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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
Published
2025-12-23
Publisher
The Indonesian Society of Internal Medicine
Language
eng
License
creativecommons.org/licenses/by/4.0

Abstract

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.

Keywords

Collaboration network of the authors

40 authors · 326 co-authorship links · showing the 40 most connected

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  • University of Indonesia
  • National Research and Innovation Agency
  • Affiliation unknown
  • Different organisations
  • Same organisation
  • Affiliation unknown
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Co-authorOrganisationJoint articles
Rudi PutrantoAffiliation unknown32
Siti SetiatiAffiliation unknown19
Murdani AbdullahAffiliation unknown17
Irsan HasanAffiliation unknown14
Em YunirUniversity of Indonesia12
Dadang MakmunAffiliation unknown11
Edward FaisalAffiliation unknown10
Kuntjoro HarimurtiAffiliation unknown10
Sally Aman NasutionAffiliation unknown10
Pringgodigdo NugrohoAffiliation unknown9
Chyntia Olivia Maurine JasirwanAffiliation unknown8
Robert SintoAffiliation unknown8
Achmad FauziAffiliation unknown8
Alvina WidhaniAffiliation unknown8
Rino Alvani GaniAffiliation unknown7
Andri Sanityoso SulaimanAffiliation unknown7
Khie Chen LieAffiliation unknown7
Iris RengganisAffiliation unknown6
Kaka RenaldiAffiliation unknown6
Dyah PurnamasariAffiliation unknown6
Marcellus SimadibrataAffiliation unknown6
Ari Fahrial SyamAffiliation unknown6
Leonard NainggolanAffiliation unknown6
Cosphiadi IrawanAffiliation unknown5
Pradana SoewondoAffiliation unknown5
Dicky Levenus TahaparyAffiliation unknown5
Kemal Fariz KalistaAffiliation unknown4
Mira YuliantiNational Research and Innovation Agency4
Idrus AlwiAffiliation unknown4
Dante Saksono HarbuwonoAffiliation unknown4
Evy YunihastutiAffiliation unknown4
Andhika RachmanAffiliation unknown3

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, first harvested 8 Nov 2026, last seen 8 Nov 2026.
Original metadata (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>