Liver function assessment with three (13)C breath tests by two-point measurements

Area of Science:

• Hepatology
• Medical Diagnostics
• Biochemistry

Background:

• Chronic liver disease diagnosis relies on invasive methods and biochemical markers with limitations.
• Non-invasive diagnostic tools are crucial for early detection and management of liver fibrosis and cirrhosis.
• Breath tests utilizing stable isotopes offer a promising non-invasive approach to assess liver function.

Purpose of the Study:

• To determine optimal expired air collection times for three (13)C breath tests in diagnosing chronic liver disease.
• To evaluate the diagnostic accuracy of these breath tests for liver dysfunction, cirrhosis, and fibrosis grading.
• To compare breath test results with routine biochemical tests and the Child-Pugh score.

Main Methods:

• Three (13)C breath tests were administered: l-[1-(13)C]phenylalanine breath test (PBT), l-[1-(13)C]methionine breath test, and [(13)C]methacetin breath test (MethaBT).
• Participants included 61 healthy controls, 98 chronic hepatitis patients, and 91 liver cirrhosis patients.
• Breath test results were analyzed for correlations with biochemical markers and the Child-Pugh score.

Main Results:

• The PBT at 30 minutes (PBT30) demonstrated diagnostic accuracy for liver cirrhosis comparable to the MethaBT at 15 minutes (Metha15).
• Both PBT30 and Metha15 showed significant correlations with the grade of liver fibrosis.
• Two-point measurements using PBT30 and Metha15 were effective for assessing liver function.

Conclusions:

• The PBT30 and Metha15 are recommended for diagnosing liver cirrhosis and assessing liver fibrosis.
• These specific time points for PBT and MethaBT provide reliable data for liver function assessment.
• Utilizing optimal timing in (13)C breath tests enhances their utility in managing chronic liver disease.