Differentiation of alcohol liver hepatitis from nonalcohol liver hepatitis using liver function tests
Mayanja, Fred Kizza
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Alcohol is a xenobiotic that is consumed by many people globally. However, in its metabolism it forms acetaldehyde, a short lived but highly toxic compound responsible for the toxic effect of alcohol consumption in high dosages. The enzymes alcohol dehydrogenase, acetaldehyde and cyp450 are important for alcohol detoxification. The liver is a major organ that is affected by the toxicity of acetaldehyde resulting in alcohol liver disease. Liver disease can also be caused by other factors such as viral infection, drugs or cancers and it is important to diagnosis the cause of the liver disease for better treatment. The objective of this study was determined whether a combination of liver function parameters i.e. aspartate aminotransferase, alanine transaminase, gamma glutamyl transferase, direct bilirubin and total bilirubin can be used to differentiate alcohol liver disease. Samples of the patients at Mulago national referral hospital with liver disease i.e. both alcohol and nonalcoholic liver disease were used. Alanine transaminase, aspartate aminotransferase, gamma glutamyl transferase, direct bilirubin and total bilirubin were determined by cobas c501 auto analyzer machine. Data analyzed to determine the sensitivity and specificity of this assay. The mean bilirubin levels were raised for both alcohol liver disease and nonalcoholic liver disease. Mean AST: ALT was greater than 2 in alcoholic liver disease and was (one) 1 in nonalcoholic liver disease. The assay had a sensitivity of 85.94% and specificity of 68.42% which implies that the assay has a good detection of disease and excludes those without the disease. Therefore by using AST: ALT>2, GGT>55, D.BIL>4.3umol/l and T.BIL >17.0umol/l alcoholic liver disease can be differentiated from nonalcoholic liver disease.
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