Liver Health Index: A potential tool to identify cows at high risk of developing diseases after calving

By Caio Figueiredo, Veterinary Medicine Extension

The transition period is considered one of the most challenging stages in the life of a dairy cow and also one of the most delicate times to manage in dairy herds. Several studies have depicted the importance of a “smooth” transition of cows into lactation on subsequent health, welfare, productive and reproductive performance, and survival. A potential aid in the identification of cows at high risk of developing diseases during the early postpartum period involves the use of negative acute phase proteins and related molecules as an indicator of detrimental inflammation. One diagnostic mechanism is termed the Liver Health Index (LHI = [(Alb − μAlb)/σAlb] + [(Chol − μChol)/σChol] − [(Bili − μBili)/σBili]). Briefly, LHI is calculated using each individual cow’s albumin, cholesterol, and bilirubin values and the sampled population mean and standard deviation. Albumin, cholesterol, and bilirubin are negative acute phase proteins (and related compounds) that indicate liver function and severity of inflammatory status. Although such compounds may not illustrate the biological processes in their entirety, LHI has been associated with differences in biomarkers of energy metabolism (i.e., glucose), liver function (i.e., bilirubin and cholesterol), inflammation (i.e., albumin, ceruloplasmin, haptoglobin, IL-1β, and IL-6), and oxidative stress (i.e., paraoxonase and glutathione).

A recent publication reported that LHI is associated with differences in cow health and performance (Kerwin et al., 2022). More specifically, postpartum cows that were affected by clinical diseases within 2 weeks postpartum had lower LHI compared with cows without clinical diseases (Table 1). Differences in productive and reproductive performance were also associated with LHI (Figure 1).

Other publications have also reported differences in cow health, performance, and behavior associated with LHI. For instance, a greater number of health problems was observed in cows with low LHI compared with cows with high LHI within 30 days postpartum (Trevisi et al., 2012; Zhou et al., 2017). Milk production within 35 days postpartum was also reduced in cows with low LHI compared with cows with high LHI (36.2 vs. 46.3 kg, respectively). Finally, LHI was highly correlated to the number of minutes of rumination per day (r = 0.75), suggesting that LHI could be used as a proxy for cow health and welfare (Calamari et al., 2014). Altogether, LHI may be a useful tool for the identification of cows at higher risk of developing diseases and aid early diagnosis of disease in dairies, particularly for those that do not possess automated activity monitoring systems (i.e., collars or ear tags).

Table 1. Least squares means and standard error of the mean (SEM) of the liver health index for cows diagnosed or not diagnosed with the negative health event of interest for a retrospective cohort study involving 72 farms across the northeastern United States. Adapted from Kerwin et al., 2022.

 n%LSM  
Variable1DisorderNo disorderDisorderNo disorderSEMP-value
MET 71 (9.0) 722 (91.1) -1.79 -0.54
0.27<0.001
DA
23 (2.7) 818 (97.3) -3.23 -0.57
0.42<0.001
CK72 (8.6) 761 (91.4) -2.22 -0.50
0.26<0.001
Cull27 (3.2) 814 (96.8) -3.55 -0.55
0.38<0.001
Any of 3132 (16.8) 653 (83.2) -1.97 -0.35
0.21<0.001
2 or more25 (3.2) 760 (96.8) -3.05 -0.58
0.41<0.001
1MET: Metritis; DA: Displaced abomasum; CK: Clinical ketosis; Cull: Culling within 30 days in milk (DIM); Any of 3: Refers to having one or more of DA, CK, or MET; 2 or more: Refers to having two or more of DA, CK, and MET

Figure 1. Summary of findings from Kerwin et al., 2022.

Diagram of the data was collected from 72 farms in New York and Vermont between November 2012 and August 2015.

This image illustrates the Liver Health Index (LHI) in cows, including its components, associated health outcomes, and data from 72 farms. Detailed steps:

  1. Data Collection:
    • Data was collected from 72 farms in New York and Vermont between November 2012 and August 2015.
    • A total of 265 primiparous (first-calf) cows and 611 multiparous (multiple-calving) cows were included, all within 3 to 12 days in milk (DIM).
  2. Components of LHI:
    • The Liver Health Index (LHI) is calculated using three biomarkers:
      • Albumin
      • Cholesterol
      • Bilirubin
  3. LHI Calculation:
    • These biomarkers are combined to determine the LHI, represented by a central circle labeled “Liver Health Index (LHI).”
  4. Associated Health Outcomes:
    • Negative Health Events:
      • A decrease in LHI is observed in cows with negative health events.
    • 305-day Mature Equivalent Milk Yield:
      • For multiparous cows: A 1-unit increase in LHI is associated with a milk yield increase of +154 ± 38 kg.
      • For primiparous cows: No significant association with milk yield.
    • Pregnancy Risk by 150 DIM:
      • For multiparous cows: A 1-unit increase in LHI corresponds to an 8% increased risk of pregnancy.
      • For primiparous cows: No significant association with pregnancy risk.

Visual Elements:

  • The image includes illustrations of a barn, a cow, and a test tube to signify sample collection.
  • Three circles representing albumin, cholesterol, and bilirubin are combined with arrows pointing to the LHI circle.
  • Three outcome circles (Negative Health Events, 305-day Mature Equivalent Milk Yield, and Pregnancy Risk by 150 DIM) are connected to the LHI circle with arrows and contain detailed descriptions of their associations.