scholarly journals Liver function tests and fibrosis scores in a rural population in Africa: a cross-sectional study to estimate the burden of disease and associated risk factors

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e032890 ◽  
Author(s):  
Geraldine O'Hara ◽  
Jolynne Mokaya ◽  
Jeffrey P Hau ◽  
Louise O Downs ◽  
Anna L McNaughton ◽  
...  
Keyword(s):  
Liver Disease ◽  
Alcohol Consumption ◽  
Liver Function ◽  
Reference Range ◽  
Liver Function Tests ◽  
Sub Saharan Africa ◽  
Reference Ranges ◽  
Cross Sectional ◽  
Function Tests ◽  
Glutamyl Transferase

ObjectivesLiver disease is a major cause of morbidity and mortality in sub-Saharan Africa, but its prevalence, distribution and aetiology have not been well characterised. We therefore set out to examine liver function tests (LFTs) and liver fibrosis scores in a rural African population.DesignWe undertook a cross-sectional survey of LFTs. We classified abnormal LFTs based on reference ranges set in America and in Africa. We derived fibrosis scores (aspartate aminotransferase (AST) to Platelet Ratio Index (APRI), fibrosis-4, gamma-glutamyl transferase (GGT) to platelet ratio (GPR), red cell distribution width to platelet ratio and S-index). We collected information about alcohol intake, and infection with HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV).SettingWe studied a population cohort in South-Western Uganda.ParticipantsData were available for 8099 adults (median age 30 years; 56% female).ResultsThe prevalence of HBV, HCV and HIV infection was 3%, 0.2% and 8%, respectively. The prevalence of abnormal LFTs was higher based on the American reference range compared with the African reference range (eg, for AST 13% vs 3%, respectively). Elevated AST/ALT ratio was significantly associated with self-reported alcohol consumption (p<0.001), and the overall prevalence of AST/ALT ratio >2 was 11% (suggesting alcoholic hepatitis). The highest prevalence of fibrosis was predicted by the GPR score, with 24% of the population falling above the threshold for fibrosis. There was an association between the presence of HIV or HBV and raised GPR (p=0.005) and S-index (p<0.001). By multivariate analysis, elevated LFTs and fibrosis scores were most consistently associated with older age, male sex, being under-weight, HIV or HBV infection and alcohol consumption.ConclusionsFurther work is required to determine normal reference ranges for LFTs in this setting, to evaluate the specificity and sensitivity of fibrosis scores and to determine the aetiology of liver disease.

scholarly journals Reducing liver function tests for statin monitoring: an observational comparison of two clinical commissioning groups

2017 ◽  
Vol 67 (656) ◽  
pp. e194-e200 ◽  
Author(s):  
Kate Homer ◽  
John Robson ◽  
Susannah Solaiman ◽  
Abigail Davis ◽  
Saima Zubeda Khan ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Liver Function Tests ◽  
Post Intervention ◽  
Cross Sectional ◽  
Function Tests ◽  
Liver Function Testing ◽  
Periodic Testing ◽  
Function Test ◽  
Function Testing

BackgroundCurrent liver function testing for statin monitoring is largely unnecessary and costly. Statins do not cause liver disease. Both reduction in test frequency and use of a single alanine transaminase (ALT) rather than a full seven analyte liver function test (LFT) array would reduce cost and may benefit patients.AimTo assess LFT testing in relation to statin use and evaluate an intervention to reduce full-array LFTs ordered by GPs for statin monitoring.Design and settingTwo-year cross-sectional time series in two east London clinical commissioning groups (CCGs) with 650 000 patients. One CCG received the intervention; the other did not.MethodThe intervention comprised local guidance on LFTs for statin monitoring and access to a single ALT rather than full LFT array.ResultsOf the total population, 17.6% were on statins, accounting for 43.2% of total LFTs. In the population without liver disease, liver function tests were 3.6 times higher for those on statins compared with those who were not. Following intervention there was a significant reduction in the full LFT array per 1000 people on statins, from 70.3 (95% confidence interval [CI] = 66.3 to 74.6) in the pre-intervention year, to 58.1 (95% CI = 55.5 to 60.7) in the post-intervention year (P<0.001). In the final month, March 2016, the rate was 53.2, a 24.3% reduction on the pre-intervention rate.ConclusionThis simple and generalisable intervention, enabling ordering of a single ALT combined with information recommending prudent rather than periodic testing, reduced full LFT testing by 24.3% in people on statins. This is likely to have patient benefit at reduced cost.

scholarly journals Author Reply—Bariatric Surgery and Liver Function Tests in Nonalcoholic Fatty Liver Disease

2017 ◽  
Vol 27 (4) ◽  
pp. 1060-1060
Author(s):  
Geraldine J. Ooi ◽  
Paul R. Burton ◽  
William W. Kemp ◽  
Stuart K. Roberts ◽  
Wendy A. Brown
Keyword(s):  
Bariatric Surgery ◽  
Liver Disease ◽  
Liver Function ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Liver Function Tests ◽  
Author Reply ◽  
Nonalcoholic Fatty Liver ◽  
Function Tests

scholarly journals Vegan Diet Advice Might Benefit Liver Enzymes in Nonalcoholic Fatty Liver Disease: an Open Observational Pilot Study

