title: The prognostic significance of caffeine half-life in saliva in children with chronic liver disease.
abstract: To evaluate its clinical value, the half-life of caffeine (1,3,7-trimethylxanthine) in saliva (SCT) after 3 mg/kg-1 oral caffeine was measured in 53 children with chronic liver disease (mean age, 4.41 years) and 48 control children (mean age, 6.26 years) in five samples over 24 h and compared with parameters of liver function and outcome. Sensitivity was 60.3% and specificity 97% of SCT for diagnosis of chronic liver disease. The correlation of SCT with serum albumin (ALB) was -0.52 (p < 0.001), total bilirubin (SBR) was 0.585 (p < 0.001), prolonged prothrombin time (PT) was 0.387 (p = 0.004), and aspartate aminotransferase (AST) was 0.538 (p = 0.001). The correlation of SCT with a clinical score of liver dysfunction calculated from the presence of features of hepatic decompensation was 0.627 (p < 0.001) and with Malatack's paediatric prognostic score was 0.505 (p < 0.001). Serial SCT and liver function tests were performed on 53 patients on 127 occasions during a mean follow-up of 361 days (range, 4-709). Of this group, 18 were listed for liver transplantation. Predictive values of outcome by analysis of variance expressed as ratio of mean squares were SBR, 34.1 (p < 0.001); log10 SCT, 20.6 (p < 0.001); ALB, 5.2 (p < 0.05); PT, 1.2 (NS). SCT correlated with clinical and biochemical parameters of severity of liver disease, but SBR was a better predictor of listing for liver transplantation in this group of paediatric patients.
authors.affiliation: Liver Unit, Children's Hospital, Ladywood Middleway.
authors.forename: A
authors.initials: A
authors.lastname: Baker
authors.forename: A
authors.initials: A
authors.lastname: Girling
authors.forename: D
authors.initials: D
authors.lastname: Worthington
authors.forename: N
authors.initials: N
authors.lastname: Ballantine
authors.forename: S
authors.initials: S
authors.lastname: Smith
authors.forename: M
authors.initials: M
authors.lastname: Tarlow
authors.forename: D
authors.initials: D
authors.lastname: Kelly
mesh_terms: D000293:Adolescent; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002110:Caffeine / Q000493:pharmacokinetics*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006207:Half-Life; D006801:Humans; D007223:Infant; D008107:Liver Diseases / Q000378:metabolism* / Q000503:physiopathology; D008111:Liver Function Tests; D008137:Longitudinal Studies; D008297:Male; D011379:Prognosis; D011517:Prothrombin Time; D012463:Saliva / Q000378:metabolism*; D012709:Serum Albumin / Q000032:analysis
chemical_list: D012709:Serum Albumin; D002110:Caffeine; D001219:Aspartate Aminotransferases; D001663:Bilirubin