ABSTRACT
AIMS: The non-invasive (13)C-methacetin ((13)C-MBT) breath test has been proposed as a measure of metabolic liver function that improves the diagnostic efficacy of serologic and biochemical tests in assessing hepatic functional capacity and liver disease severity, The goal of this study was to establish the clinical utility of this test in quantifying hepatic metabolic function in patients with liver cirrhosis of varying severity and to compare (13)C-MBT measurements with the AST/ALT ratio, APRI score, and other routine liver tests. METHODS: Routine liver function tests including serum bilirubin, aspartate aminotransferase activity (AST), alanine aminotransferase (ALT), AST/ALT ratio, the APRI score, the percentage of dose rate (PDR) and cumulative percentage of dose rate (CPDR) of the (13)C-MBT were evaluated in 52 cirrhotic patients of alcohol etiology (Child-Pugh A/B/C 10/28/14) and 37 healthy controls. RESULTS: The (13)C-MBT differed significantly between healthy controls and cirrhotic patients at all time intervals measured. It also proved the ability to differentiate patients with liver cirrhosis based on severity of hepatic impairment corresponding to the Child-Pugh classification A vs. B vs. C. The ROC curve analysis suggested that the best prediction is provided by time intervals between the 10th - 20th or 10th - 40th minute of PDR. CONCLUSIONS: The (13)C-MBT offers a reliable means for quantification of hepatic metabolic function over the complete range of functional liver impairment. It is non-invasive, easy to perform and completely safe.
Subject(s)
Acetamides/therapeutic use , Breath Tests/methods , Carbon Isotopes , Liver Cirrhosis/diagnosis , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Severity of Illness IndexABSTRACT
The paper presents a brief overview of statistical methods used in clinical and experimental medicine, ranging from basic indicators and parameters of descriptive statistics and hypotheses testing (parametric as well as non-parametric methods) to a description of the most frequently used multivariate methods in medical scientific publications, to logistic regression. The paper also describes Principle Component Analysis (PCA), which is one of the methods used to decrease a data dimensionality. The proper use of statistical methods is demonstrated on specific clinical cases.
Subject(s)
Statistics as Topic , Analysis of Variance , Data Interpretation, Statistical , Logistic Models , Multivariate Analysis , Principal Component Analysis , Regression Analysis , Statistics, NonparametricABSTRACT
Metabolic liver function is significantly decreased in patients with advanced chronic heart failure (CHF). The purpose of the study was to evaluate correlation of NT-proBNP with metabolic liver function as assessed with (13)C-methacetin breath test in patients with acute decompensation of chronic heart failure (ADHF). NT-proBNP, (13)C-methacetin breath test and investigation of other biochemical parameters were realized on days 0-2 (V1) and 2-7 (V2) after hospital admission in 13 consecutive ADHF patients. NT-proBNP and metabolic liver function as assessed with (13)C-methacetin breath test didn't change in the first days after hospital admission in ADHF patients. Correlation of NT-proBNP with the degree of metabolic liver function impairement was not significant. The study revealed significant correlation of NT-proBNP with serum ceruloplasmin and significant inverse correlation of liver function with total iron binding capacity in patients with ADHF. The results of this pilot study should be confirmed in a study with larger patient population.
