{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:34:50Z","timestamp":1787027690127,"version":"build-2736575974"},"reference-count":60,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T00:00:00Z","timestamp":1730851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fondo de Investigaci\u00f3n Sanitaria (FIS), Instituto de Salud Carlos III, Madrid, Spain","award":["PI19\/00275"],"award-info":[{"award-number":["PI19\/00275"]}]},{"name":"Fondo de Investigaci\u00f3n Sanitaria (FIS), Instituto de Salud Carlos III, Madrid, Spain","award":["PR-455\/2020"],"award-info":[{"award-number":["PR-455\/2020"]}]},{"DOI":"10.13039\/501100004587","name":"European Union, Fondo Europeo de Desarrollo Regional (FEDER) \u201cUna manera de hacer Europa\u201d","doi-asserted-by":"publisher","award":["PI19\/00275"],"award-info":[{"award-number":["PI19\/00275"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"European Union, Fondo Europeo de Desarrollo Regional (FEDER) \u201cUna manera de hacer Europa\u201d","doi-asserted-by":"publisher","award":["PR-455\/2020"],"award-info":[{"award-number":["PR-455\/2020"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Col\u00b7legi Oficial d\u2019Infermeres i Infermers de Barcelona (COIB), Spain","award":["PI19\/00275"],"award-info":[{"award-number":["PI19\/00275"]}]},{"name":"Col\u00b7legi Oficial d\u2019Infermeres i Infermers de Barcelona (COIB), Spain","award":["PR-455\/2020"],"award-info":[{"award-number":["PR-455\/2020"]}]},{"name":"Mendes SA (Lugano, Switzerland)","award":["PI19\/00275"],"award-info":[{"award-number":["PI19\/00275"]}]},{"name":"Mendes SA (Lugano, Switzerland)","award":["PR-455\/2020"],"award-info":[{"award-number":["PR-455\/2020"]}]},{"name":"Infisport (Valencia, Spain)","award":["PI19\/00275"],"award-info":[{"award-number":["PI19\/00275"]}]},{"name":"Infisport (Valencia, Spain)","award":["PR-455\/2020"],"award-info":[{"award-number":["PR-455\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>Frailty in cirrhosis or advanced chronic liver disease (ACLD) is a relevant prognostic factor. In the present study, we aimed to analyze potential biomarkers associated with frailty and its improvement in patients with ACLD. We analyzed the serum of outpatients with ACLD who participated in a previous study (Rom\u00e1n, Hepatol Commun 2024) in which frailty was assessed using the liver frailty index (LFI), and patients who were frail or prefrail were randomized to a multifactorial intervention (home exercise, branched-chain amino acids, and probiotics) or control for 12 months. We determined a biomarker battery of inflammation, bacterial translocation, and liver damage in blood and urine and blood metabolomics by 1H-NMR. Thirty-seven patients were included. According to the LFI, 32 patients were frail or prefrail, and 5 were robust. At baseline, LFI correlated with LBP, sCD163, mtDNA, FGF-21, urinary NGAL, urinary claudin-3, and the metabolites mannose, ethanol, and isoleucine. During the study, patients in the intervention group showed an improvement in LFI and a decrease in CRP, LBP, sCD163, and ccK18 compared to the control group. Metabolomics showed a decrease in dimethyl sulfone and creatinine and an increase in malonate, ornithine, isoleucine, and valine in the intervention group. We conclude that frailty in patients with ACLD is associated with biomarkers of systemic inflammation, bacterial translocation, and liver damage, and alterations of amino acid and short-chain fatty acid metabolism.<\/jats:p>","DOI":"10.3390\/biom14111410","type":"journal-article","created":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T06:27:39Z","timestamp":1730874459000},"page":"1410","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Biomarkers of Frailty in Patients with Advanced Chronic Liver Disease Undergoing a Multifactorial Intervention Consisting of Home Exercise, Branched-Chain Amino Acids, and Probiotics"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1593-7376","authenticated-orcid":false,"given":"Luca","family":"Laghi","sequence":"first","affiliation":[{"name":"Department of Agricultural and Food Sciences, University of Bologna, 47521 Cesena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1574-9861","authenticated-orcid":false,"given":"Maria \u00c0ngels","family":"Ortiz","sequence":"additional","affiliation":[{"name":"Institut de Recerca Sant Pau (IR Sant Pau), 08041 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8617-5984","authenticated-orcid":false,"given":"Giacomo","family":"Rossi","sequence":"additional","affiliation":[{"name":"School of Veterinary Medical Sciences, University of Camerino, 62032 Camerino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Rom\u00e1n","sequence":"additional","affiliation":[{"name":"CIBERehd (Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"University Nursing School EUI-Sant Pau, 08025 Barcelona, Spain"},{"name":"Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0602-3003","authenticated-orcid":false,"given":"Carlo","family":"Mengucci","sequence":"additional","affiliation":[{"name":"Department of Agricultural and Food Sciences, University of Bologna, 47521 Cesena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabet","family":"Cant\u00f3","sequence":"additional","affiliation":[{"name":"Institut de Recerca Sant Pau (IR Sant Pau), 08041 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5990-1514","authenticated-orcid":false,"given":"Lucia","family":"Biagini","sequence":"additional","affiliation":[{"name":"School of Veterinary Medical Sciences, University of Camerino, 62032 Camerino, 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Pau, 08041 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep","family":"Padr\u00f3s","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Josep","family":"Nadal","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berta","family":"Cuy\u00e0s","sequence":"additional","affiliation":[{"name":"CIBERehd (Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, 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