Assessing Non-Invasive Liver Function in Patients with Intestinal Failure Receiving Total Parenteral Nutrition—Results from the Prospective PNLiver Trial
<b>A</b><b>bstract:</b><b> </b>Liver abnormalities in intestinal failure (IF) patients receiving parenteral nutrition (PN) can progress undetected by standard laboratory tests to intestinal failure associated liver disease (IFALD). The aim of this longitudinal stu...
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Format: | Article |
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MDPI AG
2020-04-01
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Series: | Nutrients |
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Online Access: | https://www.mdpi.com/2072-6643/12/5/1217 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Elisabeth Blüthner Ulrich-Frank Pape Martin Stockmann Mirjam Karber Sebastian Maasberg Sophie Pevny Undine Gerlach-Runge Andreas Pascher Johann Pratschke Frank Tacke Jan Bednarsch |
spellingShingle |
Elisabeth Blüthner Ulrich-Frank Pape Martin Stockmann Mirjam Karber Sebastian Maasberg Sophie Pevny Undine Gerlach-Runge Andreas Pascher Johann Pratschke Frank Tacke Jan Bednarsch Assessing Non-Invasive Liver Function in Patients with Intestinal Failure Receiving Total Parenteral Nutrition—Results from the Prospective PNLiver Trial Nutrients Intestinal failure intestinal failure associated liver disease parenteral nutrition LiMAx test ICG test FibroScan |
author_facet |
Elisabeth Blüthner Ulrich-Frank Pape Martin Stockmann Mirjam Karber Sebastian Maasberg Sophie Pevny Undine Gerlach-Runge Andreas Pascher Johann Pratschke Frank Tacke Jan Bednarsch |
author_sort |
Elisabeth Blüthner |
title |
Assessing Non-Invasive Liver Function in Patients with Intestinal Failure Receiving Total Parenteral Nutrition—Results from the Prospective PNLiver Trial |
title_short |
Assessing Non-Invasive Liver Function in Patients with Intestinal Failure Receiving Total Parenteral Nutrition—Results from the Prospective PNLiver Trial |
title_full |
Assessing Non-Invasive Liver Function in Patients with Intestinal Failure Receiving Total Parenteral Nutrition—Results from the Prospective PNLiver Trial |
title_fullStr |
Assessing Non-Invasive Liver Function in Patients with Intestinal Failure Receiving Total Parenteral Nutrition—Results from the Prospective PNLiver Trial |
title_full_unstemmed |
Assessing Non-Invasive Liver Function in Patients with Intestinal Failure Receiving Total Parenteral Nutrition—Results from the Prospective PNLiver Trial |
title_sort |
assessing non-invasive liver function in patients with intestinal failure receiving total parenteral nutrition—results from the prospective pnliver trial |
publisher |
MDPI AG |
series |
Nutrients |
issn |
2072-6643 |
publishDate |
2020-04-01 |
description |
<b>A</b><b>bstract:</b><b> </b>Liver abnormalities in intestinal failure (IF) patients receiving parenteral nutrition (PN) can progress undetected by standard laboratory tests to intestinal failure associated liver disease (IFALD). The aim of this longitudinal study is to evaluate the ability of non-invasive liver function tests to assess liver function following the initiation of PN. Twenty adult patients with IF were prospectively included at PN initiation and received scheduled follow-up assessments after 6, 12, and 24 months between 2014 and 2019. Each visit included liver assessment (LiMAx [Liver Maximum Capacity] test, ICG [indocyanine green] test, FibroScan), laboratory tests (standard laboratory test, NAFLD [non-alcoholic fatty liver disease] score, FIB–4 [fibrosis-4] score), nutritional status (bioelectrical impedance analysis, indirect calorimetry), and quality of life assessment. The patients were categorized post-hoc based on their continuous need for PN into a reduced parenteral nutrition (RPN) group and a stable parenteral nutrition (SPN) group. While the SPN group (<i>n</i> = 9) had significantly shorter small bowel length and poorer nutritional status at baseline compared to the RPN group (<i>n</i><i> </i>= 11), no difference in liver function was observed between the distinct groups. Over time, liver function determined by LiMAx did continuously decrease from baseline to 24 months in the SPN group but remained stable in the RPN group. This decrease in liver function assessed with LiMAx in the SPN group preceded deterioration of all other investigated liver function tests during the study period. Our results suggest that the liver function over time is primarily determined by the degree of intestinal failure. Furthermore, the LiMAx test appeared more sensitive in detecting early changes in liver function in comparison to other liver function tests. |
topic |
Intestinal failure intestinal failure associated liver disease parenteral nutrition LiMAx test ICG test FibroScan |
url |
https://www.mdpi.com/2072-6643/12/5/1217 |
work_keys_str_mv |
