Antipyrine clearance and metabolite formation in primary biliary cirrhosis

The disposition of antipyrine is altered and may be a prognostic factor in the presence of Various types of hepatic dysfunction. The object of the pre sent study was to investigate whether antipyrine clearance and metabolite f ormation are useful to detect altered metabolic function in primary biliary cirrhosis. Saliva clearance of antipyrine arid the formation clearance of antipyrine metabolites (hydroxymethylantipyrine, HMA; norantipyrine, NORA; and 4-hydroxyantipyrine, OHA) were investigated in a group of 34 women with biopsy-proven PBC (mean age 60 years; range 39-87 years) and in 15 healthy control women (mean age 62 years; range 46-78 years). Parameters of antipy rine clearance of patients in stage I and II were similar to those observed in healthy subjects. When compared to patients in stage I, patients in adv anced stages showed a reduction in antipyrine clearance (-29% and -44% in s tages III and IV, respectively) and increases in antipyrine half-life (+24% and +75% in stages III and IV, respectively). The reduction in antipyrine clearance was due to a reduction in the formation of all three antipyrine m etabolites, with the formation clearance of bath HMA and NORA decreasing to a slightly greater extent than that of OHA. Antipyrine clearance correlate d significantly with serum bilirubin (P < 0.017) and the Mayo risk score (P < 0.001). Logistic regression analysis indicated that antipyrine clearance was an independent predictor of the histological stage of the disease (P < 0.001). Antipyrine clearance and metabolite formation is a sensitive param eter for assessing hepatic metabolic function in primary biliary cirrhosis.