Study on Causes and Ratio of the Liver Function Abnormalities in General Health Check-up

Purpose Since most of chronic liver diseases progress with no symptoms, health check-up plays an important role as triggers for further examinations and treatments. Here, we studied the proportion of liver dysfunction among patients receiving health check-up, and investigated the causes. Method The study targeted 42,003 subjects who underwent health check-up at the PL Tokyo Health Care Center between April 2007 and March 2008. We selected subjects showing liver dysfunctions with readings of GPT40-79 IU/ml and 80IU/l or more, divided by gender and age specific group in every 10-year intervals. We then took those with positive serum HBs antigen and HCV antibody as HBV (+) and HCV (+), those who drank more than 40 g of ethanol per day at least six days a week as alcohol consumption (+), and those who satisfied diagnostic criteria for fatty liver under the abdominal ultrasound examination as fatty liver (+), and analyzed the proportions of each. Results GPT40-79 IU/l liver dysfunction were found in 13.1% of males and 2.5% of females, and GPT80 IU/l or more in 2.3% of males and 0.4% of females, both showing higher levels in males. In the analysis by age, males with liver dysfunction ended to be most numerous in their 30s with 22.5% but gradually decreased with age, while females tended to gradually increase with age, peaking at 7.8% in their 70s. The most common cause of liver dysfunction was fatty liver in both men and women, this accounting for liver dysfunction in 13.0% of male cases and 17.6% of females. The next most common for males was alcohol consumption with 10.4%, while for women it was HCV (+) with 6.0%. NAFLD was 1.7% in males and 2.3% in females. Cases thought to be non-alcoholic steatohepatitis (NASH) combined with liver dysfunction were found in 0.4% of males and 0.5% females. Conclusions Liver dysfunction were found in about 15% of males and 3% of females undergoing health checkups, the most common cause being fatty liver. NAFLD, a subject of some attention in recent years, was seen in about 2% of the whole group. A quarter of those were thought to be NASH accompanied by liver dysfunction.