Evaluation of Oxidative Stress in Liver Cirrhosis Patients to Early Diagnosis of Minimal Hepatic Encephalopathy

Abstract

Introduction: Minimal hepatic encephalopathy (MHE) is mildest form of the spectrum of neuropsychiatric and neurocognitive impairment in cirrhosis. Early recognition of this impairment may prevent the progression or may delay the development of the disease to overt hepatic encephalopathy. Although certain evidence suggest that that oxidative stress is a central component in the pathogenesis MHE, data remain controversial. Aims: We tested the utility of glutathione peroxidase (GPx) as an oxidative stress marker of HE by comparing its levels in patients with MHE. Study Design: The study was conducted in 60 subjects, included 30 cirrhotic patients (19 with MHE, 11 without MHE) and 30 control subjects. Results: Cirrhosis patients with signs of MHE had decreased levels of GPx when compared to the Non-MHE and control groups. Our study provided evidence of increased oxidative stress in patients affected with MHE, as expressed by decreased serum glutathione peroxidase antioxidant. We also found a significant negative correlation between the levels of serum glutathione peroxidase antioxidant and Child-Turcotte-Pugh (CTP) score (r = -0.734, P = .0001). Conclusion: Our findings revealed that the levels of the oxidative stress marker - GPx, may contribute to early diagnosis of MHE when used in conjunction with other routine markers.