Clinical significance of arterial ketone body ratio in chronic liver disease.

BACKGROUND

Arterial ketone body ratio (acetoacetate/3-hydroxybutyrate, AKBR) has been reported to be a useful tool for the estimation of liver functional reserve, but a more recent report has cast doubt on the clinical significance of this redox theory. Furthermore, the effect of a diminution of liver functional reserve on AKBR has not been documented in chronic liver disease.

METHODS

AKBR was measured in normal control subjects (n = 10), heavy alcohol drinkers (n = 19), patients with chronic hepatitis (n = 18) and patients with liver cirrhosis (n = 25).

RESULTS

Though AKBR was lower in heavy alcohol drinkers (1.66 +/- 0. 82) than in the other noncirrhotic groups (1.97 +/- 0.93 in normal control subjects, 2.25 +/- 1.11 in patients with chronic hepatitis), this discrepancy did not reach a level of significance. AKBR in patients with liver cirrhosis (1.18 +/- 0.52) was significantly lower than that in normal controls (p < 0.01). AKBR in Child's class A, Child's class B, and Child's class C was 1.20 +/- 0.60, 1.07 +/- 0.56, and 1.27 +/- 0.45, respectively, and there were no significant differences among them.

CONCLUSION

AKBR may be parallel to liver mitochondrial redox potential and hepatic functional reserve to some extent, but it does not appear to be an accurate parameter for their estimation.