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We wish to emphasise, however, that the present study did not measure any direct marker of hepatic or systemic oxidative stresssuch as the GSH/GSSG ratio, malondialdehyde, F2-isoprostanes, or 8-hydroxy-2-deoxyguanosineand the observed clinical pattern is equally compatible with several non-redox explanations: differential reversibility of the underlying precipitating event between phenotypes, differential intensity of concurrent standard-of-care interventions in the sicker subgroup (infection control, alcohol abstinence, diuretic optimisation, nutritional support), and statistical regression toward the mean in patients with the highest baseline biochemical values

The first three have previously been reported as fasting markers 16,20 , but KB is novel

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