Published online May 7, 2016. doi: 10.3748/wjg.v22.i17.4397
Peer-review started: January 30, 2016
First decision: February 18, 2016
Revised: March 3, 2016
Accepted: March 18, 2016
Article in press: March 18, 2016
Published online: May 7, 2016
AIM: To evaluate the association between serum concentrations of S100β in patients with cirrhosis and the presence of low grade hepatic encephalopathy (HE).
METHODS: This was a cross-sectional study. The population was categorized into four groups healthy subjects, cirrhosis without HE, cirrhosis with covert hepatic encephalopathy (CHE) and cirrhosis with overt HE. Kruskal-Wallis, Mann Whitney’s U with Bonferroni adjustment Spearman correlations and area under the ROC were used as appropriate.
RESULTS: A total of 61 subjects were included, 46 cirrhotic patients and 15 healthy volunteers. S100β values were different among all groups, and differences remained significant between groups 1 and 2 (P < 0.001), and also between groups 2 and 3 (P = 0.016), but not between groups 3 and 4. In cirrhotic patients with HE S100β was higher than in patients without HE [0.18 (0.14-0.28) ng/mL vs 0.11 (0.06-0.14) ng/mL, P < 0.001]. There was a close correlation between serum concentrations of S100β and psychometric hepatic encephalopathy score in patients with cirrhosis without HE compared to the patients with cirrhosis with CHE (r = -0.413, P = 0.019). ROC curve analysis yielded > 0.13 ng/mL as the best cutoff value of S100β for the diagnosis of HE (sensitivity 83.3%, specificity 63.6%).
CONCLUSION: Serum concentrations of S100β are higher in patients with cirrhosis than in healthy volunteers, and are further increased in the presence of hepatic encephalopathy. The results suggest that serum biomarkers such as S100β could help in the correct characterization of incipient stages of HE.
Core tip: Hepatic encephalopathy is a complication present in 30%-80% of the patients with cirrhosis and it is associated with increased mortality, adverse clinical outcomes, and poor quality of life. An increased concern about early recognition of this complication has risen in recent years; however, no biochemical marker is available to date. In this paper we evaluated the performance of S100β as a biochemical marker to identify the early stages of HE, and its correlation with neuropsychometric tests.