studies

928A AASLD ABSTRACTS HEPATOLOGY, October, 2015
analysis identified altered levels of metabolites associated with
bile acids, heme metabolism, sphingosine and lipids in HPS
relative to controls. Levels of 6 of 8 primary bile acids and
only 2 of 19 secondary bile acids were increased in HPS relative
to control (others unchanged) suggesting altered excretion
and gut microbial metabolism that may affect the vasculature.
Products of heme metabolism including bilirubin, biliverdin and
urobilinogen were also increased in HPS suggesting enhanced
hemoxygenase driven heme metabolism and/or impaired
clearance which may increase carbon monoxide production.
Levels of sphingosine metabolites, potent regulators of endothelin
and nitric oxide synthase signaling, were also elevated in
HPS. Finally, global increases in fatty acid levels with reduced
monoglycerol production were found in HPS suggesting
enhanced fatty acid release or decreased clearance. Random
forest analysis showed that selected metabolites distinguished
HPS from controls with 71% accuracy. Conclusion: Human HPS
has plasma metabolic signatures consistent with alterations
in sphingosine, bile acid, heme and fatty acid metabolism,
suggesting novel mechanistic pathways and possible links to
experimental HPS. Validation in larger cohorts is required.
Disclosures:
Michael B. Fallon - Grant/Research Support: Bayer/Onyx, Eaisi, Gilead, Grifolis
The following authors have nothing to disclose: Michael J. Krowka, Kimberly A.
Forde, Karen Krok, MAMTA PATEL, Grace Lin, Jae K. Oh, Carl Mottram, Paul D.
Scanlon, Sachin Batra, David S. Goldberg, Steven M. Kawut
and of BMI 27.12 ± 5.24. The frequency of malnutrition was
14.7% for BIA, 25% for BIVA, 32% for MAMC, 13% for TSF,
and 14 for % BMIa, In the Rxc graph only patients with clinical
ascites displayed fluid retention by BIVA (55.1% vs 44.9%
without ascites, p=0.005). Also, higher stages of Child-Pugh
were significantly associated with a higher rate of malnutrition
and fluid retention (data not shown). Kaplan-Meier curves disclosed
a higher mortality in the malnourished group identified
by BIVA (39.7% vs. 21.4% in non malnourished, p=