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

ACTA MEDICA INDONESIANA · Vol. 57 No. 4 (2025)

ISSN
2338-2732, 0125-9326
Terbit
2025-12-23
Penerbit
The Indonesian Society of Internal Medicine
Bahasa
eng
Lisensi
creativecommons.org/licenses/by/4.0

Abstrak

Background: Short-chain fatty acids (SCFA) are the main metabolites of the intestinal microbiota, which play a role as colonocyte trophic factors and maintain the integrity of the gastrointestinal tract and blood-brain barrier. Microbiota dysbiosis that occurs in cirrhosis reduces SCFA production and plays a role in the pathogenesis of hepatic encephalopathy (HE). This study aims to compare the amount and composition of fecal SCFA in patients with cirrhosis, with and without HE. Methods: This research is a cross-sectional study at the Hepatobiliary Clinic and Integrated Procedure Room, Dr. Cipto Mangunkusumo Hospital, Jakarta, in 2023. Patients with cirrhosis underwent a flicker or Stroop test, fecal SCFA examination (acetate, butyrate, and propionate), and a questionnaire with a food recall technique to assess dietary patterns. Results: A total of 86 patients with cirrhosis participated in this study, with a mean age of 53 ± 8.10 years, and the majority were male (68.6%). Hepatic encephalopathy (HE) was identified in 20 patients (23.25%). Multivariable analysis of SCFA profiles showed no statistically significant associations with HE. The absolute SCFA proportion had an adjusted prevalence ratio (PR) of 1.98 [95% CI: 0.75–5.24; p = 0.171], the absolute acetate proportion had an adjusted PR of 2.06 [95% CI: 0.40–10.62; p = 0.388], and the butyrate proportion had an adjusted PR of 2.02 [95% CI: 0.76–5.39; p = 0.158]. Conclusion: Changes in SCFA composition may be associated with the presence of HE in patients with cirrhosis. Although no statistically significant relationships were found, these findings suggest that SCFA profiles warrant further investigation concerning dysbiosis and HE in cirrhosis.

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Rudi PutrantoAfiliasi tidak diketahui32
Siti SetiatiAfiliasi tidak diketahui19
Murdani AbdullahAfiliasi tidak diketahui17
Irsan HasanAfiliasi tidak diketahui14
Em YunirUniversity of Indonesia12
Dadang MakmunAfiliasi tidak diketahui11
Edward FaisalAfiliasi tidak diketahui10
Kuntjoro HarimurtiAfiliasi tidak diketahui10
Sally Aman NasutionAfiliasi tidak diketahui10
Pringgodigdo NugrohoAfiliasi tidak diketahui9
Chyntia Olivia Maurine JasirwanAfiliasi tidak diketahui8
Robert SintoAfiliasi tidak diketahui8
Achmad FauziAfiliasi tidak diketahui8
Alvina WidhaniAfiliasi tidak diketahui8
Rino Alvani GaniAfiliasi tidak diketahui7
Andri Sanityoso SulaimanAfiliasi tidak diketahui7
Khie Chen LieAfiliasi tidak diketahui7
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Kaka RenaldiAfiliasi tidak diketahui6
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Ari Fahrial SyamAfiliasi tidak diketahui6
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Kemal Fariz KalistaAfiliasi tidak diketahui4
Mira YuliantiAfiliasi tidak diketahui4
Idrus AlwiAfiliasi tidak diketahui4
Dante Saksono HarbuwonoAfiliasi tidak diketahui4
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Sumber metadata: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en-US">The Role of Changes in the Proportion of Fecal Short-Chain Fatty Acids on the Severity of Hepatic Encephalopathy in Cirrhosis Patients</dc:title>
	<dc:creator>Ferdianto, Mochamad Anief</dc:creator>
	<dc:creator>Kurniawan, Juferdy</dc:creator>
	<dc:creator>Maulahela, Hasan</dc:creator>
	<dc:creator>Rumende, Cleopas Martin</dc:creator>
	<dc:creator>Subekti, Imam</dc:creator>
	<dc:creator>Rinaldi, Ikhwan </dc:creator>
	<dc:creator>Shatri, Hamzah</dc:creator>
	<dc:creator>Lesmana, Cosmas Rinaldi </dc:creator>
	<dc:subject xml:lang="en-US">SCFA</dc:subject>
	<dc:subject xml:lang="en-US">cirrhosis</dc:subject>
	<dc:subject xml:lang="en-US">hepatic encephalopathy</dc:subject>
	<dc:subject xml:lang="en-US">feces</dc:subject>
	<dc:subject xml:lang="en-US">dysbiosis</dc:subject>
	<dc:description xml:lang="en-US">Background: Short-chain fatty acids (SCFA) are the main metabolites of the intestinal microbiota, which play a role as colonocyte trophic factors and maintain the integrity of the gastrointestinal tract and blood-brain barrier. Microbiota dysbiosis that occurs in cirrhosis reduces SCFA production and plays a role in the pathogenesis of hepatic encephalopathy (HE). This study aims to compare the amount and composition of fecal SCFA in patients with cirrhosis, with and without HE. Methods: This research is a cross-sectional study at the Hepatobiliary Clinic and Integrated Procedure Room, Dr. Cipto Mangunkusumo Hospital, Jakarta, in 2023. Patients with cirrhosis underwent a flicker or Stroop test, fecal SCFA examination (acetate, butyrate, and propionate), and a questionnaire with a food recall technique to assess dietary patterns. Results: A total of 86 patients with cirrhosis participated in this study, with a mean age of 53 ± 8.10 years, and the majority were male (68.6%). Hepatic encephalopathy (HE) was identified in 20 patients (23.25%). Multivariable analysis of SCFA profiles showed no statistically significant associations with HE. The absolute SCFA proportion had an adjusted prevalence ratio (PR) of 1.98 [95% CI: 0.75–5.24; p = 0.171], the absolute acetate proportion had an adjusted PR of 2.06 [95% CI: 0.40–10.62; p = 0.388], and the butyrate proportion had an adjusted PR of 2.02 [95% CI: 0.76–5.39; p = 0.158]. Conclusion: Changes in SCFA composition may be associated with the presence of HE in patients with cirrhosis. Although no statistically significant relationships were found, these findings suggest that SCFA profiles warrant further investigation concerning dysbiosis and HE in cirrhosis.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2025-12-23</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/2986</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 57 No. 4 (2025): Acta Medica Indonesiana; 454</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/2986/828</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2025 Mochamad Anief Ferdianto, Juferdy Kurniawan</dc:rights>
	<dc:rights xml:lang="en-US">https://creativecommons.org/licenses/by/4.0</dc:rights>
</oai_dc:dc>