title: ¹³C-methacetin breath test in the evaluation of disease severity in patients with liver cirrhosis.
abstract: OBJECTIVE
  The non-invasive (13)C-methacetin ((13)C-MBT) breath test has been proposed as a measure of metabolic liver function that improves the diagnostic efficacy of serologic and biochemical tests in assessing hepatic functional capacity and liver disease severity, The goal of this study was to establish the clinical utility of this test in quantifying hepatic metabolic function in patients with liver cirrhosis of varying severity and to compare (13)C-MBT measurements with the AST/ALT ratio, APRI score, and other routine liver tests.
  
  
  METHODS
  Routine liver function tests including serum bilirubin, aspartate aminotransferase activity (AST), alanine aminotransferase (ALT), AST/ALT ratio, the APRI score, the percentage of dose rate (PDR) and cumulative percentage of dose rate (CPDR) of the (13)C-MBT were evaluated in 52 cirrhotic patients of alcohol etiology (Child-Pugh A/B/C 10/28/14) and 37 healthy controls.
  
  
  RESULTS
  The (13)C-MBT differed significantly between healthy controls and cirrhotic patients at all time intervals measured. It also proved the ability to differentiate patients with liver cirrhosis based on severity of hepatic impairment corresponding to the Child-Pugh classification A vs. B vs. C. The ROC curve analysis suggested that the best prediction is provided by time intervals between the 10th - 20th or 10th - 40th minute of PDR.
  
  
  CONCLUSIONS
  The (13)C-MBT offers a reliable means for quantification of hepatic metabolic function over the complete range of functional liver impairment. It is non-invasive, easy to perform and completely safe.
authors.affiliation: Department of Medical Biophysics and Medical Informatics, 3rd Faculty of Medicine, Charles University in Prague, Czech Republic.
authors.forename: Jana
authors.initials: J
authors.lastname: Vranova
authors.forename: Miluse
authors.initials: M
authors.lastname: Hendrichova
authors.forename: Hana
authors.initials: H
authors.lastname: Kolarova
authors.forename: Karolina
authors.initials: K
authors.lastname: Kratka
authors.forename: Jozef
authors.initials: J
authors.lastname: Rosina
authors.forename: Jiri
authors.initials: J
authors.lastname: Horak
mesh_terms: D000081:Acetamides / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001944:Breath Tests / Q000379:methods*; D002247:Carbon Isotopes; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index
chemical_list: D000081:Acetamides; D002247:Carbon Isotopes; C035495:methacetin