Blood serum enzymatic activities for the diagnosis and differential diagnosis of chronic diffuse liver diseases
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2019;18(4):46-59.
Differential diagnosis of chronic hepatitis and hepatic cirrhosis in the early stages without the use of liver biopsy is difficult, and therefore the search for noninvasive markers of chronic diffuse liver diseases remains relevant. Changes in the enzymatic activities of blood serum can be used in the development of noninvasive markers of liver fibrosis and cirrhosis.
Objectives. To evaluate the possibility of using blood serum enzymatic activities as non-invasive markers of liver fibrosis and cirrhosis.
A total of 41 patients with chronic hepatitis and 102 patients with hepatic cirrhosis were examined. The control group included 43 practically healthy people. Patients underwent clinical and laboratory examinations, liver cirrhosis indices, levels of interleukin-13, alpha-1-defensin, hyaluronidase, trypsin-like, deoxyribonuclease and elastase blood serum levels were determined. In patients with chronic hepatitis, an increase in serum hyaluronidase, trypsin-like, deoxyribonuclease and elastase activity was found in comparison with the control group (p<0.05). In patients with liver cirrhosis, there was an increase in hyaluronidase, deoxyribonuclease and elastase, as well as a decrease in the trypsin-like activity of blood serum compared with healthy individuals (p<0.05). The correlations of the studied activities with clinical and laboratory parameters, the levels of interleukin-13 and alpha-1-defensin were established. The cut-off values of the activities were determined, at which, with high sensitivity and specificity, they can be used for the diagnosis and differential diagnosis of chronic diffuse liver diseases.
Key words: chronic hepatitis, liver cirrhosis, hyaluronidase activity, trypsin-like activity, deoxyribonuclease activity, elastase activity.
The study was supported by the Belarusian Republican Foundation for Fundamental Research.
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Information about authors:
Pryshchepenka V.A. – postgraduate of the Chair of Internal Diseases Propedeutics, Vitebsk State Order of Peoples’ Friendship Medical University.