The relative expression of hepatocellular and cholestatic liver enzymes in adult patients with liver disease - PubMed (original) (raw)
. 2020 Mar-Apr;19(2):204-208.
doi: 10.1016/j.aohep.2019.08.004. Epub 2019 Sep 20.
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- PMID: 31628070
- DOI: 10.1016/j.aohep.2019.08.004
Free article
The relative expression of hepatocellular and cholestatic liver enzymes in adult patients with liver disease
Daniel Iluz-Freundlich et al. Ann Hepatol. 2020 Mar-Apr.
Free article
Abstract
Introduction and objectives: Hepatocellular liver injury is characterized by elevations in serum alanine (ALT) and aspartate (AST) aminotransferases while cholestasis is associated with elevated serum alkaline phosphatase (ALP) levels. When both sets of enzymes are elevated, distinguishing between the two patterns of liver disease can be difficult. The aim of this study was to document the predicted ranges of serum ALP values in patients with hepatocellular liver injury and ALT or AST values in patients with cholestasis.
Materials and methods: Liver enzyme levels were documented in adult patients with various types and degrees of hepatocellular (non-alcoholic fatty liver disease, hepatitis B and C, alcohol and autoimmune hepatitis) and cholestatic (primary biliary cholangitis and primary sclerosing cholangitis) disease.
Results: In 5167 hepatocellular disease patients with ALT (or AST) values that were normal, 1-5×, 5-10× or >10× elevated, median (95% CI) serum ALP levels were 0.64 (0.62-0.66), 0.72 (0.71-0.73), 0.80 (0.77-0.82) and 1.15 (1.0-1.22) fold elevated respectively. In 252 cholestatic patients with ALP values that were normal, 1-5× or >5× elevated, serum ALT (or AST) values were 1.13 (0.93-1.63), 2.47 (2.13-2.70) and 4.57 (3.27-5.63) fold elevated respectively. In 56 patients with concurrent diseases, ALP levels were beyond predicted values for their hepatitis in 38 (68%) and ALT (or AST) values beyond predicted values for their cholestatic disorder in 24 (43%).
Conclusions: These data provide health care providers with predicted ranges of liver enzymes in patients with hepatocellular or cholestatic liver disease and may thereby help to identify patients with concurrent forms of liver disease.
Keywords: Alkaline phosphatase; Aminotransferase; Cholestasis; Hepatitis; Liver disease; Liver enzymes.
Copyright © 2019 Fundación Clínica Médica Sur, A.C. Published by Elsevier España, S.L.U. All rights reserved.
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