Table 1.
Study participants from the Uganda GPC with abnormal LFT results and fibrosis scores based on ULN according to American Reference Range (ARR) and Local Reference Range (LRR)
| Enzyme type | Total n/N (%) |
Male n/N (%) |
Female n/N (%) |
P value* |
| ALT | ||||
| Abnormal ARR† | 573/8099 (7.1) | 162/3542 (4.6) | 411/4557 (9.0) | <0.001 |
| Abnormal LRR‡ | 209/8099 (2.6) | 87/3542 (2.5) | 122/4557 (2.7) | 0.53 |
| AST | ||||
| Abnormal ARR† | 1011/8099 (12.5) | 434/3542 (12.3) | 577/4557 (12.7) | 0.58 |
| Abnormal LRR‡ | 241/8099 (3.0) | 123/3542 (3.5) | 118/4557 (2.6) | 0.02 |
| GGT§ | ||||
| Abnormal ARR† | 889/8099 (11.0) | 362/3542 (10.2) | 527/4557 (11.6) | 0.06 |
| BR | ||||
| Abnormal ARR† | 1051/8099 (13.0) | 635/3542 (18.0) | 416/4557 (9.1) | <0.001 |
| Abnormal LRR‡ | 497/8099 (6.1) | 214/3542 (6.0) | 283/4557 (6.2) | 0.75 |
| ALP¶ | ||||
| Abnormal ARR† | 1161/5616 (20.7) | 315/2273 (13.9) | 846/3343 (25.3) | <0.001 |
| Abnormal LRR‡ | 139/5616 (2.5) | 60/2273 (2.6) | 79/2273 (2.4) | 0.513 |
| FIB-4 | ||||
| Abnormal** | 99/1877 (5.3) | 54/824 (6.6) | 45/1053 (4.3) | 0.03 |
| APRI†† | ||||
| Abnormal ARR*,** | 145/1877 (7.7) | 95/824 (11.5) | 50/1053 (4.8) | <0.001 |
| Abnormal LRR*,** | 60/1877 (3.2) | 42/824 (5.1) | 18/1053 (1.7) | <0.001 |
| GPR | ||||
| Abnormal** | 441/1877 (23.5) | 185/824 (22.5) | 256/1053 (24.3) | 0.35 |
| AST/ALT | ||||
| Abnormal** | 882/8099 (10.9) | 420/3542 (11.9) | 462/4557 (10.1) | 0.01 |
| S-index | ||||
| Abnormal** | 73/1877 (3.9) | 50/824 (6.1) | 23/1053 (2.2) | <0.001 |
*P value calculated to determine whether significant difference was observed between males and females in each category using χ2 test.
†Abnormal LFTs, according to American Reference Range, ARR, are defined as test results outside of the following ranges: ALT (male: 10–55 U/L, female: 7–30 U/L), AST (male: 10–40 U/L, female: 9–32 U/L), GGT (male: 8–61 U/L, female: 5–36 U/L), BR (0–17 mmol/L) and ALP (male: 45–115 U/L, female: 30–100 U/L).
‡Abnormal LFTs, according to Local Reference Range, LRR, are defined as test results outside of the following ranges: ALT (8–61 U/L), AST (14–60 U/L), BR (2.9–37 mmol/L) and ALP (48–164 U/L).
§ LRR for GGT not defined.
¶Individuals under the age of 19 were excluded.
**Threshold usedto predict liver fibrosis: APRI > 0.7; FIB-4 >3.25; GPR >0.32; RPR >0.825; S-Index >0.3.
††APRI score calculated using ULN of AST using both the ARR and LRR.
ALP, alkaline phosphatase; ALT, alanine transminase; APRI, AST to Platelet Ratio Index; ARR, American reference range; AST, aspartate transminase; AST/ALT ratio, aspartate/alanine ratio; BR, total bilirubin; FIB-4, fibrosis 4; GGT, gamma-glutamyl transpeptidase; GPC, General Population Cohort; GPR, GGT to platelet ratio; LFT, liver function test; LRR, local reference ranges; RPR, red cell distribution width to platelet ratio; ULN, upper limit of normal.