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Association Between Laboratory Values and Covert Hepatic Encephalopathy in Patients with Liver Cirrhosis: A

Kaori Koyano1, Masanori Atsukawa1, Akihito Tsubota2

  • 1Division of Gastroenterology and Hepatology, Nippon Medical School, Tokyo 113-8602, Japan.

Journal of Clinical Medicine
|March 27, 2025
PubMed

Insights

Low vitamin D3 and albumin levels, along with esophageal varices, are linked to covert hepatic encephalopathy (CHE) in cirrhosis patients. Early detection is crucial for those with these risk factors.

Area of Science:

  • Hepatology
  • Neurology
  • Clinical Diagnostics

Background:

  • Increasing need for covert hepatic encephalopathy (CHE) diagnosis in cirrhosis patients.
  • Identification of novel factors associated with CHE is crucial for clinical practice.

Purpose of the Study:

  • To identify novel clinical factors associated with covert hepatic encephalopathy (CHE) in patients with cirrhosis.
  • To investigate the association of vitamin D3, albumin, and esophageal varices with CHE.

Main Methods:

  • Retrospective study of 402 cirrhosis patients across 17 institutions.
  • Diagnosis of CHE using the Stroop test.
  • Multivariate analysis to identify independent risk factors.

Main Results:

  • Low 25-hydroxyvitamin D3 (25(OH)D3) and esophageal varices (EV) were independent risk factors for CHE.
  • Low albumin and low 25(OH)D3 were independent laboratory factors for CHE.
  • Optimal cut-off values: albumin 3.7 g/dL, 25(OH)D3 16.5 ng/mL. CHE prevalence increased with lower 25(OH)D3 levels.

Conclusions:

  • Low 25(OH)D3 and albumin levels, and EV are positively associated with CHE in cirrhosis.
  • Decreased 25(OH)D3 levels correlate with increased CHE prevalence.
  • Patients with these risk factors require careful examination for CHE.

Keywords:
25(OH)D3Stroop testcovert hepatic encephalopathyliver cirrhosis

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