title: The role of salivary caffeine clearance in the diagnosis of chronic liver disease.
abstract: BACKGROUND
  Chronic liver diseases (CLD) are quite prevalent throughout the globe. Its early and correct diagnosis is always a concern among physicians, especially the residual liver function. For this various substrates like caffeine are being investigated in body fluids like serum and saliva. Saliva as a study sample has its own advantages due to its non invasiveness; it can be very useful study sample.
  
  
  METHODS
  30 Subjects with CLD and 15 healthy controls were administered 200 mg of caffeine. Subjects classified into severity groups (class-A-mild-n = 9, B-moderate-n = 11, and C-severe-n = 10) based on "Child-pugh classification" of severity of liver disease. After 17 h of dietary caffeine restriction and before drug administration, 0 h salivary sample was taken. After the dose of caffeine, 4 and 16 h saliva sample was taken. Blood sample was taken from controls only at same time points. These samples were analyzed on semi automated analyzer using Enzyme Multiplied Immunoassay Technique (EMIT) by spectrophotometric method. Caffeine clearance values were calculated and results were statistically analyzed.
  
  
  RESULTS
  Significant correlation was found between serum caffeine clearance and salivary caffeine clearance (SCC). Controls showed higher mean of SCC value of 1.6 ± 0.2 ml/min/kg while SCC values of subjects were less, with mean of 0.5 ± 0.2 ml/min/kg. Significant correlation was found between degree of hepatic dysfunction and SCC values.
  
  
  CONCLUSIONS
  Saliva can be used for diagnosis of CLD and assessment of residual liver function in CLD as alternative to serum.
authors: Assistant professor, Department of Oral Medicine and Radiology, King George Medical University, Lucknow, Uttar Pradesh, India.
authors: Anurag
authors: A
authors: Tripathi
authors: Department of Dental Research & Implantology, Institute of Nuclear Medicine and Allied Sciences (INMAS), Defence Research and Development Organization (DRDO), Ministry of Defence, Government of India, Timarpur, Delhi 110054, India.
authors: Brijesh
authors: B
authors: Tiwari
authors: Professor & Head, Department of Oral Medicine and Radiology, King George Medical University, Lucknow, Uttar Pradesh, India.
authors: Ranjit
authors: R
authors: Patil
authors: Assistant professor, Department of Oral Medicine and Radiology, King George Medical University, Lucknow, Uttar Pradesh, India.
authors: Vikram
authors: V
authors: Khanna
authors: Assistant professor, Department of Oral Medicine and Radiology, King George Medical University, Lucknow, Uttar Pradesh, India.
authors: Vandana
authors: V
authors: Singh
keywords: Caffeine 1, 3, 7 tri-methyl xanthine; Child- pugh classification; EMIT; Liver cirrhosis