title: Serum cholesterol: could it be a sixth parameter of Child-Pugh scoring system in cirrhotics due to viral hepatitis?
abstract: OBJECTIVE
  To determine the association of serum cholesterol levels with Child-Pugh class in patients with decompensated chronic liver disease due to viral hepatitis.
  
  
  METHODS
  Cross-sectional analytical study.
  
  
  METHODS
  Jinnah Postgraduate Medical Centre, Karachi, Medical Unit-III, Ward-7 from June to December 2010.
  
  
  METHODS
  Consecutive patients attending outpatient department or admitted in medical unit III were eligible if they had a diagnosis of cirrhosis secondary to viral hepatitis. Patients were excluded if alcoholic, diabetic, hypertensive, or with non-alcoholic fatty liver disease, autoimmune, metabolic, cardiovascular, cerebrovascular or kidney diseases and recent use of lipid-regulating drugs. Serum lipid profile was determined after an overnight fast of 12 hours. On the basis of serum total cholesterol, patients were divided into four groups; Group I with serum total cholesterol ² 100 mg/dl, Group II with level of 101-150 mg/dl, Group III with level of 151-200 mg/dl and Group IV with serum total cholesterol level of > 200 mg/dl. Hepatic dysfunction was categorized according to Child-Pugh scoring system. Chi-square and Spearman's correlation testing with p < 0.05 was accepted as significant.
  
  
  RESULTS
  One hundred and fourteen patients met the inclusion criteria with a mean age of 40.32 ± 13.59 years. Among these 32 were females (28.1%) while 82 were males (71.9%). According to Child-Pugh class; 34 patients (29.8%) presented with Child-Pugh class A, 34 (29.8%) in class B and 46 (40.4%) were in class C. Serum cholesterol (total) and triglycerides had significant association with Child-Pugh class (p = 0.0001 and p = 0.004 respectively) suggesting that as severity of liver dysfunction increases; serum cholesterol and triglycerides levels decrease. Results also revealed that males were significantly more hypocholesterolemic than females (p = 0.006).
  
  
  CONCLUSIONS
  Hypocholesterolemia is a common finding in decompensated chronic liver disease and has got significant association with Child-Pugh class. It may increase the reliability of Child-Pugh classification in assessment of severity and prognosis in chronic liver disease patients.
authors.affiliation: Medical Unit-III, Civil Hospital and Dow University of Health Sciences, Karachi. draman_ullah2000@yahoo.com
authors.forename: Amanullah
authors.initials: A
authors.lastname: Abbasi
authors.forename: Abdul Rabb
authors.initials: AR
authors.lastname: Bhutto
authors.forename: Nazish
authors.initials: N
authors.lastname: Butt
authors.forename: Keshav
authors.initials: K
authors.lastname: Lal
authors.forename: S M
authors.initials: SM
authors.lastname: Munir
mesh_terms: D000328:Adult; D002784:Cholesterol / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D006525:Hepatitis, Viral, Human / Q000097:blood / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications* / Q000821:virology; D008107:Liver Diseases / Q000150:complications; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D017678:Sex Distribution; D014280:Triglycerides / Q000097:blood
chemical_list: D014280:Triglycerides; D002784:Cholesterol