Dual-sugar tests of small intestinal permeability are poor predictors of bacterial infections and mortality in cirrhosis: A prospective study

Figure 1 Intestinal permeability is impaired in cirrhosis and correlates with severity. A: Boxplots (according to Tukey’s definition with outliers) of the intestinal permeability (IP) index as determined by the lactulose/mannitol ratio in healthy controls and in patients with cirrhosis stratified for Child-Pugh stage; B: Scatter dot and non-parametric correlation (Spearman’s rho and P value) of IP index with MELD score.

Figure 2 Correlation of intestinal permeability index with surrogates of inflammation and enterocyte mass. Scatter dot plots of the intestinal permeability (IP) index in cirrhotic patients with serum concentrations of (A) lipopolysaccharide-binding protein (LBP), (B) Interleukin-6 (IL-6) and (C) intestinal fatty acid binding protein (I-FABP). Spearman’s rho and P value for the non-parametric correlation are indicated.

Figure 3 Cumulative incidence of bacterial infections. Kaplan-Meier curves displaying (A) the cumulative incidence of spontaneous bacterial peritonitis (SBP) (censored at transplant or death; event at date of SBP) and (B) the cumulative incidence of bacterial or fungal infections (censored at transplant or death; event at hospitalization with infection) according to the intestinal permeability (IP) index at baseline stratified by tertiles [lowest tertile: T1 (< 0.111), median tertile: T2 (0.111-0.226), highest tertile: T3 (> 0.226)]. Log-rank test for linear trends (T1 to T3) over strata is indicated.

Figure 4 Survival and event-free survival. Kaplan-Meier curves of (A) cumulative survival (censored at transplant; event at death), (B) transplant-free survival (events at death or transplants) and (C) infection-free survival (censored at transplant; events at hospitalization with infection or death) according to intestinal permeability (IP) index at baseline stratified by tertiles [lowest tertile: T1 (< 0.111), median tertile: T2 (0.111-0.226), highest tertile: T3 (> 0.226)]. Log-rank test for linear trends (T1 to T3) over strata is indicated.