Open Access Open Badges Research article

Serum paraoxonase-1 as biomarker for improved diagnosis of fatty liver in dairy cows

Ayman Samir Farid12, Kazuyuki Honkawa23, Eman Mohamed Fath23, Nariaki Nonaka2 and Yoichiro Horii2*

Author affiliations

1 Department of Clinical Pathology, Faculty of Veterinary Medicine, Benha University, Moshtohor, Toukh 13736, Qalyubia, Egypt

2 Laboratory of Parasitic Diseases, Faculty of Agriculture, University of Miyazaki, Gakuen-Kibanadai, Nishi 1-1, Miyazaki 889-2192, Japan

3 Interdisciplinary Graduate School of Medicine and Veterinary Medicine, University of Miyazaki, Gakuen-Kibanadai, Nishi 1-1, Miyazaki 889-2192, Japan

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Citation and License

BMC Veterinary Research 2013, 9:73  doi:10.1186/1746-6148-9-73

Published: 11 April 2013



Fatty liver is a major metabolic disorder in dairy cows and is believed to result in major economic losses in dairy farming due to decreased health status, reproductive performance and fertility. Currently, the definitive means for diagnosing fatty liver is determining the fat content of hepatic tissue by liver biopsy, which is an invasive and costly procedure, making it poorly suited to dairy farms. Therefore, the key aim of this study was to investigate the measurement of serum paraoxonase-1 (PON1), an enzyme exclusively synthesized by the liver, as a sensitive noninvasive biomarker for diagnosis of fatty liver in dairy cows.


A comparative cohort study using serum specimens from Holstein–Friesian dairy cows (46 healthy and 46 fatty liver cases) was conducted. Serum PON1 (paraoxonase, lactonase and arylesterase) activity and other biochemical and hematological parameters were measured. We found that serum PON1 activity was lower (P<0.001) in cows suffering from fatty liver. The area under the receiver operating characteristic curve (AUC-ROC) of PON1 activity for diagnosis of fatty liver was 0.973–0.989 [95% confidence interval (CI) 0.941, 1.000] which was higher than the AUC-ROC of aspartate aminotransferase (AST), lecithin-cholesterol acyltransferase (LCAT), alkaline phosphatase (ALP), non-esterified fatty acids (NEFA), beta-hydroxybutyrate (BHBA), total cholesterol, high-density lipoprotein (HDL) and low-density lipoprotein (LDL). We found that adding serum PON1 measurement to different batteries of serum diagnostic panels showed a combination of high sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (+LR), negative likelihood ratio (−LR), diagnostic odd ratio (DOR) and overall diagnostic accuracy in diagnosing fatty liver.


The present results indicate that addition of serum PON1 activity measurement to the biochemical profile could improve the diagnosis of fatty liver in dairy cows, which would have a considerable clinical impact and lead to greater profitability in the dairy industry.

Paraoxonase; Arylesterase; Lactonase; Fatty liver; Dairy cow; Diagnosis; Liver function