Liver function tests in identifying patients with liver disease
Main Article Content
Keywords
chronic liver disease, hepatic fibrosis, serum markers, biopsy-proven, early detection
Abstract
In the context of liver disease, early detection and accurate staging of hepatic fibrosis are crucial for effective management and prognosis. Liver function tests (LFTs) are commonly used for screening, yet their correlation with biopsy-proven stages of fibrosis remains understudied. This study aims to assess the association between routine LFTs and stages of hepatic fibrosis, providing insights into potential biomarkers for early disease detection and monitoring.
Methods: A retrospective observational study analyzed data from liver biopsies to evaluate fibrosis stage in relation to AST, ALT, INR, BUN, creatinine, platelets, alkaline phosphatase, bilirubin, and albumin levels. Descriptive statistics, including mean and 95% confidence intervals, characterized serum marker distributions across fibrosis stages. Multivariable generalized linear models were employed, and two-tailed P-values were calculated to determine statistical significance.
Results: Among the investigated markers, AST exhibited statistical significance for stage 3 and 4 fibrosis, while ALT did not show significant correlation with any stage. INR was statistically significant only in stage 4 disease, albeit remaining near the upper limit of the normal range. Albumin did not demonstrate a clinically relevant association, and platelet counts remained within normal limits across all stages. Other laboratory values lacked both statistical and clinical significance in relation to fibrosis stage.
Conclusion: The findings highlight the challenge of relying solely on traditional LFTs for assessing hepatic fibrosis severity. Normal or near-normal LFT results may mask underlying liver disease, emphasizing the need for enhanced diagnostic strategies. Early identification of asymptomatic patients using more sensitive biomarkers could facilitate timely intervention and improve outcomes in chronic liver disease management
References
2. Hoyert DL, Xu J. Mortality data for 2011. Natl Vital Stat Rep. 2012;61(6):1–52.
3. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Digestive Diseases in the United States: Epidemiology and Impact. Bethesda, MD: NIH Publication; 1994. pp. 94–1447. [Google Scholar]
4. Scaglione SJ, Kliethermes S, Cao G, et al. Epidemiology of cirrhosis in the United States: a population-based study. J Clin Gastroenterol. 2015;49(8):690–696.
5. Li D, Friedman SL. Liver fibrogenesis and the role of hepatic stellate cells: insights and therapy prospects. J Gastroenterol Hepatol. 1999;14(7):618–633.
6. Abshagen K, Brensel M, Genz B, et al. Foxf1 SiRNA delivery to hepatic stellate cells by DBTC lipoplex formulations ameliorates fibrosis in bile duct ligated mice. Curr Gene Ther. 2015;15(3):215–227.
7. Han YP. Matrix metalloproteinases and liver fibrosis. J Gastroenterol Hepatol. 2006;21(suppl 3):S88–S91.
8. Bataller R, North KE, Brenner DA. Genetic polymorphisms and liver fibrosis progression: a critical review. Hepatology. 2003;37(3):493–503.
9. Iredale JP. Liver fibrosis models: exploring inflammation and repair dynamics in a solid organ. J Clin Invest. 2007;117(3):539–548.
10. Roy S, Benz F, Luedde T, Roderburg C. Role of miRNAs in regulating inflammatory processes during hepatofibrogenesis. Hepatobiliary Surg Nutr. 2015;4(1):24–33.
11. Batts KP, Ludwig J. Chronic hepatitis: terminology and reporting update. Am J Surg Pathol. 1995;19(12):1409–1417.
12. Fallowfield J, Hayes P. Hepatic fibrosis pathogenesis and treatment: reversibility of cirrhosis? Clin Med. 2011;11(2):179–183.
13. Tapper EB, Castera L, Afdhal NH. FibroScan (vibration controlled transient elastography) and its usage in the United States. Clin Gastroenterol Hepatol. 2015;13(1):27–36.
14. Wong GL. Transient elastography: a dual-purpose tool? World J Hepatol. 2013;5(5):264–274.
15. Chon YE, Choi EH, Song KJ, et al. Performance of transient elastography for liver fibrosis staging in chronic hepatitis B: a meta-analysis. PLoS One. 2012;7(9):e44930.
16. Chen YP, Liang XE. Noninvasive assessment of liver fibrosis: reducing or replacing liver biopsy? Liver Int. 2015;35(11):2483.
17. Cabibi D, Calvaruso V, Giuffrida L, et al. Comparison of histochemical staining methods and correlation with transient elastography in acute hepatitis. Pathobiology. 2015;82(1):48–52.
18. Juárez-Hernández E, Uribe-Ramos MH, Ramos-Ostos MH, et al. Factors influencing transient elastography quality. Dig Dis Sci. 2015;60(7):2177–2182.
19. Yovchev MI, Xue Y, Shafritz DA, Locker J, Oertel M. Liver repopulation by transplanted hepatic stem/progenitor cells and mature hepatocytes in fibrotic/cirrhotic rats. Hepatology. 2014;59(1):284–295.
20. Liedtke C, Luedde T, Sauerbruch T, et al. Experimental liver fibrosis research: update on animal models, legal issues, and translational aspects. Fibrogenesis Tissue Repair. 2013;6(1):19.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.