title: The liver biochemical tests and serological markers of hepatitis B virus in the very old-aged population in Taiwan.
abstract: BACKGROUND
  Human liver alters with aging. Lower serum albumin with elevation in serum cholesterol and alkaline phosphatase (ALP) has been reported in the elders, but there was no further report on the very old people (i.e., >75 Y/O). We evaluated changes of liver biochemical tests and hepatitis B virus (HBV) serological markers in the very old-aged population.
  
  
  METHODS
  From October 1993 to June 1994, 2,549 subjects attended our hospital for physical check-up. Of them 1,742 were healthy subjects (M/F = 1,058/648) and were enrolled for analysis of the normal range of liver biochemical tests in different age groups. They were divided into four groups; young-aged group (age between 18 and 40, n = 231), middle-aged group (age between 41 and 64, n = 991), old-aged group (age between 65 and 75, n = 424), and very old-aged group (age > or = 76, n = 96). The items of liver biochemical tests included albumin, total bilirubin, cholesterol, alanine aminotransferase (ALT), aspartate aminotransferase (AST), ALP and gamma-glutamyl transpeptidase (GGT). The whole population, totally 2,549 subjects, were used for the analysis of the prevalence of HBV serological markers in different age groups.
  
  
  RESULTS
  Serum albumin was the only biochemical parameter that persisted to decline after the age of 75 (p <0.05). Cholesterol began to elevate in the middle-age but decreased after 75 Y/O. The old-aged and very old-aged subjects had higher levels of serum bilirubin, AST, ALP, and GGT levels than the other two groups (p <0.05), however, the changes of ALT levels among these groups were not so remarkable. The HBV carrier rates in the young-aged, middle-aged, old-aged and the very old-aged groups were 16.8%, 12.3%, 6.8% and 7.0%, respectively (p <0.001). Furthermore, the very old-aged group had a significantly higher prevalence of negativity in both HBsAg and anti-HBs (p <0.001).
  
  
  CONCLUSIONS
  Serum albumin is the only biochemical parameter that persists to decline after the age of 75. In contrast, elevation of cholesterol tends to reverse after that age. All the aging-related changes in biochemical tests are clinically nonsignificant though some of them are significant in statistical analysis. In addition, a low HBV carrier rate and a high prevalence of negativity in both HBsAg and anti-HBs are noted in the very old-aged people, possibly due to the progressive loss of HBV markers in the elders.
authors.affiliation: Division of Gastroenterology, Veterans General Hospital-Taipei, Taiwan, R.O.C.
authors.forename: S H
authors.initials: SH
authors.lastname: Hsu
authors.forename: C Y
authors.initials: CY
authors.lastname: Chan
authors.forename: T N
authors.initials: TN
authors.lastname: Tam
authors.forename: S H
authors.initials: SH
authors.lastname: Lin
authors.forename: K C
authors.initials: KC
authors.lastname: Tang
authors.forename: S D
authors.initials: SD
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology*; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D002784:Cholesterol / Q000097:blood; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006801:Humans; D008099:Liver / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012709:Serum Albumin / Q000032:analysis
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D012709:Serum Albumin; D002784:Cholesterol; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase