Prevalence Of Abnormal Liver Enzymes Research Articles

Association of obesity profiles and metabolic health status with liver injury among US adult population in NHANES 1999–2016

The combined effect of obesity and metabolic abnormalities on liver injury is unclear. Aiming to address this knowledge gap, this cross-sectional study was conducted among 16,201 US adults. Multiple linear regression and logistic regression analyses were conducted to assess the associations of obesity profiles, metabolic health status, and weight change with the levels of liver enzymes. The analysis revealed that general obesity and abdominal obesity were positively associated with the levels of liver enzymes and the prevalence of abnormal liver enzymes (P and Ptrend < 0.05). The associations remained significant in both metabolically healthy and metabolically unhealthy subgroups. Additionally, the liver injury index levels of the metabolically unhealthy participants were higher than those of the metabolically healthy individuals within the non-obese, overweight/pre-abdominal obesity, and general/abdominal obesity subgroups (P and Ptrend < 0.05). Furthermore, the subgroup characterized by general/abdominal obesity and metabolic dysfunction exhibited the most robust association with the liver injury index compared to all other subgroups examined. In addition, positive associations were observed between the 1-year and 10-year weight changes and the levels of liver injury indicators (P and Ptrend < 0.05). In conclusion, this study demonstrates that both obesity and metabolic impairment are independently associated with liver injury, and their combined presence have an additional adverse effect on liver health. These findings underscore the importance of addressing both obesity and metabolic dysfunction in order to mitigate the risk of liver injury.

S1118 Gender Disparities of Liver Injury at Presentation in COVID-19 Patients

INTRODUCTION: There are several reports suggesting abnormal liver enzymes occur in as many as 50% of patients infected by the novel coronavirus-19 (COVID-19). The purpose of our study was to examine the gender disparities in the prevalence of abnormal liver enzymes at initial presentation in COVID-19 patients. METHODS: We reviewed the charts of 11,265 adult patients with confirmed COVID-19 infection admitted to any of the 12 hospitals in our health system from March 1 to April 30, 2020. COVID-19 status was confirmed by polymerase chain reaction of a nasopharyngeal swab specimen. Labs drawn within 24 hours of presentation were considered baseline. Patients that had an age less than 18 or missing baseline data were excluded. Abnormalities in liver chemistries for AST (Aspartate Amino Transferase) and ALT (Alanine Amino Transferase) were grouped as follows: (1) within normal limits; (2) mild: greater than the upper limit of normal (ULN) to less than or equal to 4 times the ULN; (3) moderate: greater than 4 times the ULN to less than or equal to 10 times the ULN; and (4) severe: greater than 10 times the ULN. RESULTS: After exclusions, 10,856 patients were included in our study. There was a significant difference of the prevalence of liver injury between men and women (Table 1). Liver injury was present in 61% male and 40% female (P < 0.001). On univariate analysis, men (OR: 1.77 [95% CI: 1.64–1.92] and OR: 2.56 [95% CI: 2.06–3.17]) were more likely to have mild or moderate increases in AST but the difference was not apparent with ALT levels. These results were confirmed using the adjusted analysis after adjusting for baseline demographics and comorbidities (Table 2). CONCLUSION: Males presenting with COVID-19 infection are more likely to have elevated AST levels than females. There were no significant differences in ALT levels based upon gender. Elevated AST levels have been associated with a poor prognosis in hospitalized COVID-19 patients. Further research is needed to understand the mechanism of these gender-based differences in liver enzyme elevations, and their relationship to outcomes in COVID-19 infected patients.Table 1.: Frequencies of liver injuries in patients admitted with COVID-19 infectionTable 2.: Multinomial Logistic Regression Analysis showing the relative risk of Liver injury in Male patients With COVID-19 Compared to Female patients

High Human Immunodeficiency Virus (HIV) Viral Load and Coinfection with Viral Hepatitis Are Associated with Liver Enzyme Abnormalities among HIV Seropositive Patients on Antiretroviral Therapy in the Lake Victoria Zone, Tanzania.

