title: Critical thresholds of liver function parameters for ketosis prediction in dairy cows using receiver operating characteristic (ROC) analysis.
abstract: BACKGROUND
  Fatty liver syndrome and ketosis are important metabolic disorders in high-producing cows during early lactation with fatty liver usually preceding ketosis. To date, parameters for early prediction of the risk of ketosis have not been investigated in China.
  
  
  OBJECTIVE
  To determine the predictive value of some parameters on the risk of ketosis in China.
  
  
  METHODS
  In a descriptive study, 48 control and 32 ketotic Holstein Friesian cows were randomly selected from one farm with a serum β-hydroxybutyrate (BHBA) concentration of 1.20 mmol/L as cutoff point. The risk prediction thresholds for ketosis were determined by receiver operating characteristic (ROC) analysis.
  
  
  RESULTS
  In line with a high BHBA concentration, blood glucose concentration was significantly lower in ketotic cows compared to control animals (2.77 ± 0.24 versus 3.34 ± 0.03 mmol/L; P = 0.02). Thresholds were more than 0.76 mmol/L for nonesterified fatty acids (NEFA, with 65% sensitivity and 92% specificity), more than 104 U/L for aspartate aminotransferase (AST, 74% and 85%, respectively), less than 140 U/L for cholinesterase (CHE, 75% and 59%, respectively), and more than 3.3 µmol/L for total bilirubin (TBIL, 58% and 83%, respectively). There were significant correlations between BHBA and glucose (R = -4.74), or CHE (R = -0.262), BHBA and NEFA (R = 0.520), or AST (R = 0.525), or TBIL (R = 0.278), or direct bilirubin (DBIL, R = 0.348).
  
  
  CONCLUSIONS
  AST, CHE, TBIL and NEFA may be useful parameters for risk prediction of ketosis.
  
  
  CONCLUSIONS
  This study might be of value in addressing novel directions for future research on the connection between ketosis and liver dysfunction.
authors.affiliation: a Department of College of Animal Science and Veterinary Medicine , Heilongjiang BaYi Agriculture University , Daqing 163319 , China.
authors.forename: Yuhang
authors.initials: Y
authors.lastname: Sun
authors.forename: Bo
authors.initials: B
authors.lastname: Wang
authors.forename: Shi
authors.initials: S
authors.lastname: Shu
authors.forename: Hongyou
authors.initials: H
authors.lastname: Zhang
authors.forename: Chuang
authors.initials: C
authors.lastname: Xu
authors.forename: Ling
authors.initials: L
authors.lastname: Wu
authors.forename: Cheng
authors.initials: C
authors.lastname: Xia
mesh_terms: D000818:Animals; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose / Q000032:analysis; D016022:Case-Control Studies; D002417:Cattle; D002418:Cattle Diseases / Q000097:blood*; D002681:China; D002802:Cholinesterases / Q000097:blood; D003612:Dairying; D005260:Female; D007662:Ketosis / Q000097:blood / Q000662:veterinary*; D008099:Liver / Q000378:metabolism*; D008111:Liver Function Tests / Q000662:veterinary; D016015:Logistic Models; D011237:Predictive Value of Tests; D012372:ROC Curve; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D001219:Aspartate Aminotransferases; D002802:Cholinesterases; D001663:Bilirubin
keywords: ROC analysis; bovine; dairy cows; ketosis; liver function; risk prediction; threshold