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Increased D-glucaric acid excretion by jaundiced patients
Clinical Chemistry
|October 1, 1978
Summary
Urinary D-glucaric acid, a marker of liver enzyme activity, was elevated in patients with various liver diseases. This increase suggests normal or enhanced glucuronidation, despite no correlation with standard liver function tests.
Area of Science:
- Biochemistry
- Hepatology
- Clinical Chemistry
Background:
- Urinary D-glucaric acid excretion reflects hepatic microsomal enzyme activity.
- Liver disease can alter enzyme activity, necessitating investigation of D-glucaric acid in this context.
Purpose of the Study:
- To investigate the effect of liver disease on urinary D-glucaric acid excretion.
- To determine the correlation between D-glucaric acid excretion and established liver function tests in patients with liver disease.
Main Methods:
- Studied 178 patients across different liver disease categories (nonhemolytic jaundice, viral hepatitis, obstructive jaundice, cirrhosis, mixed etiology).
- Measured urinary D-glucaric acid excretion.
- Compared excretion levels with serum concentrations of bilirubin, albumin, globulin, AST, ALP, cholesterol, and GGT.
Main Results:
- Urinary D-glucaric acid excretion was significantly increased in all patient groups compared to controls.
- The most pronounced increase was observed in the obstructive jaundice group.
- No significant correlation was found between D-glucaric acid excretion and any of the measured serum liver function tests.
Conclusions:
- Elevated urinary D-glucaric acid in liver disease indicates normal or enhanced glucuronidation capacity (UDP-glucuronosyltransferase activity).
- D-glucaric acid excretion is an independent marker of liver enzyme function, not directly correlated with common liver function tests.