P507 DIFFERENCES IN MINIMAL HEPATIC ENCEPHALOPATHY BETWEEN ALCOHOLIC COMPENSATED LIVER CIRRHOSIS AND VIRAL COMPENSATED LIVER CIRRHOSIS

Abstract

Background and Aims: Intestinal bacterial overgrowth (IBO) and bacterial translocation (BT) induce a marked proinflammatory activity in cirrhotic patients. The aim was to determine the correlation of serum lipopolysaccharide-binding protein (LBP) with severity of cirrhosis, presence of IBO, bacterial DNA in ascitic fluid (AF) and value of LBP in prediction of mortality. Methods: 42 cirrhotic patients were included in the prospective study. IBO was determined by hydrogen breath test (GASTROLYZER, Bedfont, UK). Bacterial DNA in AF were measured using polymerase chain reaction. LBP was measured by immunometric assay (ELISA Human LBP, Netherlands). The survival rate was evaluated during next forty-eight weeks. Statistical analyses were performed using SPSS 13.0. Results: LBP level increased with severity of cirrhosis according to Child–Pugh (p =0.001), it was higher in ascitic patients than in patients without ascites (p < 0.001). Patients with IBO showed greater (p = 0.001) LBP concentration than patients without IBO (15.74±12.56 versus 4.21±2.59mg/mL). Mean serum LBP level was higher in patients with BT (30.13±10.16mg/mL) in comparison with patients without BT (13.56±9.30mg/mL) (p = 0.005). Positive correlation was found between heart rate and LBP level and negative correlation between blood pressure and LBP level (p < 0.001). Using Cox-regression analysis LBP was found to be one of the risk factors of increased mortality during 48 weeks follow-up (p =0.009). Conclusions: Serum LBP elevation shows a significant correlation with severity of cirrhosis, ascites, presence of IBO and hemodynamic disorders. High LBP level is a reliable marker of BT and independent predictor of increased long-term mortality in cirrhotic patients.