Lactulose/mannitol test and specificity, sensitivity, and area under curve of intestinal permeability parameters in patients with liver cirrhosis and Crohn's disease.
The purpose of this study was to investigate and compare the specificity, sensitivity, and area under curve (AUC) of the lactulose/mannitol ratio, lactulose/creatinine ratio, and lactulose recovery and their diagnostic value for intestinal permeability assessment within the absorption lactulose/mannitol (L/M) test.


RESULTS
The value of the lactulose/mannitol ratio, lactulose/creatinine ratio, and the percentage of lactulose recovery in Crohn's disease (0.0763 +/- 0.0369; 99.62 +/- 67.87; 1.0478 +/- 0.6148) and in liver cirrhosis (0.0517 +/- 0.0365; 54.65 +/- 53.26; 0.838 +/- 0.929) were significantly different from the values measured in the control group (0.0123 +/- 0.0081; 10.95 +/- 7.07; 0.2438 +/- 0.1568), P < 0.0001-0.002). In Crohn's disease, specificity, sensitivity, and AUC were 100%, 89.5%, and 0.987, respectively, of the lactulose/mannitol ratio at a cut-off level of 0.022. In liver cirrhosis, the test characteristics were 88.5%, 84.2%, and 0.910 at a cut-off level of 0.018.


CONCLUSIONS
The lactulose/mannitol ratio was evaluated to have the highest diagnostic value to assess intestinal permeability.
Dastych
Milan
M
Department of Clinical Biochemistry and Hematology, University Hospital Brno, Jihlavská 20, 62500, Brno, Czech Republic. mdast@fnbrno.cz
Dastych
Milan
M
Novotná
Hana
H
Cíhalová
J
J
D000328:Adult; D000368:Aged; D019540:Area Under Curve; D016022:Case-Control Studies; D002463:Cell Membrane Permeability / Q000502:physiology; D003404:Creatinine / Q000493:pharmacokinetics; D003424:Crohn Disease / Q000503:physiopathology*; D003955:Diagnostic Tests, Routine / Q000592:standards; D005260:Female; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology*; D007792:Lactulose / Q000493:pharmacokinetics*; D008103:Liver Cirrhosis / Q000503:physiopathology*; D008297:Male; D008353:Mannitol / Q000493:pharmacokinetics*; D008875:Middle Aged; D012680:Sensitivity and Specificity
D008353:Mannitol; D007792:Lactulose; D003404:Creatinine