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In the last years the link between the presence of muscular alterations and hepatic encephalopathy (HE), both minimal and overt, has been deeply studied. The pathophysiological background supporting the relationship between muscle depletion, and HE is characterized by an imbalance between the capacity of muscle in ammonia metabolism and trafficking and the inability of the liver in removing ammonia through urea synthesis due to liver failure and/or the presence of porto-systemic shunts. This review will focus on the clinical burden, the physio pathological mechanisms understanding the liver muscle axis and principles of management of muscular alterations in cirrhosis.
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http://dx.doi.org/10.3390/jcm11030611 | DOI Listing |
Metab Brain Dis
September 2025
Department of Gastroenterology/Internal Medicine, Graduate School of Medicine, Gifu University, Gifu, 1-1 Yanagido, 501-1194, Japan.
Identifying the risk of overt hepatic encephalopathy (OHE) in geriatric patients with cirrhosis remains challenging. This study aimed to investigate the independent factors for OHE development in geriatric cirrhosis and to establish a simple scoring model to identify individuals at risk for OHE. We conducted a retrospective review of geriatric patients with cirrhosis aged ≥ 80 years who were admitted between April 2006 and November 2022.
View Article and Find Full Text PDFJGH Open
September 2025
Department of Genomic Medicine, Division of Biochemistry, Molecular Biology, and Nutrition University Hospital of Nancy Nancy France.
Introduction: Cirrhosis progresses from compensated to decompensated phases, often marked by portal hypertension and complications like ascites, variceal hemorrhage, and hepatic encephalopathy. The ammonia-to-urea (A-to-U) ratio, reflecting urea cycle efficiency, may offer superior diagnostic performance compared to plasma ammonia levels alone. This study compared the diagnostic accuracy of the A-to-U ratio and plasma ammonia levels for identifying portal hypertension.
View Article and Find Full Text PDFHepatology
September 2025
Department of Gastroenterology and Hepatology, UT Southwestern, Dallas, TX.
Background: The clinical course and outcomes of alcohol-associated hepatitis (AH) remain poorly understood. Major adverse liver outcomes (MALO) do not capture the added risk of return to drinking (RTD). We examined the natural history of AH and developed a composite endpoint using a contemporary observational cohort of AH.
View Article and Find Full Text PDFPatent ductus venosus is a congenital portosystemic shunt that may cause progressive portal hypertension, hepatic encephalopathy, and focal nodular hyperplasia of the liver. Embolization of the Arantius' duct is the first choice of treatment in infants and children. However, it carries the risk of coil migration into the systemic circulation in adult patients with larger Arantius ducts.
View Article and Find Full Text PDFMetab Brain Dis
September 2025
Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo, Egypt.
Acute or chronic liver damage can result in Hepatic Encephalopathy (HE), a potentially fatal neuropsychiatric condition that leads to cerebral and neurological alterations. Dapagliflozin (DAPA), an orally active Sodium/Glucose cotransporter 2 inhibitor with long duration of action. The study aim was to evaluate the potential protective impact of DAPA against HE caused by Thioacetamide (TAA) in rats.
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