Background Liver enzymes abnormalities have been found to be common among patients on antiretroviral treatment (ART). Apart from the effects of ART on these changes, other factors that can potentially contribute to the abnormal levels of these enzymes have been found to vary in different geographical locations. This study investigated factors associated with liver enzymes abnormalities among human immunodeficiency virus (HIV) infected individuals on ART from the Lake Victoria zone, Tanzania. Methods A cross-sectional study involving a total of 230 sera from HIV seropositive patients from different regions of the Lake Victoria zone was carried out in July 2017. All samples with required variables/parameters such as age, sex, ART regimen, and residence were serially included in the study. Hepatitis B virus (HBV) and Hepatitis C virus (HCV) detection and liver enzymes assays (alanine transaminase (ALAT) and aspartate transaminase (ASAT)) were assessed following the standard procedures. Data were analyzed by using STATA version 13. Results The median age of the study participants was 38 (interquartile range [IQR]:30-48) years. The overall prevalence of abnormal liver enzymes was 43.04% (99/230, 95% CI: 36.6-49.3). A total of 26.09% (60/230) had elevated ASAT while 23.9% (55/230) patients had elevated ALAT levels. ASAT levels were significantly high among patients with high HIV viral load (P= 0.002) while ALAT levels were significantly high among those coinfected with hepatitis C virus (P=0.017) and hepatitis B virus (P<0.001). Conclusion A significant proportion of HIV seropositive individuals on ART have abnormal levels of liver enzymes, which is significantly associated with high HIV viral load and viral hepatitis. This calls for the need to emphasize screening of viral hepatitis and provision of appropriate management among HIV seropositive individuals in this setting.

Prevalence of non-alcoholic fatty liver disease among obese children in North Kerala, India

Background: Obesity and related co-morbidities are increasing at an alarming pace all over the world. Non-alcoholic fatty liver disease (NAFLD) is the asymptomatic involvement of the liver mainly seen in obese individuals. NAFLD can progress to chronic liver disease and has to be identified early. The aims of our study were to determine the prevalence of nonalcoholic fatty liver disease among obese children in our local population. To determine the prevalence of abnormal liver enzymes in obese children.Methods: Cross sectional descriptive study in a tertiary care center among children aged 5-18 years for a 1 year period. NAFLD was diagnosed based on ultrasonography. Alanine amino transferase more than 40IU/l was taken as abnormal.Results: A total of 65 patients were enrolled in the study. The prevalence of NAFLD in the study group was 60%. 20% had elevated alanine amino transferase levels.Conclusions: The prevalence of fatty liver in Kerala is comparable to that in the West. Since this is a public health issue more population based studies are needed on a larger group to find out the exact magnitude of the problem.

Prevalence of abnormal serum liver enzymes in patients with type 2 diabetes mellitus: a cross-sectional study from China

