Assessing Non-Invasive Liver Function in Patients with Intestinal Failure Receiving Total Parenteral Nutrition—Results from the Prospective PNLiver Trial
| Autor: | Blüthner, Elisabeth, Pape, Ulrich-Frank, Stockmann, Martin, Karber, Mirjam, Maasberg, Sebastian, Pevny, Sophie, Gerlach-Runge, Undine, Pascher, Andreas, Pratschke, Johann, Tacke, Frank, Bednarsch, Jan |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Time Factors Nutritional Status parenteral nutrition lcsh:TX341-641 Article Liver Function Tests Malabsorption Syndromes Intestine Small Humans Longitudinal Studies Prospective Studies Aged FibroScan Liver Diseases ICG test Middle Aged Intestinal failure Intestinal Diseases Liver Quality of Life Female Parenteral Nutrition Total intestinal failure associated liver disease LiMAx test lcsh:Nutrition. Foods and food supply 600 Technik Medizin angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit Follow-Up Studies |
| Zdroj: | Nutrients, Vol 12, Iss 1217, p 1217 (2020) Nutrients |
| ISSN: | 2072-6643 |
| Popis: | Liver abnormalities in intestinal failure (IF) patients receiving parenteral nutrition (PN) can progress undetected by standard laboratory tests to intestinal failure associated liver disease (IFALD). The aim of this longitudinal study is to evaluate the ability of non-invasive liver function tests to assess liver function following the initiation of PN. Twenty adult patients with IF were prospectively included at PN initiation and received scheduled follow-up assessments after 6, 12, and 24 months between 2014 and 2019. Each visit included liver assessment (LiMAx [Liver Maximum Capacity] test, ICG [indocyanine green] test, FibroScan), laboratory tests (standard laboratory test, NAFLD [non-alcoholic fatty liver disease] score, FIB–4 [fibrosis-4] score), nutritional status (bioelectrical impedance analysis, indirect calorimetry), and quality of life assessment. The patients were categorized post-hoc based on their continuous need for PN into a reduced parenteral nutrition (RPN) group and a stable parenteral nutrition (SPN) group. While the SPN group (n = 9) had significantly shorter small bowel length and poorer nutritional status at baseline compared to the RPN group (n = 11), no difference in liver function was observed between the distinct groups. Over time, liver function determined by LiMAx did continuously decrease from baseline to 24 months in the SPN group but remained stable in the RPN group. This decrease in liver function assessed with LiMAx in the SPN group preceded deterioration of all other investigated liver function tests during the study period. Our results suggest that the liver function over time is primarily determined by the degree of intestinal failure. Furthermore, the LiMAx test appeared more sensitive in detecting early changes in liver function in comparison to other liver function tests. |
| Databáze: | OpenAIRE |
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