Evaluation of Liver Enzyme Elevation and Its Contributing Factors in Birjand, Iran

Abnormal pattern of liver enzymes can provide valuable evidence for the diagnosis of a wide range of diseases. The aim of this study was to evaluate liver enzyme elevation and its contributing factors in Birjand, Iran.
This descriptive-analytic study was conducted on 5240 residents of Birjand city, Iran. Primarily, liver enzyme test was performed for all participants and then, the test was repeated for all individuals with liver enzyme elevation (i.e. an alanine transaminase of more than 40 IU/L) at the first measurement. After that, individuals with liver enzyme elevation at both measurements were subjected to blood testing for low-density lipoprotein, high-density lipoprotein, fasting blood sugar, hepatitis B surface antigen, hepatitis C virus antibody, and total bilirubin as well as ultrasound assessment for fatty liver disease. The SPSS software (v. 16.0) was employed for data analysis.
Among 5240 individuals, 150 had liver enzyme elevation at both measurements. They aged 41.5 ± 13.1 on average and were mostly male (56.7%). The means of their serum alanine transaminase and aspartate transaminase were 65.4 ± 20.9 (IU/L) and 35.7 ± 15.1 (IU/L), respectively. The prevalence rates of hepatitis B surface antigen positivity, hepatitis C virus antibody positivity, and obesity were 14% (21 cases), 0.2% (4 cases), and 70% (100 cases), respectively. The mean of serum alanine transaminase was significantly higher among males, individuals with hepatitis B surface antigen positivity, and those with grade II and III fatty liver (P = 0.01). However, serum aspartate transaminase had no significant correlations with these factors.
Serum alanine transaminase elevation is significantly more common among males as well as individuals with fatty liver disease and hepatitis B. These findings suggest that all individuals with a serum alanine transaminase of more than 40 should be assessed for fatty liver disease and hepatitis B.