Liver blood marker testing in UK primary care: a UK wide cohort study, 2004-2016.
aspartate aminotransferase
early diagnosis
policy
population
screening
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
26 09 2022
26 09 2022
Historique:
entrez:
27
9
2022
pubmed:
28
9
2022
medline:
30
9
2022
Statut:
epublish
Résumé
We aimed to determine (1) the temporal trends of liver enzyme testing in UK general practice and (2) how these vary among different subgroups at risk of chronic liver disease (CLD). Retrospective cohort study. UK primary care database (Clinical Practice Research Datalink (CPRD)), 2004-2016. Patients aged 18 years or over, registered in the CPRD from 1 January 2004 to 31 December 2016. The frequency of testing recorded within the study period in general practice was calculated for: alanine aminotransferase (ALT); aspartate aminotransferase (AST); gamma glutamyl transferase (GGT); alkaline phosphatase (ALP); bilirubin and platelets. Analyses were conducted in subgroups of patients at high risk of developing liver disease. The study cohort included 2 912 066 individuals with median follow-up of 3.2 years. The proportion of patients with at least one measurement for ALT, ALP, bilirubin or platelet test gradually increased over the course of the study period and fell for AST and GGT. By 2016, the proportion of the population receiving one of more tests in that year was: platelet count 28.0%, ALP 26.2%, bilirubin 25.6%, ALT 23.7%, GGT 5.1% and AST 2.2%. Those patients with risk factors for CLD had higher proportions receiving liver marker assessments than those without risk factors. The striking finding that AST is now only measured in a fraction of the population has significant implications for routine guidance which frequently expects it. A more nuanced approach where non-invasive markers are targeted towards individuals with risk factors for CLD may be a solution.
Identifiants
pubmed: 36167394
pii: bmjopen-2021-058967
doi: 10.1136/bmjopen-2021-058967
pmc: PMC9516205
doi:
Substances chimiques
Biomarkers
0
gamma-Glutamyltransferase
EC 2.3.2.2
Aspartate Aminotransferases
EC 2.6.1.1
Alanine Transaminase
EC 2.6.1.2
Alkaline Phosphatase
EC 3.1.3.1
Bilirubin
RFM9X3LJ49
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e058967Informations de copyright
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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