Citation Information :
DS HK, CS MK, Vishwanath H. A Comparative Study in Assessing the Usefulness of Serum Cholinesterase, High Sensitivity C-reactive Protein with Liver Function Tests in Alcoholic Liver Disease. Indian J Med Biochem 2018; 22 (2):147-153.
Introduction: Chronic alcohol ingestion is one of the major causes of liver disease. The pathology of alcoholic liver disease consists of three major lesions (1) fatty liver; (2) alcoholic hepatitis; and (3) cirrhosis. Fatty liver is present in >90% of binge and chronic drinkers with a smaller percentage of heavy drinkers progressing to alcoholic hepatitis thought to be a precursor to cirrhosis. A lot of studies have been conducted in the past but requires further studies to prove its usefulness in the diagnosis of liver diseases. The present study has been planned to find out the use of assay of serum cholinesterase and high-sensitivity C-reactive protein (hs-CRP) in the diagnosis of alcoholic liver disease.
Materials and methods: Thirty male cases diagnosed with the alcoholic liver disease were compared with 30 male normal subjects as controls and 30 male non-alcoholic liver disease patients as an additional study group. The diagnosis was based on interview and questionnaire, clinical signs of liver disease and supporting laboratory tests [bilirubin, total protein, serum albumin, albumin:globulin (A:G), aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT)] and ultrasound.
Results and discussion: The study showed deranged liver function tests in both alcoholic and non-alcoholic cirrhosis patients compared to controls and normal liver function tests in controls. The serum cholinesterase levels were significantly decreased in alcoholic cirrhosis patients (2112.43 ± 1195.94) compared to non-alcoholic cirrhosis (4004.73 ± 971.03) patients with p-value < 0.001 whereas hs-CRP levels were significantly increased in non-alcoholic cirrhosis patients (1.79 ± 0.28) compared to alcoholic cirrhosis patients (1.23 ± 0.42) with p-value < 0.001.
Conclusion: To conclude, the marked decrease in serum cholinesterase in alcoholic cirrhosis patients suggest that its activity might be a specific indicator of liver dysfunction and may be used for the diagnosis of alcoholic cirrhosis patients and the hs-CRP can be used as a strong predictor of non-alcoholic cirrhosis.
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