ABSTRACTObjectives: This cross-sectional study aimed to determine the prevalence of elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in Chinese type 2 diabetic patients and identify contributing risk factors.Methods: This cross-sectional study was conducted in rural areas of China, and 1,198 type 2 diabetic patients with complete data were recruited. Elevated ALT and AST levels were defined as >40 U/L. Prevalence of abnormal liver enzymes was analyzed and multivariable analysis was used to identify independent risk factors.Results: 10.3% and 6.1% diabetic patients had elevated ALT and elevated AST, respectively. The prevalence of elevated liver enzymes was gender-related; it was 13.8% in men and 7.5% in women for elevated ALT, and 7.4% in men and 3.1% in women for elevated AST. High triglyceride was positively associated with both elevated ALT (OR 1.80, 95% CI 1.08–3.01, p = 0.024) and elevated AST (OR 2.24, 95%CI 1.08–4.65, p = 0.031), while taking anti-diabetes medicine was inversely related to both elevated ALT (OR 0.48, 95% CI 0.29–0.80, p = 0.005) and elevated AST (OR 0.37, 95% CI 0.17–0.82, p = 0.014). The risk of elevated ALT in diabetic patients increased with the presence of obesity (OR 2.54, 95% CI 1.07–6.01, p = 0.034), and was lower in women (OR 0.37, 95% CI 0.19–0.72, p = 0.003). Hypertension (OR 4.33, 95% CI 1.41–13.30, p = 0.011), current drinking status (OR 2.90, 95% CI 1.21–6.96, p = 0.017) and national minority (OR 3.26, 95%CI 1.31–8.12, p = 0.011) were risk factors for elevated AST.Conclusion: A relatively high prevalence of abnormal serum liver enzymes in diabetic patients was demonstrated in China, especially in males. More attention should be paid to preventing liver injuries in diabetic patients.

Prevalence of abnormal plasma liver enzymes in older people with Type 2 diabetes

To determine the prevalence and distribution of abnormal plasma liver enzymes in a representative sample of older adults with Type 2 diabetes. Plasma concentrations of alanine aminotransferase, aspartate aminotransferase and γ-glutamyltransferase were measured in a randomly selected, population-based cohort of 1066 men and women aged 60-75 years with Type 2 diabetes (the Edinburgh Type 2 Diabetes Study). Overall, 29.1% (95% CI 26.1-31.8) of patients had one or more plasma liver enzymes above the upper limit of the normal reference range. Only 10.1% of these patients had a prior history of liver disease and a further 12.4% reported alcohol intake above recommended limits. Alanine aminotransferase was the most commonly raised liver enzyme (23.1% of patients). The prevalence of abnormal liver enzymes was significantly higher in men (odds ratio 1.40, 95% CI 1.07-1.83), in the youngest 5-year age band (odds ratio 2.02, 95% CI 1.44-2.84), in patients with diabetes duration < 5 years (odds ratio 1.38, 95% CI 1.01-1.90), plasma HbA(1c) ≥ 58 mmol/mol (7.5%) (odds ratio 1.43, 95% CI 1.09-1.88), obese BMI (odds ratio 2.84, 95% CI 1.59-3.06) and secondary care management for their diabetes (odds ratio 1.40, 95% CI 1.05-1.87). However, all these factors combined accounted for only 7.6% of the variation in liver enzyme abnormality. The prevalence of elevated liver enzymes in people with Type 2 diabetes is high, with only modest variation between clinically defined patient groups. Further research is required to determine the prognostic value of raised, routinely measured liver enzymes to inform decisions on appropriate follow-up investigations.

Prevalence and Risk Factors for Liver Biochemical Abnormalities in Canadian Patients with Systemic Lupus Erythematosus

To determine the prevalence of abnormal liver enzymes in patients with systemic lupus erythematosus (SLE) and whether further investigations were done, and the differences in SLE-related and/or metabolic factors in patients with and without liver biochemical abnormalities. Patients from the University of Toronto Lupus Clinic who met at least 4 of the American College of Rheumatology classification criteria for SLE and had 1.5 times the upper limit for aspartate transaminase or alanine transaminase on 2 consecutive visits within a 2-year period were matched with controls for age, sex, and SLE duration. Demographic, clinical, and laboratory data were extracted at the time of the first appearance of liver enzyme abnormality for the cases and at the reference point for the controls. From the 1533 patients reviewed, 134 (8.7%) met the inclusion criteria. Thirty of these patients were evaluated by a hepatologist, 75 had imaging studies (41 were done specifically for liver investigation), and 13 had liver biopsies. Results based on these investigations showed 31 fatty livers, 35 cases of drug-induced hepatotoxicity, 10 autoimmune etiologies, and 3 cases of viral hepatitis. Compared to controls, cases were higher in body mass index, anti-dsDNA antibody, prevalence of hypertension, antiphospholipid syndrome, and use of immunosuppressive medication, especially azathioprine and methotrexate; they were lower in IgM. Metabolic abnormalities such as obesity and hypertension and hepatotoxic effects of medication used to treat SLE may contribute more than SLE-related factors to liver biochemical abnormalities in patients with SLE.

