Gut microbiome in patients with cirrhosis and clinically significant portal hypertension: A pilot study

doi:10.4254/wjh.124666

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World Journal of Hepatology

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1948-5182

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Hepatol. Oct 27, 2026; 18(10): 124666
Published online Oct 27, 2026. doi: 10.4254/wjh.124666

Table 1 Patients’ main clinical features, n (%)/median (range)

Baseline parameters	Patients (n = 25)
Age, years	65 (40-72)
Male sex	20 (80)
Etiology
HBV	1 (4)
HCV	5 (20)
MetALD	18 (72)^a
MASLD	1 (4)
MELD	10 (6-16)
PH features
No EV	1 (4)
EV F1	14 (56)
EV F2	6 (24)
Previous EVL	4 (16)
Total bilirubin, mg/dL	1.2 (0.8-3.5)
AST, U/L	31 (22-82)
ALT, U/L	30 (15-57)
GGT, U/L	88 (24-369)
Platelet, n/μL	72 × 10³ (40 × 10³ - 169 × 10³)
T2DM	21 (84)
BMI	31 (24-46)
Splenomegaly¹	21 (84)
Liver elastography (kPa)	24.5 (18-64)

^aP < 0.01 metabolic disfunction and alcohol related liver disease more prevalent than hepatitis C virus + hepatitis B virus.

¹Spleen length > 12 cm.

HBV: Hepatitis B virus; HCV: Hepatitis C virus; AST: Aspartate amino transaminase; ALT: Alanine amino transaminase; GGT: Gamma-glutamyl transpeptidase; MetALD: Metabolic disfunction and alcohol related liver disease; MASLD: Metabolic disfunction associated steatosic liver disease; MELD: Model of end stage liver diseases; PH: Portal hypertension; EV: Esophageal varices; EVL: Esophageal varices ligation; BMI: Body mass index; T2DM: Type 2 diabetes mellitus.

Full Size Table

Table 2 Comparison of baseline parameters between patients with and without fecal pathobionts, n (%)/median (range)

Baseline parameters	Pts with pathobionts (n = 20)	Pts without pathobionts (n = 5)	P value
Age, years	61 (40-76)	66 (65-75)	NS
Sex, males	17 (85)	4 (80)	NS
Etiology
HBV	0	1 (20)	NS
HCV	3 (15)	2 (40)	NS
MetALD	12 (70)	1 (20)	NS
MASLD	0	1 (20)	NS
MELD	9 (7-23)	9 (8-10)	NS
PH features
No EV	1 (17)	0	NS
EV F1	11 (50)	3 (60)	NS
EV F2	6 (33)	1 (20)	NS
Previous EVL	2 (17)	1 (20)	NS
Total bilirubin, mg/dL	1.1 (0.7-10)	1.3 (1.2-2.0)	NS
AST, U/L	25 (21-69)	26 (23-27)	NS
ALT, U/L	22 (17-56)	27 (22-29)	NS
GGT, U/L	60 (27-551)	20 (20-26)	NS
Platelet, n/μL	67 × 10³ (32-222 × 10³)	73 × 10³ (55-79 × 10³)	NS
T2DM	17 (85)	0	< 0.01^a
BMI	31 (24-46)	25.5 (23-27)	NS
Splenomegaly¹	20 (100)	5 (100)	NS
Liver elastography (kPa)	23 (11-64)	17 (11-37)	NS

¹pleen length > 12 cm.

^aFisher exact test.

Pts: Patients; HBV: Hepatitis B virus; HCV: Hepatitis C virus; AST: Aspartate amino transaminase; ALT: Alanine amino transaminase; GGT: Gamma-glutamyl transpeptidase; MetALD: Metabolic disfunction and alcohol related liver disease; MASLD: Metabolic disfunction associated steatosic liver disease; MELD: Model of end stage liver diseases; PH: Portal hypertension; EV: Esophageal varices; EVL: Esophageal varices ligation; BMI: Body mass index; T2DM: Type 2 diabetes mellitus.

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Table 3 Comparison of baseline parameters of patients with micro and mycobiotal pathobionts and those without, n (%)

Baseline parameters	Pts with mycrobiota pathobionts (n = 6)	Pts with mycobiota pathobionts (n = 8)	Pts with mixed pathobionts (n = 6)	Pts without pathobionts (n = 5)
Age, years	66.5 (40-72)	57 (43-76)	61 (54-65)	66 (65-75)
Males	5 (83)	6 (75)	6 (100)	4 (80)
Etiology
HBV	0	0	0	1 (20)
HCV	0	2 (25)	1 (17)	2 (40)
MetALD	6 (100)	6 (75)	5 (83)	1 (20)
MASLD	0	0	0	1 (20)
MELD	8 (7-17)	9 (9-10)	10 (7-23)	9 (8-10)
PH features
No EV	1 (17)	0	0	0
EV F1	3 (50)	4 (50)	4 (50)	3 (60)
EV F2	2 (33)	2 (25)	2 (50)	1 (20)
Previous EVL	1 (17)	2 (25)	0	1 (20)
Total bilirubin, mg/dL	1.2 (0.8-3.5)	1.1 (0.7-2.0)	1.5 (0.5-10)	1.3 (1.2-2.0)
AST, U/L	25 (22-51)	15 (27-69)	27 (21-64)	26 (23-27)
ALT, U/L	24 (17-56)	21.5 (18-45)	26 (12-44)	27 (22-29)
GGT, U/L	70 (35-551)	60 (27-380)	60 (24-105)	20 (20-26)
Platelet, n/μL	67 × 10³ (38-222 × 10³)	62 × 10³ (38-222 × 10³)	74 × 10³ (32-112 × 10³)	73 × 10³ (55-79 × 10³)
T2DM	6 (100)	6 (75)	5 (83)	0
BMI	25 (24-37)	32.5 (24-38)	31 (24-46)	25.5 (23-27)
Splenomegaly¹	6 (100)	8 (100)	6 (100)	5 (100)
Liver elastography (kPa)	15 (11-63)	44 (25-64)	23 (20-24)	17 (11-37)

¹Spleen length > 12 cm.

Full Size Table

Citation: Colucci G, Stella S, Castagnetti A, Di Rito L, Lucà M, Tosetti G, D’Ambrosio R, Lampertico P. Gut microbiome in patients with cirrhosis and clinically significant portal hypertension: A pilot study. World J Hepatol 2026; 18(10): 124666
URL: https://www.wjgnet.com/1948-5182/full/v18/i10/124666.htm
DOI: https://dx.doi.org/10.4254/wjh.124666

Colucci G, Stella S, Castagnetti A, Di Rito L, Lucà M, Tosetti G, D’Ambrosio R, Lampertico P. Gut microbiome in patients with cirrhosis and clinically significant portal hypertension: A pilot study. World J Hepatol 2026; 18(10): 124666 [DOI: 10.4254/wjh.124666]

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