Abnormal liver function tests

2019 ◽  
Vol 12 (9) ◽  
pp. 507-515
Author(s):  
Ceen-Ming Tang
Keyword(s):  
Primary Care ◽  
Liver Disease ◽  
Liver Function ◽  
Liver Function Tests ◽  
Alcoholic Fatty Liver ◽  
Premature Deaths ◽  
Function Tests ◽  
Medication Reviews ◽  
Related Liver Disease ◽  
The Uk

Liver disease is a clinical priority area identified by the RCGP, due to increasing levels of morbidity and mortality. Liver disease causes an estimated 8500 premature deaths in the UK annually, predominantly from a rise in non-alcoholic fatty liver disease, alcohol-related liver disease, and viral hepatitis. There has been a corresponding increase in liver function tests (LFTs) ordered from primary care, often as part of medication reviews or monitoring of chronic disease. GPs will therefore encounter an increasing number of abnormal LFTs in patients asymptomatic of liver disease. This article outlines a framework for investigating abnormal LFTs in primary care.

Detecting chronic liver disease: are liver function tests the solution?

2020 ◽  
Vol 81 (2) ◽  
pp. 1-8
Author(s):  
Prarthana Thiagarajan ◽  
Jane Chalmers ◽  
Indra N Guha ◽  
Martin W James
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Chronic Liver Disease ◽  
Liver Function Tests ◽  
Chronic Liver ◽  
Alcoholic Fatty Liver ◽  
Non Invasive ◽  
Function Tests ◽  
Life Years ◽  
The Uk

By 2020, chronic liver disease will have eclipsed ischaemic heart disease as the leading cause of working life years lost in the UK. As mortality from chronic liver disease continues to rise, the landscape of aetiology has shifted from infectious to non-communicable causes. In parallel with the growing prevalence of obesity and type 2 diabetes, non-alcoholic fatty liver disease is estimated to affect 25% of the UK adult population. Simultaneously, escalating alcohol consumption has fuelled public health and economic concerns regarding its widespread impact on working-age adults. Given that chronic liver disease remains clinically silent until its advanced stages, there is an urgent unmet need to identify affected individuals earlier in the disease process, enabling targeted intervention strategies which may improve prognosis. Robust epidemiological data have shown that liver fibrosis is the strongest predictor of clinically meaningful outcomes, including decompensation, liver cancer and overall mortality. Detecting fibrosis among at-risk individuals, in a manner that is reproducible, non-invasive, safe and cost effective, has become a major challenge of our time. This article addresses the pitfalls of the standard panel of liver function tests, discusses other non-invasive biomarkers and reviews imaging technologies which may revolutionise community-based diagnosis and stratification of chronic liver disease.

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 <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.

scholarly journals GPs’ experiences and perceptions of early detection of liver disease: a qualitative study in primary care

2018 ◽  
Vol 68 (676) ◽  
pp. e743-e749 ◽  
Author(s):  
Holly C Standing ◽  
Helen Jarvis ◽  
James Orr ◽  
Catherine Exley ◽  
Mark Hudson ◽  
...  
Keyword(s):  
Primary Care ◽  
Liver Disease ◽  
Qualitative Study ◽  
Early Detection ◽  
Liver Function Tests ◽  
Comparative Approach ◽  
Structured Interviews ◽  
Alcoholic Fatty Liver ◽  
Study Sites ◽  
The Uk

BackgroundThe incidence of liver disease is increasing in the UK and primary care is a key setting where improvement in the detection and management of liver disease is required. Little is known about GPs’ understanding and confidence in detecting liver disease.AimTo explore GPs’ experiences of liver disease with a focus on early detection and interpretation of liver function tests (LFTs).Design and settingA qualitative study employing semi-structured interviews of a purposive sample of GPs from five UK primary care study sites.MethodTelephone and face-to-face interviews of GPs were undertaken. Data were analysed thematically, using a constant comparative approach.ResultsFrom a total of 25 GP interviews (N = 25), four themes were identified from the data: test-requesting behaviour, confidence and challenges in diagnosing disease, access to specialist tests, and guidance and education. Participants’ descriptions of how they request and interpret LFTs varied widely. Concern over missing diagnoses was a common reason for requesting blood tests; patients with mildly abnormal LFTs and those at risk of non-alcoholic fatty liver disease (NAFLD) were a particular cause of concern. GPs saw themselves as generalists, with a reluctance to take on specialist investigations. Guidelines promoted confidence for some clinicians, but others felt that liver disease was too complex to be amenable to simple instructions. Most felt that they did not have access to relevant, focused education on liver disease.ConclusionLiver disease is not perceived as a priority in primary care. If GPs are to take on a greater role in identification and management of liver disease, support is needed to promote awareness, knowledge, and confidence.