High prevalence of abnormal liver enzymes in South African patients with type 2 diabetes mellitus attending a diabetes clinic

AbstractObjective: To determine the prevalence of liver function test abnormalities in South African black and Indian adult patients with type 2 diabetes mellitus attending a tertiary diabetes clinic.Method: The study was a retrospective chart review of patients with type 2 diabetes attending a diabetes clinic. Recorded data included the past medical and drug history, history of alcohol abuse, anthropometry, lipid profile and liver function tests.Results: The charts of 313 patients were reviewed. Liver function test abnormalities were found in 146 patients (46.6%). Of these, 15 patients had a history of alcohol abuse, or a past medical history that might explain the abnormality, and these patients were excluded from further analysis. Elevations in serum gamma-glutamyl transferase, alkaline phosphatase and alanine transaminase were found in 25.2% (n = 79), 23.3% (n = 73) and 15.3% (n = 48), respectively. Serum total cholesterol, triglycerides and low-density lipoprotein cholesterol were higher in the group...

Vietnamese community screening for hepatitis B virus and hepatitis C virus

Asian Americans represent an important cohort at high risk for viral hepatitis. To determine the prevalence of Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infection and HBV vaccination in a Vietnamese community, a total of 322 Vietnamese subjects from a local doctor's office and annual Vietnamese Health Fair were included in this study. Demographic and clinical data were collected. 2.2% of the screened cohort tested positive for anti-HCV and 9.3% tested positive for HBsAg. Unlike HBV-positive subjects, HCV-positive subjects had significantly higher liver enzymes (P = 0.0045 and P = 0.0332, respectively). The HBV-positive group was more likely to report jaundice (P = 0.0138) and a family history of HBV (P = 0.0115) compared to HBV-negative subjects. Forty-eight patients (15.5%) reported a family history of liver disease (HBV, HCV, HCC, cirrhosis, other). Of this 48, 68.8% reported no personal history of HBV vaccination and 77.1% reported no family history of vaccination for HBV. Among the 183 subjects without a family history of liver disease, 156 (85.2%) reported no personal history of vaccination and 168 (91.8%) reported no family history of vaccination. HBV vaccination rates in those reporting a family history of liver disease were significantly higher (P =0.020). There was a high prevalence of HBV infection in this community screening. Nevertheless, the rate for HBV vaccination was low. The low prevalence of abnormal liver enzymes in HBV-positive subjects emphasizes the need for screening to be triggered by risk factors and not by abnormal liver enzymes.

The Prevalence of Abnormal Liver Enzymes and Metabolic Syndrome in Obese Adolescent Females with Polycystic Ovary Syndrome

Objectives We sought to determine the prevalence of abnormal liver enzymes suggestive of nonalcoholic steatohepatitis and metabolic syndrome in obese adolescent females with polycystic ovary syndrome. Design A retrospective chart review. Participants Patients included 39 obese (body mass index Z score ≥ 2) adolescent females with a diagnosis of polycystic ovary syndrome. Clinical and biochemical data in these patients were reviewed. Main Outcome Measures Aspartate and alanine aminotransferase levels, lipid panel, blood pressure, body mass index, and glucose intolerance were the main outcome measures of the study. Results The study showed that 15.4 % (6 of 39) of patients had elevated aminotransferase levels, suggestive of nonalcoholic steatohepatitis, and 43.6 % (17 of 39) of patients qualified as having metabolic syndrome. Finally, 10.2 % (4 of 39) of patients were found to have both liver dysfunction and metabolic syndrome. Conclusion Liver dysfunction consistent with nonalcoholic steatohepatitis and metabolic syndrome are prevalent in obese adolescent females with polycystic ovary syndrome. Therefore, early screening and further work-up for both disease states are warranted in cases of young adolescent females with polycystic ovary syndrome.