2021 ◽  
Author(s):  
Giuseppe Chiarioni ◽  
Stefan Lucian Popa ◽  
Andrea Dalbeni ◽  
Carlo Senore ◽  
Daniel Corneliu Leucuta ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Liver Disease ◽  
Liver Function ◽  
Fatty Liver Disease ◽  
Liver Enzymes ◽  
Liver Function Tests ◽  
Vegan Diet ◽  
Nonalcoholic Fatty Liver ◽  
Function Tests

Background and Aims: The Western diet is rich in saturated fats, refined sugars and meat consistent with a high-energy load and secondary risk of increased metabolic diseases including nonalcoholic fatty liver disease (NAFLD). However, no data are available on potential benefit of vegan diets in NAFLD and/or nonalcoholic steatohepatitis (NASH). We aimed to study prospectively the effect of a vegan diet, excluding all animal products on liver chemistry in a group of consecutive NAFLD patients. Methods: This was a prospective, pilot study run on 40 consecutive patients affected by NAFLD. Eight subjects refused to join the study for poor diet palatability, leaving 32 patients (19 males, mean age 50 years), with abnormal measures of liver function who agreed to adhere to a vegan diet for six months. The caloric intake was tailored by the dietitian to obtain a weight loss ≥5% of body weight in overweight patients [body-mass index (BMI) ≥25] and ranged from 1500 Kcal to 1800 Kcal. Patients were contacted monthly by phone to reinforce diet and lifestyle advice and were seen at the gastrointestinal clinic when doubtful about diet advice. Results: At six-month follow-up, 6 subjects did not attend the clinic leaving only 26 patients for data analysis. Initial anthropometric values were mean weight 78 kg (range 52-95), mean body mass index (BMI) 26.8 Kg/m2 (range 20.3-31.2). Liver function tests showed mean ALT value 99 U/L (SD±45), mean AST value 54 U/L (SD±44), mean GGT value 160 U/L (SD±122), pre-treatment. After six months mean body weight was 73 Kg (range 52-87), mean BMI was 25.2 Kg/m2 (range 20.3-29.7) (p<0.001 compared to baseline for both parameters). Liver enzymes improved to a mean of ALT value 36 U/L (SD±21), AST value 27 U/L (SD±10) and GGT value 55 U/L (SD±57), respectively (p<0.001 compared to baseline for all enzymes). Normalization of liver function tests as a whole was observed in 20/26 patients (76.9%). A loss of ≥ 5% of body weight was observed in 12 patients (46.1%), but it did not correlate with the normalization of liver function tests (p=0.5). Conclusions: Our data provide preliminary evidence of improved liver enzymes in NAFLD patients with a strict vegan diet and although our study sample is limited, decreased body weight did not seem critical to the outcome.

scholarly journals Cystic fibrosis-related liver disease: a single-center experience

2011 ◽  
Vol 3 (3) ◽  
pp. 21 ◽  
Author(s):  
Paula Catarino Costa ◽  
Celeste Canha Barreto ◽  
Luisa Pereira ◽  
Maria Luisa Lobo ◽  
Maria Adília Costa ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Liver Disease ◽  
Liver Function ◽  
Pediatric Patients ◽  
Liver Function Tests ◽  
Liver Involvement ◽  
Clinical Expression ◽  
Function Tests ◽  
Related Liver Disease

Prospective studies concerning liver disease in pediatric cystic fibrosis patients are scarce. The present study aimed to describe the prevalence and clinical expression of cystic fibrosis - related liver disease, in a cohort of 62 pediatric patients. Descriptive study, resulting from the prospective evaluation, between 1994 and 2009, of 62 pediatric patients (age &lt;18 years) with cystic fibrosis. The follow-up protocol included a clinical assessment every 2 months, liver function tests every 6 months and annual liver ultrasonography. The cumulative prevalence of liver disease was 11.2% (7/62 cases). All patients had ΔF508 mutation and pancreatic insufficiency, none had meconium ileus. The liver involvement became clinically evident at a mean age of 8 years (3-15 years), revealed by hepatomegaly or hepatosplenomegaly (3 cases) and/ or abnormalities of liver function tests (3 cases) changes of liver ultrasound (7 cases) with evidence of portal hypertension (2 cases). Four patients were submitted to liver biopsy; biliary fibrosis was documented in one case, focal biliary cirrhosis in 2 cases and multilobular cirrhosis in another case. Within a median 11.6 years follow-up period (all patients under UDCA therapy after liver disease diagnosis), progression of liver disease was observed in 2 patients; one patient developed refractory variceal bleeding and progressive hepatic failure, requiring liver transplant. The results of the present study agree with those of previous pediatric studies, further documenting clinical expression of liver disease in CF patients, which is usually detected in the first decade of life and emphasize the contribution of ultrasound to early diagnosis of liver involvement. Moreover, although advanced liver disease is a relatively rare event, early isolated liver transplantation may have to be considered at this age group.

