Clinical Characteristics of Factory Workers with Asymptomatic Liver Function Test Abnormalities found on Serial Health Examination |
Kang Mo Kim, M.D., Yoon Jun Kim, M.D., Kwang Hyuck Lee, M.D.
and Domyung Paek, M.D., M.Sc., S.D.1 |
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Occupational Health Program1, School of Public Health, Institute of Health and Environment Seoul National University, Seoul, Korea |
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ABSTRACT |
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Background/Aims The liver function tests (LFTs), such as aspartate aminotransferase (AST), alanine
aminotransferase (ALT), and γ-glutamyltranspeptidase (γ-GT), have been widely used as screening tests but
their low positive predictive value can cause many false positive results. To evaluate the clinical usefulness of
these tests, we analyzed the serial LFT results for factory workers, and we compared the risk factors for the
groups that were divided according to the serial LFT results. Methods: From June 2001 to October 2001, 1223
consecutive healthy workers in a single factory were enrolled in our study; a questionnaire, LFT and liver
ultrasonography were done for all the subjects. The previous LFT results were collected from the Annual
health examination survey. According to the abnormalities on the serial LFT, the participants were classified
into three groups (abnormal-in-both, alternating or, normal-in-both) and the risk factors were compared
among these groups using multiple logistic regression analysis. Results: The prevalence of LFT abnormality
on a single test was 16.8%, but on the serial LFT, only 5% of the study participants showed consistent
abnormality. The risk factors for the abnormal-in-both group, compared with the alternating group, were
liver ultrasonography abnormality such as a fatty liver (odds ratio, 2.2; P=0.026) and a heavy alcohol intake
(more than 210 g/week) (odds ratio, 7.2; P=0.064). HBsAg was not a significant risk factor for any of the three
groups. Conclusions: In factory workers having serial LFT abnormalities, alcoholic liver disease could be the
principal cause of abnormal LFT. Even if the HBsAg were positive in patients with abnormal LFT, there is
the possibility of another causes for LFT abnormalities such as alcoholic liver disease and non-alcoholic
steatosis or steatohepatitis. (Korean J Hepatol 2005;11:144-156) |
KeyWords:
Liver function test, Alcoholic liver disease, Obesity, Fatty liver |
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