Prevalence, Aetiology and Associated Co-Morbidities of Elevated Aminotransferases in a German Cohort of Orthopaedic Surgery Patients

In a recent study on hepatitis C prevalence, we identified a high prevalence of elevated liver enzymes, well above 10 %, in orthopaedic surgery patients without evidence for viral hepatitis. We now report in another cohort, that the prevalence is indeed in that range, and that in these patients elevated liver enzymes are likely indicators for existing comorbidities. 1064 patients referred to the Department of Orthopaedic Surgery, University of Leipzig, between January 2001 and July 2005 were screened routinely for serological markers against hepatitis B and C. Out of these patients 960 individuals were tested additionally for liver enzymes. Patients with elevated aminotransferases but no evidence for hepatitis B or C were compared with two age- and sex-matched controls with normal liver enzymes to evaluate differences in the frequency of comorbidities. The prevalence of hepatitis B and C was low (HBs-antigen positive: 0.41 %, anti-HCV positive: 0 %). Of the 960 patients with no evidence for viral hepatitis and available aminotransferase values 108 cases (11.3 %) showed elevated ALT, 67 individuals (7 %) elevated AST and 125 patients (13 %) showed elevation of either one or both aminotransferases. Patients with elevated liver enzymes had a significantly higher prevalence of hypertension (73.6 vs. 57.2 %; p = 0.002), chronic ischaemic heart disease (CIHD) (30.4 vs. 15.6 %; p = 0.001), hyperlipidaemia (30.4 vs. 14.8 %; p = 0.001) and hyperuricaemia (36 vs. 23.6 %; p = 0.014). Type 2 Diabetes mellitus tended to be more frequent in patients with elevated liver enzymes, too (p = 0.056). Individuals with elevated aminotransferases presented a mean BMI of 28.7 kg/m (2) in comparison to 27.5 kg/m (2) in the control group (p = 0.055). By excluding patients with regular daily alcohol consumption, the prevalence of abnormal liver enzymes was still remarkably high (9 %). Our study proved a high prevalence of elevated aminotransferases in orthopaedic surgery patients, most frequently caused by NAFLD, and its association with a high rate of concomitant diseases. Thus, abnormal liver enzymes should lead to a focused screening for concomitant diseases such as diabetes, hypertension and coronary atherosclerosis.

Hepatotoxicity of fast food?

In the dictionary, fast food is defined as any food which may be cooked easily, and is sold by restaurants to be eaten quickly or taken away. Changes in the...

High prevalence of elevated liver enzymes in blood donors: associations with male gender and central adiposity

Nonalcoholic fatty liver disease is an increasingly recognized condition, but its exact prevalence is unknown. In this prospective, multicenter study, we evaluated the prevalence of elevated alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl-transpeptidase levels as indirect markers of nonalcoholic fatty liver disease in volunteer blood donors as well as their associations with epidemiological and anthropometrical characteristics. Alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl-transpeptidase levels were determined in blood donors from four transfusion centers during the morning sessions of a 3-month period. Cases with positive hepatitis B surface antigen, anti-hepatitis C virus, anti-HIV or elevated liver enzymes and alcohol abuse were excluded. Abnormal liver enzymes were found in 17.6% of 3063 participants (alanine aminotransferase: 14.5%, aspartate aminotransferase: 4.6%, gamma-glutamyl-transpeptidase: 4.7%). Individuals with abnormal compared with those with normal liver enzymes or alanine aminotransferase values were more frequently men and had higher weight, body mass index, waist, hip and neck circumference (P<0.001 for all comparisons). The prevalence of abnormal liver enzymes was also associated with the transfusion center ranging between 8.8 and 22.1% (P<0.001) and alcohol consumption (P=0.001). In multivariate analysis, presence of elevated enzymes was independently associated with male sex, higher weight or body mass index, higher waist circumference and transfusion center. More than 15% of Greek blood donors exhibit elevated liver enzymes, most likely as a result of unrecognized nonalcoholic fatty liver disease. The prevalence of nonalcoholic fatty liver disease is mainly associated with male sex, obesity and waist circumference, but it may range significantly among different population groups.

