Page 27 - Clinical Biochemistry

• Sampling error.
• Inter-observer variability.

Biomarkers for assessment of steatohepatitis and fibrosis
• C reactive protein: C-reactive protein (CRP) is a blood test marker for inflammation in
the body. It is risk factor for the progression of NAFLD.
• Plasma Pentraxin 3: risk factor for the progression of NAFLD.
• IL6: indicate inflammmatory activity and the degree of fibrosis.
• TNF-alpha: risk factor for the progression of NAFLD.
• Endothelin 1: is a mediator of fibrosis.
• Adiponectin: is lower in NASH.

Summary
• The blood contains 6-8 gms of proteins, out of which 4 gms are albumin and 2 gms
globulins.
• The albumin is exclusively synthesized in the liver; however, if the albumin is lowered,
therefore either the liver is not functioning well or the kidney (glomerulonephritis).
• In addition, the lowered level of albumin means a chronic case because it has a long half-
life.
• To differentiate between the kidney and liver diseases of the lowered level of albumin,
analyze the gamma globulin.
• If high, therefore the liver has the problem because it encourages its production from other
organs.
• Therefore decreased albumin and increased globulin means chronic liver disease, whereas
nephrotic disease both are lowered.
• The gamma globulin is only high in autoimmune disease.

Prothrombin time
• In case of obstructive jaundice, there is a prolongation in PT.