{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T05:57:49Z","timestamp":1773295069019,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,8,12]],"date-time":"2017-08-12T00:00:00Z","timestamp":1502496000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Italian Ministry of Health","award":["GR 2009-1604309"],"award-info":[{"award-number":["GR 2009-1604309"]}]},{"name":"Gobierno de Extremadura","award":["PO14013"],"award-info":[{"award-number":["PO14013"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Sleep preparation\/onset are associated with peripheral vasodilatation and a decrease in body temperature. The hyperdynamic syndrome exhibited by patients with cirrhosis may impinge on sleep preparation, thus contributing to their difficulties falling asleep. The aim of this study was the assessment of skin temperature, in relation to sleep\u2010wake patterns, in patients with cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty\u2010three subjects were initially recruited, and 46 completed the study. Of the final 46, 12 were outpatients with cirrhosis, 13 inpatients with cirrhosis, 11 inpatients without cirrhosis and 10 healthy volunteers. All underwent baseline sleep\u2010wake evaluation and blood sampling for inflammatory markers and morning melatonin levels. Distal\/proximal skin temperature and their gradient (<jats:styled-content style=\"fixed-case\">DPG<\/jats:styled-content>) were recorded for 24\u00a0hours by a wireless device. Over this period subjects kept a sleep\u2010wake diary.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Inpatients with cirrhosis slept significantly less well than the other groups. Inpatients and outpatients with cirrhosis had higher proximal temperature and blunted rhythmicity compared to the other groups. Inpatients with\/without cirrhosis had higher distal temperature values and blunted rhythmicity compared to the other groups. Inpatients and outpatients with cirrhosis had significantly lower <jats:styled-content style=\"fixed-case\">DPG<\/jats:styled-content> values compared to the other groups, and <jats:styled-content style=\"fixed-case\">DPG<\/jats:styled-content> reached near\u2010zero values several hours later. Significant correlations were observed between temperature and sleep\u2010wake variables and inflammatory markers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Alterations of distal\/proximal skin temperature, their gradient and their time\u2010course were observed in patients with cirrhosis, which may contribute to their sleep disturbances.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13525","type":"journal-article","created":{"date-parts":[[2017,7,21]],"date-time":"2017-07-21T16:33:20Z","timestamp":1500654800000},"page":"1833-1842","source":"Crossref","is-referenced-by-count":34,"title":["Abnormalities in the 24\u2010hour rhythm of skin temperature in cirrhosis: Sleep\u2010wake and general clinical implications"],"prefix":"10.1111","volume":"37","author":[{"given":"Maria","family":"Garrido","sequence":"first","affiliation":[{"name":"Department of Medicine University of Padova  Padova 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