Document Detail

Diagnostic and predictive factors of significant liver fibrosis and minimal lesions in patients with persistent unexplained elevated transaminases. A prospective multicenter study.
MedLine Citation:
PMID:  16837098     Owner:  NLM     Status:  MEDLINE    
BACKGROUND/AIMS: In patients with unexplained elevated transaminases, prognosis of the liver disease and factors associated with increased risk of liver fibrosis and normal/subnormal liver are unknown. The aim of this prospective study was to identify diagnosis and clinical and biological factors associated with significant (bridging) fibrosis and minimal lesions of the liver in patients with persistent unexplained elevated ALT levels. METHODS: From July 2002 through October 2004, all consecutive asymptomatic patients with unexplained chronically elevated ALT levels were included. All patients had clinical, biological, ultrasonographic examination and a liver biopsy. RESULTS: 272 patients (60.3% males, mean age 46.4 years, BMI 26.7) were included. Pathological findings were: minimal lesions (18.7%), steatosis (26.8%), NASH (32.7%), and miscellaneous (21.7%). Significant fibrosis was found in 27.4% of cases, including 9 cases of cirrhosis. By multivariate analysis, independent predictors of significant fibrosis were tobacco use (OR 2.5, 95% CI 1.34-4.74 p=0.04), BMI>25 (2.49, 1.31-4.73 p=0.005) and diabetes (4.41, 1.73-11.29 p=0.002). Independent factors associated with minimal lesions were female gender (OR 3.4 95% CI 1.73-6.75 p<0.0001) and BMI<25 (3.55, 1.8-6.98, p<0.0001). CONCLUSIONS: In patients with unexplained chronically elevated transaminases, significant fibrosis is statistically associated with tobacco use, BMI>25 and diabetes, and minimal lesions are significantly associated with female gender and BMI<25.
Victor de Lédinghen; Vlad Ratziu; Xavier Causse; Brigitte Le Bail; Dominique Capron; Christophe Renou; Christophe Pilette; Valérie Oules; Eve Gelsi; Frédéric Oberti; Anaïs Vallet-Pichard; Nicolas Le Provost; Jean-François Cadranel; ;
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2006-06-16
Journal Detail:
Title:  Journal of hepatology     Volume:  45     ISSN:  0168-8278     ISO Abbreviation:  J. Hepatol.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-05     Completed Date:  2006-11-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  592-9     Citation Subset:  IM    
Service d'Hépato-Gastroentérologie, Hôpital du Haut-Lévêque, Pessac, France.
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MeSH Terms
Alanine Transaminase / blood*
Fatty Liver / blood,  pathology,  ultrasonography
Liver / enzymology,  pathology
Liver Cirrhosis / blood*,  pathology,  ultrasonography*
Middle Aged
Predictive Value of Tests
Prospective Studies
Severity of Illness Index*
gamma-Glutamyltransferase / blood*
Reg. No./Substance:
EC; EC Transaminase

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