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  3. Sex-Specific Differences and a Predictive Model Based on Clinical and Biochemical Parameters for Minimal Hepatic Encephalopathy.

Sex-Specific Differences and a Predictive Model Based on Clinical and Biochemical Parameters for Minimal Hepatic Encephalopathy.

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Gallego JJ
  • Casanova-Ferrer F
  • Fiorillo A
  • Benlloch S
  • Urios A
  • López-Gramaje A
  • Oliver-Ferrándiz M
  • Durbán L
  • Ríos MP
  • San-Miguel T
  • Megías J
  • Escudero-García D
  • Kosenko E
  • Montoliu C

Grupos

Abstract

BACKGROUND AND AIMS: Minimal hepatic encephalopathy (MHE) affects 30%-40% of cirrhotic patients, showing cognitive and motor impairment, and affecting quality of life. MHE represents the earliest stage of hepatic encephalopathy, a condition with severe consequences. Assessing MHE from different perspectives, such as sex differences, can enhance early diagnosis and treatment, potentially preventing its progression to hepatic encephalopathy. We aimed to investigate the influence of sex on MHE and to develop a more precise diagnostic method based on clinical and biochemical parameters, taking sex differences into account. METHODS: A cross-sectional study was conducted in 612 cirrhotic patients and 167 controls (82/85 females/males). Patients were classified as without MHE (101/343 females/males) or with MHE (48/120 females/males) by Psychometric Hepatic Encephalopathy Score. Clinical and biochemical data were collected, along with cognitive and motor assessments, and blood samples to measure ammonia levels and inflammatory and oxidative stress parameters. RESULTS: While cognitive and motor impairment associated with MHE was similar in both sexes, inflammatory, biochemical, and oxidative stress parameters differed between females and males with MHE. MHE males showed higher levels of inflammation, oxidative stress, and biochemical markers of liver disease severity than MHE females. Based on clinical and biochemical data, a multivariate model was developed for each sex, capable of effectively predicting the risk of having MHE with sensitivities of 79.2%-75% and specificities of 81.2%-75.9% for females and males, respectively. CONCLUSION: Sex is an important factor in the onset and progression of MHE and should be considered in diagnosis and treatment.

© 2025 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Datos de la publicación

ISSN/ISSNe:
1478-3223, 1478-3231

LIVER INTERNATIONAL  WILEY

Tipo:
Article
Páginas:
-
PubMed:
41255242
Factor de Impacto:
2,064 SCImago ℠
Cuartil:
Q1 SCImago ℠

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Keywords

  • early diagnosis; inflammation; minimal hepatic encephalopathy; oxidative stress; sex difference

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