Brain-derived neurotrophic factor as a potential diagnostic marker in minimal hepatic encephalopathy

Agnieszka Stawicka; Magdalena Świderska; Justyna Zbrzeźniak; Natalia Sołowianowicz; Aleksandra Woszczenko; Robert Flisiak; Jerzy Jaroszewicz

doi:10.5114/ceh.2021.103242

eISSN: 2449-8238
ISSN: 2392-1099

Clinical and Experimental Hepatology

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abstract:

Original paper

Brain-derived neurotrophic factor as a potential diagnostic marker in minimal hepatic encephalopathy

Agnieszka Stawicka

¹

,

Magdalena Świderska

²

,

Justyna Zbrzeźniak

¹

,

Natalia Sołowianowicz

¹

,

Aleksandra Woszczenko

¹

,

Robert Flisiak

¹

,

Jerzy Jaroszewicz

^{1, 3}

Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland
Department of Physiology, Medical University of Bialystok, Bialystok, Poland
Department of Infectious Diseases and Hepatology, Medical University of Silesia, Katowice, Poland

Clin Exp HEPATOL 2021; 7, 1: 117-124

DOI: https://doi.org/10.5114/ceh.2021.103242

Online publish date: 2021/02/02

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Introduction
Minimal hepatic encephalopathy (MHE) is a common complication of liver cirrhosis not only leading to a decrease in the quality of life, but also predicting development of overt encephalopathy. The diagnosis of MHE usually relies on a combination of neuropsychological tests, while robust serum biomarkers are lacking. We aimed to assess serum concentrations of brain-derived neurotrophic factor (BDNF) in MHE patients.

Material and methods
Serum BDNF was assessed in 78 patients with liver cirrhosis (53 male, median age 55 years) and 40 healthy individuals. 43 subjects underwent extensive evaluation for MHE by psychometric hepatic encephalopathy score (PHES) and inhibitory control test (ICT) or critical flicker frequency (CFF).

Results
Serum BDNF was twofold lower in liver cirrhosis compared to healthy subjects [13.6 (7.8-22.6) vs. 33.0 (24.1-40.7) ng/ml, p < 0.001] and its decrease reflected a degree of liver insufficiency assessed by model for end-stage liver disease (MELD). BDNF showed a negative correlation with bilirubin (R = –0.35, p = 0.005) and international normalized ratio (INR) (R = –0.37, p = 0.003), and positive with platelets (PLT) (R = 0.36, p = 0.004), while no associations with age, sex, body mass index (BMI), waist-hip ratio (WHR), creatinine and ammonia were noted. Importantly, subjects with a diagnosis of MHE by at least two modalities showed the lowest levels of BDNF [10.9 (2.5-14.4) vs. 19.9 (9.3-29.4) ng/ml, p < 0.01]. Patients with self-reported sleep disturbances had significantly lower serum BDNF [13.0 (2.5-23.4) vs. 20.0 (8.4-31.3) ng/ml, p = 0.04].

Conclusions
The lowest serum BDNF concentration was noted in patients with MHE and sleep disturbances, which suggests a role in pathophysiology of hepatic encephalopathy but also as a potential biomarker.

keywords:

Brain-derived neurotrophic factor as a potential diagnostic marker in minimal hepatic encephalopathy

Agnieszka Stawicka 1 , Magdalena Świderska 2 , Justyna Zbrzeźniak 1 , Natalia Sołowianowicz 1 , Aleksandra Woszczenko 1 , Robert Flisiak 1 , Jerzy Jaroszewicz 1, 3

minimal hepatic encephalopathy, liver cirrhosis, BDNF, PHES, ICT

Agnieszka Stawicka

¹

,

Magdalena Świderska

²

,

Justyna Zbrzeźniak

¹

,

Natalia Sołowianowicz

¹

,

Aleksandra Woszczenko

¹

,

Robert Flisiak

¹

,

Jerzy Jaroszewicz

^{1, 3}