Tripathi Anurag, Tiwari Brijesh, Patil Ranjit, Khanna Vikram, Singh Vandana
Assistant professor, Department of Oral Medicine and Radiology, King George Medical University, Lucknow, Uttar Pradesh, India.
Department of Dental Research & Implantology, Institute of Nuclear Medicine and Allied Sciences (INMAS), Defence Research and Development Organization (DRDO), Ministry of Defence, Government of India, Timarpur, Delhi 110054, India.
J Oral Biol Craniofac Res. 2015 Jan-Apr;5(1):28-33. doi: 10.1016/j.jobcr.2014.12.003. Epub 2015 Jan 23.
Chronic liver diseases (CLD) are quite prevalent throughout the globe. Its early and correct diagnosis is always a concern among physicians, especially the residual liver function. For this various substrates like caffeine are being investigated in body fluids like serum and saliva. Saliva as a study sample has its own advantages due to its non invasiveness; it can be very useful study sample.
30 Subjects with CLD and 15 healthy controls were administered 200 mg of caffeine. Subjects classified into severity groups (class-A-mild-n = 9, B-moderate-n = 11, and C-severe-n = 10) based on "Child-pugh classification" of severity of liver disease. After 17 h of dietary caffeine restriction and before drug administration, 0 h salivary sample was taken. After the dose of caffeine, 4 and 16 h saliva sample was taken. Blood sample was taken from controls only at same time points. These samples were analyzed on semi automated analyzer using Enzyme Multiplied Immunoassay Technique (EMIT) by spectrophotometric method. Caffeine clearance values were calculated and results were statistically analyzed.
Significant correlation was found between serum caffeine clearance and salivary caffeine clearance (SCC). Controls showed higher mean of SCC value of 1.6 ± 0.2 ml/min/kg while SCC values of subjects were less, with mean of 0.5 ± 0.2 ml/min/kg. Significant correlation was found between degree of hepatic dysfunction and SCC values.
Saliva can be used for diagnosis of CLD and assessment of residual liver function in CLD as alternative to serum.
慢性肝病（CLD）在全球范围内相当普遍。其早期正确诊断一直是医生关注的问题，尤其是残余肝功能。为此，人们正在研究血清和唾液等体液中的各种底物，如咖啡因。唾液作为研究样本具有无创性等自身优势，它可能是非常有用的研究样本。
30名慢性肝病患者和15名健康对照者服用200毫克咖啡因。根据肝病严重程度的“Child-pugh分类”将受试者分为严重程度组（A类-轻度-n = 9，B类-中度-n = 11，C类-重度-n = 10）。在饮食中限制咖啡因17小时后且在给药前，采集0小时唾液样本。给予咖啡因剂量后，采集4小时和16小时唾液样本。仅在相同时间点从对照组采集血样。使用酶放大免疫分析技术（EMIT）通过分光光度法在半自动分析仪上对这些样本进行分析。计算咖啡因清除率值并对结果进行统计学分析。
血清咖啡因清除率与唾液咖啡因清除率（SCC）之间存在显著相关性。对照组的SCC值均值较高，为1.6±0.2毫升/分钟/千克，而受试者的SCC值较低，均值为0.5±0.2毫升/分钟/千克。肝功能障碍程度与SCC值之间存在显著相关性。
唾液可用于慢性肝病的诊断以及慢性肝病残余肝功能的评估，作为血清的替代方法。
