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 li ver functional reserve, but a more recent report has cast doubt on the clinical significance of this redox theory, Furthermore, the effect o f a diminution of liver functional reserve on AKBR has not been docume nted in chronic liver disease. Methods: AKBR was measured in normal co ntrol subjects (n = 10), heavy alcohol drinkers (n = 19), patients wit h 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 c ontrol subjects, 2.25 +/- 1.11 in patients with chronic hepatitis), th is discrepancy did not reach a level of significance. AKBR in patients with liver cirrhosis (1.18 +/- 0.52) was significantly lower than tha t in normal controls (p < 0.01). AKBR in Child's class A, Child's clas s 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 po tential and hepatic functional reserve to some extent, but it does not appear to be an accurate parameter for their estimation.