The performance of neurodegenerative biomarkers-neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), tau, and ubiquitin carboxy-terminal hydrolase L1 (UCHL1)-in diagnosing minimal hepatic encephalopathy (MHE) has not been systematically evaluated, simultaneously, nor have their associations with the development of overt hepatic...
Xia & He Publishing Inc.Jan 17 2025 Background and aims The performance of neurodegenerative biomarkers-neurofilament light chain , glial fibrillary acidic protein , tau, and ubiquitin carboxy-terminal hydrolase L1 -in diagnosing minimal hepatic encephalopathy has not been systematically evaluated, simultaneously, nor have their associations with the development of overt hepatic encephalopathy .
Methods In this prospective study, 124 patients with hepatic cirrhosis were recruited. The Psychometric Hepatic Encephalopathy Score was used to diagnose MHE, and OHE development was observed during a 30-day follow-up period. Plasma levels of NfL, GFAP, tau, and UCHL1 were measured using the highly sensitive single-molecule array when MHE was diagnosed. Additionally, serum interleukin-6 levels and the model for end-stage liver disease and MELD-Na scores were also measured.
Results MHE was diagnosed in 57 patients. Patients with MHE had significantly higher plasma levels of NfL and GFAP and lower tau levels compared to those without MHE. Plasma NfL and serum ammonia levels were independently associated with MHE occurrence. A combination of NfL, GFAP, tau, and UCHL1 was effective in diagnosing MHE in all cirrhotic patients , with an accuracy, sensitivity, and specificity of 71.0%, 71.9%, and 71.6%, respectively.
Conclusions The combination of plasma levels of NfL, GFAP, tau, and UCHL1 performs well in diagnosing MHE. Additionally, MELD score, IL-6, and GFAP appear to be significant predictors of OHE development in patients with hepatic cirrhosis.Journal reference:Cheng, Q., et al. . Evaluation of Plasma Neurodegenerative Biomarkers for Diagnosing Minimal Hepatic Encephalopathy and Predicting Overt Hepatic Encephalopathy in Chinese Patients with Hepatic Cirrhosis.
Hepatic Encephalopathy Cirrhosis Hepatology Liver Protein Research Ubiquitin
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