Serum Kallistatin level as a biomarker for evaluation of liver function status in cirrhotic patients

Abstract Background Liver cirrhosis (LC) represents the terminal stage of diverse chronic hepatic disorders and is characterized by substantial morbidity and mortality. Early identification of hepatic dysfunction is critical, especially during the compensated phase when clinical signs are often absent. Kallistatin (KAL), a liver-derived serine proteinase inhibitor, has demonstrated anti-inflammatory and anti-fibrotic properties and may serve as a biomarker of hepatic functional reserve. This investigation aims to evaluate serum KAL level as a biomarker for assessment of liver function status in cirrhotic cases. Results Serum KAL levels were significantly lower in cases (13.81 ± 4.56 ng/mL) compared to controls (57.93 ± 7.47 ng/mL, P < 0.001). KAL negatively correlated with spleen size ( r = –0.230, P = 0.029), ascites grade ( r = –0.235, P = 0.042), and varices grade ( r = –0.301, P = 0.009), and positively correlated with Hemoglobin (Hb) ( r = 0.623, P < 0.001), platelets ( r = 0.640, P < 0.001), and albumin ( r = 0.651, P < 0.001). Multivariate regression showed KAL as an independent predictor of albumin (β = 0.028, P = 0.03), total bilirubin (β = –0.13, P < 0.001), Alanine Aminotransferase (ALT) (β = –8.059, P = 0.004), and Aspartate Aminotransferase (AST) (β = –10.551, P = 0.005). Conclusions Serum KAL levels are substantially reduced in LC cases and show strong associations with both clinical and biochemical indicators of liver function.