Lipid profile is associated with the incidence of cognitive dysfunction in viral cirrhotic patients: A data-mining analysis
Aim: Cognitive dysfunction (CD) is frequently observed in cirrhotic patients. However, the biochemical profiles associated with CD remain unclear. We investigated the biochemical profiles associated with the incidence of CD in cirrhotic patients by using multivariate analyses, including a decision‐...
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| Vydáno v: | Hepatology research Ročník 43; číslo 4; s. 418 - 424 |
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| Jazyk: | angličtina |
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Melbourne, Australia
Blackwell Publishing Asia
01.04.2013
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| ISSN: | 1386-6346, 1872-034X |
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| Abstract | Aim: Cognitive dysfunction (CD) is frequently observed in cirrhotic patients. However, the biochemical profiles associated with CD remain unclear. We investigated the biochemical profiles associated with the incidence of CD in cirrhotic patients by using multivariate analyses, including a decision‐tree algorithm.
Methods: In this study, 27 viral cirrhotic patients were enrolled. All subjects underwent neuropsychiatric tests; two or more abnormal results were defined as CD. A logistic regression model was used for multivariate stepwise analysis. A decision‐tree algorithm was constructed, and the categorical differences based on the decision‐tree model were analyzed by χ2‐tests.
Results: Multivariate stepwise analysis showed the levels of total bilirubin, triglycerides and free fatty acids (FFA) as independent bioparameters associated with the incidence of CD in cirrhotic patients. The decision‐tree algorithm showed that among patients with FFA of 514 mEq/L or more, 77.8% had CD. Meanwhile, among patients with FFA of less than 514 mEq/L and triglycerides of 106 mg/dL or more, 20.0% had CD. The sensitivity, specificity and accuracy for the incidence of CD using the lipid profile (FFA >514 mEq/L or triglycerides <106 mg/dL) were 85.7% (12/14), 61.5% (8/13) and 74.1% (20/27), respectively.
Conclusion: The levels of total bilirubin, FFA and triglycerides are independently associated with the incidence of CD in cirrhotic patients. In addition, a decision‐tree algorithm revealed that FFA of more than 514 mEq/L or triglycerides of less than 106 mg/dL is a profile associated with the incidence of CD. Thus, this lipid profile could be a possible screening bioparameter for CD in cirrhotic patients. |
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| AbstractList | Cognitive dysfunction (CD) is frequently observed in cirrhotic patients. However, the biochemical profiles associated with CD remain unclear. We investigated the biochemical profiles associated with the incidence of CD in cirrhotic patients by using multivariate analyses, including a decision-tree algorithm.AIM Cognitive dysfunction (CD) is frequently observed in cirrhotic patients. However, the biochemical profiles associated with CD remain unclear. We investigated the biochemical profiles associated with the incidence of CD in cirrhotic patients by using multivariate analyses, including a decision-tree algorithm. In this study, 27 viral cirrhotic patients were enrolled. All subjects underwent neuropsychiatric tests; two or more abnormal results were defined as CD. A logistic regression model was used for multivariate stepwise analysis. A decision-tree algorithm was constructed, and the categorical differences based on the decision-tree model were analyzed by χ(2) -tests.METHODS In this study, 27 viral cirrhotic patients were enrolled. All subjects underwent neuropsychiatric tests; two or more abnormal results were defined as CD. A logistic regression model was used for multivariate stepwise analysis. A decision-tree algorithm was constructed, and the categorical differences based on the decision-tree model were analyzed by χ(2) -tests. Multivariate stepwise analysis showed the levels of total bilirubin, triglycerides and free fatty acids (FFA) as independent