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Abstract
Increased intestinal permeability and endotoxemia have been implicated in pathogenesis, progression and development of complications of liver cirrhosis (LC). No study has thus far been reported in Korea on the assessment of intestinal permeability using polyethylene glycol (PEG). The aim of this study was to determine whether intestinal permeability is altered in LC and correlated with clinical characteristics. 65 patients with LC and 26 healthy control subjects were studied. The intestinal permeability value is expressed as the percentage of retrieved PEG 400 and 3350 that had been orally administered in 8-hr urine samples as determined by high performance liquid chromatography. The causes of liver cirrhosis were alcohol (n=38), virus (HBV 17, HCV 9) (n= 26) and alcohol combined with HBV (n=1). Mean values for PEG 400 and 3350 retrieval were 46.5±3.22 and 0.24±0.03 in controls, 44.1±5.17 and 0.21±0.02 in LC without ascites, and 37.4±3.55 and 0.29±0.04 in LC with ascites, respectively. Intestinal permeability index (IPI) was significantly higher in LC with ascites than in healthy controls or LC without ascites (0.84±0.21 vs. 0.52±0.05 or 0.54±0.04, p<0.05). A sub-analysis relating intestinal permeability to the Child-Pugh class of LC showed significant differences between class A , B and C for PEG 3350 and IPI (p<0.05). According to sub-analysis relating IPI to the presence of encephalopathy, hypoalbuminemia of LC, there were significant differences (p<0.05), but not for patients as indicated by prolonged prothrombin time, esophageal varix or hyperbilirubinemia. The present study suggests that increased intestinal permeability is probably of importance in the pathophysiology and progression of liver cirrhosis with ascites.
Figures and Tables
Table 1
Demographics and characteristics of the subjects
*viral etiology-cirrhosis with ascites (HBV-7, HCV-4), cirrhosis without ascites (HBV-10, HCV-5); †viral etiology-HBV-1; ‡Others:pneumonia, one; pulmonary tuberculosis, one; §Different letters denote significant difference by post hoc of Scheffe (p〈.05); ll significantly different at p〈.01; ¶significantly different at p〈.001. SBP, spontaneous bacterial peritonitis; UTI, urinary tract infection.
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