The liver:
- has a central role in human metabolism;
- is extensively involved in the synthesis and catabolism of carbohydrate, lipids and proteins;
- synthesizes an array of acute phase proteins in response to inflammation and infection, and laboratory measurements of such proteins are clinically useful in monitoring disease progress;
- is specifically involved in the metabolism of bilirubin derived from the catabolism of heme;
- when affected by a variety of disease processes often causes the patient to present with jaundice due to hyperbilirubinemia;
- has a central role in the detoxification of drugs;
- its biochemical function is commonly and routinely assessed in clinical practice using a panel of blood tests, called liver function tests, abnormalities of which can point to disease affecting the hepatocelluar or biliary systems.
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- Discuss how the anatomical position and structure of the liver allows it to absorb and metabolize lipid, protein and carbohydrate, as well as xenobiotics from the intestine, before releasing such molecules or their derivatives to the systemic circulation.
- Describe the function of the liver in protein synthesis and the systemic response to inflammation.
- Outline how the liver processes bilirubin, derived from the catabolism of haem, and describe the biochemical causes of hyperbilirubinemia (jaundice) and its classification.
- How does the liver metabolize drugs?
- Discuss the biochemical tests used by the clinical laboratory in the investigation of liver disease.
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| Van der Weide J, Steijns LSW. Cytochrome P450 enzyme system: genetic polymorphisms and impact on clinical pharmacology. Ann Clin Chem 1999;36:722-29.
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Dennery PA, Seidman DS, Stevenson DK Neonatal hyperbilirubinaemia. N Engl J Med 2001;344:581-90.
Full article
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| Riordan SM, Williams R. Fulminant hepatic failure. Clinics in Liver Disease 2000;4:25-45.
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| Zakim D, Boyer TD (eds). Hepatology. A Textbook of Liver Disease. 4th edition. Philadelphia: Saunders; 2002.
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