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Serum concentration of taurochenodeoxycholic acid predicts clinically significant portal hypertension
K. Žížalová, B. Nováková, M. Vecka, J. Petrtýl, V. Lánská, K. Pelinková, V. Šmíd, R. Brůha, L. Vítek, M. Leníček
Language English Country United States
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
36433660
DOI
10.1111/liv.15481
Knihovny.cz E-resources
- MeSH
- Liver Cirrhosis complications diagnosis MeSH
- Liver MeSH
- Taurochenodeoxycholic Acid * MeSH
- Humans MeSH
- Hypertension, Portal * diagnosis MeSH
- Portal Pressure MeSH
- Prognosis MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND & AIMS: Severity of portal hypertension is usually quantified by measuring the hepatic venous pressure gradient (HVPG). However, due to its invasiveness, alternative markers are being sought. Bile acids (BA), being synthesized, metabolized, and transported by the liver, seem to have the potential to serve as endogenous markers. The aim of the present study was to determine whether serum BA reflect the severity of portal hypertension. METHODS: We correlated serum concentrations of individual BA with portal pressure (as HVPG) in an exploratory cohort of 21 cirrhotic patients with portal hypertension. The predictive potential of selected candidates was then confirmed in an independent validation cohort (n = 214). Additionally, nine previously published noninvasive markers were added to the stepwise logistic regression model to identify the most relevant ones, which were eventually used to create a prognostic index of portal hypertension. RESULTS: Serum levels of taurochenodeoxycholic acid (TCDCA) significantly correlated with HVPG and showed a high potential to predict clinically significant portal hypertension (HVPG ≥ 10 mm Hg: AUROC = 0.97 ± 0.06). This was confirmed in the validation cohort (AUROC = 0.96 ± 0.01). The predictive index (constructed based on AST/ALT, spleen diameter, and TCDCA concentration) was able to distinguish clinically significant portal hypertension with 95% sensitivity and 76% specificity. CONCLUSIONS: TCDCA seems to be a promising noninvasive marker of clinically significant portal hypertension. Its predictive potential may be further enhanced when it is combined with both the AST/ALT ratio and spleen diameter.
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