The Assessment of Liver Disease Utilizing a Panel of Liver Function Tests
Main Article Content
Abstract
Liver is a vital organ in the body that perform very important functions to keep health hemostasis. Liver function tests are a group of tests that determine the liver health in physiological and pathological conditions. The main objectives of the present study were to assess liver function using a panel of liver function tests among a sample of liver patients and to compare their levels with a sample of subjects who had no liver disease. To achieve the study objectives, we analyzed a dataset posted on Kaggle. The dataset described Indian liver patients and included 583 subjects among which 414 patients with liver disease and 167 subjects without liver disease. The results showed that demographic variables including age and gender were predictors of liver disease. On the other hand, liver function tests including bilirubin, ALT, AST, albumin, albumin globulin ratio, alkaline phosphatase were significantly associated with liver disease. The level of total proteins was not significantly associated with liver disease. Taken together, liver function tests can be used to assess liver disease. The interpretation of total proteins and AST should be considered with cautious
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. Lala V, Goyal A, Bansal P, et al (2021). Liver Function Tests. [Updated 2021 Aug 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Availablefrom:
https://www.ncbi.nlm.nih.gov/books/NBK4 82489.
II. Newsome PN, Cramb R, Davison SM, et al (2018). Guidelines on the management of abnormal liver blood tests. Gut, 67:6-19.
III. Dufour DR, Lott JA, Nolte FS, et al (2000). Diagnosis and monitoring of hepatic injury. II. Recommendations for use of laboratory tests in screening, diagnosis, and monitoring. Clin Chem, 46:2050–68.
IV. Williams R, Aspinall R, Bellis M, et al (2014). Addressing liver disease in the UK: a blueprint for attaining excellence in health care and reducing premature mortality from lifestyle issues of excess consumption of alcohol, obesity, and viral hepatitis. Lancet 384:1953– 97.
doi:10.1016/S0140-6736(14)61838-9.
V. Ribeiro AJS, Yang X, Patel V, Madabushi R, Strauss DG(2019). Liver Microphysiological Systems for Predicting and Evaluating Drug Effects. Clin PharmacolTher., 106(1):139-147. [PMC free article] [PubMed].
VI. Vagvala SH, O'Connor SD (2018). Imaging of abnormal liver function tests. Clin Liver Dis (Hoboken). 11(5):128-134. [PMC free article] [PubMed]
VII. Wilkerson RG, Ogunbodede AC (2019). Hypertensive Disorders of Pregnancy. Emerg Med Clin North Am. 37(2):301-316. [PubMed].
VIII. Gazzin S, Vitek L, Watchko J, et al (2016). A novel perspective on the biology of bilirubin in health and disease. Trends Mol Med, 22:758–68.doi:10.1016/j.molmed.2016.07.004.
IX. Monaghan G, Ryan M, Seddon R, et al (1996). Genetic variation in bilirubin UPD-glucuronosyltransferase gene promoter and Gilbert’s syndrome. Lancet, 347:578– 81.doi:10.1016/S0140-6736(96)91273-8.
X. Posen S, Doherty E (1981). The measurement of serum alkaline phosphatase in clinical medicine. Adv Clin Chem, 22:163–245.
XI. Whitehead MW, Hawkes ND, Hainsworth I, et al (1999). A prospective study of the causes of notably raised aspartate aminotransferase of liver origin. Gut, 45:129–33.doi:10.1136/gut.45.1.129.
XII. Daniel S, Ben-Menachem T, Vasudevan G, et al (1999). Prospective evaluation of unexplained chronic liver transaminase abnormalities in asymptomatic and symptomatic patients. Am J Gastroenterol, 94:3010– 4.doi:10.1111/j.1572-0241.1999.01451.x.
https://www.webmd.com/a-to-z- guides/what-is-a-total-serum-protein- test,retrieved in 6/12/2021.
XIII. Sabatino A., Regolisti G., Karupaiah T., Sahathevan S., Singh B.K.S., Khor B.H., Salhab N., Karavetian M., Cupisti A., Fiaccadori E (2017). Protein-energy wasting and nutritional supplementation in patients with end-stage renal disease on hemodialysis. Clin. Nutr. 36:663–671. doi: 10.1016/j.clnu.2016.06.007.
XIV. Tian C.R., Qian L., Shen X.Z., Li J.J., Wen J.T (2014). Distribution of serum total protein in elderly Chinese. PLoSONE,.9:e101242.
doi: 10.1371/journal.pone.0101242.
XV. Busher JT. Serum Albumin and Globulin. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990.
XVI. Chapter 101. Available from: https://www.ncbi.nlm.nih.gov/books/NBK2 04.
XVII. Alpert JP, Greiner A, Hall S (2004). Health fair screening: the clinical utility of the comprehensive metabolic profile. Fam Med., 36(7):514-9. PMID: 15243834.
XVIII. https://www.kaggle.com/sanjames/li ver-patients-analysis-prediction-accuracy, retrieved in 6/12/2021.
XIX. Maya Balakrishnan, Parth Patel, Sydney Dunn-Valadez, Cecilia Dao, Vinshi Khan, Hiba Ali, Laith El-Serag, Ruben Hernaez, Amy Sisson, Aaron P. Thrift, Yan Liu, Hashem B. El-Serag, Fasiha Kanwal (2021). Women Have a Lower Risk of Nonalcoholic Fatty Liver Disease but a Higher Risk of Progression vs Men: A Systematic Review and Meta-analysis, Clinical Gastroenterology and Hepatology, 19 (1): 61-71.e15,
XX. Kim, I. H., Kisseleva, T., & Brenner, D. A. (2015). Aging and liver disease. Current opinion in gastroenterology, 31(3), 184–191.
https://doi.org/10.1097/MOG.00000000000 00176.
XXI. Suh B, Park S, Shin DW, Yun JM, Keam B, Yang HK, Ahn E, Lee H, Park JH, Cho B. Low albumin-to-globulin ratio associated with cancer incidence and mortality in generally healthy adults. Ann Oncol. 2014 Nov;25(11):2260-2266.
doi:10.1093/annonc/mdu274. Epub 2014 Jul 23.
PMID: 25057172.