An Update on the Role of Alanine Aminotransferase in the Detection of Chronic Liver Diseases Relevant to Primary Care.

Abstract

Alanine aminotransferase (ALT) is a key biomarker used in primary care to detect chronic liver diseases, particularly in high-risk populations such as those with metabolic syndrome and obesity. This review explores the role ALTs play in screening for asymptomatic liver diseases and its ability to predict all-cause and liver-related mortality. While ALT remains valuable for screening in high-risk groups, its utility in the general population is limited due to a lack of cost-effective studies. Recent research suggests that lower ALT thresholds may improve early detection of liver disease, especially in individuals with non-alcoholic fatty liver disease. However, ALT alone may not be sufficient, as it has limitations regarding specificity and sensitivity. Combining ALT with other diagnostic tools, such as imaging techniques and additional liver enzyme markers, could enhance screening accuracy and early detection in primary care settings. Regular monitoring and adapting ALT cutoff values for specific populations are recommended to optimize liver disease management. This approach could lead to improved clinical outcomes, reduced progression to severe liver conditions, and better healthcare resource utilization.