{"id":"b351f143-7e8c-5663-95f0-e726feb25667","stable_key":"e0ea2d6a-7429-5e9f-b774-41e5e3288da3:e-clin-cirrhosis-ratio-boundary","predicate":"normalization_changes","statement":"In the cirrhosis cohort, cholesterol normalization classified fewer patients as vitamin E deficient than absolute concentrations; the authors cautioned that the ratio could obscure reduced status in advanced liver disease.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"context_dependent","is_public":true,"mechanism_event_id":"68ccc0c5-69e0-5106-ba4b-68ca7cdc4dfc","mechanism_event_label":"Lipid correction is useful context, but it can also conceal a problem when liver disease changes both measurements.","subject":{"id":"d3a1b93d-0a2c-5d1b-b672-5e4ef4b09a10","slug":"cholesterol","display_name":"Cholesterol","entity_type_key":"lipid"},"object":{"id":"c3d98784-c6b5-5f67-a14d-260f8ded4e5d","slug":"vitamin-e-status-classification","display_name":"Vitamin E status classification","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"68ccc0c5-69e0-5106-ba4b-68ca7cdc4dfc","stable_key":"e0ea2d6a-7429-5e9f-b774-41e5e3288da3:e-clin-cirrhosis-ratio-boundary-event","event_type":"observed_intervention","label":"Lipid correction is useful context, but it can also conceal a problem when liver disease changes both measurements.","description":"In the cirrhosis cohort, cholesterol normalization classified fewer patients as vitamin E deficient than absolute concentrations; the authors cautioned that the ratio could obscure reduced status in advanced liver disease.","status":"provisional","compartment":null,"participants":[{"entity":{"id":"40a6525a-76b8-576e-b73d-1e11aecf5f8d","slug":"alpha-tocopherol","display_name":"Alpha-tocopherol","entity_type_key":"small_molecule"},"role":"measured_vitamer","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"d3a1b93d-0a2c-5d1b-b672-5e4ef4b09a10","slug":"cholesterol","display_name":"Cholesterol","entity_type_key":"lipid"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""},{"entity":{"id":"c3d98784-c6b5-5f67-a14d-260f8ded4e5d","slug":"vitamin-e-status-classification","display_name":"Vitamin E status classification","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":2,"notes":""}]},"contexts":[{"dimension":"availability_state","value_text":"biomarker_context","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null},{"dimension":"cross_nutrient","value_text":"false","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"experimental_model","value_text":"Observational comparison of 85 cirrhosis and 50 noncirrhotic liver-disease patients","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"Absolute vitamin E compared with vitamin E/cholesterol ratio using study-specific healthy-control reference limits.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"No direct tissue adequacy test. Cirrhosis changes lipid handling; neither an absolute concentration nor a normalized ratio alone establishes cellular function.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Vitamin E research collection; topical membership is not evidence of a direct dietary effect.","comparator":null,"unit":null,"notes":"","entity":{"slug":"vitamin-e","display_name":"Vitamin E","entity_type_key":"chemical_species"}},{"dimension":"organism","value_text":"Homo sapiens","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"Lipid correction is useful context, but it can also conceal a problem when liver disease changes both measurements.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[e-clin-cirrhosis1999] Vitamin E status in patients with liver cirrhosis: normal or deficient? (1999). https://pubmed.ncbi.nlm.nih.gov/9920150/ DOI: 10.1016/s0026-0495(99)90015-x","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"Serum and liver-disease context","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"trigger_kind","value_text":"biomarker_context","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null}],"evidence":[{"id":"571c9672-be0d-56c9-9da0-2db950db3b85","evidence_kind":"source_excerpt","locator":"Lines 1245-1256","start_line":1245,"end_line":1256,"excerpt":"### e-clin-cirrhosis-ratio-boundary\nIn the cirrhosis cohort, cholesterol normalization classified fewer patients as vitamin E deficient than absolute concentrations; the authors cautioned that the ratio could obscure reduced status in advanced liver disease.\nCondition category: biomarker_context\nnutrient_topic: Vitamin E research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: Lipid correction is useful context, but it can also conceal a problem when liver disease changes both measurements.\norganism: Homo sapiens\ntissue_or_cell_type: Serum and liver-disease context\nexperimental_model: Observational comparison of 85 cirrhosis and 50 noncirrhotic liver-disease patients\nlimitations: No direct tissue adequacy test. Cirrhosis changes lipid handling; neither an absolute concentration nor a normalized ratio alone establishes cellular function.\nexposure: Absolute vitamin E compared with vitamin E/cholesterol ratio using study-specific healthy-control reference limits.\ncross_nutrient: false\n[e-clin-cirrhosis1999] Vitamin E status in patients with liver cirrhosis: normal or deficient? (1999). https://pubmed.ncbi.nlm.nih.gov/9920150/ DOI: 10.1016/s0026-0495(99)90015-x","model_system":"Observational comparison of 85 cirrhosis and 50 noncirrhotic liver-disease patients","directness":"author_interpretation","verification_status":"source_derived_draft","notes":"Exact curation-document quotation, not publisher quotation. Study references: [e-clin-cirrhosis1999] Vitamin E status in patients with liver cirrhosis: normal or deficient? (1999). https://pubmed.ncbi.nlm.nih.gov/9920150/ DOI: 10.1016/s0026-0495(99)90015-x","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"3ac41dba-4727-5116-a556-ac3bbb0dc41c","stable_key":"import-e0ea2d6a-7429-5e9f-b774-41e5e3288da3","title":"Vitamin E: transport, membrane protection and nutrient interactions (2026-09-17)","document_type":"imported_text","citation_label":"AI-assisted literature curation; primary study URLs and scope retained in the document and extraction. Not publisher full text.","file_path":"","sha256":"a90b6565e092c6a2da07f74cf758792c2cf63b40746260c8ff12bd64322c36f4","revision_id":"956793d1-23e4-5397-9291-25c1732a8e02","review_status":"unverified_draft","notes":""}}],"relations":[],"conflicts":[],"corrections":[],"research":null}