Serum Kallistatin and Cholinesterase as Biomarkers for the Diagnosis of Liver Cirrhosis in Patients with Hepatitis C Viral Infection
Amany M. Elsaeed, Sahar Mohamed Ismail, Naglaa A. Elgendy · Clinical Medicine and Diagnostics · 2016
Background: Early diagnosis of liver cirrhosis in chronic hepatitis C patients is important because cirrhosis per se is an independent predictor of mortality. Cirrhosis is diagnosed clinically, the use of laboratory and imaging data, and liver biopsy. However, these methods have their limitations. These findings suggest the need for diagnostic biomarkers that could add to the sensitivity and accuracy. Serum Kallistatin and cholinesterase may fall into this category of bio markers as the liver represents the major site of synthesis and secretion of both of them and their levels reflect the synthetic function of liver. Objective: To assess serum Kallistatin and cholinesterase levels in cases of liver cirrhosis due to hepatitis C viral infection and correlates their levels with compensated liver cirrhosis and decompensated cirrhosis, and their serum levels with incidence of hepatocellular carcinoma. Methods: Forty-five patients who were included and classified into 15 patients with compensated liver cirrhosis, 15 patients with decompensated liver cirrhosis and 15 patients with hepatocellular carcinoma. They were compared with 15 sex and age matched healthy individuals for control. Levels of serum kallistatin was measured by enzyme-linked immunosorbent assay and serum cholinesterase was measured using colorimetric assay. Results: There was a highly significant decrease in serum Kallistatin and cholinesterase in patients with compensated cirrhosis when compared with control (P<0.000) and decreased levels in decompensated cirrhotic patients. The lowest levels of serum kallistatin and cholinesterase were found in decompensated cirrhotic patients as compared to compensated and HCC patients (P <0.000- P <0.000), respectively. Conclusion: Both serum kallistatin and cholinesterase can be used as reliable biomarkers for the diagnosis of, evaluation of the extent of liver cirrhosis and progression to hepatocellular carcinoma.