title: In patients with liver cirrhosis, proinflammatory interleukins correlate with health-related quality of life irrespective of minimal hepatic encephalopathy.
abstract: BACKGROUND
  Liver cirrhosis is associated with latent systemic inflammatory response syndrome as evidenced by elevated levels of proinflammatory cytokines. It has been proposed that inflammatory mediators play a role in the pathogenesis of minimal and overt hepatic encephalopathy (HE); hence, they may also have an effect on health-related quality of life (HRQL). The aim of this study was to investigate the relationship between serum levels of interleukin-1β (IL-1β), IL-6, and IL-18 and the occurrence of minimal HE and HRQL.
  
  
  METHODS
  Forty-two consecutive patients with liver cirrhosis were prospectively enrolled to the study. Minimal HE was detected by the Psychometric Hepatic Encephalopathy Score (PHES) and critical flicker frequency. HRQL was assessed with Chronic Liver Disease Questionnaire and 36-Item Short Form Health Survey (SF-36) questionnaires. The interleukins studied were determined using colorimetric sandwich enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Serum levels of interleukins correlated with liver dysfunction, but did not discriminate patients with minimal HE from those with overt or absent HE. IL-1β and IL-6 showed significant correlations with PHES, but showed no relationship with critical flicker frequency. Serum IL-6 and IL-18 correlated with both physical-related general health and mental component summary evaluated by the SF-36 questionnaire.
  
  
  CONCLUSIONS
  This study shows that chronic inflammation plays a role in impaired HRQL in patients with cirrhosis irrespective of minimal HE.
authors.affiliation: aLiver Research Laboratories bDepartment of Neurology cMedical Biology Laboratory, Pomeranian Medical University dDepartment for Internal Medicine, A. Sokolowski Hospital, Szczecin eDepartment of Gastroenterology and Hepatology, Medical University of Silesia, Katowice fDepartment of General, Transplant and Liver Surgery of the Medical University of Warsaw, Warsaw, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Wunsch
authors.forename: Dorota
authors.initials: D
authors.lastname: Koziarska
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Milkiewicz
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Naprawa
authors.forename: Przemysław
authors.initials: P
authors.lastname: Nowacki
authors.forename: Marek
authors.initials: M
authors.lastname: Hartleb
authors.forename: Piotr
authors.initials: P
authors.lastname: Milkiewicz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006501:Hepatic Encephalopathy / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000534:rehabilitation; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007378:Interleukins / Q000097:blood*; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications* / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D007378:Interleukins