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Minimal hepatic encephalopathy (MHE) — present in up to half of cirrhotic patients with no clinical symptoms of hepatic encephalopathy (HE) — is associated with impaired quality of life and diminished ability to perform daily tasks. Diagnosis currently relies on the psychometric hepatic encephalopathy score (PHES), which is derived from a complex battery of tests. Now, investigators in Spain have conducted a pilot study to identify serum biomarkers for MHE.
Knowing that animal models of HE identified hyperammonemia, altered nitric oxide and cyclic guanosine monophosphate (cGMP) metabolism, and neuroinflammation as contributors to mild cognitive impairment, the researchers investigated the diagnostic value of cGMP, nitrites + nitrates, and 3-…