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Liver function tests (LFTs or LFs), also referred to as a hepatic panel or liver panel, are groups of blood tests that provide information about the state of a patient's liver. [1] These tests include prothrombin time (PT/INR), activated partial thromboplastin time (aPTT), albumin , bilirubin (direct and indirect), and others.
The proportion of AST to ALT in hepatocytes is about 2.5:1, but because AST is removed from serum by the liver sinusoidal cells twice as quickly (serum half-life t 1/2 = 18 hr) compared to ALT (t 1/2 = 36 hr), so the resulting serum levels of AST and ALT are about equal in healthy individuals, resulting in a normal AST/ALT ratio around 1.
FibroTest has been evaluated in relation to liver biopsy (the current reference standard in liver disease assessment) in people with hepatitis C, hepatitis B, [1] alcoholic liver disease, [2] and non-alcoholic fatty liver disease. [3] They are most useful for cirrhosis and less useful for other stages of liver disease. [4]
Fatty liver disease (FLD), also known as hepatic steatosis and steatotic liver disease (SLD), is a condition where excess fat builds up in the liver. [1] Often there are no or few symptoms. [ 1 ] [ 2 ] Occasionally there may be tiredness or pain in the upper right side of the abdomen . [ 1 ]
According to NICE guidelines, statins can continue unless liver enzyme levels double within three months of starting statins. [66] Treatment with pentoxifylline is not recommended. [14] Omega-3 fatty acids may reduce liver fat and improve blood lipid profile but do not seem to improve liver histology (fibrosis, cirrhosis, cancer). [14]
Despite cessation of alcohol use, only 10% will have normalization of histology and serum liver enzyme levels. [26] As previously noted, the MDF has been used to predict short-term mortality (i.e., MDF ≥ 32 associated with spontaneous survival of 50–65% without corticosteroid therapy, and MDF < 32 associated with spontaneous survival of 90%).
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