The utility of the 13C-galactose breath test as a measure of liver function.
BACKGROUND
The 13C-galactose breath test has been reported to be an accurate, non-invasive method for the assessment of liver function.


OBJECTIVE
To determine the optimal doses of labelled and unlabelled carrier galactose necessary to perform the 13C-galactose breath test, to assess the utility of the 13C-galactose breath test in distinguishing between normal subjects and those with liver cirrhosis and to determine whether the 13C-galactose breath test can stratify patients with cirrhosis based on their Child-Pugh score.


METHODS
Twenty-three control subjects and 30 patients with liver cirrhosis received fixed doses of unlabelled carrier galactose and labelled 13C-galactose. Breath samples were collected just before and at 30-min intervals up to 4 h after the ingestion of unlabelled carrier galactose and labelled 13C-galactose. Each sample was analysed for its 13CO2 content.


RESULTS
Doses of 25 g/m2 of unlabelled carrier galactose and 100 mg of 13C-galactose had the greatest sensitivity (93%; 95% confidence interval, 76-99%) and specificity (87%; 95% confidence interval, 65-97%) for distinguishing between normal subjects and cirrhotics when the test was performed 2 h after ingestion. The 13C-galactose breath test was also able to distinguish between class A and class B or C cirrhotics.


CONCLUSIONS
The 13C-galactose breath test is a useful non-invasive tool for distinguishing between healthy subjects and patients with liver cirrhosis and between cirrhotics with well-compensated liver disease and those with decompensated liver disease.
Saadeh
S
S
Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Behrens
P W
PW
Parsi
M A
MA
Carey
W D
WD
Connor
J T
JT
Grealis
M
M
Barnes
D S
DS
D001944:Breath Tests; D002250:Carbon Radioisotopes; D005260:Female; D005690:Galactose / Q000097:blood; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis* / Q000503:physiopathology; D008111:Liver Function Tests / Q000379:methods / Q000592:standards; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity
D002250:Carbon Radioisotopes; D005690:Galactose