bioparameters associated with the incidence of CD in cirrhotic patients. The decision-tree algorithm showed that among patients with FFA of 514 mEq/L or more, 77.8% had CD. Meanwhile, among patients with FFA of less than 514 mEq/L and triglycerides of 106 mg/dL or more, 20.0% had CD. The sensitivity, specificity and accuracy for the incidence of CD using the lipid profile (FFA >514 mEq/L or triglycerides <106 mg/dL) were 85.7% (12/14), 61.5% (8/13) and 74.1% (20/27), respectively.RESULTS Multivariate stepwise analysis showed the levels of total bilirubin, triglycerides and free fatty acids (FFA) as independent bioparameters associated with the incidence of CD in cirrhotic patients. The decision-tree algorithm showed that among patients with FFA of 514 mEq/L or more, 77.8% had CD. Meanwhile, among patients with FFA of less than 514 mEq/L and triglycerides of 106 mg/dL or more, 20.0% had CD. The sensitivity, specificity and accuracy for the incidence of CD using the lipid profile (FFA >514 mEq/L or triglycerides <106 mg/dL) were 85.7% (12/14), 61.5% (8/13) and 74.1% (20/27), respectively. The levels of total bilirubin, FFA and triglycerides are independently associated with the incidence of CD in cirrhotic patients. In addition, a decision-tree algorithm revealed that FFA of more than 514 mEq/L or triglycerides of less than 106 mg/dL is a profile associated with the incidence of CD. Thus, this lipid profile could be a possible screening bioparameter for CD in cirrhotic patients.CONCLUSION The levels of total bilirubin, FFA and triglycerides are independently associated with the incidence of CD in cirrhotic patients. In addition, a decision-tree algorithm revealed that FFA of more than 514 mEq/L or triglycerides of less than 106 mg/dL is a profile associated with the incidence of CD. Thus, this lipid profile could be a possible screening bioparameter for CD in cirrhotic patients. Cognitive dysfunction (CD) is frequently observed in cirrhotic patients. However, the biochemical profiles associated with CD remain unclear. We investigated the biochemical profiles associated with the incidence of CD in cirrhotic patients by using multivariate analyses, including a decision-tree algorithm. In this study, 27 viral cirrhotic patients were enrolled. All subjects underwent neuropsychiatric tests; two or more abnormal results were defined as CD. A logistic regression model was used for multivariate stepwise analysis. A decision-tree algorithm was constructed, and the categorical differences based on the decision-tree model were analyzed by χ(2) -tests. Multivariate stepwise analysis showed the levels of total bilirubin, triglycerides and free fatty acids (FFA) as independent bioparameters associated with the incidence of CD in cirrhotic patients. The decision-tree algorithm showed that among patients with FFA of 514 mEq/L or more, 77.8% had CD. Meanwhile, among patients with FFA of less than 514 mEq/L and triglycerides of 106 mg/dL or more, 20.0% had CD. The sensitivity, specificity and accuracy for the incidence of CD using the lipid profile (FFA >514 mEq/L or triglycerides <106 mg/dL) were 85.7% (12/14), 61.5% (8/13) and 74.1% (20/27), respectively. The levels of total bilirubin, FFA and triglycerides are independently associated with the incidence of CD in cirrhotic patients. In addition, a decision-tree algorithm revealed that FFA of more than 514 mEq/L or triglycerides of less than 106 mg/dL is a profile associated with the incidence of CD. Thus, this lipid profile could be a possible screening bioparameter for CD in cirrhotic patients. Aim: Cognitive dysfunction (CD) is frequently observed in cirrhotic patients. However, the biochemical profiles associated with CD remain unclear. We investigated the biochemical profiles associated with the incidence of CD in cirrhotic patients by using multivariate analyses, including a decision-tree algorithm. Methods: In this study, 27 viral cirrhotic patients were enrolled. All subjects underwent neuropsychiatric tests; two or more abnormal results were defined as CD. A logistic regression model was used for multivariate stepwise analysis. A