Determination of the reference range of whole blood cholinesterase activities in Thai postmortem cases
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Abstract
Background: Whole blood cholinesterase activities are biomarkers for diagnosis of organophosphate and carbamate poisoning. The reference ranges for these biomarkers in Thai people were available for living people. However, there is no baseline data for these biomarkers in Thai postmortem cases.
Objectives: The objective of this study is to study the reference range of whole blood cholinesterase activities in Thai postmortem cases and factors influencing enzyme activities.
Materials and methods: Postmortem blood samples were collected from Thai dead bodies who were 18-60 years old and were sent for medico-legal autopsies at the Department of Forensic Medicine, Siriraj Hospital, Mahidol University between 9th June 2020 and 31st December 2020. Data including gender, age, postmortem interval (PMI) and liver pathology were recorded. Whole blood cholinesterase activities were analyzed by using UV-visible spectrophotometer. Whole blood cholinesterase activities were analyzed using descriptive statistics. Mann-Whitney U test and Kruskal-Wallis H test were also tested for comparison between each factor using statistical significance at p<0.05.
Results: There were 176 subjects recruited in this study (121 males and 55 females). Whole blood cholinesterase activities in all subjects were 3514.32-7771.13 IU/mL and the mean and median values were 6150.27 and 6326.78 IU/mL, respectively. There was significant difference among classified four age groups (p value=0.014). Whole blood cholinesterase activities of two lower age groups (18-30 and 31-40 years old) were significantly lower than the third age group (41-50 years old) (p value=0.027 and 0.005, respectively). Whole blood cholinesterase activities were also significantly related to PMI (p value=0.042). The values from early PMI (0-8 hours) period was significantly lower than the values from the second PMI (8-16 hours) period (p value=0.043). In addition, postmortem cases with fatty change >50% significantly presented lower enzyme activities than those with fatty change <50% (p value=0.042).
Conclusion: Whole blood cholinesterase activities in Thai postmortem cases whose age ranged from 18 to 60 years old were 3514.32-7771.13 IU/mL. Age, PMI and liver pathology were three factors that affect whole blood cholinesterase activities in Thai postmortem cases.
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