Echo-doppler hepatic measurements combined with quantitative liver function tests in chronic liver disease

2000 ◽  
Vol 32 ◽  
pp. 223
Author(s):  
A. Fasoli ◽  
P. Borro ◽  
F. Botta ◽  
B. Chiarbonello ◽  
P. Durando ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Chronic Liver Disease ◽  
Liver Function Tests ◽  
Chronic Liver ◽  
Function Tests

scholarly journals A High Percentage of Patients Recovered From COVID-19 but Discharged With Abnormal Liver Function Tests

2021 ◽  
Vol 12 ◽  
Author(s):  
Qinyi Gan ◽  
Beilei Gong ◽  
Manli Sun ◽  
Zhujun Cao ◽  
Yuyan Zheng ◽  
...  
Keyword(s):  
Liver Function ◽  
Oxygenation Index ◽  
Liver Function Tests ◽  
Gamma Glutamyl Transferase ◽  
Function Tests ◽  
Liver Functions ◽  
Global Health Issue ◽  
Treatment Data ◽  
Independent Risk Factors ◽  
Glutamyl Transferase

BackgroundCoronavirus disease 2019 (COVID-19) pandemic has become the most severe global health issue. Abnormal liver functions are frequently reported in these patients. However, liver function abnormality was often overlooked during COVID-19 treatment, and data regarding liver functions after cure of COVID-19 is limited. This study aimed to reveal the changes of liver function tests (LFTs) during hospitalization, and its clinical significance in patients with COVID-19.MethodsIn this retrospective, bi-center study, a total of 158 hospitalized patients diagnosed with COVID-19 in China were included from January 22nd, 2020 to February 20th, 2020. Clinical features, laboratory parameters including LFTs, and treatment data were collected and analyzed. LFTs included alanine transaminase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, and total bilirubin. Patients were considered with abnormal LFTs when any value of these tests was higher than upper limit of normal.ResultsOf 158 patients with COVID-19, 67 (42.41%) patients had abnormal LFTs on admission and another 50 (31.65%) patients developed abnormal LFTs during hospitalization. The incidence of LFTs abnormality in severe COVID-19 cases was significantly higher than non-severe cases. All LFTs in COVID-19 patients were correlated with oxygenation index. There was no statistical difference in treatment between the patients with or without liver test abnormalities. By the time of discharge, there were still 64 (40.50%) patients with abnormal LFTs. Logistic regression analysis identified younger age, hypertension and low lymphocyte counts as independent risk factors for persistent abnormal LFTs during hospitalization.ConclusionLiver function tests abnormality was common in COVID-19 patients and was more prevalent in severe cases than in non-severe cases. A substantial percentage of patients still had abnormal LFTs by the time of discharge.

scholarly journals Comparison of Liver Function Tests in Normal Pregnancy with Non-pregnant Matched Controls

2020 ◽  
Vol 33 (1) ◽  
pp. 17-24
Author(s):  
M Rokeya Khatun ◽  
Amina Khatun ◽  
Md Nowshad Ali
Keyword(s):  
Liver Function ◽  
Serum Albumin ◽  
Pregnant Women ◽  
Liver Function Tests ◽  
Albumin Concentration ◽  
Third Trimester ◽  
Serum Globulin ◽  
College Hospital ◽  
Cross Sectional ◽  
Function Tests

Background: Change of liver biochemical profiles is normal during pregnancy. It is almost impossible to understand disease processes that can threaten women during pregnancy without understanding normal physiological change. Aim of this study is to evaluate changes in serum liver function tests in normal pregnant women in first, second and third trimester. Material and Methods: The cross-sectional comparative study was carried out in the Department of Obstetrics & Gynaecology of Rajshahi Medical College Hospital, Bangladesh in 2019. This study consists of 90 pregnant women and 90 matched control. Among the 90 pregnant women, 30 were in first trimester, 30 were in second trimester and 30 were in third trimester. Blood samples were taken for routine liver function and protein profiles Results: Serum total and direct bilirubin concentrations were significantly lower in second and third trimester. The mean ALP level was slightly increased in 2nd trimester and drastically increased in 3rd trimesters during pregnancy. Serum ALT and AST activity was significantly increased in third trimester. No significant change in serum total proteins concentration, but serum albumin concentration was significantly lower and serum globulin concentration was significantly higher in all three trimester. Serum albumin/globulin ratio was significantly reduced in second and third trimester. Conclusion: Relative values of various liver function tests during gestational trimesters appear to be the best guide to confirm the diagnosis and treatment strategies. Thus, gynecologists should routinely monitor liver function tests in all gestational trimesters to avoid the future complications to mother and offspring. TAJ 2020; 33(1): 17-24

Sign in / Sign up

Export Citation Format

Share Document