Evaluation of serum C24 ceramide as a predictor of hepatic decompensation in patients with liver cirrhosis

Abstract EN

Background: It was found that there is a significant progressive decrease in the serum level of C24 ceramide with increasing severity of cirrhosis.

Our aim was to evaluate the efficacy of C24 Ceramide (C24Cer) as a predictor of decompensation in cirrhotic patients at Suez Canal University hospital, Ismailia, Egypt.

Subjects and Methods: Patients with viral related liver cirrhosis were consecutively confronted in the outpatient and inpatient sections.

They were classified according to Child-Pugh into A, B, C groups.

A control group (13 individuals) was compared with each group.

Clinical assessment and Liver profile were performed.

The serum level of C24Cer was measured using 20μL extracted serum with methanol: chloroform: HCl (15: 83: 2), using liquid chromatography coupled to tandem mass spectrometry.

Results: Patients with Child-A cirrhosis showed a significantly higher mean C24Cer level compared to Child-C patients (p <0.001).

Pairwise comparisons showed a statistically significant stepwise decrease in the mean C24Cer level from control group to Child-A, B then C cirrhotic patients respectively (p-value: 0.029, <0.001, and <0.001).

There was a highly significant negative correlation between C24Cer and each of total bilirubin, PT, ascites grade, hepatic encephalopathy grade, and Child score (p < 0.001 for each) as well as a highly significant positive correlation with albumin level (p < 0.001).

Conclusion: a low serum C24Cer is associated with hepatic decompensation and is good with a sensitivity of 100% and a specificity of 73% .

Further studies are needed to elucidate the real-life significance of C24Cer as a non-invasive mortality predictor in cirrhosis.