decision-tree algorithm was constructed, and the categorical differences based on the decision-tree model were analyzed by chi 2-tests. Results: Multivariate stepwise analysis showed the levels of total bilirubin, triglycerides and free fatty acids (FFA) as independent bioparameters associated with the incidence of CD in cirrhotic patients. The decision-tree algorithm showed that among patients with FFA of 514mEq/L or more, 77.8% had CD. Meanwhile, among patients with FFA of less than 514mEq/L and triglycerides of 106mg/dL or more, 20.0% had CD. The sensitivity, specificity and accuracy for the incidence of CD using the lipid profile (FFA >514mEq/L or triglycerides <106mg/dL) were 85.7% (12/14), 61.5% (8/13) and 74.1% (20/27), respectively. Conclusion: The levels of total bilirubin, FFA and triglycerides are independently associated with the incidence of CD in cirrhotic patients. In addition, a decision-tree algorithm revealed that FFA of more than 514mEq/L or triglycerides of less than 106mg/dL is a profile associated with the incidence of CD. Thus, this lipid profile could be a possible screening bioparameter for CD in cirrhotic patients. Aim: Cognitive dysfunction (CD) is frequently observed in cirrhotic patients. However, the biochemical profiles associated with CD remain unclear. We investigated the biochemical profiles associated with the incidence of CD in cirrhotic patients by using multivariate analyses, including a decision‐tree algorithm. Methods: In this study, 27 viral cirrhotic patients were enrolled. All subjects underwent neuropsychiatric tests; two or more abnormal results were defined as CD. A logistic regression model was used for multivariate stepwise analysis. A decision‐tree algorithm was constructed, and the categorical differences based on the decision‐tree model were analyzed by χ 2 ‐tests. Results: Multivariate stepwise analysis showed the levels of total bilirubin, triglycerides and free fatty acids (FFA) as independent bioparameters associated with the incidence of CD in cirrhotic patients. The decision‐tree algorithm showed that among patients with FFA of 514 mEq/L or more, 77.8% had CD. Meanwhile, among patients with FFA of less than 514 mEq/L and triglycerides of 106 mg/dL or more, 20.0% had CD. The sensitivity, specificity and accuracy for the incidence of CD using the lipid profile (FFA >514 mEq/L or triglycerides <106 mg/dL) were 85.7% (12/14), 61.5% (8/13) and 74.1% (20/27), respectively. Conclusion: The levels of total bilirubin, FFA and triglycerides are independently associated with the incidence of CD in cirrhotic patients. In addition, a decision‐tree algorithm revealed that FFA of more than 514 mEq/L or triglycerides of less than 106 mg/dL is a profile associated with the incidence of CD. Thus, this lipid profile could be a possible screening bioparameter for CD in cirrhotic patients. Aim: Cognitive dysfunction (CD) is frequently observed in cirrhotic patients. However, the biochemical profiles associated with CD remain unclear. We investigated the biochemical profiles associated with the incidence of CD in cirrhotic patients by using multivariate analyses, including a decision‐tree algorithm. Methods: In this study, 27 viral cirrhotic patients were enrolled. All subjects underwent neuropsychiatric tests; two or more abnormal results were defined as CD. A logistic regression model was used for multivariate stepwise analysis. A decision‐tree algorithm was constructed, and the categorical differences based on the decision‐tree model were analyzed by χ2‐tests. Results: Multivariate stepwise analysis showed the levels of total bilirubin, triglycerides and free fatty acids (FFA) as independent bioparameters associated with the incidence of CD in cirrhotic patients. The decision‐tree algorithm showed that among patients with FFA of 514 mEq/L or more, 77.8% had CD. Meanwhile, among patients with FFA of less than 514 mEq/L and triglycerides of 106 mg/dL or more, 20.0% had CD. The sensitivity, specificity and accuracy for the incidence of CD using the lipid profile (FFA >514 mEq/L or triglycerides <106 mg/dL) were 85.7% (12/14), 61.5% (8/13) and 74.1% (20/27), respectively. Conclusion: The levels of total bilirubin, FFA and triglycerides are independently associated with the incidence of CD in cirrhotic patients. In addition, a decision‐tree algorithm revealed that FFA of more than 514 mEq/L or triglycerides of less than 106 mg/dL is a profile associated with the incidence of CD. Thus, this lipid profile could be a possible screening bioparameter for CD in cirrhotic patients. |
