Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website http://www.gastrores.org

Original Article

Volume 5, Number 5, October 2012, pages 182-189

Abnormal Gas Diffusing Capacity and Portosystemic Shunt in Patients With Chronic Liver Disease

Figure 1. Mean values of H/L ratios of the patients. Asterisk (*) shows the significant difference among 3 groups by ANOVA (P < 0.01). CAH: chronic active hepatitis; Class A: Child-Pugh class A; Class B: Child-Pugh class B.

**Table 1.** Demographic and Clinical Characteristics of the Patients
Variables	CAH	Class A	Class B	Total
The numbers of each variable among the groups were analyzed by Chi-square analysis at P < 0.05 level. CAH: chronic acute hepatitis; Class A: Child-Pugh Class A; Class B: Child-Pugh Class B; HBV: hepatitis B virus; HCV: hepatitis C virus. Asterisk (*) shows significant differences among the three groups in each variable by ANOVA at P < 0.05 level. ALT: alanine aminotransferase; AST: aspartate aminotransferase; TB: total bilirubin; PT: prothrombin time.
Numbers of patients	15	16	13	44
Age (years, mean ± SD)	32.3 ± 8.5	47.2 ± 12.1	48.6 ± 10.3	40.3 ± 8.3
Gender (male/female)	9/6	12/4	9/4	30/14
Etiology (numbers (%))
HBV induced	14 (93.3)	9 (56.3)	12 (92.3)	35 (79.5)
HCV induced	0 (0.0)	4 (25.0)	0 (0.0)	4 (9.1)
Alcohol-related	1 (6.7)	2 (12.5)	1 (7.7)	4 (9.1)
Unknown	0 (0.0)	1 (6.3)	0 (0.0)	1 (2.3)
Smoking status (numbers (%))
No smoking	7 (46.7)	6 (37.5)	4 (30.7)	17 (38.6)
Former or current smoker	8 (53.3)	10 (62.5)	9 (69.3)	27 (61.4)
Evaluation of chest radiography (numbers (%))
Normal	14 (93.3)	16(100.0)	12 (92.3)	42 (95.5)
Abnormal	1 (6.7)	0 (0.0)	1 (7.7)	2 (4.5)
Liver function test (Mean ± S.D)
ALT (U/L)	116.9 ± 86.6	61.6 ± 36.2	51.3 ± 33.9*
AST (U/L)	69.3 ± 50.1	62.6 ± 36.2	60.2 ± 24.5
TB (mg/dL)	1.9 ± 0.7	1.1 ± 0.5	2.1 ± 0.8
Albumin (g/dL)	4.4 ± 0.6	4.4 ± 0.6	3.5 ± 0.6
PT (%)	95.8 ± 11.2	91.3 ± 12.9	64.9 ± 10.6*

Table 1. Demographic and Clinical Characteristics of the Patients

Variables

CAH

Class A

Class B

Total

The numbers of each variable among the groups were analyzed by Chi-square analysis at P < 0.05 level. CAH: chronic acute hepatitis; Class A: Child-Pugh Class A; Class B: Child-Pugh Class B; HBV: hepatitis B virus; HCV: hepatitis C virus. Asterisk (*) shows significant differences among the three groups in each variable by ANOVA at P < 0.05 level. ALT: alanine aminotransferase; AST: aspartate aminotransferase; TB: total bilirubin; PT: prothrombin time.

Numbers of patients

Age (years, mean ± SD)

32.3 ± 8.5

47.2 ± 12.1

48.6 ± 10.3

40.3 ± 8.3

Gender (male/female)

9/6

12/4

9/4

30/14

Etiology (numbers (%))

HBV induced

14 (93.3)

9 (56.3)

12 (92.3)

35 (79.5)

HCV induced

0 (0.0)

4 (25.0)

0 (0.0)

4 (9.1)

Alcohol-related

1 (6.7)

2 (12.5)

1 (7.7)

4 (9.1)

Unknown

0 (0.0)

1 (6.3)

0 (0.0)

1 (2.3)

Smoking status (numbers (%))

No smoking

7 (46.7)

6 (37.5)

4 (30.7)

17 (38.6)

Former or current smoker

8 (53.3)

10 (62.5)

9 (69.3)

27 (61.4)

Evaluation of chest radiography (numbers (%))

Normal

14 (93.3)

16(100.0)

12 (92.3)

42 (95.5)

Abnormal

1 (6.7)

0 (0.0)

1 (7.7)

2 (4.5)

Liver function test (Mean ± S.D)

ALT (U/L)

116.9 ± 86.6

61.6 ± 36.2

51.3 ± 33.9*

AST (U/L)

69.3 ± 50.1

62.6 ± 36.2

60.2 ± 24.5

TB (mg/dL)

1.9 ± 0.7

1.1 ± 0.5

2.1 ± 0.8

Albumin (g/dL)

4.4 ± 0.6

3.5 ± 0.6

PT (%)

