జీర్ణకోశ & జీర్ణ వ్యవస్థ

నైరూప్య

To Study the Significance of Serum Uric Acid Level in Chronic Liver Disease

M Chandramouli, P Punekar, D Prasad

Introduction: Chronic liver disease is one of the frequent causes of death, especially in the developing world. The increasing prevalence of chronic liver disease has been noted in recent times. Hyperuricemia results in endothelial dysfunction, insulin resistance, oxidative stress and adipose tissue inflammation, which leads to development of fatty liver, progression of NAFLD to NASH, and progression of viral and alcoholic liver disease all of which direct towards Chronic liver disease. In Chronic liver disease, High serum uric acid is independently associated with severe disease and poor prognosis. Our aim is to study serum uric acid levels and its significance in patients of chronic liver disease.

Methods: In this study we included 66 patients of chronic liver disease of different etiology; we excluded the patients with factors that influence the level of serum uric acid. After noting patients complaints and conducting thorough physical examination, patient were subjected to various laboratory tests including serum uric acid and liver function tests among others. CTP score was calculated for each patient. Using suitable statistical method, data was analysed to find out any association between serum uric acid level and different causes of chronic liver disease and disease severity using Child Turcotte pugh grading.

Results: We had a total of 66 patients of chronic liver disease, 46 (69.7%) were male, Mean age was found to be 44 ± 12 years. Alcoholic liver disease was the most common cause (52%) of CLD followed by chronic hepatitis B (23%). A higher serum uric acid level was observed among patients with Hepatitis B (7.42 ± 2.8) and patients with CTP class C (7.37 ± 2.8). In our study Correlation between serum uric acid and CTP score (P=0.020), Albumin (P=0.0303), Bilirubin (P=0.0435), INR (P=0.0454), SGOT (P=0.0068), and SGPT (P=0.0397) were found to be statistically significant.

Conclusion: Increased serum uric acid level with increasing child pugh score showed that uric acid can be reliable and cost effective marker for evaluation of severity of liver cirrhosis in chronic liver disease. Serum uric acid, when used as a prognostic marker for liver parenchymal disease is a potential non-invasive and inexpensive method to indicate disease severity, complications and can serve as an early tool for intervention