Prevelance of abnormal serum aminotransferase values in overweight and obese adolescents

(1) To determine the prevalence of abnormal liver enzymes in overweight and obese adolescents and (2) to determine the relationship of alcohol ingestion and serum antioxidants to the presence of abnormal liver enzymes in overweight and obese adolescents. Serum alanine aminotransferase (ALT) and gamma-glutamyl transpeptidase levels were measured in 2450 children between the ages of 12 and 18 years, enrolled in the National Health and Examination Survey, cycle III (NHANES III). Obesity was defined as a body mass index >95th percentile for age and sex. Overweight was defined as a body mass index >85th percentile for age and sex. Nutritional intake was assessed by 24-hour dietary recall and food frequency questionnaires. Serum antioxidants were measured by high-pressure liquid chromatography. Sixty percent of adolescents with elevated ALT levels were either overweight or obese. Overall, 6% of overweight adolescents had elevated ALT levels (odds ratio: 3.4 [95% CI: 3.5-12.8]). Ten percent of obese adolescents had elevated ALT levels (odds ratio: 6.7 [95% CI: 3.5-12.8]). In addition, approximately 1% of obese adolescents demonstrated ALT levels over twice normal. Approximately 50% of of obsese adolescents who reported modest alcohol ingestion (4 times per month or more) had elevated ALT levels (odds ratio: 10.8, 95% CI: 1.5-77). Other factors associated with elevated ALT levels in overweight and obese adolescents include increased age, elevated glycolated hemoglobin, elevated triglycerides, and decreased levels of serum antioxidants-vitamin E, beta-carotene, and vitamin C. Overweight and obesity are the most common findings in adolescents with elevated ALT levels. Even modest alcohol consumption may significantly increase the likelihood of obese adolescents developing obesity-related liver disease.

Prevalence of abnormal liver enzymes in overweight and obese adolescents

Prevalence of abnormal liver enzymes in overweight and obese adolescents

Prevalence of Hepatitis B Surface Antigenemia among Patients with Schistosoma Mansoni

This case-control study was designed to determine the prevalence of persistent hepatitis B surface antigenemia (HBsAG) among patients with schistosoma mansoni and to rationalize their vaccination against hepatitis B virus (HBV) infection. Seventy consecutive patients with a confirmed diagnosis of schistosoma mansoni were matched for age, sex, nationality, and residence (for Saudis only) with 70 healthy controls. Despite identical mean ages, sex, and nationality distribution, 18 schistosomiasis patients (26%) had positive HBsAg as compared with only three of the controls (4%). The odd ratio for HBsAg antigenemia among patients as compared to controls was 7.73 (95% confidence interval (CI) = 2-35.01, P = 0.0004. Neither sex nor nationality had any influence on the positive rate for HBsAg found in schistosomiasis patients. Patients with schistosomiasis and a concomitant positive HBsAg had significantly more derangement of their hepatic enzymes (14 out of 18; 78%) as compared with those without this viral serological marker (22 out of 52; 42%) (odd ratio - 4.77; 95% CI=1.22-20.11; P = 0.009). I have concluded that patients with schistosoma mansoni are exposed to a higher risk of acquiring HBV infection and that concomitant schistosomiasis and HBV infection has a deleterious effect on hepatic enzymes as well as other liver functions. Prospective evaluation of the preventive role of HBV vaccine among these patients is warranted.