Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2016, vol. 25, nr 1, January-February, p. 77–81

doi: 10.17219/acem/60878

Publication type: original article

Language: English

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13C-Methacetin Breath Testing in Patients with Non-Alcoholic Fatty Liver Disease

Radosław Kempiński1,A,B,C,D,E,F, Katarzyna Neubauer1,A,B,C,D,E,F, Szymon Wieczorek2,A,B,C,D,E,F, Robert Dudkowiak1,A,B,C,D,E,F, Maria Jasińska1,B, Elżbieta Poniewierka1,A,B,C,D,E,F

1 Department of Gastroenterology and Hepatology, Wroclaw Medical University, Poland

2 Department of Internal and Occupational Diseases and Hypertension, Wroclaw Medical University, Poland

Abstract

Background. Non-alcoholic fatty liver disease (NAFLD) is a very common chronic liver condition which may potentially develop into fibrosis and cirrhosis. Liver biopsy is still the gold standard for liver fibrosis detection in these patients. However, non-invasive tools for liver assessment in NAFLD patients, like the 13C-methacetin breath test, may be useful.
Objectives. The aim of the study was to evaluate the utility of the 13C-methacetin breath test in NAFLD patients, especially in predicting significant fibrosis.
Material and Methods. Thirty three patients (24 male and 9 female (average age 47.9)) with histologically proven NAFLD had the 13C-methacetin breath test performed.
Results. Different forms of NAFLD were found during the histology phase, from simple steatosis to advanced fibrosis. Simple steatosis (SS) was found in 18 subjects (54.5%), in another 15 (45.5%) signs of inflammation and fibrosis (NASH) were observed. However, more than half of the patients with liver fibrosis had only minimal changes described (0/1). The sensitivity of the test was highest for cumulative recovery after 10 min of the test and for a combination of two parameters (the cumulative recovery after 40 min and the time of maximal momentary recovery). The positive predictive value was low for all the parameters under consideration, but the negative predictive value was over 0.8 in significant fibrosis detection.
Conclusion. The 13C-methacetin breath test could be a promising noninvasive tool for excluding at least F1 fibrosis in NAFLD patients.

Key words

NAFLD, liver fibrosis, methacetin breath test

References (12)

  1. Vernon G, Baranova A, Younossi ZM: Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther 2011, 34, 274–285.
  2. Korey KE, Kaplan LM: Obesity and liver disease: the epidemic of the twenty-first century. Clin Liver Dis 2014, 18, 1–18.
  3. Argo CK, Northup PG, Al-Osaimi AM, Caldwell SH: Systematic review of risk factors for fibrosis progression in non-alcoholic steatohepatitis. J Hepatol 2009, 51, 371–379.
  4. Nalbantoglu I, Brunt EM: Role of liver biopsy in non-alcoholic fatty liver disease. World J Gastroenterol 2014, 20, 9026–9037.
  5. Chalasani N, Younossi Z, Lavine JE, Mae Diehl A, Brunt EM, Cusi K, Charlton M, Sanyal AJ: AASLD PRACTICE GUIDELINES The Diagnosis and Management of Non-Alcoholic Fatty Liver Disease: Practice Guidelines by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology 2012, 55, 2005–2023.
  6. Takahashi Y, Fukusato T: Histopathology of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis. World J Gastroenterol 2014, 20, 15539–15548.
  7. Piccinino F, Sagnelli E, Pasquale G, Giusti G: Complications following percutaneous liver biopsy. A multicentre retrospective study on 68, 276 biopsies. J Hepatol 1986, 2, 165–173.
  8. Fierbinteanu-Braticevici C, Plesca DA, Tribus L, Panaitescu E, Braticevici B: The role of 13C-methacetin breath test for non-invasive evaluation of non-alcoholic fatty liver disease. J Gastrointestin Liver Dis 2013, 22, 149–156.
  9. Portincasa P, Grattagliano I, Lauterburg BH, Palmieri VO, Palasciano G, Stellaard F: Liver breath tests non-invasively predict higher stages of non-alcoholic steatohepatitis. Clin Sci 2006, 111, 135–143.
  10. Braden B, Faust D, Sarrazin U: 13C-methacetin breath test as liver function test in patients with chronic hepatitis C virus infection. Aliment Pharmacol Ther 2005, 21, 179–185.
  11. Kochel-Jankowska A, Hartleb M, Jonderko K, Kaminska M, Kasicka-Jonderko A: 13C-methacetin breath test correlates with clinical indices of liver disease severity in patients with primary biliary cirrhosis. J Physiol Pharmacol 2013, 64, 27–33.
  12. Petrolati A, Festi D, De Berardinis G: 13C-methacetin breath test for monitoring hepatic function in cirrhotic patients before and after liver transplantation. Aliment Pharmacol Ther 2003, 18, 785–790.
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