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Zhang P, Gan D, Chi X, Mao D, Gao Y, Li Y, Zhou D, Li Q, Zhang M, Lu B, Li F, Xue J, Wang X, Du H, Li X, Liang Y, Ye Y. Regression-based Chinese norms of number connection test A and digit symbol test for diagnosing minimal hepatic encephalopathy. Sci Rep 2024; 14:4005. [PMID: 38369632 PMCID: PMC10874952 DOI: 10.1038/s41598-024-54696-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 02/15/2024] [Indexed: 02/20/2024] Open
Abstract
Number connection test A (NCT-A) and digit symbol test (DST), the preferential neuropsychological tests to detect minimal hepatic encephalopathy (MHE) in China, haven't been standardized in Chinese population. We aimed to establish the norms based on a multi-center cross-sectional study and to detect MHE in cirrhotic patients. NCT-A and DST were administered to 648 healthy controls and 1665 cirrhotic patients. The regression-based procedure was applied to develop demographically adjusted norms for NCT-A and DST based on healthy controls. Age, gender, education, and age by education interaction were all predictors of DST, while age, gender, and education by gender interaction were predictors of log10 NCT-A. The predictive equations for expected scores of NCT-A and DST were established, and Z-scores were calculated. The norm for NCT-A was set as Z ≤ 1.64, while the norm for DST was set as Z ≥ - 1.64. Cirrhotic patients with concurrent abnormal NCT-A and DST results were diagnosed with MHE. The prevalence of MHE was 8.89% in cirrhotic patients, and only worse Child-Pugh classification (P = 0.002, OR = 2.389) was demonstrated to be the risk factor for MHE. The regression-based normative data of NCT-A and DST have been developed to detect MHE in China. A significant proportion of Chinese cirrhotic patients suffered from MHE, especially those with worse Child-Pugh classification.
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Affiliation(s)
- Peng Zhang
- Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing, China
- Department of Gastroenterology and Hepatology, Beijing University of Chinese Medicine Affiliated Dongfang Hospital, Beijing, China
| | - Danan Gan
- Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing, China
- Department of Gastroenterology and Hepatology, Institute of Liver Disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Xiaoling Chi
- Department of Hepatology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Dewen Mao
- Department of Hepatology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi Province, China
| | - Yueqiu Gao
- Department of Hepatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yong Li
- Department of Hepatology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Daqiao Zhou
- Department of Hepatology, Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, Guangdong Province, China
| | - Qin Li
- The Fourth Ward, Fuzhou Infectious Disease Hospital, Fuzhou, Fujian Province, China
| | - Mingxiang Zhang
- Department of Integrated Traditional and Western Medicine on Liver Diseases, Shenyang Infectious Disease Hospital, Shenyang, Liaoning Province, China
| | - Bingjiu Lu
- Department of Hepatology, The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, China
| | - Fengyi Li
- Treatment and Research Center of Infectious Disease, The Fifth Medical Center of the General Hospital of the People's Liberation Army, Beijing, China
| | - Jingdong Xue
- Department of Hepatology, Shanxi Hospital of Traditional Chinese Medicine, Xi'an, Shanxi Province, China
| | - Xianbo Wang
- Department of Hepatology, Beijing Ditan Hospital, Beijing, China
| | - Hongbo Du
- Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing, China
- Department of Gastroenterology and Hepatology, Institute of Liver Disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Xiaoke Li
- Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing, China
- Department of Gastroenterology and Hepatology, Institute of Liver Disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Yijun Liang
- Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing, China
- Department of Gastroenterology and Hepatology, Institute of Liver Disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Yongan Ye
- Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing, China.
- Department of Gastroenterology and Hepatology, Institute of Liver Disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China.
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