/bf01537219

Cited by 20 publications

(16 citation statements)

References 24 publications

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“…The two groups showed statistically significant difference (P=0.001) based on presence and absence of varices. This is consistent with studies by Torres et al, Gurubacharya et al, Kajani et al, Dittrich et al [17][18][19][20] We also assessed the correlation between grade of varices and SAAG values. When the Value of SAAG was < 1.1 it was noted that Grade II and III varices were absent.…”

Section: Discussionsupporting

confidence: 89%

Correlation of serum-ascites albumin concentration gradient and endoscopic parameters of portal hypertension in chronic liver disease

Suresh

Jagini

2018

Int J Adv Med

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Background: In many studies Serum ascitic albumin gradient (SAAG) was found to be an independent predictor of PHTN and EV especially in alcoholic cirrhosis. Objectives of this study was to study correlation of level of “Serum-Ascites Albumin Concentration Gradient” (SAAG) and complications of “Portal hypertension” (PHTN), manifested by “Esophageal Varices” (EV).Methods: Present study was hospital based cross sectional study. The sample (100) was of patients with ascites. SAAG was measured in all subjects. EV was assessed by endoscopy in all. Data was analyzed using proportions and appropriate statistical tests.Results: High SAAG value was seen in 79% of the patients. EV incidence was 84.5%. “child-pugh score” and size of the portal vein was found to be associated with EV. The incidence of EV among patients with high “SAAG value of 1.1 to 1.44 g/dl” was 50%. The size of the EV was found to be significantly associated with SAAG level.Conclusions: Patients having ascites with EV were also having high levels of SAAG. Thus, we conclude that value of SAAG more than or equal to 1.2±0.05 g/dl can be used as a predictor of EV presence among ascites patients.

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Section: Discussionsupporting

confidence: 89%

Correlation of serum-ascites albumin concentration gradient and endoscopic parameters of portal hypertension in chronic liver disease

Suresh

Jagini

2018

Int J Adv Med

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“…9 The only study in the literature examining such a relationship, reported by Kajani and coworkers, in 24 patients with chronic nonalcoholic liver disease, showed no correlation (r=0.398) between measured portal venous pressure and SAAG, and three of their patients had a SAAG <1.1 g/dL. 10 We found five of our liver disease patients with a SAAG <1.1 g/dL. These were due to viral causes of liver cirrhosis and had no superimposed SBP or hepatocellular carcinoma.…”

Section: Discussionmentioning

confidence: 98%

“…Despite the lack of linear correlation between measured portal venous pressure and SAAG in nonalcoholic liver disease, 10 SAAG is still a useful diagnostic biochemical parameter, which can be used to separate ascites of liver disease (nonalcoholic) from other causes of ascites (malignancy and tuberculosis) and should replace the exudate/transudate concept in the differential diagnosis of ascites.…”

Section: Discussionmentioning

confidence: 99%

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Etiology of Ascites and the Diagnostic Value of Serum-Ascites Albumin Gradient in Non-Alcohol Liver Disease

Al-Knawy

1997

Ann Saudi Med

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This study was designed to determine the different etiologies of ascites and the diagnostic value of serum-ascites albumin gradient (SAAG) in patients with ascites of non-alcoholic liver disease in Southern Saudi Arabia. A total of 132 patients with ascites (96 males and 36 females, mean age 58.8±15.9 years) were studied for the different causes of ascites. In 55 patients with liver disease and 22 patients with nonliver disease (malignancy and peritoneal tuberculosis), we compared SAAG with the three usual parameters of ascitic fluid biochemical analysis used in the differential diagnoses of ascites. The nonliver disease group showed higher ascitic fluid total protein (aTP) concentration (4.77±2.05 versus 1.98±1.56 g/dL), ascitic to serum ratio of total protein (a/sTP) concentration (0.75±0.43 versus 0.26±0.19), ascitic fluid lactic dehydrogenase (aLDH) level (565.4±353.4 versus 254.1±205.03 U/L) and a lower SAAG (0.6±0.30 versus 1.71±0.61). P<0.0001 for all parameters. The positive predictive values for aTP, a/sTP, aLDH and SAAG to detect ascites due to liver disease were 68%, 76%, 67%, and 80%, respectively, while the negative predictive values were 96%, 96%, 84%, and 98%, respectively. Liver causes accounted for 69.7% of cases, followed by peritoneal tuberculosis 10.6%, malignancy 9.1%, congestive heart failure 7.6%, and nephrotic syndrome 3.0%. SAAG is a useful diagnostic parameter which can be used to separate ascites of liver disease (nonalcoholic) from other causes of ascites, with an efficiency of 91%. SAAG should replace the traditional parameters (aTP, a/sTP, and aLDH) used in the differential diagnosis of ascites. In our series, liver disease is the major cause of ascites, followed by peritoneal tuberculosis.

