The cholinesterase test is a laboratory test requested with the aim of checking the person’s degree of exposure to toxic products, such as pesticides, insecticides, herbicides or fertilizers, for example, and is therefore more suitable for farmers, as they are in constant contact with agricultural products.
Cholinesterase is an enzyme present in the body responsible for the degradation of a substance called acetylcholine, a neurotransmitter responsible for controlling nerve impulses to the muscles. There are two classes of cholinesterase:
- Erythrocyte cholinesterase, which is carried by red blood cells;
- Plasma cholinesterase or serum, which is cholinesterase produced by the liver, pancreas and small intestine and which circulates in the blood plasma.
Monitoring cholinesterase levels is important so that any changes can be identified and treated quickly, avoiding complications for the person.
What is it for
The cholinesterase test is recommended by doctors mainly to monitor the degree of exposure of farmers, for example, to insecticides and pesticides.
Furthermore, the dosage of this enzyme can be requested to monitor patients with liver disease, especially those undergoing liver transplantation, as they normally have decreased cholinesterase levels.
Cholinesterase measurement may also be indicated for people who have mutations that interfere with the correct functioning or production of this enzyme.
Reference values
The reference values for the cholinesterase test vary depending on the laboratory and the kit used to perform the test. Thus, normal reference values can be between:
- Men: 4620 – 11500 U/L
- Women: 3930 – 10800 U/L
This test is carried out like any other blood test, that is, a small blood sample is collected and sent to the laboratory to be analyzed by the biochemistry sector. According to the laboratory, it may be recommended to fast for at least 4 hours.
What the results mean
Os low levels cholinesterase levels mainly indicate prolonged exposure to organophosphate pesticides (1) (2)which are substances present in insecticides, pesticides and herbicides capable of inhibiting the activity of this enzyme, leading to the accumulation of acetylcholine and which may result in the appearance of some signs and symptoms, such as:
- Cramps;
- Diarrhea;
- Vomiting;
- Excessive salivation;
- Visual difficulty;
- Decrease in blood pressure;
- Muscle weakness;
- Paralysis.
Although the decrease in cholinesterase levels is mainly related to intoxication, there may also be a decrease in this enzyme in cases of hepatitis, cirrhosis, congestive heart failure, acute infection, heart attack, malnutrition, pulmonary embolism and muscular dystrophy. Therefore, it is important that the result of the cholinesterase test is interpreted together with the results of other tests so that the cause of the decrease in this enzyme can be identified and the most appropriate treatment can be indicated.
On the other hand, the high levels of cholinesterase, normally occur due to obesity, diabetes, nephrotic syndrome and hyperthyroidism.
bliography
- GOLD ANALYSIS. Colinesterase -PP. 2012. Available at: <http://www.goldanalisa.com.br/arquivos/%7B4999E320-AA6E-4D30-A013-2B8014189255%7D_Cholinesterase.pdf>. Accessed on Jan 20, 2022
- GOVERNMENT OF GOIÁS. Update of parameters for monitoring Cholinesterase in health agents who use organophosphate and carbamate insecticides in vector control activities. 2015. Available at: <http://www.sgc.goias.gov.br/upload/arquivos/2015-01/01—copia-de-nt-006-parametros-colinesterase-versaodevep1.pdf>. Accessed on Jan 20, 2022
- BIOCLIN. Cholinesterase. 2020. Available at: <https://quibasa.bioclin.com.br/anexos/INSTRUCOES_COLINESTERASE_TRILINGUE.pdf>. Accessed on Jan 20, 2022
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