title: Lipid profile is associated with the incidence of cognitive dysfunction in viral cirrhotic patients: A data-mining analysis.
abstract: OBJECTIVE
  Cognitive dysfunction (CD) is frequently observed in cirrhotic patients. However, the biochemical profiles associated with CD remain unclear. We investigated the biochemical profiles associated with the incidence of CD in cirrhotic patients by using multivariate analyses, including a decision-tree algorithm.
  
  
  METHODS
  In this study, 27 viral cirrhotic patients were enrolled. All subjects underwent neuropsychiatric tests; two or more abnormal results were defined as CD. A logistic regression model was used for multivariate stepwise analysis. A decision-tree algorithm was constructed, and the categorical differences based on the decision-tree model were analyzed by χ(2) -tests.
  
  
  RESULTS
  Multivariate stepwise analysis showed the levels of total bilirubin, triglycerides and free fatty acids (FFA) as independent bioparameters associated with the incidence of CD in cirrhotic patients. The decision-tree algorithm showed that among patients with FFA of 514 mEq/L or more, 77.8% had CD. Meanwhile, among patients with FFA of less than 514 mEq/L and triglycerides of 106 mg/dL or more, 20.0% had CD. The sensitivity, specificity and accuracy for the incidence of CD using the lipid profile (FFA >514 mEq/L or triglycerides <106 mg/dL) were 85.7% (12/14), 61.5% (8/13) and 74.1% (20/27), respectively.
  
  
  CONCLUSIONS
  The levels of total bilirubin, FFA and triglycerides are independently associated with the incidence of CD in cirrhotic patients. In addition, a decision-tree algorithm revealed that FFA of more than 514 mEq/L or triglycerides of less than 106 mg/dL is a profile associated with the incidence of CD. Thus, this lipid profile could be a possible screening bioparameter for CD in cirrhotic patients.
authors.affiliation: Division of Gastroenterology, Department of Medicine Department of Digestive Disease Information and Research, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Eitaro
authors.initials: E
authors.lastname: Taniguchi
authors.forename: Takumi
authors.initials: T
authors.lastname: Kawaguchi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sakata
authors.forename: Minoru
authors.initials: M
authors.lastname: Itou
authors.forename: Tetsuharu
authors.initials: T
authors.lastname: Oriishi
authors.forename: Michio
authors.initials: M
authors.lastname: Sata