Abstract
Background: The Model for End-Stage Liver Disease (MELD) score is used to assess the degree of hepatic insufficiency. In order to find a predictive indicator for the severity of liver disease we investigated the correlation of inflammatory parameters [Quinolinic acid (QuinA), neopterin, C-reactive protein (CRP), and Iinterleukin-6] with MELD score. Method: Serum samples from ninety-four patients with liver cirrhosis were categorized in 2 groups according to MELD score (group-I, MELD <20, n = 61) and (group-II, MELD≥20, n = 33). QuinA was analysed using tandem mass spectrometry. Serum levels of CRP, IL-6, and neopterin were estimated by ELISA. Results: Serum levels of QuinA, neopterin, CRP, and IL-6 were significantly correlated with MELD score (r = 0.77, 0.75, 0.57, and 0.50; p < 0.0001, respectively). Patients of group-II had significantly higher serum levels QuinA, neopterin, CRP, and IL-6 than group-I (p ≤ 0.0001). ROC curve analysis showed that QuinA and neopterin are more sensitive markers of severity of liver disease than CRP and IL-6 (AUC=0.89, 0.89, 0.74 and 0.73, respectively). Conclusion: Our data indicate that increased QuinA and neopterin concentrations in correlation with MELD score reflect not only the status of activated cell-mediated immunity but also the severity of liver dysfunction.
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