Die Rolle der Hyaluronsäure als Leberfunktionsparameter

Concluding from our results of this clinical study, the hyaluronic acid seems useful for the confirmation or the classification of the severity of liver diseases, but is not helpful in the early detection of liver diseases. As all preceding calculations and evaluations have demonstrated, there is no significant correlation between hyaluronate and other standard liver function tests. The sensitivity in our group is also too low to detect any existing liver diseases. With a total number of 20 clinically detected liver diseases such as steatosis, cirrhosis or metastasis, hyaluronic acid indicated only in four cases pathologic values (sensitivity of 20%) and a sensitivity of 26% in the group of “self defined” liver disease (pathological liver function test with or without liver disease). Although there is a high correlation to ASAT and to albumin, the hyaluronic acid does not provide any additional diagnostic advantages. Also the high correlation of elevated bilirubin as a sign of cholestasis restricts the significance of hyaloronic acid because of its low sensitivity. The highest sensitivity and specificity for recognizing liver malfunctioning is presumably best achieved by combining certain lab tests, as described in the fibrosis scores in chapter 2.10, but not by a single test. Despite the low sensitivity of the hyaluronic acid, its specificity is 100%. The comparative MEGX test showed a higher sensitivity, however a lower specificity of only 50% of wrong positive results. This can be explained by the high sensitivity of the test. Since the aim of this study was to find a sensitive diagnostic tool for the early detection of liver dysfunction, hyaluronic acid could not substitute the combination of different liver function tests. Therefore, it is not suitable as a highly sensitive marker for liver function