[ALT screening for chronic liver diseases: scrutinizing the evidence].
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[ALT screening for chronic liver diseases: scrutinizing the evidence]. / Wedemeyer, H; Hofmann, W P; Lüth, Stefan; Malinski, P; Thimme, R; Tacke, F; Wiegand, J.
In: Z GASTROENTEROL, Vol. 48, No. 1, 1, 2010, p. 46-55.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - [ALT screening for chronic liver diseases: scrutinizing the evidence].
AU - Wedemeyer, H
AU - Hofmann, W P
AU - Lüth, Stefan
AU - Malinski, P
AU - Thimme, R
AU - Tacke, F
AU - Wiegand, J
PY - 2010
Y1 - 2010
N2 - Elevated serum amino-transferase levels may be associated with liver injury. Testing for aspartate aminotransferase (AST) or alanine aminotransferase (ALT) is part of many routine screening approaches. The aim of this manuscript was to scrutinize the evidence for using ALT testing as a primary screening parameter for liver diseases. We conclude that (i) elevated serum ALT levels indicate a high specificity and a reasonable sensitivity liver injury, (ii) 10 - 25 % of German adults have elevated ALT levels, (iii) ALT values are increased in the majority but not all patients with acute and chronic liver disease (iv) elevated ALT-values are associated with an increased risk of liver-specific mortality, (v) elevated ALT values are also a risk factor for non-hepatic diseases including diabetes mellitus type 2, metabolic syndrome, cardiovascular diseases and malignancies, (vi) many liver diseases identified by an ALT screening can be treated successfully including prevention of development of clinical endpoints, (vii) an ALT-screening is very likely to be cost-effective although studies are needed for Germany to support this conclusion.
AB - Elevated serum amino-transferase levels may be associated with liver injury. Testing for aspartate aminotransferase (AST) or alanine aminotransferase (ALT) is part of many routine screening approaches. The aim of this manuscript was to scrutinize the evidence for using ALT testing as a primary screening parameter for liver diseases. We conclude that (i) elevated serum ALT levels indicate a high specificity and a reasonable sensitivity liver injury, (ii) 10 - 25 % of German adults have elevated ALT levels, (iii) ALT values are increased in the majority but not all patients with acute and chronic liver disease (iv) elevated ALT-values are associated with an increased risk of liver-specific mortality, (v) elevated ALT values are also a risk factor for non-hepatic diseases including diabetes mellitus type 2, metabolic syndrome, cardiovascular diseases and malignancies, (vi) many liver diseases identified by an ALT screening can be treated successfully including prevention of development of clinical endpoints, (vii) an ALT-screening is very likely to be cost-effective although studies are needed for Germany to support this conclusion.
KW - Comorbidity
KW - Germany
KW - Humans
KW - National Health Programs economics
KW - Cost-Benefit Analysis
KW - Cross-Sectional Studies
KW - Predictive Value of Tests
KW - Prognosis
KW - Chronic Disease
KW - Alanine Transaminase blood
KW - Aspartate Aminotransferases blood
KW - Evidence-Based Medicine economics
KW - Hepatitis, Autoimmune diagnosis
KW - Hepatitis, Viral, Human diagnosis
KW - Liver Diseases diagnosis
KW - Liver Function Tests economics
KW - Mass Screening economics
KW - Comorbidity
KW - Germany
KW - Humans
KW - National Health Programs economics
KW - Cost-Benefit Analysis
KW - Cross-Sectional Studies
KW - Predictive Value of Tests
KW - Prognosis
KW - Chronic Disease
KW - Alanine Transaminase blood
KW - Aspartate Aminotransferases blood
KW - Evidence-Based Medicine economics
KW - Hepatitis, Autoimmune diagnosis
KW - Hepatitis, Viral, Human diagnosis
KW - Liver Diseases diagnosis
KW - Liver Function Tests economics
KW - Mass Screening economics
M3 - SCORING: Zeitschriftenaufsatz
VL - 48
SP - 46
EP - 55
JO - Z GASTROENTEROL
JF - Z GASTROENTEROL
SN - 0044-2771
IS - 1
M1 - 1
ER -
