Alpha-1-Antitrypsin in Liver Disease

Low alpha-1 -antitrypsin (AAT) levels are known to be associated with liver disease. As AAT is also synthesised in the liver, we investigated whether liver disease itself may result in low AAT levels. AAT was measured in plasma from 100 patients with various liver diseases including hepatitis, cirrhosis, jaundice and liver failure. Twenty-eight patients had increased AAT values (greater than 3·;1 g/L), 70 had normal AAT values (between 1·;5 and 3·;1 g/L) and 2 had decreased AAT levels (< 1·;5 g/L). The 2 patients with low AAT levels were found to be of the PiMZ phenotype. There was no significant correlation between any of the standard ‘liver function tests' and the AAT level. Our findings suggest that in liver disease AAT levels are usually normal or increased. Low levels are uncommon and the possibility of an abnormal AAT phenotype being associated with the liver disease should be examined.

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Pregnancy-associated liver disease: a curriculum-based review

Frontline Gastroenterology ◽

10.1136/flgastro-2017-100924 ◽

2018 ◽

Vol 9 (3) ◽

pp. 170-174 ◽

Cited By ~ 10

Author(s):

Claire Kelly ◽

Marinos Pericleous

Keyword(s):

Liver Disease ◽

Liver Function ◽

Liver Diseases ◽

Pregnant Patient ◽

Liver Function Tests ◽

Abnormal Liver Function ◽

Common Reason ◽

Blood Tests ◽

Function Tests ◽

Unique Potential

Pregnancy is associated with changes in normal physiology, including changes to the normal parameters for blood tests. Abnormal liver function tests are a common reason for referral to gastroenterology. However, in the pregnant patient, there are unique potential causes. It is of prime importance to be aware of pregnancy-specific liver diseases as they can be serious and progress rapidly affecting outcomes for both the mother and fetus. Here, we provide an overview of the manifestations of pregnancy-related liver diseases and discuss their potential consequences.

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

Obesity Surgery ◽

10.1007/s11695-017-2551-7 ◽

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

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Liver Function Tests and Physiological Features of Liver Failure

Principles of Physiology for the Anaesthetist ◽

10.1201/9780429288210-39 ◽

2020 ◽

pp. 241-242

Author(s):

Peter Kam ◽

Ian Power ◽

Michael J. Cousins ◽

Philip J. Siddal

Keyword(s):

Liver Function ◽

Liver Failure ◽

Liver Function Tests ◽

Function Tests

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

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld-3064 ◽

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.

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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 ◽

10.1136/bmjopen-2019-032890 ◽

2020 ◽

Vol 10 (3) ◽

pp. e032890 ◽

Cited By ~ 2

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.

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Prevalence of chronic liver disease in HBsAg-positive carriers with normal liver function tests

Journal of Hepatology ◽

10.1016/s0168-8278(87)80284-2 ◽

1987 ◽

Vol 5 ◽

pp. S102

Keyword(s):

Liver Disease ◽

Liver Function ◽

Chronic Liver Disease ◽

Normal Liver ◽

Liver Function Tests ◽

Chronic Liver ◽

Normal Liver Function ◽

Function Tests

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Liver Diseases and Liver Function Tests

Clinical Chemistry, Immunology and Laboratory Quality Control ◽

10.1016/b978-0-12-407821-5.00010-3 ◽

2014 ◽

pp. 177-195

Author(s):

Amitava Dasgupta ◽

Amer Wahed

Keyword(s):

Liver Function ◽

Liver Diseases ◽

Liver Function Tests ◽

Function Tests

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

Pediatric Reports ◽

10.4081/pr.2011.e21 ◽

2011 ◽

Vol 3 (3) ◽

pp. 21 ◽

Cited By ~ 4

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 <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.

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