Dynamic of Specific Laboratory Indicators in Some Liver Diseases

Abstract

The liver is the largest organ in the human body after the skin.

Clinical and laboratory indicators in liver diseases are diverse in terms of the type of analysis and degree of variation. This diversity arises from the complex functional characteristics of the liver, which occupies a central role in the intermediary metabolism of substances in the human organism.

The liver has significant functional reserves; therefore, minor damage often goes unnoticed. Many indicators can remain within reference ranges, which does not necessarily rule out pathology.

The main functions of the liver are:

• Metabolic function – metabolism of carbohydrates, lipids, amino acids, proteins, and hormones;
• Detoxification function – processing bilirubin, ammonia, alcohol, and medications;
• Excretory function – gallstones, bilirubin, and cholesterol;
• Biosynthetic function – production of albumins, acute-phase proteins, pro- and anticoagulant factors, urea, creatinine, glycogen, ketone bodies, and bile acids from cholesterol;
• Depot function – storage of glycogen, lipids, amino acids, proteins, iron, copper, vitamins, and blood;
• Phagocytosis – elimination of bacteria from the gastrointestinal tract.

Liver diseases represent a large group with varied etiologies, including metabolic, autoimmune, neoplastic, vascular, toxic, parasitic, and biliary tract obstruction-related causes.

Tests with high diagnostic and prognostic value for assessing the functional capacity of the liver parenchyma include AFP, CA 19-9, bile pigments (bilirubin), organ-specific liver enzymes (ASAT, ALAT, GGT), total protein, and prothrombin time.

The dynamics of these indicators were progressive in the patients described below before their admission for treatment in the Gastroenterology Clinic at St. Ivan Rilski University Hospital - Stara Zagora. These patients had been under long-term observation (2–8 years) with periodic hospitalizations.