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Significance of the (13)C-caffeine breath test for patients with cirrhosis.

Konstantinou D, Margariti E, Hadziyannis E, Pectasides D, Papatheodoridis GV - Ann Gastroenterol (2014)

Bottom Line: The mean single 15-min, 30-min, 45-min and 1-h CBT results, as well as cumulative CBT values differed significantly between healthy controls or chronic liver disease patients and cirrhotics (1-h CBT: 3.22±1.06 or 3.56±2.80 vs. 1.69±2.52, P≤0.01).In contrast, the CBT results at any time point or cumulative values did not correlate with MELD or Child-Pugh scores.However, in patients with decompensated cirrhosis, CBT results do not seem to be associated with the Child-Pugh and MELD scores.

View Article: PubMed Central - PubMed

Affiliation: 2nd Department of Internal Medicine, Athens University Medical School, Hippokration General Hospital (Dimitrios Konstantinou, Ekaterini Margariti, Emilia Hadziyannis, Dimitrios Pectasides, George V. Papatheodoridis).

ABSTRACT

Background: The 13C-caffeine breath test (CBT) is a non-invasive, quantitative test of liver function which has been shown to correlate inversely to the Child-Pugh score. The aim of the study was to determine the utility of CBT in the assessment of cirrhosis and its correlation to the model for end-stage liver disease (MELD) score.

Methods: Thirty-nine patients, 29 with cirrhosis and 10 with chronic liver disease without cirrhosis, and 8 healthy volunteers were included. Cirrhotic patients were graded according to Child-Pugh and MELD scores. All participants underwent CBT and laboratory tests on the same day. The results of the CBT were expressed as percentages of changes over baseline values (Δ‰) per 100 mg caffeine.

Results: The mean single 15-min, 30-min, 45-min and 1-h CBT results, as well as cumulative CBT values differed significantly between healthy controls or chronic liver disease patients and cirrhotics (1-h CBT: 3.22±1.06 or 3.56±2.80 vs. 1.69±2.52, P≤0.01). In contrast, the CBT results at any time point or cumulative values did not correlate with MELD or Child-Pugh scores. Receiver operating characteristics (ROC) analysis showed that the 30-min CBT values were more accurate in differentiating cirrhotics from chronic liver disease patients (area under ROC curve: 0.871).

Conclusions: CBT can reliably differentiate the patients with decompensated cirrhosis from non-cirrhotic patients with chronic liver diseases. However, in patients with decompensated cirrhosis, CBT results do not seem to be associated with the Child-Pugh and MELD scores.

No MeSH data available.


Related in: MedlinePlus

Results of the caffeine breath test (CBT) in 29 patients with cirrhosis, 10 non-cirrhotic patients with chronic liver disease and 8 healthy controls. (A) All patients in each group. (B) Smokers vs. non-smokers in each group. Boxes and whiskers plots express medians, interquartile and overall ranges. The outlying values are plotted individually
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Figure 2: Results of the caffeine breath test (CBT) in 29 patients with cirrhosis, 10 non-cirrhotic patients with chronic liver disease and 8 healthy controls. (A) All patients in each group. (B) Smokers vs. non-smokers in each group. Boxes and whiskers plots express medians, interquartile and overall ranges. The outlying values are plotted individually

Mentions: The mean single 1-h CBT (CBT-1h) values were significantly lower in the 29 patients with cirrhosis (1.69±2.52) than in the 10 patients with chronic liver disease (3.56±2.80, P=0.01) or in the 8 healthy controls (3.22±1.06, P=0.004), but they showed no significant difference between healthy controls and chronic liver disease patients (P=0.73). Similar differences were also observed for the results of single points CBT at 15, 30 and 45 min and the cumulative results of CBT, as shown in Fig. 2A. The exclusion of smokers did not change the results of these comparisons (Fig. 2B). Similarly, the exclusion of patients under proton pump inhibitors and/or ciprofloxacin did not change the results of these comparisons.


