Lowering the upper limit of normal serum alanine aminotransferase levels may detect patients with hidden chronic liver disease in the elderly

Schmilovitz Weiss Hemda; Gingold Belfer Rachel; Issa Nidal; Boltin Doron; Beloosesky Yichayaou; Morag Koren Nira; Meyerovitch Joseph; Weiss Avraham

doi:10.21767/2471-982X-C1-003

Lowering the upper limit of normal serum alanine aminotransferase levels may detect patients with hidden chronic liver disease in the elderly

Joint Event on 7^th Edition of International Conference on Internal Medicine and Patient Care & 6^th Edition of International Conference on Pain Management
March 26-28, 2018 Vienna, Austria

Schmilovitz Weiss Hemda, Gingold Belfer Rachel, Issa Nidal, Boltin Doron, Beloosesky Yichayaou, Morag Koren Nira, Meyerovitch Joseph and Weiss Avraham

Hasharon Hospital - RMC, Israel Beilinson Hospital - RMC, Israel Sackler School of Medicine - Tel Aviv University, Israel Clalit Health - Tel Aviv University, Israel

Posters & Accepted Abstracts: Int J Anesth Pain Med

DOI: 10.21767/2471-982X-C1-003

Abstract

Background: Recently lowering upper limit of normal (ULN) values of serum alanine aminotransferase (ALT) was suggested. Aim: To investigate the prevalence of significant liver disease among community dwelling elderly (>65 years) in central Israel, whose ALT level fell in the range between the former and the new range (â�?�?delta rangeâ�?�?). Patients & Methods: The database was searched for those who underwent â�?¥ 1 ALT measurement (IU/L) in 2002-2012. In a previous study a new range of ALT has been proposed: men: 15-42, women: 10-26. In this study the prevalence of significant liver disease in the delta range: men 42-45, women 26-34 was investigated. APRI, FIB-4 and AAR were applied for evaluating liver fibrosis. Prevalence of significant liver diseases was set by Chi-Square tests, mean fibrosis scores were compared using ANOVA followed by Bonferroni post-hoc test. The receiver operating characteristic model was used to test the ability of the scores to predict cirrhosis. Results: 2022 of 49634 (41% male, mean age of 83�?±6 years) were diagnosed with chronic liver disease (CLD) and 366 with cirrhosis. The two were more prevalent among men (15.3% vs. 4.9% and 4.2% vs. 0.9%, respectively) and women (7.8% vs. 3.3% and 1.5% vs. 0.4%, respectively) in the delta range compared to the new ALT range. Mean fibrosis scores of FIB4, APRI and AAR were significantly increased in the â�?�?delta rangeâ�?�? compared to the new ALT range. Conclusion: Lowering the current ULN of ALT l may help detecting significant liver diseases.