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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jun 28, 2015; 7(12): 1701-1707
Published online Jun 28, 2015. doi: 10.4254/wjh.v7.i12.1701
Published online Jun 28, 2015. doi: 10.4254/wjh.v7.i12.1701
1H nuclear magnetic resonance spectroscopy-based metabonomic study in patients with cirrhosis and hepatic encephalopathy
Konstantinos John Dabos, John Nicholas Plevris, Peter Clive Hayes, Centre of Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, Scotland, United Kingdom
John Andrew Parkinson, Department of Chemistry, University of Strathclyde, Glasgow G1 1XW, United Kingdom
Ian Howard Sadler, Department of Chemistry, University of Edinburgh, Edinburgh EH16 4SA, Scotland, United Kingdom
Author contributions: Plevris JN and Hayes PC conceived the study; Dabos KJ and Plevris JN designed the study; Dabos KJ and Parkinson JA performed the data collection; Sadler IH helped with the data collection; Dabos KJ wrote the manuscript; all authors critically reviewed the manuscript and approved it.
Ethics approval: The study was reviewed and approved by the Lothian Research Ethics Committee Institutional Review Board.
Clinical trial registration: As this trial recruited before 1999 it was not registered with a clinical trials registry.
Informed consent: All study participants or their next of kin provided written informed consent prior to study enrolment.
Conflict-of-interest: The authors do not disclose any conflicts of interest.
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Konstantinos John Dabos, MD, PhD, Centre of Liver and Digestive Disorders, Royal Infirmary of Edinburgh, 49 Little France Crescent, Edinburgh EH16 4SA, Scotland, United Kingdom. konstantinos.dabos@nhslothian.scot.nhs.uk
Telephone: +44-131-2421627
Received: March 12, 2015
Peer-review started: March 12, 2015
First decision: April 10, 2015
Revised: May 9, 2015
Accepted: June 4, 2015
Article in press: June 8, 2015
Published online: June 28, 2015
Processing time: 109 Days and 16.7 Hours
Peer-review started: March 12, 2015
First decision: April 10, 2015
Revised: May 9, 2015
Accepted: June 4, 2015
Article in press: June 8, 2015
Published online: June 28, 2015
Processing time: 109 Days and 16.7 Hours
Core Tip
Core tip: Few studies have approached the metabolic abnormalities of liver cirrhosis and its complication hepatic encephalopathy. This study provides evidence that in stable cirrhosis key metabolic pathways are impaired and confirms the fact that there is impaired gluconeogensis, impaired ketogensis and ketone bodies break down as well as impaired urea cycle. In encephalopathy there is a reversal in the pattern of branch chain amino acids concentrations towards normal. By using stepwise discriminating analysis we were able to separate with remarkable accuracy metabolic phenotypes of cirrhotic patients from controls and also those who suffered from encephalopathy from those cirrhotics who did not.