Kim Mo-Jong, Kim Jung-Hee, Jung Jang-Han, Kim Sung-Eun, Kim Hyoung-Su, Jang Myoung-Kuk, Park Sang-Hoon, Lee Myung-Seok, Suk Ki Tae, Kim Dong Joon, Choi Eun-Kyoung, Park Ji-Won
Ilsong Institute of Life Science, Hallym University, Seoul 07247, Republic of Korea.
Department of Biomedical Gerontology, Graduate School of Hallym University, Chuncheon-si 24252, Republic of Korea.
Diagnostics (Basel). 2023 Jan 17;13(3):333. doi: 10.3390/diagnostics13030333.
Hepatic encephalopathy (HE) is one of the main complications of liver cirrhosis (LC) and is classified into minimal hepatic encephalopathy (MHE) and overt hepatic encephalopathy (overt HE). S100B is expressed mainly in astrocytes and other glial cells, and S100B has been reported to be associated with various neurological disorders. The present study aimed to investigate the diagnostic ability of serum S100B to discriminate the grade of HE and the parameters correlated with serum S100B levels. Additionally, we investigated whether serum S100B levels can be used to predict 1-year mortality in cirrhotic patients. In total, 95 cirrhotic patients were consecutively enrolled and divided into the following three groups: (i) without any types of HEs; (ii) with MHE; and (iii) with overt HE. The diagnosis of MHE was made by the Mini-Mental State Examination (MMSE) and Psychometric Hepatic Encephalopathy Score (PHES). Among the three groups, there were no significant differences in serum S100B levels regardless of HE severity. The clinical parameters correlated with serum S100B levels were age, serum bilirubin, and creatinine levels. The Model for End-Stage Liver Disease (MELD) score showed a significant positive correlation with serum S100B levels. The relationship between serum S100B levels and MELD score was maintained in 48 patients without any type of HE. Additionally, hyperammonemia, low cholesterol levels, and the combination of serum S100B levels ≥ 35 pg/mL with MELD score ≥ 13 were factors for predicting 1- year mortality. In conclusion, serum S100B level was not useful for differentiating the severity of HE. However, we found that serum S100B levels can be affected by age, serum bilirubin, and creatinine in cirrhotic patients and are associated with MELD scores. Additionally, serum S100B levels showed the possibility of predicting 1-year mortality in cirrhotic patients. These findings suggest that serum S100B levels may reflect liver dysfunction and prognosis in liver disease.
肝性脑病（HE）是肝硬化（LC）的主要并发症之一，可分为轻微肝性脑病（MHE）和显性肝性脑病（显性HE）。S100B主要在星形胶质细胞和其他神经胶质细胞中表达，据报道S100B与多种神经系统疾病有关。本研究旨在探讨血清S100B对鉴别HE分级的诊断能力以及与血清S100B水平相关的参数。此外，我们还研究了血清S100B水平是否可用于预测肝硬化患者的1年死亡率。总共连续纳入了95例肝硬化患者，并将其分为以下三组：（i）无任何类型的HE；（ii）患有MHE；（iii）患有显性HE。MHE的诊断通过简易精神状态检查表（MMSE）和心理测量肝性脑病评分（PHES）进行。在这三组中，无论HE的严重程度如何，血清S100B水平均无显著差异。与血清S100B水平相关的临床参数为年龄、血清胆红素和肌酐水平。终末期肝病模型（MELD）评分与血清S100B水平呈显著正相关。在48例无任何类型HE的患者中，血清S100B水平与MELD评分之间的关系依然存在。此外，高氨血症、低胆固醇水平以及血清S100B水平≥35 pg/mL与MELD评分≥13的组合是预测1年死亡率的因素。总之，血清S100B水平对区分HE的严重程度并无帮助。然而，我们发现肝硬化患者的血清S100B水平会受到年龄、血清胆红素和肌酐的影响，并且与MELD评分相关。此外，血清S100B水平显示出预测肝硬化患者1年死亡率的可能性。这些发现表明血清S100B水平可能反映了肝脏疾病中的肝功能障碍和预后情况。
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