Mogarekar Mukund Ramchandra, Talekar Swati Jitendra
Department of Biochemistry, Swami Ramanand Teerth Rural Government Medical College, Ambajogai 431 517, Beed, Maharashtra, India.
Indian J Gastroenterol. 2013 Sep;32(5):307-10. doi: 10.1007/s12664-013-0334-1. Epub 2013 May 23.
PON1 is an HDL-associated enzyme having antioxidant activity. PON1 is synthesized in the liver, and there is decreased synthesis of PON1 with increased lipid peroxidation. The study was carried with the aim of establishing whether chronic liver disease (CLD) produced any significant changes in serum arylesterase (AE) and lactonase activities of PON. The second objective was to determine whether there was any correlation between serum AE and lactonase activities and the various routine liver function tests. The usefulness of adding serum lactonase and AE activity to standard liver function tests was analyzed by multiple logistic regression analysis. Finally, the diagnostic efficacy or analytical performance of AE and lactonase in assessing patients with CLD was determined using 'receiver operating characteristic' (ROC) plot.
The study group consisted of 120 subjects; 60 were patients with liver disease out of which 40 were having chronic alcoholic liver disease and 20, acute viral hepatitis B, and 60 were healthy controls. Serum PON1 lactonase activity was measured manually using dihydrocoumarin, and AE activity was measured using phenylacetate as substrate. Liver function tests (bilirubin, albumin, AST, ALT, alkaline phosphatise) were done by standard technique.
The serum lactonase and AE activities were decreased significantly in patients with chronic alcoholic liver disease (p < 0.001, p < 0.001) and acute viral hepatitis B (p < 0.001, p < 0.001). Both measurements showed higher efficiency in testing liver dysfunction in multivariate regression analysis. Model 1 consisted of bilirubin, albumin, AST, ALT, and alkaline phosphatase, R2 = 0.912. Model 2 consisted of model 1+arylesterase having higher R2 = 0.0.954, and model 3 consisted of model 1+lactonase having R2 = 0.962. ROC plots demonstrated a high diagnostic accuracy for serum PON1 lactonase (area under ROC curve = 0.982) and serum PON1 arylesterase (area under ROC curve = 0.986).
Low PON1 lactonase and AE activity were found in acute viral hepatitis B and in chronic alcoholic hepatitis.
对氧磷酶1（PON1）是一种与高密度脂蛋白相关的具有抗氧化活性的酶。PON1在肝脏中合成，随着脂质过氧化增加，PON1的合成减少。本研究旨在确定慢性肝病（CLD）是否会使血清对氧磷酶（PON）的芳基酯酶（AE）和内酯酶活性发生显著变化。第二个目标是确定血清AE和内酯酶活性与各种常规肝功能检查之间是否存在相关性。通过多元逻辑回归分析评估在标准肝功能检查中增加血清内酯酶和AE活性的效用。最后，使用“受试者工作特征”（ROC）曲线确定AE和内酯酶在评估CLD患者时的诊断效能或分析性能。
研究组由120名受试者组成；60名是肝病患者，其中40名患有慢性酒精性肝病，20名患有急性乙型病毒性肝炎，60名是健康对照。使用二氢香豆素手动测量血清PON1内酯酶活性，以苯乙酸为底物测量AE活性。通过标准技术进行肝功能检查（胆红素、白蛋白、谷草转氨酶、谷丙转氨酶、碱性磷酸酶）。
慢性酒精性肝病患者（p < 0.001，p < 0.001）和急性乙型病毒性肝炎患者（p < 0.001，p < 0.001）的血清内酯酶和AE活性显著降低。在多变量回归分析中，这两项测量在检测肝功能障碍方面均显示出更高的效率。模型1包括胆红素、白蛋白、谷草转氨酶、谷丙转氨酶和碱性磷酸酶，R2 = 0.912。模型2由模型1加芳基酯酶组成，R2更高，为0.954，模型3由模型1加内酯酶组成，R2 = 0.962。ROC曲线显示血清PON1内酯酶（ROC曲线下面积 = 0.982）和血清PON1芳基酯酶（ROC曲线下面积 = 0.986）具有较高的诊断准确性。
在急性乙型病毒性肝炎和慢性酒精性肝炎中发现PON1内酯酶和AE活性较低。
