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In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
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Liver function tests in patients with bacteremia.

Shinichiro Kanai1, Takayuki Honda, Takeshi Uehara

  • 1Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan.

Journal of Clinical Laboratory Analysis
|January 18, 2008
PubMed
Summary

Liver function tests like gamma-glutamyl transpeptidase and alkaline phosphatase may indicate bacteremia. Lower cholinesterase levels are also linked to bacteremia, suggesting their use in early sepsis detection.

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Area of Science:

  • Clinical Medicine
  • Infectious Diseases
  • Hepatology

Background:

  • Bacteremia, a serious bloodstream infection, requires early detection for effective treatment.
  • Liver function tests (LFTs) are commonly used to assess liver health but their role in detecting bacteremia is less understood.
  • Distinguishing bacteremia from other bacterial infections without liver disease is crucial for appropriate clinical management.

Purpose of the Study:

  • To investigate the utility of various liver function tests as potential early indicators of bacteremia.
  • To compare LFT profiles in patients with confirmed bacteremia versus those with bacterial infections but no bacteremia.
  • To identify specific LFTs that are significantly altered during bacteremia.

Main Methods:

  • A comparative study involving 156 patients with confirmed bacteremia and 211 bacteremia-negative controls with bacterial infections.
  • Analysis of liver function tests including gamma-glutamyl transpeptidase (gamma-GT), alkaline phosphatase (ALP), albumin, total cholesterol, and cholinesterase.
  • Exclusion of patients with pre-existing liver diseases to isolate the effects of bacteremia.

Main Results:

  • Serum gamma-GT and ALP levels were significantly higher in the bacteremia group.
  • Serum albumin, total cholesterol, and cholinesterase levels were significantly lower in the bacteremia group.
  • Serum cholinesterase was identified as an independent factor for bacteremia (adjusted OR 0.319). C-reactive protein (CRP) showed no significant difference.

Conclusions:

  • Certain liver function tests, particularly gamma-GT, ALP, and cholinesterase, show significant alterations in patients with bacteremia.
  • These LFTs, especially cholinesterase, may serve as valuable, accessible biomarkers for the early detection of sepsis.
  • Further research could validate these findings and integrate LFTs into sepsis screening protocols.