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Diagnosis of chylous abdominal effusions: what is the triglyceride threshold value?

Authors :
Lefrère, Bertrand
Curis, Emmanuel
Bittar, Randa
Levasseur, Antoine
Grès, Pierre
Guilbert, Zoé
Zenati, Belkacem
Cherfils, Corinne
Sakka, Mehdi
Bonnefont-Rousselot, Dominique
Lefrère, Bertrand
Curis, Emmanuel
Bittar, Randa
Levasseur, Antoine
Grès, Pierre
Guilbert, Zoé
Zenati, Belkacem
Cherfils, Corinne
Sakka, Mehdi
Bonnefont-Rousselot, Dominique
Source :
Biochemia Medica; ISSN 1330-0962 (Print); ISSN 1846-7482 (Online); Volume 33; Issue 2
Publication Year :
2023

Abstract

IntroductionChylous abdominal effusions are serious complications that can be triggered by various aetiologies. The biochemical diagnosis of chyle leakage in ascites or in peritoneal fluid capsules relies on the detection of chylomicrons. Assaying the fluid’s concentration of triglycerides is still the first-line tool. Given that only one comparative study has sought to quantify the value of the triglyceride assay for diagnosing chylous ascites in humans, our objective was to provide practical triglyceride thresholds. Materials and methodsWe conducted a 9-year, retrospective, single-centre study of adult patients and compared a triglyceride assay with lipoprotein gel electrophoresis for the analysis of 90 non-recurring abdominal effusions (ascites and abdominal collections) of which 65 were chylous. ResultsA triglyceride threshold of 0.4 mmol/L was associated with a sensitivity > 95%, and a threshold of 2.4 mmol/L was associated with a specificity > 95%. According to Youden index, the best threshold was 0.65 mmol/L with a sensitivity of 88 (77-95)%, a specificity of 72 (51-88)%, and, in our series, a positive predictive value of 89 (79-95)% and a negative predictive value of 69 (48-86)%. ConclusionsIn our series, cut-off of 0.4 mmol/L could be used for ruling-out diagnosis of chylous effusions, while cut-off of 2.4 mmol/L could be used for reasonably confirming diagnosis.

Details

Database :
OAIster
Journal :
Biochemia Medica; ISSN 1330-0962 (Print); ISSN 1846-7482 (Online); Volume 33; Issue 2
Notes :
application/pdf, English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1394875538
Document Type :
Electronic Resource