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Sex-Specific Differences and a Predictive Model Based on Clinical and Biochemical Parameters for Minimal Hepatic
Juan José Gallego1,2, Franc Casanova-Ferrer1, Alessandra Fiorillo1
1INCLIVA Biomedical Research Institute, Valencia, Spain.
Sex influences minimal hepatic encephalopathy (MHE) in cirrhosis patients. Males show higher inflammation and oxidative stress. Sex-specific models improve MHE diagnosis, aiding early intervention for this early stage of hepatic encephalopathy.
Area of Science:
- Hepatology
- Neurology
- Biochemistry
Background:
- Minimal hepatic encephalopathy (MHE) affects 30-40% of cirrhosis patients, causing cognitive and motor deficits.
- MHE is the earliest stage of hepatic encephalopathy, a condition with severe consequences.
- Understanding sex differences in MHE can improve early diagnosis and treatment.
Purpose of the Study:
- To investigate the influence of sex on MHE.
- To develop sex-specific diagnostic methods for MHE using clinical and biochemical parameters.
Main Methods:
- Cross-sectional study of 612 cirrhotic patients and 167 controls.
- MHE classification using Psychometric Hepatic Encephalopathy Score.
- Collection of clinical, biochemical, cognitive, motor, ammonia, inflammatory, and oxidative stress data.
Main Results:
- Cognitive and motor impairments in MHE were similar between sexes.
- MHE males exhibited higher inflammation, oxidative stress, and liver disease severity markers than MHE females.
- Sex-specific multivariate models accurately predicted MHE risk (75%-81% specificity, 75%-79% sensitivity).
Conclusions:
- Sex is a significant factor in MHE development and progression.
- Incorporating sex into MHE diagnosis and treatment strategies is crucial.
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