Etiology of elevated alanine aminotransferase in a south Indian population: A community based study

Ramit Mahajan, (2014) Etiology of elevated alanine aminotransferase in a south Indian population: A community based study. Masters thesis, Christian Medical College, Vellore.


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INTRODUCTION: Liver diseases are among the top ten killer diseases in India. Besides this, liver diseases are associated with lot of morbidity leading to recurrent hospitalizations and prolonged medical attention, leaving the patients physically, mentally, emotionally and financially devastated. The common risk factors for chronic liver disease include non alcoholic fatty liver disease (NAFLD), chronic viral hepatitis and alcohol(8). Other etiologies include autoimmune hepatitis, Wilson’s disease, hemochromatosis and vascular diseases of the liver. Knowledge of the cause of liver disease helps predict complications and direct treatment decisions. It also helps to prevent similar diseases in the family by early screening (viral hepatitis B and C) or genetic testing (in Wilson’s disease and hemochromatosis). AIM / OBJECTIVES: To estimate the burden of liver disease in a southern Indian community by determining the prevalence and etiology of elevated alanine aminotransferase in this population. MATERIAL AND METHODS: A total of 9000 individuals from the city of Vellore and its neighbouring rural areas were screened for a seroprevalence study of celiac disease conducted by the Christian Medical College, Vellore as part of a three centre study in northern, north-eastern and southern India. Of these, 199 healthy individuals (145 males) had elevated ALT (>44U/l). Ninety one participants (77 males) had persistently elevated ALT, of which 56 patients (52 males) underwent further evaluation. These individuals were invited to answer a questionnaire and undergo anthropometry, blood investigations and ultrasonography to assess various etiologies of liver disease. Standard descriptive statistics were used. RESULTS: The estimated prevalence of persistently elevated ALT suggestive of possible liver damage in this south Indian population was 1.73% (1.01% to 1.93%). The most common etiologies of elevated ALT were alcohol intake (46.4%), NAFLD (42.9%) and hepatitis B (10.7%). No participant had hepatitis C infection. A majority (71.4%) of individuals had metabolic syndrome, 92% of whom had NAFLD. CONCLUSIONS: From a public health perspective, early clinical intervention and primary prevention are important and strategies to reduce both alcohol consumption and obesity may lead to reduction in liver disease.

Item Type: Thesis (Masters)
Additional Information: Reg.No.16112755
Uncontrolled Keywords: Etiology, elevated alanine aminotransferase, south Indian population, community based study.
Subjects: MEDICAL > Gastroenterology
Depositing User: Kambaraman B
Date Deposited: 15 Jan 2020 16:06
Last Modified: 15 Jan 2020 16:06

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