| Author | Kawaguchi, Takumi Taniguchi, Eitaro Oriishi, Tetsuharu Sata, Michio Sakata, Masahiro Itou, Minoru |
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| BackLink | https://cir.nii.ac.jp/crid/1571698601100499200$$DView record in CiNii https://www.ncbi.nlm.nih.gov/pubmed/22882558$$D View this record in MEDLINE/PubMed |
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| Notes | ark:/67375/WNG-L14P985F-6 ArticleID:HEPR1076 istex:E3BFACB029384615CE6E939D8B503FA45194D8F9 This study was supported, in part, by a Grant‐in‐Aid for Young Scientists (B) (no. 22790874 to T. K.) from the Ministry of Education, Culture, Sports, Science and Technology of Japan, and by Health and Labor Sciences Research Grants for Research on Hepatitis from the Ministry of Health, Labour and Welfare of Japan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Conflict of interest ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1 |
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Role of small intestinal bacterial overgrowth and delayed gastrointestinal transit time in cirrhotic patients with minimal hepatic encephalopathy. J Hepatol 2010; 53: 849-55. Kawaguchi T, Kakuma T, Yatsuhashi H et al. Data mining reveals complex interactions of risk factors and clinical feature profiling associated with the staging of non-hepatitis B virus/non-hepatitis C virus-related hepatocellular carcinoma. Hepatol Res 2011; 41: 564-71. Butterworth RF. Pathogenesis of hepatic encephalopathy: new insights from neuroimaging and molecular studies. J Hepatol 2003; 39: 278-85. Lal S, Young SN, Sourkes TL. Letter: 5-hydroxytryptamine and hepatic coma. Lancet 1975; 2: 979-80. Soriano G, Roman E, Cordoba J et al. Cognitive dysfunction in cirrhosis is associated with falls: a prospective study. Hepatology 2012; 55: 1922-30. Spector AA. Fatty acid binding to plasma albumin. J Lipid Res 1975; 16: 165-79. Oida T. 1H-NMR study on the interactions of human serum albumin with free fatty acid. J Biochem 1986; 100: 1533-42. Watanabe A, Sakai T, Sato S et al. Clinical efficacy of lactulose in cirrhotic patients with and without subclinical hepatic encephalopathy. Hepatology 1997; 26: 1410-14. Seyama Y, Kokudo N. Assessment of liver function for safe hepatic resection. Hepatol Res 2009; 39: 107-16. Romero-Gomez M, Boza F, Garcia-Valdecasas MS, Garcia E, Aguilar-Reina J. Subclinical hepatic encephalopathy predicts the development of overt hepatic encephalopathy. Am J Gastroenterol 2001; 96: 2718-23. Rossi S, Ravetta V, Rosa L et al. Repeated radiofrequency ablation for management of patients with cirrhosis with small hepatocellular carcinomas: a long-term cohort study. 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publication-title: Hepatology – volume: 14 start-page: 2 issue: 1 year: 1996 end-page: 11 article-title: Subclinical encephalopathy publication-title: Dig Dis – volume: 27 start-page: 174 year: 2011 end-page: 9 article-title: Diet and cognition in chronic liver disease publication-title: Curr Opin Gastroenterol – volume: 100 start-page: 1533 year: 1986 end-page: 42 article-title: 1H‐NMR study on the interactions of human serum albumin with free fatty acid publication-title: J Biochem – volume: 102 start-page: 1903 year: 2007 end-page: 9 article-title: Minimal hepatic encephalopathy: a vehicle for accidents and traffic violations publication-title: Am J Gastroenterol – volume: 39 start-page: 278 year: 2003 end-page: 85 article-title: Pathogenesis of hepatic encephalopathy: new insights from neuroimaging and molecular studies publication-title: J Hepatol – volume: 42 start-page: S45 year: 2005 end-page: 53 article-title: Minimal hepatic encephalopathy: diagnosis, clinical significance and