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- Title
Metabolomics as a diagnostic tool for idiopathic non-cirrhotic portal hypertension.
- Authors
Seijo, Susana; Lozano, Juan Jose; Alonso, Cristina; Miquel, Rosa; Berzigotti, Annalisa; Reverter, Enric; Turon, Fanny; Martínez ‐ Chantar, Mari Luz; Castro, Azucena; Mato, Jose M.; Hernández ‐ Gea, Virginia; Bosch, Jaume; García ‐ Pagán, Juan Carlos
- Abstract
Background Idiopathic non-cirrhotic portal hypertension ( INCPH) is a rare life-threatening liver disease that lacks a specific diagnostic test being frequently misdiagnosed as cryptogenic cirrhosis. Preliminary data from our group identified a plasma metabolomic profile able to differentiate INCPH from patients with cirrhosis ( CH) and healthy volunteers ( HV). However, the untargeted methodology applied was unable to identify all the specific metabolites, hampering the possibility of building-up diagnostic models. This study applies a wide-coverage of previously identified metabolites through a high-throughput metabolomics technology, evaluating if there is a metabolomic profile that allows a non-invasive diagnosis of INCPH. Methods We included 34 patients with INCPH, 34 with CH and 34 HV. We performed a targeted metabolomic analysis of serum samples using UPLC- MS. The best combination of a set of specific metabolites was obtained using stepwise logistic regression ( LR) and recursive partitioning analysis ( RPA). Results After internal cross-validation, LR analysis identified a subset of 5-metabolites that clearly differentiate INCPH patients from CH and HV (average corrected optimism AUROC = 0.8871 [0.838-0.924]). Using high and low cut-off values the model has an excellent capacity to respectively diagnose or exclude INCPH. The RPA analysis strategy used the 3-metabolites signature differentiating INCPH from CH and the 2-metabolites signature differentiating INCPH from HV. A decision tree applying sequentially these metabolic profiles diagnosed 88% of INCPH patients. Conclusions Different metabolomic profiles allow the diagnosis of INCPH with high specificity and sensibility and may represent excellent clinical tools for its diagnosis avoiding multiple and invasive tests.
- Subjects
METABOLOMICS; PORTAL hypertension; LIVER diseases; CIRRHOSIS of the liver; METABOLITES; LOGISTIC regression analysis
- Publication
Liver International, 2016, Vol 36, Issue 7, p1051
- ISSN
1478-3223
- Publication type
Article
- DOI
10.1111/liv.12972