title: Lactulose/mannitol test and specificity, sensitivity, and area under curve of intestinal permeability parameters in patients with liver cirrhosis and Crohn's disease.
abstract: 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.
authors.affiliation: Department of Clinical Biochemistry and Hematology, University Hospital Brno, Jihlavská 20, 62500, Brno, Czech Republic. mdast@fnbrno.cz
authors.forename: Milan
authors.initials: M
authors.lastname: Dastych
authors.forename: Milan
authors.initials: M
authors.lastname: Dastych
authors.forename: Hana
authors.initials: H
authors.lastname: Novotná
authors.forename: J
authors.initials: J
authors.lastname: Cíhalová
mesh_terms: 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
chemical_list: D008353:Mannitol; D007792:Lactulose; D003404:Creatinine