The Role of Changes in the Proportion of Fecal Short-Chain Fatty Acids on the Severity of Hepatic Encephalopathy in Cirrhosis Patients.

Hepatic encephalopathy was identified in 23.25% of cirrhosis patients enrolled in the study.

• A total of 86 patients with cirrhosis participated in this cross-sectional study.
• 20 patients (23.25%) were identified as having hepatic encephalopathy.
• Mean age of participants was 53 ± 8.10 years.
• The majority of participants were male (68.6%).
• HE diagnosis was assessed using a flicker or Stroop test.

The absolute SCFA proportion was not significantly associated with hepatic encephalopathy in multivariable analysis.

• Adjusted prevalence ratio (PR) for absolute SCFA proportion was 1.98 [95% CI: 0.75–5.24; p = 0.171].
• The analysis was multivariable, adjusting for other covariates.
• The study examined fecal SCFA including acetate, butyrate, and propionate.

Acetate proportion was not significantly associated with hepatic encephalopathy in multivariable analysis.

• Adjusted PR for absolute acetate proportion was 2.06 [95% CI: 0.40–10.62; p = 0.388].
• Despite the lack of statistical significance, the point estimate suggested a roughly two-fold higher prevalence ratio.
• Acetate is one of the main fecal SCFA metabolites examined.

Butyrate proportion was not significantly associated with hepatic encephalopathy in multivariable analysis.

• Adjusted PR for butyrate proportion was 2.02 [95% CI: 0.76–5.39; p = 0.158].
• Butyrate functions as a colonocyte trophic factor and contributes to gastrointestinal tract integrity.
• The point estimate for butyrate was similar in magnitude to that of total SCFA and acetate.

Microbiota dysbiosis in cirrhosis reduces SCFA production and is implicated in the pathogenesis of hepatic encephalopathy.

• SCFAs are described as the main metabolites of the intestinal microbiota.
• SCFAs play a role as colonocyte trophic factors and maintain the integrity of the gastrointestinal tract and blood-brain barrier.
• Dysbiosis-related reduction in SCFA production is proposed as a mechanism linking gut microbiota changes to HE development in cirrhosis.

The study was conducted as a cross-sectional design at a single tertiary center in Jakarta in 2023.

• The study site was the Hepatobiliary Clinic and Integrated Procedure Room, Dr. Cipto Mangunkusumo Hospital, Jakarta.
• Data collection occurred in 2023.
• Dietary patterns were assessed using a questionnaire with a food recall technique alongside fecal SCFA examination.