Study of Adenosine Deaminase Levels Along With Alanine and Aspartate Aminotransferase, Total Proteins and A/G Ratio in Cirrhosis

Abstract

Liver is the most bio-chemically complex organ. It plays a vital role in the metabolism and in the detoxification and elimination of toxic substances. Alcohol is the most common cause of hepatic injury terminating in cirrhosis. Acetaldehyde metabolite formed during the metabolism of ethanol is very reactive compound and is the mediator of tissue and organ damage. Many individuals with liver disease maintain normal function despite extensive liver damage. In such cases measurement of liver enzymes which are released into circulation as a result of liver cell injury, through non-specific may be helpful to assess the severity of liver damage. Main aim of the study is to evaluate the serum adenosine deaminase activity (ADA) along with other known markers of liver function such as alanine aminotransferase (ALT), aspartate aminotransferase (AST),, Total proteins and A/G ratio in patients with alcoholic cirrhosis, infective hepatitis and to assess the utility of these parameters as diagnostic and prognostic indicators of liver function. This study was done at Gandhi Hospital secunderabad; The patients included in the study were selected from out-patient and wards of Gastroenterology department of Gandhi hospital. Oral informed consent was taken from the persons who were included in the study. 12 individuals aged between 25-60 yrs were taken as controls. Most of them were males. 12 patients clinically diagnosed as alcoholic cirrhosis, confirmed by history, abdominal ultrasound scan and altered liver functions and 11 patients with viral hepatitis(serologically positive for HbsAg) were selected for study. In our study raised serum ADA levels are seen in cirrhosis patients when compared to normal individuals. Serum transaminases showed moderate raise when compared to normal individuals. Serum AST levels were greater than ALT. The serum AST: ALT ratio is >1. The total serum proteins showed marked reduction when compared to normal individuals. Serum albumin is reduced to greater extent. Serum globulins were increased when compared to normal individuals, resulting in reversal of normal A/G ratio. The reverse of A/G ratio indicates the severity of disease.