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“…Il est également souligné dans la littérature qu'une relation directe existait entre le SAAG et les différentes mesures de l'HTP tels que le gradient de pression portale [14], la pression portale nette [15], ou la pression portale corrigée [16]. Selon Starling, le GASA peu invasif était un meilleur indicateur de l'HTP [9,17].…”

Section: Discussionunclassified

Intérêt du gradient de concentration sérum-ascite en albumine dans le diagnostic des varices œsophagiennes chez le cirrhotique africain, Abidjan (Côte d’Ivoire)

Okon

Thot’o

N'dri

et al. 2015

J Afr Hepato Gastroenterol

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Intérêt du gradient de concentration sérum-ascite en albumine dans le diagnostic des varices oesophagiennes chez le cirrhotique africain, Abidjan (Côte d'Ivoire)Interest serum-ascites albumin concentration gradient in the diagnosis of esophageal varices in cirrhotic African, Abidjan (Côte d'Ivoire) Résumé Buts : Déterminer la corrélation entre le gradient de concentration sérum-ascite en albumine (GASA) et la prédic-tion des varices oesophagiennes (VO) et autres paramètres de l'hypertension portale (HTP) à savoir signes rouges, grades des varices, varices cardiotubérositaires et les gastropathies d'HTP chez le cirrhotique noir africain en Côte d'Ivoire. Patients et méthode : Etude transversale rétrospective portant sur 113 dossiers médicaux de patients présentant une ascite liée à l'HTP. La fibroscopie digestive haute pour la recherche de signes d'HTP. Le dosage des protéines dans le sérum et le liquide d'ascite a été réalisé par les méthodes chimiques courantes. La sensibilité et la spécificité obtenues par l'aire sous la courbe ROC (Receiver-Operating-Characteristic). Résultats : A 1,1 g/dl, le GASA prédisait les VO avec une sensibilité (53,3%), une spécificité (80%) pour une performance diagnostique faible (64%). A partir de 1,5 g/dl du SAAG, la spécificité était maximale (100%) mais on relevait 40% de faux-négatifs. Pour une valeur-seuil de -1,240 g/dl, la performance diagnostique du GASA était meilleure avec une sensibilité (96%), une spécificité (55%) pour une performance diagnostique à 84%. Conclusion : La valeur seuil du GASA efficace pour la détection des VO était inférieure chez les sujets africains en raison des facteurs nutritionnel et infectieux fréquents dans ces pays à faible revenu. Mots clés Varices oesophagiennes · Gradient · Albumine · Cirrhose · AfriqueAbstract Aims: To determine the correlation between the concentration Serum Ascites Albumin Gradient (SAAG) and the prediction of esophageal varices (VO) and other parameters of portal hypertension (PHT), namely red signs grades varicose veins, varicose veins and cardio tuberosity, the gastropathie portal hypertension among African blacks cirrhotic Ivory Coast. Patients and Methods: A retrospective cross-sectional study of 113 medical records of patients with ascites associated with PH. The gastroscopy to search for signs of HTP. The protein assay in serum and ascitic fluid produced by standard chemical methods. The sensitivity and specificity obtained by the area under the ROC curve (Receiver-Operating-Characteristic). Results: 1.1 g/dl, the SAAG predicted VO with a sensitivity (53.3%), specificity (80%) for low diagnostic accuracy (64%). From 1.5 g/dl of SAAG, specificity was highest (100%) but fell 40% false-negative. For a threshold value of -1.240 g/dl, the diagnostic performance of SAAG was better with a sensitivity (96%), specificity (55%) for a diagnostic accuracy of 84%. Conclusion: The threshold value of SAAG effective for the detection of VO was lower among African because of frequent nutritional and infectious factors in these low-in...

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Serum-ascites albumin gradients in nonalcoholic liver disease

Cited by 20 publications

References 24 publications

Correlation of serum-ascites albumin concentration gradient and endoscopic parameters of portal hypertension in chronic liver disease

Correlation of serum-ascites albumin concentration gradient and endoscopic parameters of portal hypertension in chronic liver disease

Etiology of Ascites and the Diagnostic Value of Serum-Ascites Albumin Gradient in Non-Alcohol Liver Disease

Intérêt du gradient de concentration sérum-ascite en albumine dans le diagnostic des varices œsophagiennes chez le cirrhotique africain, Abidjan (Côte d’Ivoire)

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