Abstract
Background: Increased blood uric acid levels in chronic liver disease (CLD) promote endothelial dysfunction, insulin resistance, oxidative stress, and systemic inflammation, all of which are key risk factors for liver disease development.
Objective: The purpose of this study was to see correlation between blood uric acid levels with Child-Turcotte-Pugh (CTP) score and platelet indices.
Methods: A hospital-based cross-sectional research was conducted on individuals with CLD who were above the age of 18. A total of 54 people were included in the study. The levels of uric acid in the blood, as well as the CTP score and platelet indices, were assessed.
Results: Among 54 patients most patients belonged to CTP class C (51.85%) followed by CTP class B (40.74%) CTP class A (7.4%). The most prevalent cause of CLD (59.25%) is alcoholic liver disease. The average blood uric acid level in the CTP class A, B, C were 3.75 ± 1.5, 4.2 ± 2.29 and 6.26 ± 2.92 respectively andclinically important, showing positive correlation uric acid and CTP score (r value: 0.347, P- value 0.001). It was also found that platelet distribution width increases with increasing serum uric acid level.
Conclusion: A rise in serum uric acid level coincides with an increase in Child Pugh score, implying that uric acid estimation can be a viable and cost-effective diagnostic marker for assessing the severity of liver cirrhosis.
Keywords: CLD, Serum Uric acid, Child Pugh score, cirrhosis.
References
- Roth GA, Abate D, Abate KH. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018; 392:1736–1788.
- Anthony PP, Ishak KG, Nayak NC, Poulsen HE, Scheuer PJ, Sobin LH. The morphology of cirrhosis. Recommendations on definition, nomenclature, and classification by a working group sponsored by the World Health Organization. J Clin Pathol. 1978;31:395–414.
- D'Amico G, Garcia-Tsao G, Pagliaro L. Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies. J Hepatol. 2006;44:217–231.
- Fleming KM, Aithal GP, Card TR, West J. All-cause mortality in people with cirrhosis compared with the general population: a population-based cohort study. Liver Int. 2012;32:79–84.
- Ge PS, Runyon BA. Treatment of patients with cirrhosis. N Engl J Med. 2016; 375:767–777.
- Mukker P, Haridas A, Kallinkeel N, G AP. Comparative study of platelet indices in cirrhosis, cirrhosis with sepsis and normal population. Int J Res Med Sci. 2016 Dec 30;4(5):1423–8.
- Gasse P, Riteau N, Charron S, Girre S, Fick L, Pétrilli V, et al. Uric acid is a danger signal activating NALP3 inflammasome in lung injury inflammation and fibrosis. Am J Respir Crit Care Med. 2009 May 15;179(10):903-13.
- Takase S, Takada A, Tsutsumi M, Matsuda Y. Biochemical markers of chronic alcoholism. Alcohol. 1985;2:405-10.
- Yamamoto T, Moriwaki Y, Takahashi S. Effect of ethanol on metabolism of purine bases (hypoxanthine, xanthine, and uric acid). Clin Chim Acta. 2005 Jun;356(1–2):35–57.
- Choudhary J, Fiza B, Sinha M. Serum Uric Acid Level and Its Association with Child Pugh Score in Chronic Liver Disease. 2019 [cited 2021 Aug 26]; Available from: http://imsear.searo.who.int/handle/123456789/203475.
- Prakash BC, Rai SK. Study of serum uric acid in liver cirrhosis and its correlation with Child Turcotte Pugh, MELD and UKELD score. Int J Res Med Sci. 2020 Jan 27;8(2):450–4.
- Das J, Natarajan R, Deka G C.Serum Uric Acid Level in Chronic Liver Disease and Its Relation to Child-Turcotte-Pugh (CTP) Score. ijmsir, Vol( 5);4:148 – 160.
- Mukherjee PS, Vishnubhatla S, Amarapurkar DN, Das K, Sood A, Chawla YK, et al. Etiology and mode of presentation of chronic liver diseases in India: a multi centric study. PLoS One. 2017 Oct 26;12(10):1–13.
- Ahmed S, Payeng D, Das A. Etiological profile of cirrhosis of liver from North-East India with reference to their anti-hepatitis A virus seroprevalence. Oncol Gastroenterol Hepatol Reports. 2015 Jan;4(1):8.
- Operational guidelines of Non Alcoholic Fatty Liver Disease (NAFLD) into NPCDCS. Ministry of Health and Family welfare.[online].2021.[cited on dec 26]. Available from URL: https://main.mohfw.gov.in/newshighlights-42.
Corresponding Author
Dr Manomenane M
Postgraduate, Department of Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
DOI: https://dx.doi.org/10.18535/jmscr/v10i2.19
