Title: A study of serum arginase activity in diagnosis of liver diseases
Authors: P. Anand, A.K. Badrinath, Suresh Babu .S
DOI: https://dx.doi.org/10.18535/jmscr/v7i7.74
Abstract
Background: Liver disease presents as a spectrum of clinically asymptomatic liver disease to end stage liver disease. Various serum markers used in liver diseases but are not specific or sensitive and influenced by other factors. We do a battery of investigations - liver function tests. Liver biopsy is the gold standard investigation, but is invasive. There is a still a search for a non invasive and a better marker for diagnosis of liver diseases. Serum arginase an enzyme of urea cycle gets elevated in liver damage and can be used in diagnosing liver diseases.
Objective: To assess the serum arginase activity and state that it can be a marker of diagnosis of liver disease. To assess the severity of liver disease using serum arginase
Materials and Methods: This was a rural based teaching hospital based cross sectional study of 80 patients with liver diseases. The serum arginase level (by elisa method) in the patients were compared with the novel liver function tests. Also we analysed whether serum arginase can be used as a indicator of disease severity by comparing it with the Child-Pugh score and MELD score.
Results: The mean serum arginase value of the study subjects by ELISA method was 92.38 ng/ml with a p value of 0.01 and was found to be statistically significant. When compared with AST & ALT using Child Pugh and Meld score, serum arginase was found to have a poor correlation with severity with a p value of 0.976 with CP score and 0.83 with MELD score which was statistically insignificant. Serum AST values were better predictor of severity with a p value of 0.432 with CP score and 0.018 with MELD score which was statistically significant.
Conclusion: Serum arginase can be used in diagnosis of liver diseases but a poor indicator of the severity when compared with scoring systems. Serum AST correlated better with severity in this study.
References
- Giannini EG, Testa R, Savarino V. Liver enzyme alteration: a guide for clinicians. 2005;172(3):367–79.
- Pratt DS, Kaplan MM. Evaluation of abnormal liver-enzyme results in asymptomatic patients. N Engl J Med. 2000;342:1266–71.
- Van Zasten SJO, Depla ACTM, Dekker PC et al. The clinical importance of routine measurement of liver enzymes, total protein and albumin in a general medicine outpatient clinic:a prospective study. N Engl J Med. 1992;40:53
- Chrzanowska A, Mielczarek-putam, Skwarek A,, Krawczyl M, Baranczyk- kuzma A. Serum arginase activity in patient with liver cirrhosis and hepato cellular carcinoma. Wiad lek. 2007;60(5-6):215-18.
- Green RM, Flamm S. AGA technical review on the evaluation of liver chemistry tests. 2002;123:1367–84.
- Suthat L, Rong QI, David WC, Frank W. Relationship between alcohol drinking and aspartate aminotransferase,: alkaline aminotransferase (AST:ALT) ratio, Mean corpuscular volume (MCV), Gamma-glutamyl transpeptidase (GGT) and Apolipoprotein A1 and B in the US population. J Stud Alcohol Drugs. 2010;71:249-52.
- Francois D, Dominique V. Assessment of the prognosis of cirrhosis:Child–Pugh versus MELD. Journal of Hepatology. 2005;42:S100–S107.
- Ikemoto M, Tsunekawa S, Tanaka K, Tanaka A, Yamaoka Y, Ozawa K, et al. Liver-type arginase in serum during and after liver transplantation: a novel index in monitoring conditions of the liver graft and its clinical significance. Clin Chim Acta. 1998;271:11-23.
- Ikemoto M, Shoji T, Yoshinobu T, Masayuki T. Liver-Type Arginase is a highly sensitive marker for hepatocellular damage in rats. Clinical Chemistry. 2001;5(1):945-47.
- Masaki I, Shoji T, Masaaki A, Yoshihiro F, Hiroshi M, Makoto I, et al. A useful ELISA system for human liver type arginase and its utility in diagnosis of liver disease. Clinical biochemistry. 2001;34:455- 61.
- Ikemoto M, Ishida A, Tsunekawa S, Ozawa K, Kasai Y, Totani M, Ueda K. Development of a new ELISA system for human liver-type arginase and its potential clinical application. Clin Chem. 1993;39:794-99.
- Chrzanowska A, Grabon W, Mielczarek PM, Baranczyk KM. Significance of arginase determination in body fluids of patients with hepatocellular carcinoma and liver cirrhosis before and after surgical treatment. Clin Biochem. 2014;47(12): 1056-59.
- Robert TM, Santiago G. Serum arginase activity. Exp biol fv Med (Mayood). 1957; 95(2):225-26.
- Chhabra R J, Kamariya C P, Ketan M. Study on some amino acid metabolising enzymes and associated changes in certain human liver disorders. Int J of Clinical Biochemistry and Research. 2015;2(2):65-72.