The liver, the largest organ in the human body, performs hundreds of critical functions, including bile formation, protein synthesis, glycogen storage, drug detoxification, toxic product removal, blood clotting regulation, and metabolic functions.
Speaking with the editorial team of OnlyMyHealth Dr. Ajay Phadke, Director, Strategy & Business Development, Agilus Diagnostics Ltd. shares exclusive insights on the growing epidemic of liver diseases in India and the importance of liver functions. Here is what he shared with us.
India's Liver Disease Prevalence
India contributes to a staggering 20% of global deaths due to liver disease. The cultural-lifestyle transition in the country has created conditions for the increasing prevalence of liver disease. Poor dietary choices, alcohol habits, and sedentary lifestyles have exacerbated the situation. Nearly one-fourth of the adult population in India is either overweight or obese and at risk for Fatty Liver Disease. Chronic Liver Disease in India often presents late in its clinical course, frequently when decompensation has already set in.
Causes of Acute and Chronic Liver Disease
In adults, the Hepatitis E Virus is the most common cause of Acute Hepatitis (AH). Other significant causes of AH in adults include the hepatitis B virus (HBV), alcoholic hepatitis, and drug-induced liver injury (DILI).
In India, Hepatitis B Virus (HBV) is the most prevalent cause of Chronic Liver Disease (CLD), including cirrhosis and hepatocellular carcinoma (HCC). However, alcohol consumption is rising quickly and is beginning to overtake HBV as the main cause of CLD. Along with a growing body fat index and diabetes incidence, NAFLD (Non-Alcoholic Fatty Liver Disease) burden continues to increase. India is a vast country, and the regional variations in the root causes are notable. The highest HBV prevalence is found in parts of the North-East, East, and South of India, while the highest HCV prevalence is found in parts of the North and East of the country.
Also read: 9 Tips To Avoid Infection In Rainy Season
Liver Function Tests
There are multiple tests that help evaluate liver function. These tests are AST (Aspartate Transaminase), ALT (Alanine Transaminase), Alkaline Phosphatase, Bilirubin, Gamma-glutamyltransferase, Total Protein Test, A/G ratio (Albumin/Globulin Ratio), L-lactate dehydrogenase (LD) and Prothrombin Time. A common test, the total protein test and measuring its ratio, is crucial in evaluating liver health.
Total Protein Test and A/G Ratio
A total protein test counts every form of protein present in the blood. The body's ability to function depends on proteins. Albumin and globulins are the two main categories of proteins that can be detected in blood.
Numerous health issues, such as liver and kidney disease and dietary inadequacies, can be identified by measuring the total protein level and the albumin to globulin ratio.
Also read: 9 Tips To Avoid Infection In Rainy Season
Interpreting Liver Function Test Results
Elevated alanine aminotransferase (ALT) and elevated aspartate aminotransferase (AST) are the two most common abnormalities of a liver function test in an asymptomatic person. Clinicians should interpret liver function tests with other laboratory tests, clinical signs, and patient history to reach an accurate diagnosis and develop appropriate treatment plans.
Changing Epidemiology and the Need for Intervention
The epidemiology of liver disease is changing in India. Improved preventative measures, awareness, more effective linkage to care for early-stage liver disease, and better screening strategies could be potentially valuable interventions. In addition, India urgently needs a liver disease registry and morbidity/mortality database to combat the upcoming burden of CLD in the country.