scholarly journals Alterations of liver function tests in diabetic obese and nonobese individuals

Biomedicine ◽  
2021 ◽  
Vol 41 (4) ◽  
pp. 781-786
Author(s):  
Avinash S. ◽  
Santhi Silambanan
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Cost Effective ◽  
Liver Function Tests ◽  
P Value ◽  
Alcoholic Fatty Liver ◽  
Nonalcoholic Fatty Liver ◽  
Function Tests

Introduction and Aim: India has emerged as the diabetes capital in Southeast Asia having around 74 million with diabetes, with a prevalence of 9.8% in 18–99 years of age. In type 2 diabetes mellitus, triglycerides get deposited in liver thus altering its structure and function, which is the feature of nonalcoholic fatty liver disease. This study was undertaken to study the alterations in liver function tests in obese and nonobese diabetic individuals.   Materials and Methods: The Department of Biochemistry at Sri Ramachandra Institute of Higher Education and Research was chosen to conduct the retrospective study on 200 diabetic individuals from September 2019 to February 2020. The data obtained were serum liver function tests, HbA1c, plasma glucose and lipid profile. Before the study ethics approval was obtained from the Institutional Ethics Committee for studies involving human participants. The obtained data were subjected to statistical analysis using SPSS version 16 and a P value less than 0.05 was considered statistically significant.   Results: Transaminases and ALP were significantly altered in obese diabetics; were positively correlated with bilirubin. TGL was negatively correlated with AST/ALT ratio.   Conclusion: Liver enzymes and bilirubin were altered in obese diabetics. Measurement of liver function biomarkers are cost effective diagnostic markers of non-alcoholic fatty liver disease.

scholarly journals Effectiveness of phosphatidylcholine as adjunctive therapy in improving liver function tests in patients with non-alcoholic fatty liver disease and metabolic comorbidities: real-life observational study from Russia

2020 ◽  
Vol 7 (1) ◽  
pp. e000368 ◽  
Author(s):  
Igor V Maev ◽  
Aleksey A Samsonov ◽  
Liudmila K Palgova ◽  
Chavdar S Pavlov ◽  
Elena N Shirokova ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Observational Study ◽  
Fatty Liver Disease ◽  
Liver Function Tests ◽  
Newly Diagnosed ◽  
Alcoholic Fatty Liver ◽  
Function Tests ◽  
Metabolic Comorbidities ◽  
Alcoholic Fatty Liver Disease

ObjectiveNon-alcoholic fatty liver disease (NAFLD) is the most common cause of abnormal results of liver function tests. Earlier research showed that polyenylphosphatidylcholine (PPC) has hepatoprotective effects and thus can be used for the treatment of NAFLD and the prevention of its progression. Accordingly, the aim of this observational study was to evaluate if PPC administered as adjunctive therapy in routine clinical practice can effectively improve liver function tests of NAFLD in Russian patients with associated metabolic comorbidities.DesignA total of 2843 adult patients with newly diagnosed NAFLD, who had a least one of four comorbidities, namely, overweight/obesity, hypertension, type 2 diabetes mellitus, and hypercholesterolaemia, and who were prescribed 1.8 g/day of PPC as an adjunctive treatment to standard care, were enrolled during 2015–2016. Laboratory data were collected at baseline and 12 and 24 weeks of the study, and included liver function tests (aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT)), fasting plasma glucose, and lipid profile.ResultsOverall, 2263 patients (79.6%) had at least two metabolic comorbidities associated with NAFLD, and overweight/obesity was the most common comorbidity reported in 2298 (80.8%) patients. At 24 weeks, there was a significant decrease in liver enzyme levels (all p<0.001 compared with baseline). Across the four comorbidity subgroups, there was a mean drop of ALT levels ranging from 19.7 to 22.0 U/L, AST from 16.9 to 18.4 U/L, and GGT from 17.2 to 18.7 U/L. Similar findings were reported in subgroups with either one, two, three, or four comorbidities, with a significant decrease in liver enzyme levels ranging from 18.4 to 22.4 U/L for ALT, 14.8 to 18.7 U/L for AST, and 15.5 to 19.5 U/L for GGT.ConclusionsAdjuvant treatment with PPC resulted in consistent improvements in liver enzymes in patients with newly diagnosed NAFLD and associated metabolic comorbidities.Trial registration numberNCT00063622.

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
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