Relationship between alanine and aspartate transaminases (ALT and AST) and fatty liver on ultrasound

Abstract

Background: Non-alcoholic Fatty liver disease, also known as NAFLD is said to result from a number of disorders such as insulin resistance, Obesity & diabetes mellitus possibly as a result of an unhealthy and sedentary life style. The prevalence of NAFLD is stated to be 25.23%, but it ranges between 115 to 45% in Asian countries globally. Plasma aminotransferases (aspartate1aminotransferase [AST] & alanine aminotransferase [ALT]) are increased in patients with non-alcoholic fatty liver disease (NAFLD). Aim:To find the relationship between alanine and aspartate transaminases (ALT and AST) and fatty liver on ultrasound. Study design & duration: Retrospective Study, September 2017-2018. Settings: Radiology Department of Avicenna Medical College and Hospital, Lahore. Methods: 274 patients present with age of 18 years and above with demographic features as body mass index, grade of fatty liver and also noted ALT, AST and size of fatty liver were included from the study. Grade I was labeled if there was increased hepatic echogenicity but visible periportal & diaphragmatic echogenicity. Grade II was considered if increased hepatic echogenicity causes imperceptible periportal echogenicity, without obscuration of diaphragm. Grade III was considered as marked increase in liver echogenicity with imperceptible periportal echogenicity and diaphragm. The patients were then followed for the Alanine transaminase (ALT) and Aspartate transaminase (AST) Results: In this study The mean age of patients 53.8±11.94. There were 116(42.3%) male and 158(57.6%) females. Majority of patients were of grade II fatty liver 126(45.9%). Grade III fatty liver was found in 110(40.1%) and grade I fatty liver was found in 38(13.8%). hepatomegaly was seen in 153(55.8%) patients. None of the grade I fatty liver patients were found to have raised ALT or AST. Raised ALT was found in 21 patient of grade II and 15 of grade III fatty liver patients. Raised AST was found in 20 of grade II and 7 had grade III fatty liver patients. Conclusion: The conclusion of this study that mean of ALT increased as compare to AST. None of the grade I fatty liver patients were found to have raised ALT or AST. Raised ALT was found in 21 patient of grade II and 15 of grade III fatty liver patients. Keywords: Fatty liver disease, Grade I, II, III, AST, ALT