Association of Caffeine Clearance with Serum AST/ALT Ratio in Chronic Liver Disease

Abstract

Background: Serum AST/ALT ratio more than one (>1) was seen to be the first manifestation of cirrhosis in
chronic liver disease. It was considered to be due to increased serum AST level by its release from the
mitochondria of massive number of necrosed liver cells with a simultaneous decrease in serum ALT level
due to decreased production by reduced number of living hepatocytes. It increases with increasing degree
of fibrosis. Caffeine clearance test measures the hepatic microsomal function quantitatively. The aim of the
present study was to find a correlation between caffeine clearance and AST/ALT ratio in patients of cirrhosis
to prove the efficacy of caffeine clearance test to measure the extent of liver fibrosis.
Methods: Forty (40) hospitalized patients of chronic liver disease were included in this study. According to
Child Pugh scoring, twenty-seven (27) patients belonged to Child class Aand thirteen (13) to Child class B.
A baseline blood sample was drawn after an overnight fast immediately followed by oral administration of
200 mg caffeine. Three more blood samples were drawn after three hours intervals. Caffeine concentration
was measured by High Performance Liquid Chromatography (HPLC). 6 hours and 9 hours samples were
used to measure caffeine clearance. Serum ASTand ALT were measured by commercially available kits.
Results: Pearson correlation test was used to establish the relationship between caffeine clearance and
AST/ALTratio. Adefinite negative association was found.
Conclusion: Caffeine clearance test may be used to measure the funcational capacity of liver in patients of
liver cirrhosis