title: A profile of volatile organic compounds in exhaled air as a potential non-invasive biomarker for liver cirrhosis.
abstract: Early diagnosis of liver cirrhosis may prevent progression and development of complications. Liver biopsy is the current standard, but is invasive and associated with morbidity. We aimed to identify exhaled volatiles within a heterogeneous group of chronic liver disease (CLD) patients that discriminates those with compensated cirrhosis (CIR) from those without cirrhosis, and compare this with serological markers. Breath samples were collected from 87 CLD and 34 CIR patients. Volatiles in exhaled air were measured by gas chromatography mass spectrometry. Discriminant Analysis was performed to identify the optimal panel of serological markers and VOCs for classifying our patients using a random training set of 27 CIR and 27 CLD patients. Two randomly selected independent internal validation sets and permutation test were used to validate the model. 5 serological markers were found to distinguish CIR and CLD patients with a sensitivity of 0.71 and specificity of 0.84. A set of 11 volatiles discriminated CIR from CLD patients with sensitivity of 0.83 and specificity of 0.87. Combining both did not further improve accuracy. A specific exhaled volatile profile can predict the presence of compensated cirrhosis among CLD patients with a higher accuracy than serological markers and can aid in reducing liver biopsies.
authors.affiliation: Division Gastroenterology-Hepatology, Department of Internal Medicine, School for Nutrition and Metabolism Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, the Netherlands.
authors.forename: Kirsten E
authors.initials: KE
authors.lastname: Pijls
authors.affiliation: Department of Pharmacology and Toxicology, School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, the Netherlands.|Top Institute Food and Nutrition (TIFN), Wageningen, the Netherlands.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Smolinska
authors.affiliation: Division Gastroenterology-Hepatology, Department of Internal Medicine, School for Nutrition and Metabolism Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, the Netherlands.
authors.forename: Daisy M A E
authors.initials: DM
authors.lastname: Jonkers
authors.affiliation: Department of Pharmacology and Toxicology, School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, the Netherlands.
authors.forename: Jan W
authors.initials: JW
authors.lastname: Dallinga
authors.affiliation: Division Gastroenterology-Hepatology, Department of Internal Medicine, School for Nutrition and Metabolism Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, the Netherlands.
authors.forename: Ad A M
authors.initials: AA
authors.lastname: Masclee
authors.affiliation: Division Gastroenterology-Hepatology, Department of Internal Medicine, School for Nutrition and Metabolism Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, the Netherlands.
authors.forename: Ger H
authors.initials: GH
authors.lastname: Koek
authors.affiliation: Department of Pharmacology and Toxicology, School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, the Netherlands.
authors.forename: Frederik-Jan
authors.initials: FJ
authors.lastname: van Schooten
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers; D016022:Case-Control Studies; D045853:Exhalation; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism*; D008107:Liver Diseases / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D055549:Volatile Organic Compounds; D055815:Young Adult
chemical_list: D015415:Biomarkers; D055549:Volatile Organic Compounds
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