95.8 ± 11.2

91.3 ± 12.9

64.9 ± 10.6*

**Table 2.** Pulmonary Function and Arterial Blood Gas Analysis of the Patients
Variables	CAH (n = 15)	Class A (n = 16)	Class B (n = 13)
* shows the significant differences among the three groups in each variable by ANOVA at P < 0.01 level. † and †† show the significant differences among the groups in each variable by Chi-square analysis at P < 0.05 and P < 0.01, respectively. FVC: forced vital capacity; FEV1: forced expiratory volume for 1 second; TLC: total lung capacity; DLco: diffusing capacity for carbon monoxide; VA: alveolar volume; PaO₂: partial pressure of arterial oxygen; SaO₂ : saturation of arterial oxygen.
Spirometry and Single breath technique (mean % of predicted value ± S.D.)
FVC	91.7 ± 7.4	103.2 ± 11.9	98.2 ± 11.8
FEV1	94.7 ± 8.9	98.0 ± 12.2	96.5 ± 10.4
FEV1/FVC	103.2 ± 4.9	94.9 ± 2.9	101.1 ± 7.8
TLC	91.9 ± 9.9	96.1 ± 10.8	94.9 ± 11.9
DLco	81.1 ± 11.9	77.7 ± 12.6*	69.3 ± 9.4*
DLco/VA	94.3 ± 9.6	85.4 ± 17.4*	79.1 ± 8.4*
Arterial blood gas analysis
PaO₂ (mmHg)	96.3 ± 8.4	88.7 ± 13.6	88.1 ± 10.8
SaO₂ (%)	98.2 ± 1.4	95.5 ± 4.8	96.5 ± 1.2
Pulmonary function abnormality (case, %)
Diffusion impairment††	1 (6.7)	4 (25.0)	8 (61.5)
Restrictive defect	2 (13.3)	1 (6.3)	1 (7.7)
Obstructive defect	0 (0.0)	0 (0.0)	0 (0.0)
Total case (%)†	3 (20.0)	5 (31.3)	9 (69.2)

Table 2. Pulmonary Function and Arterial Blood Gas Analysis of the Patients

Variables

CAH (n = 15)

Class A (n = 16)

Class B (n = 13)

* shows the significant differences among the three groups in each variable by ANOVA at P < 0.01 level. † and †† show the significant differences among the groups in each variable by Chi-square analysis at P < 0.05 and P < 0.01, respectively. FVC: forced vital capacity; FEV1: forced expiratory volume for 1 second; TLC: total lung capacity; DLco: diffusing capacity for carbon monoxide; VA: alveolar volume; PaO₂: partial pressure of arterial oxygen; SaO₂ : saturation of arterial oxygen.

Spirometry and Single breath technique (mean % of predicted value ± S.D.)

FVC

91.7 ± 7.4

103.2 ± 11.9

98.2 ± 11.8

FEV1

94.7 ± 8.9

98.0 ± 12.2

96.5 ± 10.4

FEV1/FVC

103.2 ± 4.9

94.9 ± 2.9

101.1 ± 7.8

TLC

91.9 ± 9.9

96.1 ± 10.8

94.9 ± 11.9

DLco

81.1 ± 11.9

77.7 ± 12.6*

69.3 ± 9.4*

DLco/VA

94.3 ± 9.6

85.4 ± 17.4*

79.1 ± 8.4*

Arterial blood gas analysis

PaO₂ (mmHg)

96.3 ± 8.4

88.7 ± 13.6

88.1 ± 10.8

SaO₂ (%)

98.2 ± 1.4

95.5 ± 4.8

96.5 ± 1.2

Pulmonary function abnormality (case, %)

Diffusion impairment††

1 (6.7)

4 (25.0)

8 (61.5)

Restrictive defect

2 (13.3)

1 (6.3)

1 (7.7)

Obstructive defect

0 (0.0)

Total case (%)†

3 (20.0)

5 (31.3)

9 (69.2)

**Table 3.** Differences of Pulmonary Function According to Disease Category and Smoking Status and Correlation With H/L Ratio
Variables	FVC	FEV1	FEV1/FVC	TLC	DLco	DLco/VA
All the data were presented as p-values by two-way ANOVA, and * shows the significant p-value under 0.05 level. † and †† show the significant correlations between pulmonary function such as spirometric indices and H/L ratio by Pearson’s correlation analysis at P < 0.05 and P < 0.001 levels, respectively. Disease category includes ‘chronic active hepatitis’, ‘Child-Pugh class A’ and ‘Child-Pugh class B’. Smoking status includes ‘nonsmokers’ and ‘former or current smokers’. Interaction means relationship between disease category and smoking status.
Disease Category	0.022*	0.679	0.012*	0.538	0.044*	0.013*
Smoking Status	0.100	0.190	0.541	0.716	0.522	0.886
Interaction	0.072	0.244	0.316	0.612	0.538	0.547
H/L ratio	0.2653	0.089	-0.3072†	0.1666	-0.3395†	-0.4801††

Table 3. Differences of Pulmonary Function According to Disease Category and Smoking Status and Correlation With H/L Ratio

Variables

FVC

FEV1

FEV1/FVC

TLC

DLco

DLco/VA

All the data were presented as p-values by two-way ANOVA, and * shows the significant p-value under 0.05 level. † and †† show the significant correlations between pulmonary function such as spirometric indices and H/L ratio by Pearson’s correlation analysis at P < 0.05 and P < 0.001 levels, respectively. Disease category includes ‘chronic active hepatitis’, ‘Child-Pugh class A’ and ‘Child-Pugh class B’. Smoking status includes ‘nonsmokers’ and ‘former or current smokers’. Interaction means relationship between disease category and smoking status.

Disease Category

0.022*

0.679

0.012*

0.538

0.044*

0.013*

Smoking Status

0.100

0.190

0.541

0.716

0.522

0.886

Interaction

0.072

0.244

0.316

0.612

0.538

0.547

H/L ratio

0.2653

0.089

-0.3072†

0.1666

-0.3395†

-0.4801††