Presepsin as a biomarker of bacterial translocation and an indicator for the prescription of probiotics in cirrhosis

Table 1 Main characteristics of cirrhosis patients with increased and normal presepsin levels, n (%)

	Patients with increased presepsin level	Patients with normal presepsin level	P value
Age, yr	49 (43-59)	52 (42-56)	0.868
Body mass index, kg/m2	25.9 (24.7-30.1)	25.3 (21.6-28.4)	0.275
Male/female	12/15	7/14	0.316
Etiology of cirrhosis: Alcohol	13 (48.1)	10 (47.6)	> 0.050
HBV	3 (11.1)	-
HCV	3 (11.1)	3 (14.3)
Metabolic dysfunction-associated steatotic liver disease	2 (7.4)	1 (4.8)
Mixed	4 (14.8)	3 (14.3)
Cryptogenic	2 (7.4)	4 (18.0)
Child–Pugh score	9 (8-10)	8 (7-9)	0.009
Esophageal varices (Grade 1)	9 (33.3)	9 (42.9)	0.353
Esophageal varices (Grade 2-3)	15 (55.5)	10 (47.6)	0.399
Minimal hepatic encephalopathy	19 (70.4)	14 (66.7)	0.588
Overt hepatic encephalopathy	1 (3.7)	3 (14.3)	0.215
Ascites	21 (77.7)	16 (76.2)	0.582
Ascites (Grade 1)	11 (40.7)	12 (57.1)	0.201
Ascites (Grade 2-3)	10 (37.0)	4 (19.0)	0.149
Serum total protein, g/L	73 (65-76)	70 (61-74)	0.344
Serum albumin, g/L	32 (30-34)	35 (33-37)	0.049
Serum total bilirubin, μmol/L	60 (36-78)	37 (26-57)	0.022
International normalized ratio	1.63 (1.39-1.75)	1.48 (1.36-1.61)	0.151
Red blood cells, 1012 cell/L	3.6 (3.1-4.2)	3.6 (3.3-4.2)	0.934
White blood cells, 109 cell/L	3.7 (2.6-5.2)	3.3 (2.6-5.9)	0.942
Platelets, 109 cell/L	94 (52-104)	94 (66-105)	0.64
Serum creatinine, μmol/L	77 (67-91)	76 (66-107)	0.625
Serum sodium, mmol/L	141 (139-142)	141 (140-142)	0.983
Alanine aminotransferase, U/L	26 (18-50)	28 (20-45)	0.723
Aspartate aminotransferase, U/L	52 (41-77)	48 (28-51)	0.151
Gamma glutamyl transferase, U/L	72 (44-114)	68 (37-269)	0.575
Alkaline phosphatase, U/L	261 (194-330)	242 (215-388)	0.506
C-reactive protein, mg/L	9 (5-15)	7 (3-12)	0.399
Splenic length, cm	15.0 (13.0-17.0)	15.0 (13.2-18.4)	0.708

HBV: Hepatitis B virus; HCV: Hepatitis C virus.

Table 2 Significant correlations between blood presepsin levels and gut microbiota taxa

Direct correlations			Inverse correlations
Taxon rank	Taxon	R, P value	Taxon rank	Taxon	R, P value
Phylum	Proteobacteria	0.316, 0.029	Family	Lachnospiraceae	0.447, 0.0421
Class	Bacilli	0.470, 0.0321		Propionibacteriaceae	-0.302, 0.038
	Gammaproteobacteria	0.351, 0.014	Genus	Fusicatenibacter	-0.297, 0.040
Family	Erysipelatoclostridiaceae	0.384, 0.007		Holdemanella	-0.315, 0.029
	Eubacteriaceae	0.340, 0.018
	Vibrionaceae	0.366, 0.010
	Xanthobacteraceae	0.363, 0.011
Genus	Escherichia-Shigella	0.338, 0.019
	Stenotrophomonas	0.365, 0.011
	Vibrio	0.346, 0.016

¹For the range of presepsin levels from 1 to 1000 pg/mL.

Table 3 Change in the values of the main cirrhosis indicators as a result of the probiotic (Saccharomyces boulardii) taking, depending on the baseline presepsin level, n (%)

	Elevated baseline presensin level (n = 13)			Normal baseline presensin level (n = 9)
	At the beginning of the study	After the probiotic course	P value	At the beginning of the study	After the probiotic course	P value
Child–Pugh score	9 (8-11)	7 (6-9)	0.004	8 (7-8)	7 (6-8)	0.124
Child–Pugh class, A/B+C	0/13	5/8	0.020	0/9	2/7	0.235
No hepatic encephalopathy	2 (15.4)	8 (61.5)	0.021	2 (22.2)	3 (33.3)	0.500
Ascites	12 (92.3)	5 (38.4)	0.006	8 (88.9)	5 (55.5)	0.147
Serum albumin, g/L	32 (30-34)	33 (32-39)	0.033	35 (33-36)	38 (37-39)	0.008
Serum total bilirubin, μmol/L	52 (36-120)	29 (26-40)	0.016	34 (26-44)	25 (22-35)	0.066
Alanine aminotransferase, U/L	26 (18-47)	26 (18-40)	0.272	30 (21-41)	33 (25-39)	0.813
Aspartate aminotransferase, U/L	60 (37-75)	39 (27-51)	0.012	45 (28-51)	36 (36-42)	0.314
Gamma glutamyl transferase, U/L	92 (44-207)	56 (40-89)	0.196	37 (31-317)	62 (30-115)	0.193
Alkaline phosphatase, U/L	268 (245-355)	210 (187-245)	0.013	261 (227-446)	215 (188-275)	0.110