Document Detail

Regional variations in the concentrations of ketone bodies in cirrhosis and hepatic encephalopathy: a study in patients with TIPSS.
MedLine Citation:
PMID:  21457443     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Little is known about the metabolism of acetoacetate and β-hydroxybutyrate in patients with cirrhosis and encephalopathy.
AIMS: We investigated the fate of ketone bodies in these conditions.
MATERIALS AND METHODS: We studied 18 cirrhotic patients with encephalopathy and 17 cirrhotics without. At the time of insertion of a transjugular intrahepatic portosystemic stent shunt (TIPSS) or at the time of portographical assessment of the shunt's patency, we collected blood from the internal jugular, the right atrium, the inferior vena cava, the hepatic, the portal, the splenic veins and the radial artery. We used nuclear magnetic resonance spectroscopy to measure the concentrations of acetoacetate and β-hydroxybutyrate.
RESULTS: There was no difference in the total ketone body concentrations between the two groups. The mitochondrial redox potential was significantly higher in the encephalopathics (142/54=2.63 vs 52/83=0.62) (P<0.01). β-hydroxybutyrate was significantly lower in the portal vein of encephalopathics (52 ± 4 vs 28 ± 3) (P<0.02) and in the splenic vein (48 ± 6 vs 32 ± 5) (P<0.04). Acetoacetate was significantly higher in encephalopathics in the internal jugular vein (134 ± 12 vs 92 ± 16) (P<0.03), the right atrium (112 ± 18 vs 68 ± 11) (P<0.03), the hepatic vein (162 ± 25 vs 115 ± 19) (P<0.05), the portal vein (133 ± 20 vs 81 ± 14) (P<0.02) and the splenic vein (167 ± 24 vs 122 ± 21) (P<0.04). All measurements are expressed in μmols/L.
CONCLUSIONS: There are significant variations in the regional concentrations of the ketone bodies in encephalopathy.
Konstantinos J Dabos; Benjamin A Haughton; Benjamin J Houghton; Emmanouil Pyleris; Doris N Redhead; Peter C Hayes; Ian H Salder; John N Plevris
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2011-03-06
Journal Detail:
Title:  Liver international : official journal of the International Association for the Study of the Liver     Volume:  31     ISSN:  1478-3231     ISO Abbreviation:  Liver Int.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-04     Completed Date:  2011-07-19     Revised Date:  2011-11-25    
Medline Journal Info:
Nlm Unique ID:  101160857     Medline TA:  Liver Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  707-11     Citation Subset:  IM    
Copyright Information:
© 2011 John Wiley & Sons A/S.
Department of Hepatology, University of Edinburgh, Edinburgh, UK.
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MeSH Terms
3-Hydroxybutyric Acid / blood*
Acetoacetates / blood*
Analysis of Variance
Biological Markers / blood
Hepatic Encephalopathy / blood*,  etiology
Liver / metabolism*
Liver Cirrhosis / blood,  complications,  surgery*
Magnetic Resonance Spectroscopy
Middle Aged
Portasystemic Shunt, Transjugular Intrahepatic*
Treatment Outcome
Reg. No./Substance:
0/Acetoacetates; 0/Biological Markers; 300-85-6/3-Hydroxybutyric Acid; 541-50-4/acetoacetic acid
Erratum In:
Liver Int. 2011 Sep;31(8):1242
Note: Houghton, Benjamin J [corrected to Haughton, Benjamin A]

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