Compartmental model describing the physiological basis for the HepQuant SHUNT test. 2023

Michael P McRae, and Steve M Helmke, and James R Burton, and Gregory T Everson
Custom Diagnostic Solutions LLC, Houston, Texas. Electronic address: michaelpmcrae@gmail.com.

The HepQuant SHUNT test quantifies hepatic functional impairment from the simultaneous clearance of cholate from the systemic and portal circulations for the purpose of monitoring treatment effects or for predicting risk for clinical outcome. Compartmental models are defined by distribution volumes and transfer rates between volumes to estimate parameters not defined by noncompartmental analyses. Previously, a noncompartmental analysis method, called the minimal model (MM), demonstrated reproducible and reliable measures of liver function (Translational Research 2021). The aim of this study was to compare the reproducibility and reliability of a new physiologically based compartmental model (CM) vs the MM. Data were analyzed from 16 control, 16 nonalcoholic steatohepatitis (NASH), and 16 hepatitis C virus (HCV) subjects, each with 3 replicate tests conducted on 3 separate days. The CM describes transfer of cholates between systemic, portal, and liver compartments with assumptions from measured or literature-derived values and unknown parameters estimated by nonlinear least-squares regression. The CM was compared to the MM for 6 key indices of hepatic disease in terms of intraclass correlation coefficient (ICC) with a lower acceptable limit of 0.7. The CM correlated well with the MM for disease severity index (DSI) with R2 (95% confidence interval) of 0.96 (0.94-0.98, P < 0.001). Acceptable reproducibility (ICC > 0.7) was observed for 6/6 and 5/6 hepatic disease indices for CM and MM, respectively. SHUNT, a measure of the absolute bioavailability, had ICC of 0.73 (0.60-0.83, P = 0.3095) for MM and 0.84 (0.76-0.90, P = 0.0012) for CM. The CM, but not the MM, allowed determination of anatomic shunt and hepatic extraction and improved the within individual reproducibility.

UI MeSH Term Description Entries
D008099 Liver A large lobed glandular organ in the abdomen of vertebrates that is responsible for detoxification, metabolism, synthesis and storage of various substances. Livers
D008111 Liver Function Tests Blood tests that are used to evaluate how well a patient's liver is working and also to help diagnose liver conditions. Function Test, Liver,Function Tests, Liver,Liver Function Test,Test, Liver Function,Tests, Liver Function
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000090005 Epidemiological Models Mathematical models of the transmission of infectious diseases. They predict spread of a disease by incorporating disease-related (e.g., infectious agent, mode of transmission, latent period, infectious period) and abiotic factors (e.g., social, cultural, demographic, and geographic factors). Communicable Disease Models,Compartmental Models,Models, Epidemiological,SIR Models,SIS Model,Susceptible Infected Recovered Models,Susceptible Infected Susceptible Model,Communicable Disease Model,Compartmental Model,Disease Model, Communicable,Epidemiological Model,Model, Communicable Disease,Model, Compartmental,Model, Epidemiological,Model, SIS,SIR Model,SIS Models
D015203 Reproducibility of Results The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results. Reliability and Validity,Reliability of Result,Reproducibility Of Result,Reproducibility of Finding,Validity of Result,Validity of Results,Face Validity,Reliability (Epidemiology),Reliability of Results,Reproducibility of Findings,Test-Retest Reliability,Validity (Epidemiology),Finding Reproducibilities,Finding Reproducibility,Of Result, Reproducibility,Of Results, Reproducibility,Reliabilities, Test-Retest,Reliability, Test-Retest,Result Reliabilities,Result Reliability,Result Validities,Result Validity,Result, Reproducibility Of,Results, Reproducibility Of,Test Retest Reliability,Validity and Reliability,Validity, Face
D020355 Cholates Salts and esters of CHOLIC ACID. Cholate
D065626 Non-alcoholic Fatty Liver Disease Fatty liver finding without excessive ALCOHOL CONSUMPTION. Fatty Liver, Nonalcoholic,NAFLD,Nonalcoholic Fatty Liver Disease,Nonalcoholic Steatohepatitis,Fatty Livers, Nonalcoholic,Liver, Nonalcoholic Fatty,Livers, Nonalcoholic Fatty,Non alcoholic Fatty Liver Disease,Nonalcoholic Fatty Liver,Nonalcoholic Fatty Livers,Nonalcoholic Steatohepatitides,Steatohepatitides, Nonalcoholic,Steatohepatitis, Nonalcoholic

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