Chronic liver disease (CLD) is a significant cause of morbidity and mortality worldwide. Non-invasive evaluation of hepatic disease severity is a crucial relevant issue to further enhance clinical management and therapeutic treatment. 

The author of the present study retrospectively compared the diagnostic and prognostic performance of various non-invasive tools such as LiMAx, transient elastography (TE), and biomarkers in identifying different severity stages during the course of CLD. The patients were categorized into four groups based on clinical parameters: (1) patients without CLD as control group, (2) patients suffering from CLD without having cirrhosis, (3) patients with CLD and compensated cirrhosis, and, (4) patients with CLD and decompensated cirrhosis. Patients with acute liver failure were excluded from the analysis.

The study included a total of 464 patients who underwent LiMAx measurement at the University for a period of one year. The patients allotted in different groups were 72 patients for group 1, 134 patients for group 2, 160 patients for group 3, and 98 patients for group 4, respectively. 

The results of the study showed that median LiMAx values remarkably reduced with respect to increasing degree of CLD: (1) 510 µg/h/kg, (2) 390 µg/h/kg, (3) 264 µg/h/kg, and (4) 151 µg/h/kg. The contrast of the diagnostic accuracy of the LiMAx test in detecting patients with presence of cirrhosis (groups 1 and 2 vs. groups 3 and 4), an AUROC of 0.942 was found (cut-off 322 µg/h/kg, sensitivity 86.1%, specificity 91.3%). Moreover, LiMAx was more efficacious than TE and serum biomarkers in predicting patients’ outcome by 90-day mortality (AUROC 0.811). 

Therefore, based on these observations, it can be concluded that enzymatic liver function assessed by LiMAx was closely related to different severity stages of CLD. Moreover, it acts as a reliable diagnostic and prognostic tool with a precision similar to current standard methods.

Source: Buechter M, Kersting S, Gerken G, Kahraman A. Enzymatic liver function measured by LiMAx – a reliable diagnostic and prognostic tool in chronic liver disease. Scientific Reports. 2019;9(13577). Available at: https://www.nature.com/articles/s41598-019-49746-1