Enzymatic Exploration of Alcoholic Liver Disease
Journal Title: Scholars International Journal of Biochemistry - Year 2018, Vol 1, Issue 4
Abstract
Alcoholic liver disease (ALD) is the most common liver disease in world. For many reasons, it is underestimated and underdiagnosed. Liver disease is the most likely diagnosis if the AST level is more than twice that of ALT, a ratio some studies have found in more than 80 percent of alcoholic liver disease patients. An elevated level of the liver enzyme GGT is another gauge of heavy alcohol use and liver injury. A group of blood tests called liver function tests can be used to diagnose liver disease. Other blood tests can be done to look for specific liver problems or genetic conditions. Imaging tests like ultrasound, CT scan and MRI can show liver damage. An early diagnosis is absolutely essential as alcohol is a hepatotoxin that is commonly consumed worldwide and is associated with a spectrum of liver injury including simple steatosis or fatty liver, alcoholic hepatitis, fibrosis, and cirrhosis. Alcoholic liver disease (ALD) is a general term used to refer to this spectrum of alcohol-related liver injuries. The two major end points of ALD are alcoholic liver cirrhosis and the rare and clinically-defined alcoholic hepatitis (AH). The prediction and early diagnosis of both entities is still insufficiently solved and usually relies on a combination of laboratory, clinical and imaging findings. It is not widely conceived that conventional screening tools for ALD such as ultrasound imaging or routine laboratory testing can easily overlook ca. 40% of manifest alcoholic liver cirrhosis. Non-invasive methods such as transient elastography (Fibroscan), acoustic radiation force impulse imaging or shear wave elastography have significantly improved the early diagnosis of alcoholic cirrhosis. Present algorithms allow either the exclusion or the exact definition of advanced fibrosis stages in ca. 95% of patients. The correct interpretation of liver stiffness requires a timely abdominal ultrasound and actual transaminases levels. Other non-invasive methods such as controlled attenuation parameter, serum levels of M30 or M65, susceptometry or breath tests are under current evaluation to assess the degree of steatosis, apoptosis and iron overload in these patients. Liver biopsy still remains an important option to rule out comorbidities and to confirm the prognosis namely for patients with AH.
Authors and Affiliations
Dr. Anil Batta
Keywords
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