The breathprints in patients with liver disease identify novel breath biomarkers in alcoholic hepatitis.
The breathprints in patients with liver disease identify novel breath biomarkers in alcoholic hepatitis.
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DOI：
10.1016/j.cgh.2013.08.048
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发表时间：
2014-03
影响因子：
12.6
通讯作者：
Dweik, Raed A.
中科院分区：
文献类型：
--
作者：
Hanouneh, Ibrahim A.;Zein, Nizar N.;Cikach, Frank;Dababneh, Luma;Grove, David;Alkhouri, Naim;Lopez, Rocio;Dweik, Raed A.
选择离子流管质谱法（SIFT-MS）可以精确地识别人体呼吸中的微量气体，在十亿分之一的范围内。我们研究了呼气样本中挥发性化合物的浓度是否与酒精性肝炎（AH）的诊断和AH患者肝脏疾病的严重程度相关。我们从一家三级医疗中心招募了肝病患者。研究人群分为AH合并肝硬化（n=40）和肝硬化合并急性代偿失调（n=40）；无肝脏疾病的个体作为对照（n=43）。我们使用SIFT-MS鉴定和测量了禁食受试者呼吸样本中的14种挥发性化合物。我们使用各种统计分析来比较各组患者的临床特征和呼吸中化合物的水平，并测试化合物水平与肝脏疾病严重程度之间的相关性。采用Logistic回归分析建立AH的预测模型。我们确定了6种化合物（2-丙醇、乙醛、丙酮、乙醇、戊烷和三甲胺[TMA]），与对照组相比，它们在肝病患者中的水平升高。与急性代偿失代偿患者或对照组相比，AH患者呼吸样本中TMA、丙酮和戊烷的平均浓度特别高（P< 0.001）。利用受试者工作特征曲线分析，我们建立了一个基于TMA、丙酮和戊烷（TAP）呼吸水平的AH诊断模型。TAP评分在36分及以上时诊断为AH (AUC=0.92)，敏感性为90%，特异性为80%。基于终末期肝病评分模型的呼气TMA水平与AH严重程度的相关性较低（r=0.38； 95%可信区间，0.07-0.69；P= 0.018）。根据呼吸样本中挥发性化合物的水平，我们可以识别AH患者与急性代偿失代偿患者或无肝脏疾病的个体。呼出的TMA水平与AH的严重程度适度相关。这些结果可用于AH的诊断或确定患者预后。
Selected-ion flow-tube mass spectrometry (SIFT-MS) can precisely identify trace gases in the human breath, in the parts-per-billion range. We investigated whether concentrations of volatile compounds in breath samples correlate with the diagnosis of alcoholic hepatitis (AH) and the severity of liver disease in patients with AH. We recruited patients with liver disease from a single tertiary care center. The study population was divided those with AH with cirrhosis (n=40) and those with cirrhosis with acute decompensation from etiologies other than alcohol (n=40); individuals without liver disease served as controls (n=43). We used SIFT-MS to identify and measure 14 volatile compounds in breath samples from fasted subjects. We used various statistical analyses to compare clinical characteristics and breath levels of compounds among groups, and test the correlation between levels of compounds and severity of liver disease. Logistic regression analysis was performed to build a predictive model for AH. We identified 6 compounds (2-propanol, acetaldehyde, acetone, ethanol, pentane and trimethylamine [TMA]) whose levels were increased in patients with liver disease compared with controls. Mean concentrations of TMA, acetone, and pentane were particularly high in breath samples from patients with AH, compared to those with acute decompensation or controls (for both, P<.001). Using receiver operating characteristic curve analysis, we developed a model for the diagnosis of AH based on breath levels of TMA, acetone, and pentane (TAP). TAP scores of 36 or higher identified the patients with AH (AUC=0.92), with 90% sensitivity and 80% specificity. The levels of exhaled TMA had a low level of correlation with the severity of AH based on model for end-stage liver disease score (r=0.38; 95% confidence interval, 0.07–0.69; P=.018]. Based on levels of volatile compounds in breath samples, we can identify patients with AH vs patients with acute decompensation or individuals without liver disease. Levels of exhaled TMA moderately correlate with the severity of AH. These findings might be used in diagnosis of AH or in determining patient prognosis.
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DOI：
10.1002/hep.23009
发表时间：
2009-08
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
作者：
Rao R
通讯作者：
Rao R
影响因子：
1.9
作者：
Mitchell, S;Ayesh, R;Smith, R
通讯作者：
Smith, R
影响因子：
4.3
作者：
Zhang, AQ;Mitchell, SC;Smith, RL
通讯作者：
Smith, RL
影响因子：
2
作者：
Prince, Barry J.;Milligan, Daniel B.;McEwan, Murray J.
通讯作者：
McEwan, Murray J.
磷脂酰胆碱的肠道菌群代谢促进心血管疾病。
影响因子：
64.8
作者：
Wang, Zeneng;Klipfell, Elizabeth;Bennett, Brian J.;Koeth, Robert;Levison, Bruce S.;Dugar, Brandon;Feldstein, Ariel E.;Britt, Earl B.;Fu, Xiaoming;Chung, Yoon-Mi;Wu, Yuping;Schauer, Phil;Smith, Jonathan D.;Allayee, Hooman;Tang, W. H. Wilson;DiDonato, Joseph A.;Lusis, Aldons J.;Hazen, Stanley L.
通讯作者：
Hazen, Stanley L.