title: Effects of alcohol and prescription and over-the-counter drug use on liver enzyme profiles.
abstract: Liver function tests are commonly ordered during routine checkups or in an effort to identify the cause of underlying disease. Elevated liver enzymes usually indicate a disease or an insult to the liver, the main causes of which can be hepatitis (caused by virus infection or chemical exposures) or cirrhosis of the liver due to alcohol abuse. Results from the Metropolitan Life Insurance Testing Laboratory confirm national data showing a slow rise in the percentage of "free-living" persons with elevated liver enzymes. The percentage of "abnormal" results increased despite unchanged analytic methods or quality control measures during the data gathering period. In addition, the proportions of abnormal enzyme levels have increased while U.S. per capita alcohol consumption has decreased and sales of over-the-counter medications that elevate liver enzymes have increased. Thus, it is increasingly more difficult to determine the true cause of elevated liver enzymes. As more Americans self-medicate and as more prescription drugs become available over-the-counter, which can have subtle or overt effects on liver enzyme secretion, the causes for abnormal enzyme levels will remain difficult to interpret. Continued monitoring of liver enzyme levels and the prevalence of drug and alcohol use are necessary to determine if the noted rise in abnormal levels is associated with increased morbidity or adverse outcome.
authors.forename: N J
authors.initials: NJ
authors.lastname: Haley
mesh_terms: D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions; D000431:Ethanol / Q000009:adverse effects*; D006801:Humans; D007352:Insurance, Life / Q000706:statistics & numerical data; D008099:Liver / Q000187:drug effects* / Q000201:enzymology*; D008111:Liver Function Tests; D012016:Reference Values; D014481:United States
chemical_list: D000431:Ethanol