Article Text


Chronic disease
SP1-91 Non-invasive assessment of hepatic injury in chronic liver diseases: implementation in clinical practice. A comparative study in Manipal teaching hospital of Western Nepal
  1. A Mittal1,
  2. B Sathian1,
  3. A Kumar2,
  4. N Chandrasekharan1
  1. 1Manipal College of Medical Sciences, Pokhara, Nepal
  2. 2College of Medicine & JNM Hospital, West Bengal, India


Background Chronic hepatitis B and C together with alcoholic (ALD) and non-alcoholic fatty liver diseases (NAFLD) represent the major forms of progressive liver disease.

Objective To assess the extent of liver injury by estimation of biochemical parameters and its significance in clinical practice.

Materials and Methods It was a retrospective study carried out from the data maintained in the Department of Biochemistry of the Manipal Teaching Hospital, Pokhara, Nepal between 1 June 2009 and 31 July 2010. Descriptive statistics and testing of hypothesis were used for the analysis using SPSS 16 software.

Result Of the 653 subjects, 48.5% were controls, 19.6% ALD, Viral Hepatitis 18.4% and 13.5% had NAFLD. In cases of viral hepatitis, mean values of aspartate aminotransferase and alanine aminotransferase were markedly increased as compared to controls. However, in alcoholic patients, ALT level is usually elevated to a lesser degree than AST level. The mean value of AST was markedly increased in comparison to ALT leading to significantly higher AST/ALT ratio 1.59 with CI (1.49 to 1.69) (p=0.001). In NAFLD patients, there was mild to moderate elevation in serum levels of AST, ALT or both. The mean value of the ratio of AST/ALT was 1.03±0.26 but this ratio increases as fibrosis advances, leading to a loss of its diagnostic accuracy in patients with cirrhotic non-alcoholic fatty liver disease.

Conclusion Simple, cheap and reliable non-invasive biochemical markers should be used for early stage detection of liver diseases especially the countries having low socioeconomic status like Nepal.

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