Julia Uhanova1, Gerald Minuk1, Kamila Premji2, Natasha Chandok1,2,3. 1. Section of Hepatology, John Buhler Research Centre, University of Manitoba, Winnipeg, Manitoba. 2. Division of Gastroenterology, Multi-Organ Transplant Program, University of Western Ontario, London, Ontario. 3. Department of Medicine, William Osler Health Centre, Brampton, Ontario.
Abstract
Background: Routine measurement of liver transaminases is common in the general monitoring of patients with non-alcoholic fatty liver disease (NAFLD), but there is little data to support the utility of this practice. The aims of this study were to determine how alanine aminotransferase (ALT) results vary over time in patients with NAFLD; and to determine if serial measurement of ALT is a useful clinical marker for progression of NAFLD. Methods: Consecutive adult patients with NAFLD were followed prospectively in a tertiary liver disease clinic over a 15-year period. Clinicodemographic characteristics and the change in liver enzymes, liver function, and histopathology were followed over time. Paired t test, chi-square test, analysis of variance (ANOVA), and logistic regression were performed to assess the relationship between ALT and severity of NAFLD, or development of cirrhosis or hepatocellular carcinoma (HCC). Results/ Conclusion: A change in liver transaminases over time is not a useful metric in predicting outcomes in patients with NAFLD. Additionally, all stages of NAFLD are equally responsive to standard medical interventions of advocating for weight loss and correcting metabolic disturbances.
Background: Routine measurement of liver transaminases is common in the general monitoring of patients with non-alcoholic fatty liver disease (NAFLD), but there is little data to support the utility of this practice. The aims of this study were to determine how alanine aminotransferase (ALT) results vary over time in patients with NAFLD; and to determine if serial measurement of ALT is a useful clinical marker for progression of NAFLD. Methods: Consecutive adult patients with NAFLD were followed prospectively in a tertiary liver disease clinic over a 15-year period. Clinicodemographic characteristics and the change in liver enzymes, liver function, and histopathology were followed over time. Paired t test, chi-square test, analysis of variance (ANOVA), and logistic regression were performed to assess the relationship between ALT and severity of NAFLD, or development of cirrhosis or hepatocellular carcinoma (HCC). Results/ Conclusion: A change in liver transaminases over time is not a useful metric in predicting outcomes in patients with NAFLD. Additionally, all stages of NAFLD are equally responsive to standard medical interventions of advocating for weight loss and correcting metabolic disturbances.
Authors: Pinelopi Manousou; George Kalambokis; Federica Grillo; Jennifer Watkins; Elias Xirouchakis; Maria Pleguezuelo; Gioacchino Leandro; Vasiliki Arvaniti; Giacomo Germani; David Patch; Vincenza Calvaruso; Dimitri P Mikhailidis; Amar P Dhillon; Andrew K Burroughs Journal: Liver Int Date: 2011-03-06 Impact factor: 5.828
Authors: Jacob A Udell; Charlie S Wang; Jill Tinmouth; J Mark FitzGerald; Najib T Ayas; David L Simel; Michael Schulzer; Edwin Mak; Eric M Yoshida Journal: JAMA Date: 2012-02-22 Impact factor: 56.272
Authors: Mariana Lazo; Ruben Hernaez; Susanne Bonekamp; Ihab R Kamel; Frederick L Brancati; Eliseo Guallar; Jeanne M Clark Journal: BMJ Date: 2011-11-18