Utility of the activity of small intestine type-ALP as a marker for diagnostic criteria in liver diseases

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We studied the utility of small intestine-type ALP (SI-ALP) activity, which was measured based on an inhibition assay using L-phenylalanine, as one of the markers for diagnostic criteria in liver diseases in comparison with other markers. Chronic liver diseases were divided into the following 4 groups: group L light liver fibrosis (fatty liver, alcoholic liver diseases, etc.). group 2: chronic hepatitis (hepatitis B, C, and nonB, nonC), group 3: liver cirrhosis including liver-cell carcinoma complications and group 4: other particular chronic liver diseases (PBC, IPH, NASH, etc.). Although many markers were found to discriminate between group 2 and 3 using a nonparametric multiple comparison test, the markers to distinguish between group 1 and 2 were only the SI-ALP (P<0.05) and the ratio of SI-ALP against γ-GT (P<0.005). In addition, the ROC analysis for discrimination between group 1 and 2 showed that the most efficient discrimination was achieved by taking the ratio of SI-ALP against γ-GT, followed by γ-GT and SI-ALP. Thus, the SI-ALP is a useful marker for diagnostic criteria on the occurrence of fibrosis in liver disease, and the diagnostic criteria are certainly improved by taking its ratio to γ-GT.