AT elisabethbluthner assessingnoninvasiveliverfunctioninpatientswithintestinalfailurereceivingtotalparenteralnutritionresultsfromtheprospectivepnlivertrial AT ulrichfrankpape assessingnoninvasiveliverfunctioninpatientswithintestinalfailurereceivingtotalparenteralnutritionresultsfromtheprospectivepnlivertrial AT martinstockmann assessingnoninvasiveliverfunctioninpatientswithintestinalfailurereceivingtotalparenteralnutritionresultsfromtheprospectivepnlivertrial AT mirjamkarber assessingnoninvasiveliverfunctioninpatientswithintestinalfailurereceivingtotalparenteralnutritionresultsfromtheprospectivepnlivertrial AT sebastianmaasberg assessingnoninvasiveliverfunctioninpatientswithintestinalfailurereceivingtotalparenteralnutritionresultsfromtheprospectivepnlivertrial AT sophiepevny assessingnoninvasiveliverfunctioninpatientswithintestinalfailurereceivingtotalparenteralnutritionresultsfromtheprospectivepnlivertrial AT undinegerlachrunge assessingnoninvasiveliverfunctioninpatientswithintestinalfailurereceivingtotalparenteralnutritionresultsfromtheprospectivepnlivertrial AT andreaspascher assessingnoninvasiveliverfunctioninpatientswithintestinalfailurereceivingtotalparenteralnutritionresultsfromtheprospectivepnlivertrial AT johannpratschke assessingnoninvasiveliverfunctioninpatientswithintestinalfailurereceivingtotalparenteralnutritionresultsfromtheprospectivepnlivertrial AT franktacke assessingnoninvasiveliverfunctioninpatientswithintestinalfailurereceivingtotalparenteralnutritionresultsfromtheprospectivepnlivertrial AT janbednarsch assessingnoninvasiveliverfunctioninpatientswithintestinalfailurereceivingtotalparenteralnutritionresultsfromtheprospectivepnlivertrial |
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doaj-cddd6273a3a7421d8ef930871a2840602020-11-25T03:54:56ZengMDPI AGNutrients2072-66432020-04-01121217121710.3390/nu12051217Assessing Non-Invasive Liver Function in Patients with Intestinal Failure Receiving Total Parenteral Nutrition—Results from the Prospective PNLiver TrialElisabeth Blüthner0Ulrich-Frank Pape1Martin Stockmann2Mirjam Karber3Sebastian Maasberg4Sophie Pevny5Undine Gerlach-Runge6Andreas Pascher7Johann Pratschke8Frank Tacke9Jan Bednarsch10Department of Gastroenterology and Hepatology, Campus Virchow-Klinikum and Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, GermanyDepartment of Internal Medicine and Gastroenterology | Asklepios Klinik St. Georg, Asklepios Medical School, Lohmühlenstr. 5, 20099 Hamburg, GermanyDepartment of Surgery, Campus Virchow-Klinikum and Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyBerlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178 Berlin, GermanyDepartment of Internal Medicine and Gastroenterology | Asklepios Klinik St. Georg, Asklepios Medical School, Lohmühlenstr. 5, 20099 Hamburg, GermanyDepartment of Gastroenterology and Hepatology, Campus Virchow-Klinikum and Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, GermanyDepartment of Surgery, Campus Virchow-Klinikum and Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of General, Visceral and Transplantation Surgery, Münster University Hospital, Albert-Schweitzer-Campus 1, 48149 Münster, GermanyDepartment of Surgery, Campus Virchow-Klinikum and Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Gastroenterology and Hepatology, Campus Virchow-Klinikum and Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, GermanyDepartment of Surgery, Campus Virchow-Klinikum and Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany<b>A</b><b>bstract:</b><b> </b>Liver abnormalities in intestinal failure (IF) patients receiving parenteral nutrition (PN) can progress undetected by standard laboratory tests to intestinal failure associated liver disease (IFALD). The aim of this longitudinal study is to evaluate the ability of non-invasive liver function tests to assess liver function following the initiation of PN. Twenty adult patients with IF were prospectively included at PN initiation and received scheduled follow-up assessments after 6, 12, and 24 months between 2014 and 2019. Each visit included liver assessment (LiMAx [Liver Maximum Capacity] test, ICG [indocyanine green] test, FibroScan), laboratory tests (standard laboratory test, NAFLD [non-alcoholic fatty liver disease] score, FIB–4 [fibrosis-4] score), nutritional status (bioelectrical impedance analysis, indirect calorimetry), and quality of life assessment. The patients were categorized post-hoc based on their continuous need for PN into a reduced parenteral nutrition (RPN) group and a stable parenteral nutrition (SPN) group. While the SPN group (<i>n</i> = 9) had significantly shorter small bowel length and poorer nutritional status at baseline compared to the RPN group (<i>n</i><i> </i>= 11), no difference in liver function was observed between the distinct groups. Over time, liver function determined by LiMAx did continuously decrease from baseline to 24 months in the SPN group but remained stable in the RPN group. This decrease in liver function assessed with LiMAx in the SPN group preceded deterioration of all other investigated liver function tests during the study period. Our results suggest that the liver function over time is primarily determined by the degree of intestinal failure. Furthermore, the LiMAx test appeared more sensitive in detecting early changes in liver function in comparison to other liver function tests.https://www.mdpi.com/2072-6643/12/5/1217Intestinal failureintestinal failure associated liver diseaseparenteral nutritionLiMAx testICG testFibroScan |