Histopathologic and biochemical liver test abnormalities in chronic asymptomatic or oligosymptomatic alcoholics: a review.
OBJECTIVE
To review the medical literature regarding the histopathologic and biochemical liver test abnormalities in chronic asymptomatic or oligosymptomatic alcoholics.


METHODS
Review of articles in the MEDLINE and LILACS databases regarding serum levels and prevalence of alterations in aspartate-aminotransferase, alanine-aminotransferase, alkaline phosphatase, and total bilirubin, in relation to liver histopathology, with or without discrimination of types of histopathologic alteration.


RESULTS
Global mean prevalence rates of aspartate-aminotransferase and alanine-aminotransferase alterations were 86.3% and 51.1%; in cases with steatosis they were 79.1% and 38.5%; and in cases of hepatitis, 90.1% and 58%. In all studies, prevalence rates of aspartate-aminotransferase alterations were significantly higher with lower variability than those of alanine-aminotransferase. Mean aspartate-aminotransferase levels were higher than 2N (N is the upper normal limit of the method employed) in all cases with hepatitis histopathology, while those of alanine-aminotransferase were 1.48N, in the same cases. Prevalence of alkaline phosphatase and total bilirubin abnormalities were 74.5% and 74.9% globally; in cases of steatosis, they were 70.9% and 67.9%; and in cases of hepatitis, 75.9% and 77.7%. Mean alkaline phosphatase levels were above the upper normal limit in all cases, but those of total bilirubin were above normal in 4 of 7 hepatitis studies.


CONCLUSIONS
Prevalence of aspartate-aminotransferase alteration was consistently related to presence of histopathologic abnormalities; an enzyme level higher than 2N suggests the diagnosis of alcoholic hepatitis.
Borini
Paulo
P
Faculty of Medicine of Mar lia, Marília, São Paulo, Brazil.
Guimarães
Romeu Cardoso
RC
Borini
Sabrina Bicalho
SB
D000437:Alcoholism / Q000201:enzymology*; D000469:Alkaline Phosphatase / Q000378:metabolism; D001663:Bilirubin / Q000378:metabolism; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008099:Liver / Q000201:enzymology* / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male
D000469:Alkaline Phosphatase; D001663:Bilirubin