Noninvasive classification of liver disease in asymptomatic and oligosymptomatic male alcoholics

Abstract

The predominant type of liver alteration in asymptomatic or oligosymptomatic chronic male alcoholics (N = 169) admitted to a psychiatric hospital for detoxification was classified by two independent methods: liver palpation and multiple quadratic discriminant analysis (QDA), the latter applied to two parameters reported by the patient (duration of alcoholism and daily amount ingested) and to the data obtained from eight biochemical blood determinations (total bilirubin, alkaline phosphatase, glycemia, potassium, aspartate aminotransferase, albumin, globulin, and sodium). All 11 soft and sensitive, and 13 firm and sensitive livers formed fully concordant groups as determined by QDA. Among the 22 soft and not sensitive livers, 95% were concordant by QDA grouping. Concordance rates were low (55%) in the 73 firm and not sensitive livers, and intermediate (76%) in the 50 not palpable livers. Prediction of the liver palpation characteristics by QDA was 95% correct for the firm and not sensitive livers and moderate for the other groups. On a preliminary basis, the variables considered to be most informative by QDA were the two anamnestic data and bilirubin levels, followed by alkaline phosphatase, glycemia and potassium, and then by aspartate aminotransferase and albumin. We conclude that, when biopsies would be too costly or potentially injurious to the patients to varying extents, clinical data could be considered valid to guide patient care, at least in the three groups (soft, not sensitive; soft, sensitive; firm, sensitive livers) in which the two noninvasive procedures were highly concordant in the present study.

Indocyanine green clearance varies as a function of N-acetylcysteine treatment in a murine model of acetaminophen toxicity

“…Elevated hepatic transaminase levels are used as a measure of hepatocyte lysis and thus do not reflect the functional capacity of the liver. Because structurally injured hepatocytes may be partially functional [3,4], it is important to distinguish liver cell injury from loss of functional capacity. Assays that characterize liver function are critical in studies that assess hepatic recovery following toxin-mediated and other causes of liver injury.…”

Clinical and Laboratorial Characteristics of the Liver in Aged and Non-Aged Alcoholics

“…Concomitantly, hepatocyte lesion is accompanied by reduction in the synthesis of proteins and other substances. 11 The outcome is the establishment of a vicious cycle where liver dysfunction is accentuated. .…”

“…It should be considered that the hepatic alterations representative of steatosis, inflammation and fibrosis are not mutually exclusive and some of them may overlap, occurring in different degrees of intensity and simultaneously in the same patient. 34 Correlations have been found between histopathology and hepatic semiology 35,36 , serum biochemistry 10,36,37 and associations of clinical and biochemical data 11,36,38 . and the clinical, biochemical and diagnostic data associations 39,40 .…”

“…It is presently established that alcohol is the most important factor, together with nutritional deficiencies following low food ingestion and inadequate uptake and metabolism of nutrients, in causing the various structural, functional and metabolic liver alterations [11][12][13][14] .…”

Quantitative Grading Using Grey Relational Analysis on Ultrasonographic Images of a Fatty Liver

“…Thus, in most Western countries, this diagnostic method is rarely used [10]. Additionally, a liver biopsy has limitations: it is costly and requires hospitalisation for at least 48 h [11].…”