Study on Causes and Ratio of the Liver Function Abnormalities in General Health Check-up

Abstract

Purpose Since most of chronic liver diseases progress with no symptoms, health checkup plays an important role as triggers for further examinations and treatments. Here, we studied the proportion of liver dysfunction among patients receiving health checkup , and investigated the causes. Method The study targeted 42,003 subjects who underwent health checkup at the PL Tokyo Health Care Center between April 2007 and March 2008. We selected subjects showing liver dysfunctions with readings of GPT40-79 IU/ml and 80IU/l or more, divided by gender and age specifi c group in every 10-year intervals. We then took those with positive serum HBs antigen and HCV antibody as HBV (ϩ) and HCV (ϩ), those who drank more than 40 g of ethanol per day at least six days a week as alcohol consumption (ϩ), and those who satisfied diagnostic criteria for fatty liver under the abdominal ultrasound examination as fatty liver (ϩ), and analyzed the proportions of each. Results GPT40-79 IU/l liver dysfunction were found in 13.1% of males and 2.5% of females, and GPT80 IU/l or more in 2.3% of males and 0.4% of females, both showing higher levels in males. In the analysis by age, males with liver dysfunction ended to be most numerous in their 30s with 22.5% but gradually decreased with age, while females tended to gradually increase with age, peaking at 7.8% in their 70s. The most common cause of liver dysfunction was fatty liver in both men and women, this accounting for liver dysfunction in 13.0% of male cases and 17.6% of females. The next most common for males was alcohol consumption with 10.4%, while for women it was HCV (ϩ) with 6.0%. NAFLD was 1.7% in males and 2.3% in females. Cases thought to be non-alcoholic steatohepatitis (NASH) combined with liver dysfunction were found in 0.4% of males and 0.5% females. Conclusions Liver dysfunction were found in about 15% of males and 3% of females undergoing health checkups, the most common cause being fatty liver. NAFLD, a subject of some attention in recent years, was seen in about 2% of the whole group. A quarter of those were thought to be NASH accompanied by liver dysfunction.

Association between High-Sensitive C-Reactive Protein and the Development of Liver Damage in Japanese Male Workers

“…Increased HDL-C levels had negative associations with the development of liver damage, suggesting that an increase in HDL-C may protect the liver [ 45 ]. The negative association of older age with the development of liver damage is in agreement with both a cross-sectional study [ 37 ] and a longitudinal study [ 48 ].…”

“…A Japanese group also reported that among subjects receiving health check-ups, liver dysfunction defined as ALT ≥ 40 IU/L was found in 15.4% in men. The most common cause of elevated ALT was fatty liver, with this accounting for liver dysfunction in 13.0% of males [ 37 ]. The reason for the causal association between increased HsCRP levels and liver damage defined as AST ≥40 IU/L is unclear.…”

Nonalcoholic Steatohepatitis as Fatal Fatty Liver - The next main target in the field of liver disease

“…Against such backgrounds, we so far followed up and reported the cases of fatty liver encountered on the occasion of health check-ups 1,2) . Currently, many of the researchers and clinicians involved in the care and management of liver disease shifted their targets to "obesity and hepatic dysfunction" i.e.…”