Abnormal Liver Tests In A Mediterranean Population

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Abnormal Liver Tests In A Mediterranean Population

A recent population-based study in a small town in Southern Italy found that one

in eight residents had abnormal liver tests. While alcohol consumption was the

most common causative factor, nonalcoholic fatty liver disease (NAFLD) is an

increasingly prevalent source of the problem. The study is published in the May

2005 issue of Hepatology, the official journal of the American Association for

the Study of Liver Diseases (AASLD). Published by Wiley & Sons, Inc., the

journal is available online via Wiley InterScience at

www.interscience.wiley.com/?journal/?hepatology.

Chronic liver disease is a serious public health issue in many communities. It

can be caused by high alcohol consumption, hepatitis B and C, and nonalcoholic

fatty liver disease, a condition associated with obesity, insulin resistance,

high cholesterol and the like. The importance of these causative factors varies

from one location to another. For example, in the U.S., the majority of altered

liver enzymes are related to NAFLD, while in northern Italian populations, much

is related to alcohol. Factors leading to liver disease had not been thoroughly

studied in Southern Italy, so researchers, led by Gaspare Pendino of

Reggio Calabria, assessed the prevalence and etiology of altered liver tests in

the general population of Cittanova, a small southern Italian town.

They generated a random sample of residents 12 years or older and screened 1645

participants for abnormal liver values, antigens to hepatitis B and C and

alcohol consumption. From each individual, they also gathered socioeconomic

data, medical history and body mass index.

More than 12 percent of those screened had abnormal liver values, with

prevalence increasing with age. The age-trend was mainly due to chronic HCV

infection, which affected 6.5 percent of the study population overall and

increased in prevalence with age. More men than women had elevated liver tests,

which was probably attributable to greater alcohol consumption among men.

Almost 46 percent of the altered liver values in Cittanova were attributable to

excessive alcohol consumption. Nearly 20 percent was due to hepatitis (18.6

percent hepatitis C, 1 percent for hepatitis B.) A combination of alcohol and

hepatitis caused 9 percent of cases. A tiny percentage was caused by rare

conditions. And researchers estimated that the remaining 24 percent of cases

were due to NAFLD. High BMI, high cholesterol, and hyperglycemia were

independently associated with those cases, and 63.3 percent had a bright liver

at echography.

While the use of medications could not be excluded as a cause of the abnormal

test results in the suspected NAFLD cases, " it must be stressed, " say the

authors, " that in almost all cases the medication was for one of the possible

alterations related to the metabolic syndrome (i.e. anti-hypertensive, lipids

lowering, antidiabetic). "

Cittanova is involved in the epidemic of obesity, with nearly 17 percent of the

population having a BMI above 30, however, that rate is still far below other

parts of the world, like the U.S. where more than 30 percent of the population

has a BMI of 30 or more.

" The leading causes of altered liver tests are alcohol, HCV and NAFLD in

Cittanova, " the authors conclude, " NAFLD is emerging as an important etiology. "

http://www.sciencedaily.com/releases/2005/07/050701065422.htm