Routine Tests Miss Liver Disease

Routine blood tests that screen for liver disease may not be effective in people who are morbidly obese, says an American study.

Many obese people accumulate fat in the liver, which can be associated with liver inflammation and injury. Routine blood tests to measure liver enzyme levels are often done in these people to detect possible liver damage.

This study included 147 morbidly obese people who were screened for elevations of liver enzymes and then had gastric bypass surgery. Liver biopsies done on these patients found fat accumulation was present in 134 of the patients (91 percent).

Non-alcoholic steatohepatitis (NASH) was found in 20 of the patients (13 percent). NASH is known to progress to significant liver scarring and even cirrhosis of the liver.

However, routine blood screening tests measuring liver enzymes and liver function were normal in 15 of the 20 patients (75 percent) who were found to have NASH. The screening test even gave a normal result for one person with cirrhosis.

The study was presented Oct. 24 at the annual meeting of the American Association for the Study of Liver Diseases in Boston.

"Unfortunately, routine blood tests that screen for liver disease may not detect significant injury and scarring in the majority of these persons," researcher Dr. Patricia Latham, of George Washington University, says in a prepared statement.

"More investigative studies are needed to determine the extent of liver injury in persons with lesser degrees of obesity, and additional noninvasive diagnostic tests are needed to evaluate liver injury and scar formation in these cases. These issue will become more pressing as future research helps us to understand the mechanism of the injury and the means to prevent it," Latham says.

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