recommendations publication-title: J Hepatol – year: 2012 article-title: Fish to meat intake ratio and cooking oils are associated with hepatitis C virus carriers with persistently normal alanine aminotransferase levels publication-title: Hepatol Res – volume: 283 start-page: 397 year: 1999 end-page: 401 article-title: Role of serotonin in the paradoxical calming effect of psychostimulants on hyperactivity publication-title: Science – volume: 22 start-page: 125 year: 2007 end-page: 38 article-title: Role of ammonia and inflammation in minimal hepatic encephalopathy publication-title: Metab Brain Dis – volume: 40 start-page: 251 year: 2010 end-page: 60 article-title: A predictive model of response to peginterferon ribavirin in chronic hepatitis C using classification and regression tree analysis publication-title: Hepatol Res – volume: 103 start-page: 1674 year: 2008 end-page: 81 article-title: Deleterious effect of cirrhosis on outcomes after motor vehicle crashes using the nationwide inpatient sample publication-title: Am J Gastroenterol – volume: 253 start-page: 3023 year: 1978 end-page: 8 article-title: Human serum albumin. I. On the relationship of fatty acid and bilirubin binding sites and the nature of fatty acid allosteric effects–a monoanionic spin label study publication-title: J Biol Chem – volume: 39 start-page: 739 year: 2004 end-page: 45 article-title: Minimal hepatic encephalopathy impairs fitness to drive publication-title: Hepatology – volume: 46 start-page: 922 year: 2007 end-page: 38 article-title: Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis publication-title: Hepatology – volume: 136 start-page: 553S year: 2006 end-page: 9S article-title: Exercise, serum free tryptophan, and central fatigue publication-title: J Nutr – volume: 106 start-page: 317 year: 2011 end-page: 18 article-title: Editorial: rifaximin and minimal hepatic encephalopathy publication-title: Am J Gastroenterol – volume: 22 start-page: 257 year: 1972 end-page: 63 article-title: Fine structural changes in the sural nerve of patients with acanthocytosis publication-title: Acta Neuropathol – volume: 36 start-page: 950 year: 1982 end-page: 62 article-title: Medium‐chain triglycerides: an update publication-title: Am J Clin Nutr – volume: 38 start-page: S122 year: 2008 end-page: S7 article-title: Diagnosis of sub‐clinical hepatic encephalopathy by Neuropsychological Tests (NP‐tests) publication-title: Hepatol Res – volume: 57 start-page: 1156 year: 2008 end-page: 65 article-title: Pathogenetic mechanisms of hepatic encephalopathy publication-title: Gut – volume: 49 start-page: 346 year: 2008 end-page: 53 article-title: Detection of minimal hepatic encephalopathy: normalization and optimization of the Psychometric Hepatic Encephalopathy Score. A neuropsychological and quantified EEG study publication-title: J Hepatol – volume: 53 start-page: 136 year: 2011 end-page: 47 article-title: Repeated radiofrequency ablation for management of patients with cirrhosis with small hepatocellular carcinomas: a long‐term cohort study publication-title: Hepatology – volume: 140 start-page: 478 year: 2011 end-page: 87 article-title: Rifaximin improves driving simulator performance in a randomized trial of patients with minimal hepatic encephalopathy publication-title: Gastroenterology – volume: 39 start-page: 107 year: 2009 end-page: 16 article-title: Assessment of liver function for safe hepatic resection publication-title: Hepatol Res – volume: 45 start-page: 549 year: 2007 end-page: 59 article-title: Lactulose improves cognitive functions and health‐related quality of life in patients with cirrhosis who have minimal hepatic encephalopathy publication-title: Hepatology – volume: 21 start-page: 824 year: 2009 end-page: 7 article-title: 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| SubjectTerms | Algorithms decision-tree algorithm fatty acid minimal hepatic encephalopathy neuropsychiatric test neurospsychiatric test |
| Title | Lipid profile is associated with the incidence of cognitive dysfunction in viral cirrhotic patients: A data-mining analysis |
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