Serum cholinesterase as liver function test in cirrhotic patients at Soba Teaching hospital, Khartoum, Sudan

Abstract

It is suggested that plasma cholinesterase level is affected by liver cirrhosis due to hepatocyte injury. The objective of this study was to determine cholinesterase values in association with albumin and prothrombin during both the compensated and decompensated stages in cirrhotic patients. A total of 150 consecutive episodes of liver cirrhotic patients, aged (68.9 ± 10 years) admitted to the hospital between June 2015 and December 2015 were studied. They were classified into subgroups according to severity and the stages of disease into group A (compensated stage) and group B (decompensated stage), each containing 75 patients. Fifty apparently healthy participants aged 64.5 ± 13 years were recruited as controls. Blood samples were drawn and targeted parameters were assessed using commercial kits according to the manufacturer's guide. SPSS package was used for data analysis. There was a significant difference in the mean serum cholinesterase activity, albumin level and prothrombin time of cases and controls. The mean serum cholinesterase value of compensated cirrhotic patients was 3143.83 ± 1583.44 IU/L and it was significantly higher (p = 0.000) than that of decompensated cirrhotic patients (1895.32 ± 531.79 IU/L). There was a strong negative correlation between serum cholinesterase activity and prothrombin time (r = -0.580, p = 0.000) and a strong positive correlation between serum cholinesterase activity and albumin concentration (r = 0.617, p = 0.00). The results conclude that, cholinesterase level reflects liver cell conditions wherein low levels indicate hepatocellular damage. In addition, its levels are stable and not easily affected by medications that are given for cirrhotic patients thus, can be used as a marker for the diagnosis and prognosis of liver damage along with prothrombin time and albumin.

Serum Cholinesterase Level in Patients with Cirrhosis of Liver and Its Correlation with the Severity of the Disease

“…The result was statistically significant (p<.001). This was in agreement with the findings of Mohamed et al 6 , Thathiya et al 7 , and Ramachandran et al 8 . Mohamed et al found mean serum cholinesterase 2519.58 ± 3.2 U/L in cirrhotic patients and 5984.0 ± 1.9 U/L in controls.…”

“…Mohamed et al found mean serum cholinesterase 2519.58 ± 3.2 U/L in cirrhotic patients and 5984.0 ± 1.9 U/L in controls. 6 In Ramachandran et al, median serum cholinesterase in cirrhotic patients was 1590 U/L (110-8143U/L) compared to controls 7886 U/L (2022-21673U/L), p < 0.001. 8 In the study of Thathiya et al, the level of serum cholinesterase was significantly lower in chronic liver disease patients (2314 ± 1413 U/L) when compared to controls (7883 ± 1012 U/L).…”

“…In the study of Mohamed et al, a similar finding was observed in albumin level and prothrombin time. 6 Serum albumin level and prothrombin time are useful tools for monitoring the synthetic activity of the liver. Thus, albumin levels decrease when cirrhosis occurs, and they have prognostic value in cirrhotic patients.…”

“…In a study, Ramachandran et al found serum cholinesterase levels below 3506 had 98.7% sensitivity and 80.3% specificity in predicting cirrhosis. 6 They also mentioned that it is useful in assessing the prognosis of cirrhosis. Meng et al found that the combination of cholinesterase with the Child-Pugh score may be more subjective and accurate in evaluating the liver reserve function of cirrhotic patients.…”

Study of serum cholinesterase as a biomarker in a sample of patients with viral hepatitis B or hepatitis C in Baghdad

“…Therefore, a more precise and sensitive test for diagnosing liver disease is needed (4). Cholinesterases are a class of enzymes that catalyze the breakdown of the neurotransmitter acetylcholine, producing choline and acetic acid, a necessary process for cholinergic neurotransmission to be restored (5). Cholinesterases are classified into two types: acetylcholinesterase (AChE) and butyryl cholinesterase (BChE).…”