title: New proposal for the serum ascites albumin gradient cut-off value in Chinese ascitic patients.
abstract: BACKGROUND
  Serum ascites albumin gradient (SAAG) has been recognized as a reliable marker in the differential diagnosis of ascites. The etiological background of cirrhosis is rather different between western countries and eastern countries. The threshold of SAAG in Chinese ascitic patients has not been evaluated yet. The aim of this study was to define a new reasonable threshold of SAAG in Chinese ascitic patients.
  
  
  METHODS
  Adult patients with ascites admitted to the Shanghai Changzheng Hospital from Jan 2004 to Jun 2010 were retrospectively analyzed. The diagnostic criteria for cirrhotic ascites are clinical manifestations, radiological features and esophageal-gastric varicosis, or histopathology. Serum was detected by chemical method using a commercial kit. We used receiver operating characteristic (ROC) analysis to achieve maximal sensitivity and specificity of SAAG.
  
  
  RESULTS
  The mean value of SAAG in portal-hypertension-related ascites was significantly higher than that in the non-portal-hypertension-related ascites (21.15 ± 4.38 g/L vs 7.48 ± 3.64 g/L, P = 0.002). The SAAG cut-off value under 12.50 g/L predicted portal hypertension ascites with the sensitivity of 99.20%, specificity of 95.10% and accuracy of 97.65%.
  
  
  CONCLUSIONS
  SAAG is useful to distinguish portal-hypertension-related ascites and non-portal-hypertension-related ascites, and 12.50 g/L might present as a more reasonable threshold in Chinese ascitic patients.
  The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1602582638991860.
authors: Department of Gastroenterology, Shanghai Changzheng Hospital, Second Military Medical University, Fengyang Road, Shanghai 200003, China. weifenxie@medmail.com.cn.
authors: Cai-feng
authors: CF
authors: Jiang
authors: Bin
authors: B
authors: Shi
authors: Jian
authors: J
authors: Shi
authors: Zong-li
authors: ZL
authors: Yuan
authors: Wei-fen
authors: WF
authors: Xie
mesh_terms: D000328:Adult; D000368:Aged; D001201:Ascites / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D002681:China; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology*; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis*; D000075462:Serum Albumin, Human
chemical_list: C422455:ALB protein, human; D015415:Biomarkers; D012709:Serum Albumin; D000075462:Serum Albumin, Human
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