Liver function tests in identifying patients with liver disease

Abstract

Background and aimsMany patients with liver disease come to medical attention once they have advanced cirrhosis or acute decompensation. Most often, patients are screened for liver disease via liver function tests (LFTs). There is very limited published data evaluating laboratory values with biopsy-proven stages of hepatic fibrosis. We set out to evaluate whether any correlation exists between routine LFTs and stages of hepatic fibrosis.MethodsA large retrospective observational study on 771 liver biopsies was conducted for evaluating the stage of fibrosis with AST, ALT, INR, BUN, creatinine, platelets, alkaline phosphatase, bilirubin, and albumin. Mean and 95% confidence intervals were used to describe the distributions of serum markers in different fibrosis stages. Multivariable generalized linear models were used and a two-tailed P-value was calculated.ResultsALT was not statistically significant for any stage, and AST was statistically significant for stage 3 and 4 fibrosis. INR was statistically significant only in stage 4 disease but remained near the upper limit of normal range. Albumin failed to show a clinically relevant association. Platelets remained within normal laboratory range for all stages. The remaining laboratory values failed to show statistical and clinical significance.ConclusionThe health care burden from chronic liver disease (CLD) will likely continue to rise, unless clinicians are made aware that normal or near normal laboratory findings may be seen in asymptomatic patients. Earlier identification of asymptomatic patients will allow for treatment with new promising modalities and decrease morbidity and mortality from CLD. Our study shows that laboratory values correlate poorly with liver disease.

Effect of Bambara groundnut (Vigna subterranea) consumption on biomarkers of oxidative stress in alloxan-induced diabetic Wistar rats

“…However, treatment of diabetic rats with diet of 10% Bambara groundnut seed flour for 28 days significantly (p<0.05) reversed the above parameters towards normalcy. Elevations of AST, ALT and ALP are attributed to hepatocellular damage and decreased liver functions as has been previously reported by Ahmed et al (2018). The highest levels of SOD and GSHPER were found in rat group C (the group on 10% Bambaragroundnut diet), there was increased activities of SOD and GSHPER in diabetic untreated rats (Table 3).…”

“…It is also responsible for blood detoxification and purification. Aspartate transaminase (AST), Alkaline phosphatase (ALP) and Alanine transaminase (ALT) are biomarkers of liver injury used in investigating the integrity of the liver in apparently healthy patients (Ahmed et al, 2018).…”

Gut Microbiota Characterization in Patients with HCC Post Chronic HCV Infection

“…[42][43][44][45] Bacteroides is the most predominant bacteria in the colon, with Bacteroides fragilis group is the most abundant one among Bacteroides species. [46] Bacteroides together with other gut commensal bacteria provide the human body with energy through Carbohydrate fermentation producing a pool of volatile fatty acids that are absorbed in the colon. [47] Akkermansia muciniphila is one of gut micro-biota known to have an anti-in ammatory effect in humans, improves hepatic in ammation and protect against liver cell damage through an immune-mediated mechanism.…”

An Updated Review on the Epidemiology, Pathophysiology, Etiology and Diagnosis of Liver Cirrhosis

“…The diagnosis is achieved by associating the laboratory analyzes with clinical and imaging studies. When suspected liver pathology is identified, a complete hepatic profile consisting of blood biochemistry should be performed with platelet count, prothrombin time, transaminases, bilirubin, alkaline phosphatase, gamma-glutamyltransferase (GGT) and albumin [72].…”

“…Bilirubin values are usually normal in the compensated state but when the disease progresses they gradually rise, so it is considered an essential parameter for assessing liver function in the Child-Pugh [72]. Albumin is produced exclusively by the liver; therefore, it is a marker which indicates hepatic synthesis dysfunction [75].…”