Simple new test can predict risk of liver damage years before symptoms

A simple test can help predict the risk of serious liver damage years before symptoms strike, new research suggests.

It is estimated that liver disease, which can be caused by alcohol consumption or high levels of fat in the body, kills 11,000 Britons each year.

If caught early on, patients have a better chance of survival, but it is often symptomless in the initial stages. 

Swedish researchers have developed a test that can predict the risk of developing severe liver disease 10 years before its onset, which could allow for early intervention, and life-prolonging treatment.

Hannes Hagström, the lead researcher from Karolinska Institute said: ‘This is an important step towards being able to offer early screening for liver disease in primary care.

‘Drug treatment is now available, soon hopefully also in Sweden, for treating people at a high risk of developing liver diseases such as cirrhosis or liver cancer.’ 

The test involves three blood tests, and has already been used in primary care to detect irreversible scarring of the organ known as cirrhosis, which is linked to the development of liver cancer.

‘These are diseases that are growing increasingly common and that have a poor prognosis if detected late,’ added co-author Rickard Strandberg.

The team looked at data from over 480,000 people in Stockholm who had health checks between 1985 and 1996. 

After following the patients for 30 years, they discovered 1.5 per cent developed severe liver disease such as cirrhosis or liver cancer, or required a liver transplant.

Their analysis allowed them to develop a core model to predict if people would develop the disease. It was accurate in 88 per cent of cases.

The model, which is called CORE, is a web-based calculator which uses advanced statistical methods. 

It is based on five factors: age, sex and levels of three common liver enzymes (AST, ALT and GGT), which are commonly measured during regular health checks.

They hope that the tool, which is already available for doctors to use, will become a vital way to look for hidden warning signs during primary care treatment.

CORE performed better than the current FIB-4 method—which is used to assess risk of liver disease, particularly in patients with risk factors like fatty liver disease.

Professor Hagström added: ‘Primary care hasn’t had the tools to detect the risk of severe liver disease in time.

‘FIB-4 is not suited for the general population and is less effective at predicting the future risk of severe liver disease.’ 

The test was also trialled on two other population groups in Finland and the UK and was found to detect the illness with high accuracy.

However, they added further research needs to be done into the efficacy of the test, particularly on high-risk groups like people with type 2 diabetes or obesity.

Types of liver disease include alcohol-related liver disease, non-alcohol fatty liver disease, hepatitis, Haemochromatosis and primary biliary cholangitis.

Early signs of the first, caused by regularly drinking too much alcohol, include nausea, weight loss, loss of appetite, as well as yellowing of the eyes or skin.

On the other hand, signs of non-alcohol fatty liver disease include fatigue, feeling unwell and liver pain or discomfort, which is felt in your tummy, under the right ribs.

Meanwhile, signs of liver cirrhosis—late-stage liver disease—also includes visible blood vessels on the skin and blotchy red palms of the hands that’s harder to see on darker skin.

Similarly, early signs of liver cancer include the yellowing of the eyes and skin, loss of appetite, losing weight without trying and flu-like symptoms. 

A lump in the right side of your tummy, flu-like symptoms and digestive issues like nausea, vomiting, indigestion and a swollen tummy are also signs of the cancer. 

Earlier this month other research showed three common heart related conditions may raise risk of death from liver disease by 40 per cent. 

US scientists discovered these were high blood pressure, type 2 diabetes, and having low levels of high-density lipoprotein cholesterol (HDL)—so called ‘good cholesterol’.

It has long been warned that sedentary lifestyles and ultra-processed, high salt, fatty and sugary foods could be driving the condition, particularly in younger people. 

Where liver disease was once largely confined to the elderly and heavy drinkers, it is now rising rapidly among younger adults.