Abstract
Background: Cirrhosis impairs the liver's synthetic and excretory functions, disrupting both biochemical and coagulation homeostasis. This study evaluated liver function tests (LFTs) and coagulation parameters in patients with cirrhosis and examined their interrelationship.
Methods: In this cross-sectional study, 68 adults with clinically or laboratory-confirmed cirrhosis were recruited from the pathology and gastroenterology departments of two tertiary-care hospitals in Lahore, Pakistan, using non-probability purposive sampling. Serum bilirubin, ALT, AST, ALP, albumin, total protein, prothrombin time (PT), INR, activated partial thromboplastin time (APTT), and platelet count were measured. Data were analysed in SPSS v27 using descriptive statistics, Spearman correlation, and linear regression (significance set at p < 0.05).
Results: The cohort (58.8% female; mean age 53.7 ± 13.2 years) showed elevated AST (96.3 ± 30.4 U/L), ALT (78.0 ± 26.6 U/L) and ALP (225.4 ± 68.1 U/L), with an AST/ALT ratio of 1.40, alongside raised total bilirubin (4.15 ± 1.40 mg/dL) and low albumin (2.66 ± 0.41 g/dL). Coagulation indices were prolonged (PT 21.9 ± 3.5 sec; INR 1.88 ± 0.33; APTT 48.8 ± 6.0 sec) and platelet counts were reduced (99.9 ± 23.5 ×10⁹/L). Non-alcoholic fatty liver disease (36.8%) and alcoholic liver disease (33.8%) were the leading etiologies. Total and direct bilirubin were strongly correlated (r = 0.909, p < 0.01); PT showed a weak positive correlation with albumin (r = 0.286, p < 0.05). No biochemical marker independently predicted INR on regression analysis (all p > 0.05).
Conclusion: Cirrhosis was associated with concurrent hepatocellular injury, impaired synthetic function, and coagulopathy, reinforcing the value of combined LFT and coagulation panels in disease assessment, though no single marker reliably predicted INR in this cohort.
The findings suggest that while bilirubin and liver enzymes strongly indicate liver damage, coagulation markers alone are insufficient predictors of cirrhosis severity, emphasizing the need for multidimensional clinical assessment