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Enzymatic Liver Function Capacity Correlates with Disease Severity of Patients with Liver Cirrhosis: A Study with the LiMAx Test

Digestive Diseases and Sciences volume 59, pages 2983–2991 (2014)Cite this article

Abstract

Background

Assessment and quantification of actual liver function is crucial in patients with chronic liver disease to monitor disease progression and predict individual prognosis. Mathematical models, such as model for end-stage liver disease, are used for risk stratification of patients with chronic liver disease but do not include parameters that reflect the actual functional state of the liver.

Aim

We aimed to evaluate the potential of a 13C-based liver function test as a stratification tool by comparison with other liver function tests and clinical parameters in a large sample of healthy controls and cirrhotic patients.

Methods

We applied maximum liver function capacity (LiMAx) to evaluate actual liver function in 347 patients with cirrhosis and in 86 controls.

Results

LiMAx showed strong negative correlation with Child-Pugh Score (r = −0.707; p < 0.001), MELD (r = −0.686; p < 0.001) and liver function tests. LiMAx was lower in patients with liver cirrhosis compared to healthy controls [99 (57–160) µg/kg/h vs. 412 (365–479) µg/kg/h, p < 0.001] and differed among Child-Pugh classes [a: 181 (144–227) µg/kg/h, b: 96 (62–132) µg/kg/h and c: 52 (37–81) µg/kg/h; p < 0.001]. When stratified patients according to disease severity, LiMAx results were not different between cirrhotic patients and cirrhotic patients with transjugular intrahepatic portosystemic shunt.

Conclusions

LiMAx appears to provide reliable information on remnant enzymatic liver function in chronic liver disease and allows graduation of disease severity.

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Acknowledgments

This study was funded in part by the European Union’s 7th Framework Programme, d-LIVER Grant agreement no. 287596.

Conflict of interest

Martin Stockmann is the inventor of the LiMAx test and has capital interest in Humedics, the company marketing the LiMAx test. In addition he is steering board member for the d-LIVER Project (funded by the European Commission Framework Program). Maximilian Jara and James Orr disclose receiving research Grants in order of the d-LIVER European Commission Framework Program (Grant agreement no. 287596). Remaining authors who have taken part in this study declared that they do not have anything to disclosure regarding funding or conflict of interest with respect to this manuscript.

Author information

Affiliations

  1. Department of General, Visceral and Transplantation Surgery, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Maciej Malinowski, Maximilian Jara, Katja Lüttgert & Martin Stockmann

  2. Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK

    James Orr

  3. Department of Hepatology and Gastroenterology, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Germany

    Eckart Schott

  4. Department of General-, Visceral-, Vascular- and Paediatric Surgery, University Hospital of Würzburg, Oberdürrbacher, Str. 6, 97080, Würzburg, Germany

    Johan Friso Lock

Authors
  1. Maciej Malinowski
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  2. Maximilian Jara
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  3. Katja Lüttgert
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  4. James Orr
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  5. Johan Friso Lock
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  6. Eckart Schott
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  7. Martin Stockmann
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Corresponding author

Correspondence to Maciej Malinowski.

Additional information

Maciej Malinowski and Maximilian Jara have contributed equally to this work.

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Malinowski, M., Jara, M., Lüttgert, K. et al. Enzymatic Liver Function Capacity Correlates with Disease Severity of Patients with Liver Cirrhosis: A Study with the LiMAx Test. Dig Dis Sci 59, 2983–2991 (2014). https://doi.org/10.1007/s10620-014-3250-z

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Keywords

  • LiMAx
  • Cirrhosis
  • Liver function
  • Liver function tests
  • Disease severity
  • Surrogate marker