Serum cholinesterase: A predictive biomarker of hepatic reserves in chronic hepatitis D

Table 1 Baseline characteristics of the study patients

No. of patients	233
Male:female	192:41
Age (yr)	42 (16-69)
BMI (kg/m2)	23.4 (14.3-40)
Ascites	50 (21.5)
Encephalopathy	15 (6.4)
Bilirubin (mg/dL)	0.90 (0.2-6.9)
Albumin (g/dL)	3.8 (1.8-5.0)
INR	1.13 (0.6-2.6)
Creatinine (mg/dL)	0.8 (0.4-1.96)
Sodium (mmol/L)	139 (120-150)
AST (IU/L)	53 (10-638)
Platelets (× 109/L)	120 (22-388)
Cholinesterase (IU/L)	5508 (861-12891)
Child class
A	167 (71.7)
B	52 (22.3)
C	14 (5.0)
CTP score	5 (5-13)
MELD score	8 (6-24)
MELD sodium	9 (6-26)
MELD score 15 or more	24 (10.3)
APRI	1.26 (0.19-10.8)
APRI 1.5 or more	100 (42.9)
BEA class
A	6 (2.6)
B	164 (70.4)
C	63 (27)
BEA score	4 (1-7)

Values are median (range) or n (%). BMI: Body mass index; INR: International normalization ratio; AST: Aspartate aminotransferase; CTP: Child Turgotte Pugh; MELD: Model for End Stage Liver Disease; APRI: AST to platelet ratio index; BEA: Baseline-event-anticipation.

Table 2 Mean cholinesterase levels

Parameter	Values (U/L)	P value
Child class
A (CTP up to 6)	7058 ± 208
B (CTP 7-9)	3773 ± 372	< 0.001 (A vs B)
C (CTP ≥ 10)	1605 ± 129	< 0.001 (B vs C)
MELD score
≥ 15	2285 ± 373
< 15	6423 ± 206	< 0.001
APRI
≥ 1.5	4002 ± 219
< 1.5	7498 ± 251	< 0.001
BEA score
A	8036 ± 967
B	6993 ± 222	0.337 (A vs B)
C	3211 ± 258	< 0.001 (B vs C)

Values are mean ± SE. CTP: Child Turcotte Pugh; MELD: Model for End Stage Liver Disease; APRI: AST to platelet ratio index; BEA: Baseline-event-anticipation.

Table 3 Receiver operating characteristic analysis

State variable	AUC	Std. error	Asymptotic sig. (P value)	95%CI
Ascites	0.836	0.038	< 0.001	0.762-0.910
CTP ≥ 7	0.889	0.029	< 0.001	0.832-0.946
CTP ≥ 10	0.966	0.013	< 0.001	0.940-0.992
MELD ≥ 10	0.798	0.034	< 0.001	0.731-0.864
MELD ≥ 15	0.913	0.038	< 0.001	0.838-0.987
APRI ≥ 1.5	0.825	0.026	< 0.001	0.773-0.877
BEA ≥ 5	0.871	0.028	< 0.001	0.816-0.926

CTP: Child Turcotte Pugh; MELD: Model for End Stage Liver Disease; APRI: AST to platelet ratio index; BEA: Baseline-event-anticipation.

Table 4 Optimal cholinesterase cutoffs

State variable	Cholinesterase cut off value (IU/L)	Sensitivity, % (95%CI)	Specificity, % (95%CI)	Likelihood ratio
Ascites	< 3812	80.00 (66.28- 89.97)	81.97 (75.62-87.25)	4.436
CTP ≥ 7	< 3812	79.10 (67.43-88.08)	67.47 (59.78-74.53)	2.432
CTP ≥ 10	< 2853	100.00 (79.41-100.00)	84.79 (79.31-89.29)	6.576
MELD ≥ 10	< 4719	72.09 (61.38-81.23)	80.27 (72.91-86.37)	3.654
MELD ≥ 15	< 2829	91.67 (73.00-98.97)	87.56 (82.31-91.71)	7.369
BEA ≥ 5	< 4719	82.54 (70.90-90.95)	77.06 (70.00-83.15)	3.598
APRI ≥ 1.5	< 3954	58.00 (47.71-67.80)	55.64 (46.78-64.25)	1.307

CTP: Child Turcotte Pugh; MELD: Model for End Stage Liver Disease; APRI: AST to platelet ratio index; BEA: Baseline-event-anticipation.