| Aims:The purpose of this study was to evaluate serum ceruloplasmin(CP)content in patients with liver diseases of different etiologies and stages of disease.The correlations between CP and some commonly used clinical indicators in patients with Wilson disease(WD)and non-WD diseases were also analyzed.Methods:1077 patients were enrolled in the Department of Hepatology,the First Hospital of Jilin University,from January 2012 to January 2018.Ceruloplasmin was monitored and the decline of serum CP levels in different liver diseases was analyzed.Patients with WD were divided into non-cirrhotic and cirrhotic Child-pugh A,B,C groups according to the severity of liver disease,and then serum CP levels were compared.The correlation between serum CP and albumin(ALB),prothrombin time(PT),platelets(PLT)in non-Child-pugh C and Child-pugh C WD patients were analyzed.The correlation between CP,serum copper and 24-hour urinary copper in untreated and treated WD patients was also analyzed.In non-WD liver disease,the correlation between CP and ALB,prealbumin(PA),PT were analyzed.The serum ceruloplasmin levels in acute viral hepatitis,chronic viral hepatitis,severe viral hepatitis,viral hepatitis cirrhosis and virus-associated liver cancer were compared between groups.According to non-alcoholic fatty liver disease activity score(NAS),patients with nonalcoholic fatty liver disease(NAFLD)were classified into NAS≥5 and NAS <5 groups to compare the levels of CP.SPSS20.0 software was usedfor statistical analysis and GraphPad Prism 5 software was used for mapping.Results:1.The serum ceruloplasmin concentration in 97.6% of WD patients was lower than 0.2 g/L,and 88.1% of them were below 0.1 g/L.In non-WD group,ceruloplasmin was lower than 0.2 g/L in 24.3% of the patients,of which 0.2% were below 0.1 g/L.The proportion of patients with a decrease in serum ceruloplasmin was 69.9% for liver failure,4.5% for acute viral hepatitis,33.3% for chronic viral hepatitis,40.0% for viral hepatitis cirrhosis,13.0% for primary liver cancer,47.6% for nonalcoholic fatty liver disease,22.5% for alcoholic liver disease,15.1% for drug-induced liver injury,2.8% for autoimmune liver disease,21.3% for unexplained liver damage,and 24.8% for unknown cirrhosis.2.The difference of serum CP between non-cirrhotic and Child-pugh C WD patients was statistically significant(p<0.05),and the CP level of non-cirrhotic group was lower.In non-Child-pugh C WD patients,there was no significant correlation between CP and ALB,PT,PLT(p>0.05).In Child-pugh C WD patients,CP had a positive correlation with PT(r=0.595,p<0.05).In both untreated and treated WD patients,there was a positive correlation between CP and serum copper(r=0.479 and 0.761,respectively,p<0.05),and no significant correlation between 24-hour urine copper and CP,serum copper(p>0.05).3.In non-WD group,serum CP was positively correlated with ALB and PA,and negatively correlated with PT(r=0.068,0.091 and-0.297 respectively,p<0.05).4.Serum CP in chronic viral hepatitis,severe viral hepatitis and viral hepatitis cirrhosis group were significantly lower than that in acute viral hepatitis and virus-related liver cancer group(p<0.05).The CP of severe viral hepatitis group was significantly lower than that of chronic viralhepatitis group(p<0.05).5.There was no significant difference in CP level between patients with NAS≥5 and NAS <5 in non-alcoholic fatty liver disease(p> 0.05).Conclusions:The reduction of ceruloplasmin is common in Wilson disease,and a mild to moderate decrease can occur in other liver diseases.For these patients,it should be noted that the decrease of ceruloplasmin is caused by the injury of liver cells or missed diagnosis of Wilson disease. |
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