Asymptomatic hypertransaminasemia in patients in primary care

asymptomatic hypertransaminasemia (AH) is a common finding in clinical practice. We propose to determine the prevalence of AH in our environment, its epidemiology and its evolution.

we studied a random sample of 1,136 blood tests undertaken in 2006, excluding patients with known hepatic disease or symptoms or signs of liver disease, and following the evolution of the AHs until 2009. Data was analyzed using bivariate and multivariate logistic regression.

the percentage of patients found with a AH was 15.24% (95% CI 13.52 to 16.96%). The rates of AST and ALT, were 6.93% (95% CI 5.71 to 8.15%) and 14.31% (95% CI 12.65 to 15.97%) respectively. The percentage of normalization of transaminase values in a second analytical control was a 31.81% (95% CI: 26.21 to 37.4%). An association was found between AH and BMI (OR: 1.129, 95% CI 1.062 to 1.199) and between the persistence of AH and GGT (OR: 1.011, 95% CI 1.003 to 1.018). Fundamental tests such as hepatitis serology or ultrasound were performed on only 50% of patients (with 32% of steatohepatitis).

the prevalence found in our study of AH was relatively high (15.24%), being more frequently encountered in obese subjects. Nearly a third of the AHs is normalized in a subsequent blood test. The high GGT is associated with persistence of AH. There is great variability in terms of additional testing in patients with AH and the application of such tests is not protocol.