Abdel-Razik A, et al. - Researchers evaluated serum homocysteine as a precise indicative marker for the diagnosis of all variants of spontaneous bacterial peritonitis (SBP). As compared to the non-SBP patients, serum and ascitic homocysteine were considerably elevated in SBP patients. Results of this study suggested that serum homocysteine could provide a safe and noninvasive diagnostic marker for all variants of SBP.

Methods

• In this prospective work, 323 consecutive ascitic patients were registered.
• Utilizing an enzyme-linked immunosorbent assay, serum and ascitic fluid of homocysteine were evaluated.

Results

• Participants in the study were classified into a non-SBP group, comprising 262 members and a SBP group with 61 members.
• It was observed that serum and ascitic homocysteine were considerably elevated in the SBP group vs the non-SBP group (17.94±7.57 vs. 11.75±5.68 μmol/l; P<0.001 and 14.70±5.45 vs. 9.75±4.55 μmol/l; P<0.001).
• At a cutoff value of 17.79 μmol/l, serum homocysteine had 89.3% specificity and 95.1% sensitivity for distinguishing SBP (area under the curve: 0.932).
• At a cutoff value of 16.1 μmol/l, ascitic homocysteine had 84.4% specificity and 92.7% sensitivity for distinguishing SBP (area under the curve: 0.901).
• It was noted that both were positively linked with the polymorphonuclear count, C-reactive protein, Child–Pugh score, and Model For End-Stage Liver Disease score, and negatively linked with the protein content in the ascitic fluid and estimated glomerular filtration rate.
• There was a marked reduction in serum and ascitic homocysteine levels after SBP therapy.