[Download] "Evidence for a Substantial Genetic Influence on Biochemical Liver Function Tests: Results from a Population-Based Danish Twin Study (Enzymes and Protein Markers)" by Clinical Chemistry # Book PDF Kindle ePub Free
eBook details
- Title: Evidence for a Substantial Genetic Influence on Biochemical Liver Function Tests: Results from a Population-Based Danish Twin Study (Enzymes and Protein Markers)
- Author : Clinical Chemistry
- Release Date : January 01, 2001
- Genre: Chemistry,Books,Science & Nature,
- Pages : * pages
- Size : 228 KB
Description
Biochemical liver function tests are some of the most frequently used tests in the clinic. Strictly speaking, the term "liver function test" is inaccurate because enzyme activities reflect dysfunction and are not specific to the liver, whereas bilirubin and protein concentrations are affected by factors such as hemolysis and nutritional state. Alanine aminotransferase (ALT), [5] lactate dehydrogenase (LDH), and [gamma]-glutamyltransferase (GGT) indicate the degree of cellular injury that has occurred during the past few hours (1). GGT is believed to be the most suitable of these liver function tests for examining long-standing excessive alcohol consumption, because alcohol induces formation of the enzyme, and for the recognition of cholestasis (2-4). The albumin concentration indicates the protein synthetic function of the liver, but albumin synthesis decreases very rapidly (in a few days) in persons on a protein-deficient diet (5). Hypoalbuminemia in liver disease indicates that a chronic liver disease is present (1). Bilirubin is one of the most commonly used liver function tests. Bilirubin is a metabolic breakdown product of heme derived from senescent red blood cells. The liver conjugates and excretes bilirubin into the bile (1). Increased concentrations of unconjugated bilirubin have a high predictive value in the diagnosis of many hepatobiliary disorders. Liver function tests are used for identifying patients with liver disease; in the differential diagnosis of jaundice; in monitoring the severity, course, and response to treatment of disease; and in detecting hepatotoxicity caused by drugs. Findings of transient, asymptomatic increases in liver function test results, particularly transaminase concentrations are common (6, 7). In particular, treatment with many common drugs [e.g., nonsteroidal anti-inflammatory drugs among others (8)] may cause increases in liver enzyme activity in the absence of clinical liver disease. Although these liver function tests have a low sensitivity for detecting liver diseases and the values frequently are temporarily increased, they are among the most frequently used biochemical tests in screening for diseases in older age groups. Abnormal values usually lead the physician to request a repeated evaluation and new testing, which is accompanied by concern on the patient's part and additional expense. One study showed that 25-30% of asymptomatic workers screened by five liver tests (bilirubin, ALT, LDH, alkaline phosphatase, and aspartate aminotransferase) had serum concentrations exceeding the reference intervals (6).