Role of gut microbiota in the pathogenesis and therapeutics of minimal hepatic encephalopathy via the gut-liver-brain axis

作者：Ming Luo, Ruijuan Xin, Fang-Rui Hu, Yao Li, Shengjuan Hu, Feihu Bai · 发表于：World Journal of Gastroenterology · 年份：2023 · DOI：10.3748/wjg.v29.i1.144 · 被引用次数：46 · 研究领域：Liver Disease and Transplantation、Liver Disease Diagnosis and Treatment、Gut microbiota and health

Minimal hepatic encephalopathy (MHE) adversely affects the clinical outcomes of patients with liver cirrhosis.This prospective study aimed to evaluate the utility of the Stroop test in the diagnosis of MHE and prediction of overt hepatic encephalopathy (OHE) in Japanese patients with cirrhosis.We enrolled 152 patients who underwent the Stroop test between November 2018 and February 2020.MHE was diagnosed using a combination of neuropsychological tests as the gold standard.The enrolled patients were followed up prospectively until the occurrence of OHE or August 2020.The optimal cutoff value of the Stroop test measurements was determined by receiver operating characteristic (ROC) curve analysis, and its predictive ability was assessed using the area under the ROC curve (AUC).Among the 139 eligible patients, 50 (36%) were diagnosed with MHE.The OffTime+OnTime cutoff value of 218.3 seconds had the best discriminative ability for MHE diagnosis, with an AUC of 0.77, a sensitivity of 74%, and a specificity of 75%.During a median follow-up of 10.8 months, 6 (4%) patients developed OHE.The OffTime+OnTime cutoff value of 305.6 seconds had the highest predictive ability for OHE, with an AUC of 0.79, a sensitivity of 67%, and a specificity of 92%.This value predicted OHE occurrence independent of liver functional reserve and prior OHE (hazard ratio, 19.8; P = 0.003).These two cutoff values remained statistically significant even when patients with prior OHE were excluded from the analys...