Serum Paraoxonase-Early Diagnostic Biomarker in NASH/NAFLD BC06-BC09
Jyotchna Devi Bade,
Flat No. 03, 786 Towers, Near Saraswati Mahal Theater, Bakarsahebpeta, Srikakulam-532001, Andhra Pradesh, India.
Introduction: Non-Alcoholic Steatohepatitis (Nash)/Non-Alcoholic Fatty Liver Disease (NAFLD) is one of the important causes of morbidity and mortality worldwide. Serum paraoxonase (PON 1) is a glycosylated protein, an esterase associated with High density lipoprotein (HDL), and can be speculated to be a potential biomarker of liver injury or lipid peroxidation.
Aim: To assess the PON 1activity in NASH/NAFLD in combination with standard liver function tests in evaluating liver damage.
Materials and Methods: The case-control study was conducted at Department of Biochemistry, Osmania General Hospital, Hyderabad, India. Serum Paraoxonase levels were estimated in 30 clinically diagnosed NASH/NAFLD patients, and 30 apparently healthy blood donors. Serum Paraoxonase levels was measured by kinetic assay in spectrophotometer along with standard liver function tests (total and direct bilirubin, total protein, albumin, Alanine Transaminase (AST), Aspartate Transaminase (AST), Alkaline Phosphatase (ALP). Results were expressed as Mean±Standard deviation (Mean±SD) of various parameters. Paired t-test was used to compare the parameters between control and case group. ROC curve analysis was done to assess maximum sensitivity and maximum specificity and diagnostic efficiency. A p-value of <0.05 was considered to be statistically significant.
Results: Serum PON 1 levels were significantly (p-value < 0.001) decreased in patients (712.7±232.9 ng/mL) when compared with controls (988±238 ng/mL). ROC curve analysis showed increased senstivity (86.67%) and decreased specificity (60%) of PON 1 as compared to total and direct bilirubin, AST and ALT. The Area Under Curve (AUC) for serum PON 1 was 0.79, and PON 1 had highest diagnostic efficiency of 73% as compared to other liver parameters (56.6%-69.9%) in NASH /NAFLD.
Conclusion: Serum Paraoxonase is an early diagnostic marker for patients with oxidative stress like NASH/NAFLD and serum PON 1 levels should be measured along with standard liver function tests.