Significance of the (13)C-caffeine breath test for patients with cirrhosis.

Konstantinou D, Margariti E, Hadziyannis E, Pectasides D, Papatheodoridis GV - Ann Gastroenterol (2014)

Results of the caffeine breath test (CBT) in 29 patients with cirrhosis, 10 non-cirrhotic patients with chronic liver disease and 8 healthy controls. (A) All patients in each group. (B) Smokers vs. non-smokers in each group. Boxes and whiskers plots express medians, interquartile and overall ranges. The outlying values are plotted individually
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3959537&req=5

Figure 2: Results of the caffeine breath test (CBT) in 29 patients with cirrhosis, 10 non-cirrhotic patients with chronic liver disease and 8 healthy controls. (A) All patients in each group. (B) Smokers vs. non-smokers in each group. Boxes and whiskers plots express medians, interquartile and overall ranges. The outlying values are plotted individually
Mentions: The mean single 1-h CBT (CBT-1h) values were significantly lower in the 29 patients with cirrhosis (1.69±2.52) than in the 10 patients with chronic liver disease (3.56±2.80, P=0.01) or in the 8 healthy controls (3.22±1.06, P=0.004), but they showed no significant difference between healthy controls and chronic liver disease patients (P=0.73). Similar differences were also observed for the results of single points CBT at 15, 30 and 45 min and the cumulative results of CBT, as shown in Fig. 2A. The exclusion of smokers did not change the results of these comparisons (Fig. 2B). Similarly, the exclusion of patients under proton pump inhibitors and/or ciprofloxacin did not change the results of these comparisons.

Bottom Line: The mean single 15-min, 30-min, 45-min and 1-h CBT results, as well as cumulative CBT values differed significantly between healthy controls or chronic liver disease patients and cirrhotics (1-h CBT: 3.22±1.06 or 3.56±2.80 vs. 1.69±2.52, P≤0.01).In contrast, the CBT results at any time point or cumulative values did not correlate with MELD or Child-Pugh scores.However, in patients with decompensated cirrhosis, CBT results do not seem to be associated with the Child-Pugh and MELD scores.

View Article: PubMed Central - PubMed

Affiliation: 2nd Department of Internal Medicine, Athens University Medical School, Hippokration General Hospital (Dimitrios Konstantinou, Ekaterini Margariti, Emilia Hadziyannis, Dimitrios Pectasides, George V. Papatheodoridis).

ABSTRACT

Background: The 13C-caffeine breath test (CBT) is a non-invasive, quantitative test of liver function which has been shown to correlate inversely to the Child-Pugh score. The aim of the study was to determine the utility of CBT in the assessment of cirrhosis and its correlation to the model for end-stage liver disease (MELD) score.

Methods: Thirty-nine patients, 29 with cirrhosis and 10 with chronic liver disease without cirrhosis, and 8 healthy volunteers were included. Cirrhotic patients were graded according to Child-Pugh and MELD scores. All participants underwent CBT and laboratory tests on the same day. The results of the CBT were expressed as percentages of changes over baseline values (Δ‰) per 100 mg caffeine.

Results: The mean single 15-min, 30-min, 45-min and 1-h CBT results, as well as cumulative CBT values differed significantly between healthy controls or chronic liver disease patients and cirrhotics (1-h CBT: 3.22±1.06 or 3.56±2.80 vs. 1.69±2.52, P≤0.01). In contrast, the CBT results at any time point or cumulative values did not correlate with MELD or Child-Pugh scores. Receiver operating characteristics (ROC) analysis showed that the 30-min CBT values were more accurate in differentiating cirrhotics from chronic liver disease patients (area under ROC curve: 0.871).

Conclusions: CBT can reliably differentiate the patients with decompensated cirrhosis from non-cirrhotic patients with chronic liver diseases. However, in patients with decompensated cirrhosis, CBT results do not seem to be associated with the Child-Pugh and MELD scores.

No MeSH data available.


Related in: MedlinePlus