Alanine aminotransferase (ALT) elevation in blood donors can be related to many variables such as viral hepatitis, overweight and ethanol consumption.
Dr Torezan-Filho and colleagues from Sao Paulo in Brazil designed a study in order to define factors associated with ALT elevation in candidates for blood donation.
The researchers evaluated ALT levels during follow-up, and aimed to establish a histological diagnosis of hepatic disease.
The research team enrolled 119 subjects in the study.
All participants were hepatitis B surface antigen/anti-hepatitis C virus negative and had been rejected as blood donors as a result of elevated ALT (>1.5 times the upper normal limit (UNL) in two determinations).
The researchers investigated alcoholism, obesity, drug-induced liver disease, diabetes, hemochromatosis and 1-anti-trypsin deficiency in all of the 119 participants (113 males, six females, aged 33.4±8.4 years).
| Obesity and alcoholism were most frequently associated with ALT elevation|
During follow-up, the research team determined ALT every 8 weeks and liver biopsy was recommended in cases with persistently elevated ALT levels.
The researchers found that obesity (30%) and alcoholism (29%) were most frequently associated with ALT elevation.
In 9% of cases no association was found.
The research team also noted that ALT levels decreased significantly, regardless of the associated factor.
Liver histology in 40 patients showed steatosis (35%), steatohepatitis (30%), non-specific reactive hepatitis (13% of cases), normal liver (15% of cases) and alcoholic cirrhosis, hemochromatosis and non-specific portal fibrosis in three cases.
Dr Torezan-Filho concluded, "ALT levels usually dropped during follow-up and although severe hepatic lesions can be found in asymptomatic blood donors, mild hepatic damage is the rule."