Except for increased serum alkaline phosphatase (AP) effects on metabolic, synthetic, and excretory hepatic levels, the changes in liver function test (LFT) values functions. 2 The biliary excretion of bromosulfophthaduring normal pregnancy have not been clearly estab-lein decreases during pregnancy. 3,4 Some authors have lished, mainly because most studies do not include stated that there is a subclinical physiological cholestamatched controls. We therefore measured the serum val-sis during pregnancy. 5 The increase in plasma volume ues of routine liver tests including 5 -nucleotidase and that occurs during pregnancy leads to hemodilution 6,7 total bile acids in 103 healthy pregnant women (first tri-and decreases the serum protein concentrations. Semester, n Å 34; second trimester, n Å 36; third trimester, rum alkaline phosphatase levels increase in late pregn Å 33) and in 103 age-matched controls not receiving nancy because of both a production of the placental oral contraception. Fasting blood samples were taken.isoenzyme and an increase in the bone isoenzyme. [8][9][10] Because of hemodilution, serum albumin levels were significantly lower during all trimesters. As expected, AP It is therefore not surprising that changes in liver funcactivity was significantly higher in the third trimester. tion tests (LFTs) occur during pregnancy. NevertheSerum aspartate transaminase (AST) activity and total less, except for increased alkaline phosphatase levels, bile acid (TBA) concentrations did not differ between which have been clearly demonstrated, the changes in pregnant and nonpregnant women. Serum alanine the other LFT values have not been clearly established, transaminase (ALT) activity was slightly higher in the and a recent review in this field has shown that there second-trimester pregnant women than in controls (6.8 are some discordances in the literature. 11 The identifi-{ 4.5 vs. 8.2 { 5.8, P Å .04), although all values remained cation of these physiological changes is important for within normal limits. In pregnant women, total and free the diagnosis of liver diseases during pregnancy.bilirubin concentrations were significantly lower durThus, the aim of this study was to evaluate the ing all three trimesters, as was conjugated bilirubin during the second and third trimesters. Serum g-glutamyl changes in serum levels of routine LFTs, i.e., alkaline transpeptidase (GGT) activity was significantly lower in phosphatase (AP), alanine transaminase (ALT), asparthe second and third trimesters. Serum 5 -nucleotidase tate transaminase (AST), g-glutamyltranspeptidase activity was slightly but significantly higher in the sec-(GGT), total and conjugated bilirubin, 5 -nucleotidase, ond and third trimesters. The knowledge of these results and total bile acids (TBA) during normal pregnancy is useful for the interpretation of LFT values and the compared with a control group of nonpregnant women. hemodilution. The pregnant woman experiences physiological PATIENTS AND METHODSchanges to support fetal growth and development. Dur...

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It has been known for some years that a partial deglycosylation of transferrin occurs in the sera of alcohol abusers. Different methods have been proposed in order to evaluate this carbohydrate-deficient fraction of serum transferrin. Chromatofocusing or isoelectric focusing followed by direct immunofixation have been used until now. Recently, a new method called the carbohydrate-deficient transferrin (CDT) test based on ion-exchange chromatography has been developed by Stibler et al. (Alcohol Clin Exp Res 10:535-544, 1986). Here we compare this new method with results obtained using our Tf index determination method. The upper limit of normal values was set to the 90th percentile of the values observed in a reference population. The population under investigation consisted of 50 healthy volunteers and 160 alcohol abusers whose ethanol consumption was evaluated through a questionnaire. Sensitivity and specificity of the CDT test have been found higher than 0.76 and 0.90, respectively. The correlation between both methods was 0.794, a satisfactory result considering that the CDT test and the Tf index do not exactly measure the same part of the carbohydrate-deficient transferrin. In a population of 23 patients with liver diseases not related to alcohol abuse, no abnormal CDT value was observed. We can conclude from these results that the CDT test now seems to be the best test to detect alcohol abusers.