title: [Prediction of histological liver damage in asymptomatic alcoholic patients by means of clinical and laboratory data].
abstract: Looking for a noninvasive method to predict liver histologic alterations in alcoholic patients without clinical signs of liver failure, we studied 187 chronic alcoholics recently abstinent, divided in 2 series. In the model series (n = 94) several clinical variables and results of common laboratory tests were confronted to the findings of liver biopsies. These were classified in 3 groups: 1. Normal liver; 2. Moderate alterations; 3. Marked alterations, including alcoholic hepatitis and cirrhosis. Multivariate methods used were logistic regression analysis and a classification and regression tree (CART). Both methods entered gamma-glutamyltransferase (GGT), aspartate-aminotransferase (AST), weight and age as significant and independent variables. Univariate analysis with GGT and AST at different cutoffs were also performed. To predict the presence of any kind of damage (Groups 2 and 3), CART and AST > 30 IU showed the higher sensitivity, specificity and correct prediction, both in the model and validation series. For prediction of marked liver damage, a score based on logistic regression and GGT > 110 IU had the higher efficiencies. It is concluded that GGT and AST are good markers of alcoholic liver damage and that, using sample cutoffs, histologic diagnosis can be correctly predicted in 80% of recently abstinent asymptomatic alcoholics.
authors.affiliation: Unidad de Alcoholismo, Hospital San Borja-Arriarán, Santiago de Chile.
authors.forename: H
authors.initials: H
authors.lastname: Iturriaga
authors.forename: S
authors.initials: S
authors.lastname: Hirsch
authors.forename: D
authors.initials: D
authors.lastname: Bunout
authors.forename: M
authors.initials: M
authors.lastname: Díaz
authors.forename: M
authors.initials: M
authors.lastname: Kelly
authors.forename: G
authors.initials: G
authors.lastname: Silva
authors.forename: M P
authors.initials: MP
authors.lastname: de la Maza
authors.forename: M
authors.initials: M
authors.lastname: Petermann
authors.forename: G
authors.initials: G
authors.lastname: Ugarte
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications*; D001219:Aspartate Aminotransferases / Q000097:blood; D006801:Humans; D008099:Liver / Q000473:pathology*; D008108:Liver Diseases, Alcoholic / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases
vernacular_title: Predicción del daño histológico hepático en pacientes alcoholicos asintomáticos mediante datos clínicos y de laboratorio.