Liver Enzyme and Bilirubin Abnormalities and Associated Factors Among Patients with Liver Disease in a Tertiary Hospital, Northwest Ethiopia: A Cross-Sectional Study

Abstract

BACKGROUND: Liver disease is a disturbance of the normal and healthy functioning of the liver. It is directly linked to liver synthesis, excretion, and metabolism and results in liver dysfunction. Thus, this study aimed to evaluate the extent of liver function abnormalities and their related factors in patients with liver disease. METHODS: This cross-sectional study was conducted on 307 patients with liver disease via consecutive sampling from August 22, 2022, to October 24, 2022, at the University of Gondar Comprehensive Specialized Hospital. Approximately 3 ml of venous blood was collected and analysed via a _Beckman Coulter 700 chemistry analyser. _The data were analysed via the Statistical Package for Social Sciences version 25 software. Frequencies and proportions were used to characterize the results. Bivariable and multivariable logistic regression analyses were used to investigate factors associated with liver function abnormalities. Statistical significance was set at P <0.05. RESULTS: Among the 307 patients, 117 (38.11%, 95% CI: 32.64%, 43.57%), 212 (69.06%; 95% CI: 63.85%, 74.25%), and 168 (54.72%, 95% CI: 49.12%, 60.32%) had abnormal ALT, AST, and total bilirubin, respectively. Nearly one-fourth (25.40%) of the patients had all liver function test abnormalities. Male sex (AOR = 0.17; 95% CI: 0.08, 0.38) and the presence of viral hepatitis (AOR = 3.85; 95% CI: 1.23, 12.02) were significantly associated with abnormal liver ALT levels. A history of blood transfusion (AOR=0.45; 95% CI: 0.21, 0.95), lack of vegetable feeding habits (AOR=2.73; 95% CI: 1.34, 5.59), lack of physical exercise habits (AOR=2.97; 95% CI: 1.44, 6.11), and alcoholic liver disease (AOR=17.09; 95% CI: 1.96, 148.98) were significantly associated with AST abnormalities. Anaemia (AOR=3.33; 95% CI: 1.58, 7.08), a lack of vegetable feeding habits (AOR=1.98; 95% CI: 1.06, 3.69), and a lack of physical exercise habits (AOR=4.03; 95% CI: 1.90, 8.57) were significantly associated with total bilirubin abnormalities. CONCLUSION: In this study, patients with liver disease presented substantial liver function abnormalities. Viral hepatitis was associated with increased ALT levels, whereas alcoholic liver disease was only associated with increased AST levels. Blood transfusion, lack of physical activity, and lack of vegetables are associated with increased bilirubin levels. Therefore, clinicians should consider these factors in the management and treatment of patients with liver disease.