| Autor: |
Laghi L; Department of Agricultural and Food Sciences, University of Bologna, 47521 Cesena, Italy., Ortiz MÀ; Institut de Recerca Sant Pau (IR Sant Pau), 08041 Barcelona, Spain., Rossi G; School of Veterinary Medical Sciences, University of Camerino, 62032 Camerino, Italy., Román E; CIBERehd (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas), Instituto de Salud Carlos III, 28029 Madrid, Spain.; University Nursing School EUI-Sant Pau, 08025 Barcelona, Spain.; Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain., Mengucci C; Department of Agricultural and Food Sciences, University of Bologna, 47521 Cesena, Italy., Cantó E; Institut de Recerca Sant Pau (IR Sant Pau), 08041 Barcelona, Spain., Biagini L; School of Veterinary Medical Sciences, University of Camerino, 62032 Camerino, Italy., Sánchez E; Institut de Recerca Sant Pau (IR Sant Pau), 08041 Barcelona, Spain.; CIBERehd (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas), Instituto de Salud Carlos III, 28029 Madrid, Spain., Mulet M; Institut de Recerca Sant Pau (IR Sant Pau), 08041 Barcelona, Spain., García-Osuna Á; Department of Biochemistry, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain., Urgell E; Department of Biochemistry, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain., Kaur N; Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain., Poca M; CIBERehd (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas), Instituto de Salud Carlos III, 28029 Madrid, Spain.; Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain., Padrós J; Department of Physical Medicine and Rehabilitation, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain., Nadal MJ; Department of Physical Medicine and Rehabilitation, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain., Cuyàs B; CIBERehd (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas), Instituto de Salud Carlos III, 28029 Madrid, Spain.; Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain., Alvarado E; CIBERehd (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas), Instituto de Salud Carlos III, 28029 Madrid, Spain.; Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain., Vidal S; Institut de Recerca Sant Pau (IR Sant Pau), 08041 Barcelona, Spain.; Department of Cellular Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain., Juanes E; Department of Pharmacy, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain., Ferrero-Gregori A; Institut de Recerca Sant Pau (IR Sant Pau), 08041 Barcelona, Spain., Escorsell À; Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain.; Faculty of Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain., Soriano G; CIBERehd (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas), Instituto de Salud Carlos III, 28029 Madrid, Spain.; Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain.; Faculty of Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain. |
| Abstrakt: |
Frailty in cirrhosis or advanced chronic liver disease (ACLD) is a relevant prognostic factor. In the present study, we aimed to analyze potential biomarkers associated with frailty and its improvement in patients with ACLD. We analyzed the serum of outpatients with ACLD who participated in a previous study (Román, Hepatol Commun 2024) in which frailty was assessed using the liver frailty index (LFI), and patients who were frail or prefrail were randomized to a multifactorial intervention (home exercise, branched-chain amino acids, and probiotics) or control for 12 months. We determined a biomarker battery of inflammation, bacterial translocation, and liver damage in blood and urine and blood metabolomics by 1 H-NMR. Thirty-seven patients were included. According to the LFI, 32 patients were frail or prefrail, and 5 were robust. At baseline, LFI correlated with LBP, sCD163, mtDNA, FGF-21, urinary NGAL, urinary claudin-3, and the metabolites mannose, ethanol, and isoleucine. During the study, patients in the intervention group showed an improvement in LFI and a decrease in CRP, LBP, sCD163, and ccK18 compared to the control group. Metabolomics showed a decrease in dimethyl sulfone and creatinine and an increase in malonate, ornithine, isoleucine, and valine in the intervention group. We conclude that frailty in patients with ACLD is associated with biomarkers of systemic inflammation, bacterial translocation, and liver damage, and alterations of amino acid and short-chain fatty acid metabolism. |
