Table 9

Studies that have followed up patients from the general population after abnormal LFT

Author and Country

Date

Type of Study and population studied

Analytes Used

Patients enrolled

Patients with abnormal LFTs (%)

Prevalence of viral hepatitis in patients with abnormal LFTs

Notes

McLernon DJ et al. [31] Scotland

2009

Record Linkage; laboratory database of GP tests, hospital admissions and death certificates.

Bilirubin, Albumin, ALP, GGT, ALT, AST (transaminases sometimes combined). GP selected

95,977

20,827 (21.7%)

2.2%

Median follow up of 3.7 years. Risk of under ascertainment.

Pendino GM et al. [35] Italy

2005

Prospective Cohort Study; general population.

AST, ALT, GGT.

1,645

319 (19.4%)

17.9%

High baseline rate of viral hepatitis; 5.6%.

Kim HC et al. [30] Korea

2004

Record Linkage: insurance data and death certificates.

AST, ALT.

142,055

11,193 (7.9%)

N/A

Outcome was liver disease mortality.

Yano E et al. [16] Japan

2001

Prospective Cohort Study; "healthy" office workers.

AST, ALT, GGT.

1,973

358 (18.1%)

2.7%

Assumed that all liver cancer and cirrhosis was a result of viral hepatitis.

Daniel S et al. [36] USA

1999

Prospective Cohort Study; primary care population.

ALT, AST raised 50% above normal on at least two occasions across a six month period.

1,124

1,124 (100%)

N/A

Marker was negative patients only, so infected patients excluded from analysis.

Mathiesen UL et al. [37] Sweden

1999

Prospective Cohort Study; primary care population.

AST, ALT raised for at least 6 months. (ALP had to be normal).

150

150 (100%)

15.3%

Whitehead MW et al. [39] UK

1999

Prospective Cohort Study; primary care population.

AST markedly raised (10 times (>400 U/l) above the upper limit of normal.)

137

137 (100%)

2.2%

Bellentani S et al. [34] Italy

1994

Prospective Cohort; general population.

AST, ALT, GGT.

6,917

1,473 (21.3%)

2.4%

Hultcrantz R et al. [38] Scandinavia

1986

Prospective Cohort Study; primary care population.

AST, ALT moderately raised for at least 6 months.(ALP had to be below twice the upper limit of normal).

149

149 (100%)

2.7%

We also identified a relevant study by Kim and colleagues. This study prospectively followed a group of "healthy" Korean factory workers taking measurements of ALT, AST and GGT on at least two separate occasions. The full article was in Korean so we only had access to the abstract [53].

ALT: Alanine aminotransferase;

AST: Aspartate aminotransferase;

ALP: Alkaline phosphatase;

GGT: Gamma-glutamyltransferase;

HBV: Hepatitis B;

HCV: Hepatitis C;

LFT: Liver function test.

Arnold et al. BMC Family Practice 2011 12:9   doi:10.1186/1471-2296-12-9