Variability and Lability of Ammonia Levels in Healthy Volunteers and Patients With Cirrhosis: Implications for Trial Design and Clinical Practice

被引：34

作者：

Bajaj, Jasmohan S. ^{[1
,2
]}

Bloom, Patricia Pringle ^{[3
,4
]}

Chung, Raymond T. ^{[3
,4
]}

Hassanein, Tarek I. ^{[5
]}

Padilla-Martinez, Marielys ^{[5
]}

Kayali, Zeid ^{[6
]}

Rockey, Don C. ^{[7
]}

Sasso, Roula ^{[7
]}

Muthukumar, Alagar R. ^{[8
]}

Lee, William M. ^{[8
]}

Denney, William S. ^{[9
]}

Gavis, Edith A. ^{[1
,2
]}

Anderson, Cami ^{[10
]}

Blankstein, Larry ^{[10
]}

Brennan, Aoife M. ^{[10
]}

Puurunen, Marja K. ^{[10
]}

Lawitz, Eric ^{[11
]}

机构：

[1] Virginia Commonwealth Univ, Richmond, VA 23298 USA

[2] McGuire VA Med Ctr, Richmond, VA 23249 USA

[3] Massachusetts Gen Hosp, Liver Ctr, Boston, MA 02114 USA

[4] Massachusetts Gen Hosp, GI Div, Boston, MA 02114 USA

[5] Southern Calif Res Ctr, Coronado, CA USA

[6] Inland Empire Liver Fdn, Rialto, CA USA

[7] Med Univ South Carolina, Charleston, SC 29425 USA

[8] Univ Texas Southwestern Med Ctr Dallas, Dallas, TX 75390 USA

[9] Human Predict LLC, Cambridge, MA USA

[10] Synlogic Inc, Cambridge, MA USA

[11] Univ Texas Hlth San Antonio, Texas Liver Inst, San Antonio, TX USA

来源：

AMERICAN JOURNAL OF GASTROENTEROLOGY | 2020年 / 115卷 / 05期

关键词：

HEPATIC-ENCEPHALOPATHY; INTERNATIONAL SOCIETY; CHALLENGE; MODEL;

D O I：

10.14309/ajg.0000000000000384

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Introduction: Ammonia levels are used to assess hepatic encephalopathy, but their levels are highly variable in clinical practice. Methods: We studied factors associated with variation in ammonia values in cirrhotic patients without previous hepatic encephalopathy and healthy volunteers (HVs). Results: Ammonia increased by 12% and 18% at 1 and 2 hour, respectively, after a protein meal in 64 cirrhotic patients (P< 0.001). In 237 HVs, ammonia levels varied significantly between sites (P< 0.0001). New site-specific ammonia upper limits based on HV levels using a strict analysis protocol differed from routinely used values. Correlation between paired fresh samples was high (r = 0.83) but modest between fresh and frozen samples (r = 0.62). Discussion: Sample handling, processing, and protein intake impact ammonia levels across sites.

引用

页码：783 / 785

页数：3

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