A Comparative Study of Pseudocholinesterase Activities in Relation to Transaminases, GGT and ALP in Liver Disorder in Hospital Based Study

Abstract

Objective: To compare pseudocholinesterase activities in relation to transaminases, GGT and ALP in liver diseases. Method: A prospective study was conducted at College of Medical Sciences –Teaching Hospital (CMS-TH), from May 2011 to May 2013 with 25 healthy (controls) and 25 diagnosed cases each of carcinoma of liver, cirrhosis of liver, infective hepatitis and obstructive jaundice among both sexes of same age group attending medical outpatient and inpatient departments. Serum pseudocholinesterase and other liver function test parameters were performed with semi - autoanalyzer and Roche Hitachi 902 respectively. Result: Pseudocholinesterase level was significantly decrease in the order of control (mean ± SD = 6865.12 ± 928.41) > obstructive jaundice (mean ± SD = 5539 ± 791.05) > infective hepatitis (mean ± SD = 3800.69 ± 764.17) > cirrhosis of liver (mean ± SD = 1735.16 ± 433.82) > carcinoma of liver (mean ± SD = 1369.48 ± 276.64). The difference in the means was statistically significant (p<0.001). Similarly aspartate transaminase (AST) (Mean ± SD= 311.48 ± 177.15) and alanine transaminase (ALT) (Mean ± SD = 491.36 ± 308.92) were higher in hepatitis but in carcinoma of liver the AST (Mean ± SD = 292.55 ± 92.85) level was higher than ALT (Mean ± SD = 179.24 ± 70.25). The difference in the means was statistically significant (p<0.001). AST level was 1.6 time higher than ALT. alkaline phosphatase (ALP) (Mean ± SD = 419.39 ± 90.49) and gamma glutamyl transaminase (GGT) (Mean ± SD = 257.81 ± 68.29) level were higher in obstructive jaundice and GGT (Mean ± SD = 195.54 ± 107.75) level was found to be higher in carcinoma of liver. The difference in the means was statistically significant (p<0.001) Conclusion: There was significant decrease in pseudocholinesterase level in carcinoma of liver followed by cirrhosis of liver and less so in infective hepatitis. AST and ALT level were higher in hepatitis cases. The level of AST was found higher in carcinoma of liver than ALT. In obstructive jaundice ALP and GGT was raised and statistically significant. GGT level was raised in carcinoma of liver. Pseudocholinesterase level was found to be normal in obstructive jaundice. The study results indicated that with more severe liver cell destruction or cell degeneration, there was corresponding significant decrease in the level of pseudocholinesterase, which could be used as diagnostic marker of liver disease.