Relationship between routine biochemical liver function tests and severity of liver damage in alcoholic patients

Abstract

SUMMARY: The aim of this study was to investigate the relationship between routine biochemical liver function tests (LFT) that are perfoimed in Sri Lankan hospitals and the severity of liver damage (assessed histologically) in alcoholics. Results of routine LFT (serum bilirubin, SOFT, albumin and prothrombin time.) were correlated to histological changes in the liver in 50 (49 males and one female, mean age 46.6 years) out of 76 patients who were admitted to hospital with problems related to alcohol dependence. There was no mortality, and only minimal morbidity associated with the liver biopsy procedure. When 3 or more LFT were abnormal irreversible liver damage was always present histologically. When only 1 or 2 LFT were abnormal irreversible changes occurred in 42.9%. However, of 9 patients in whom all 4 LFT were normal, 7 (77.8%) had abnormal liver histology, including 4 (44.4%) with irreversible changes. Although there was a strong relationship between widespread abnormalities in routine LFT and irreversible liver damage, many patients with irreversible liver damage may have gone undetected if reliance was placed solely on these tests. Therefore, a liver biopsy is recommended for accurate assessment of the severity of liver damage in alcoholic patients.