Professor Patrick Marcellin, founder and organizer of the Paris Hepatology Conference (PHC), calls for the urgent implementation of large-scale measures to curb the underestimated mortality of liver diseases and advocates for screening by a systematic assay of transaminases during routine examinations.
"He was a liver" who never talked about him. Like all livers, like almost all livers. Because, the one whom the doctors call the "prince of the organism" is able to absorb the worst torments.
Even if our liver is almost eternal, it is not a reason not to respect it and in the same way as one protects one's heart, one warms one's joints or one exercises one's memory, to the regime it is not only to improve its line but to let a little blow the "little prince".
Liver diseases : a mortality higher than diabetes with twice as many people suffering.
Current global estimates, certainly underestimated, indicate that 844 million people suffer from liver disease, which causes a high death rate: 2 million deaths per year. By way of comparison, diabetes responsible for 1.6 million deaths affects 422 million people.
Schematically, it can be said that the liver destroyed at 80%, continues to provide almost all of his work. But, 81% sick, the whole body dies. This shadow worker has another amazing property: he is able to regenerate himself. Graft 1/2 liver. A few months later it is on a whole liver that we can count. I told you, a real prince of the body. And it's rather good news in a country where precisely one does not spare his liver. Because the role of this body the largest of our body is not the heaviest, the heaviest is the skin, is a real chemical plant that guarantees the functioning of all other organs. Hence the verdict of death when it no longer works. Who says "factory" first says waste treatment and, in particular, toxic. This is why in case of drug or food poisoning, it is first the liver that "toast". And, about toast, his main enemy is alcohol. The liver is also a high place of storage ... of essential elements like sugar, iron or mineral salts and production of products like cholesterol. The storage in the liver ... it is to the extreme what is called, in the duck or the goose, the foie gras which is nothing other than a species of cirrhosis provoked artificially in the animal by gavage.
Elevated transaminases : the alarm signal of a suffering liver
Frequent, silent, generally asymptomatic whatever their causes, liver diseases are unknown to the public and insufficiently diagnosed by doctors. Transaminases are enzymes present inside the cells of several organs such as the heart, the muscles, and especially the liver. Whenever one of these organs suffers, the destroyed cells release these transaminases. We understand why, thanks to the measurement of their rate, we have a fairly faithful measure of the state of these organs. It is a simple examination (a blood test) fast, reliable and above all cheap which becomes one of the major criteria for screening tests. Two types of transaminases are measured: ASAT and ALAT. If ALT is higher than ASAT, it is a liver problem. Conversely, if the ASATs are more numerous than the ALATs, they are of muscular origin
High transaminase levels are a reliable indicator of liver inflammation, a central mechanism responsible for the progression of liver disease. Its correlation with the severity of liver disease is not perfect and any increase, however small, must alert. This is the best simple and inexpensive test for screening for liver disease for any cause. The stage of the disease, fibrosis or cirrhosis, can then be determined in a second time by reliable complementary examinations (scores, blood tests, elastometry). The biopsy of the liver, which makes it possible to accurately determine the state of the liver, an invasive procedure and associated with a significant morbidity, is rarely used.
For Professor Patrick Marcellin, founder of the PHC, it is urgent to set up mass actions to reduce the mortality of liver diseases. Routine transaminase assays are now the best available tool for large-scale screening of these neglected diseases.