EVALUATION AND COMPARISON OF LIVER MARKERS IN ACUTE LIVER FAILURE VS CHRONIC LIVER FAILURE IN DISTRICT FAISALABAD: A CROSS-SECTIONAL STUDY

Abstract

Background: Liver failure is a life-threatening clinical condition resulting from the inability of the liver to maintain its metabolic, synthetic, and detoxification functions. Acute liver failure presents with sudden and severe hepatic dysfunction, whereas chronic liver failure develops gradually following prolonged liver injury. Biochemical liver markers remain central to differentiating these entities and assessing disease severity, yet comparative local data remain limited.

Objective: To evaluate and compare biochemical liver markers in patients with acute liver failure and chronic liver failure in order to identify characteristic laboratory patterns that aid clinical differentiation.

Methods: A retrospective cross-sectional study was conducted at Allied Hospital Faisalabad. A total of 100 patients aged 20–60 years were included, comprising 44 males and 56 females. Serum samples were analyzed using a Microlab 300 semi-automated chemistry analyzer. Measured parameters included alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, total bilirubin, direct bilirubin, and indirect bilirubin. Standard reagent kits and manufacturer-recommended protocols were followed. Data were summarized using descriptive and comparative analysis.

Results: Acute liver failure showed markedly elevated aminotransferases, with mean ALT values of 370 U/L in males and 360 U/L in females, compared with 120 U/L and 110 U/L in chronic liver failure, respectively. Mean AST levels were also higher in acute liver failure (360 U/L in males, 355 U/L in females) than in chronic liver failure (135 U/L and 110 U/L). Cholestatic markers demonstrated variable patterns, with ALP values reaching 375 U/L in females with acute liver failure and 252 U/L in males with chronic disease. Mean GGT levels were higher in acute liver failure (200 U/L in males, 180 U/L in females) compared with chronic liver failure. Total bilirubin levels were elevated in both groups but were higher in acute liver failure, reaching 4.5 mg/dL in females. Direct bilirubin predominated in acute cases, whereas indirect bilirubin was relatively higher in chronic liver failure.

Conclusion: Distinct biochemical patterns were observed between acute and chronic liver failure, with acute disease characterized by pronounced hepatocellular injury and chronic disease showing sustained cholestatic and metabolic alterations. These findings support the clinical utility of liver markers in differentiating liver failure types and guiding early diagnosis and management.