Serum amyloid P-component as a marker of liver disease

The P-component of amyloid is a normal serum protein designated SAP. In view of recent in vivo experiments that suggested a possible role for the liver in the synthesis of SAP, we decided to evaluate the usefulness of its serum level as a marker of liver involvement. The study included 198 healthy adults, 154 patients with liver diseases, and 27 HBsAg carriers. Normal serum level of SAP was 66.12 micrograms/ml for males and 57.17 micrograms/ml for females. Patients with liver disease had a significantly decreased level of SAP. The mean serum level of SAP in cirrhosis was 30.15 in chronic active hepatitis--37.16 and in acute hepatitis--44.86 micrograms/ml. Asymptomatic HBsAg carriers had a normal SAP level (mean 65.48 micrograms/ml). Thirty-two patients with acute hepatitis were tested during the acute stage of the disease and after complete recovery. In all but three patients, a significant increase in SAP level, from a mean of 35.8 to 58.48 micrograms/ml, was observed. These results suggest a close correlation between serum levels of SAP and the degree of disease activity and hepatic impairment in patients with liver diseases, especially in those with acute hepatitis. Repeat determinations of SAP in patients with liver diseases could possibly help in their routine management.