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Lactulose/Mannitol Test and Specificity, Sensitivity, and Area under Curve of Intestinal Permeability Parameters in Patients with Liver Cirrhosis and Crohn's Disease

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Abstract

The purpose of this study was to investigate and compare the specificity, sensitivity, and area under curve (AUC) of the lactulose/mannitol ratio, lactulose/creatinine ratio, and lactulose recovery and their diagnostic value for intestinal permeability assessment within the absorption lactulose/mannitol (L/M) test. Results The value of the lactulose/mannitol ratio, lactulose/creatinine ratio, and the percentage of lactulose recovery in Crohn’s disease (0.0763 ± 0.0369; 99.62 ± 67.87; 1.0478 ± 0.6148) and in liver cirrhosis (0.0517 ± 0.0365; 54.65 ± 53.26; 0.838 ± 0.929) were significantly different from the values measured in the control group (0.0123 ± 0.0081; 10.95 ± 7.07; 0.2438 ± 0.1568), P < 0.0001–0.002). In Crohn’s disease, specificity, sensitivity, and AUC were 100%, 89.5%, and 0.987, respectively, of the lactulose/mannitol ratio at a cut-off level of 0.022. In liver cirrhosis, the test characteristics were 88.5%, 84.2%, and 0.910 at a cut-off level of 0.018. Conclusion The lactulose/mannitol ratio was evaluated to have the highest diagnostic value to assess intestinal permeability.

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Acknowledgment

This work was supported by the Grant Agency of the Health Ministerium, Czech Republic NR9084-3.

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Authors and Affiliations

  1. Department of Clinical Biochemistry and Hematology, University Hospital Brno, Jihlavská 20, 62500, Brno, Czech Republic

    Milan Dastych, Hana Novotná & J. Číhalová

  2. Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czech Republic

    Milan Dastych, Hana Novotná & J. Číhalová

  3. Department of Internal Medicine and Gastroenterology, University Hospital Brno, Brno, Czech Republic

    Milan Dastych Jr

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  1. Milan Dastych
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  2. Milan Dastych Jr
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  4. J. Číhalová
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Correspondence to Milan Dastych.

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Dastych, M., Dastych, M., Novotná, H. et al. Lactulose/Mannitol Test and Specificity, Sensitivity, and Area under Curve of Intestinal Permeability Parameters in Patients with Liver Cirrhosis and Crohn's Disease. Dig Dis Sci 53, 2789–2792 (2008). https://doi.org/10.1007/s10620-007-0184-8

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  • DOI: https://doi.org/10.1007/s10620-007-0184-8

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