Diurnal variation of serum alanine transaminase activity in chronic liver disease

✍ Scribed by Juan Córdoba; Ken O'Riordan; Josée Dupuis; Jayme Borensztajn; Andres T. Blei

• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 36 KB
• Volume: 28
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.510280640

✦ Synopsis

The determination of serum levels of alanine transaminase (ALT) is a critical tool in the diagnosis and follow up of patients with liver disease. We were interested in the recent article by Piton et al., 1 which identified factors associated with ALT variability from a cohort of 1,033 blood donors and estimated the clinical impact of correcting the normal upper limit value of ALT according to these parameters. However, the authors did not mention if blood sampling was obtained at the same time of the day and if they assessed the role of this factor on ALT values. In healthy individuals there is a such a variation of ALT 2 and other blood analytes 3 of low amplitude that does not pose diagnostic problems. However, in patients with high values of ALT, the changes could be of significance. Different biological rhythms have been shown to be abnormal in patients with cirrhosis 4-6 and in rats with portacaval anastomosis. It is unknown whether a common abnormality may also affect the diurnal variation of ALT.

We examined the diurnal variation of serum ALT in a group of 12 patients with cirrhosis (5 men, 7 women; 35-63 years; mean age, 47 years) of different etiologies (5 alcoholic, 4 hepatitis C, and 3 primary biliary cirrhosis) staged Child-