Elevated liver enzyme (AST and ALT) as biomarkers for severe dengue in Nepalese patients: a cross-sectional study
Abstract
Dengue remains a major global health concern, with rising incidence and severity in endemic regions. Liver involvement, particularly elevated transaminases such as aspartate aminotransferase (AST) and alanine aminotransferase (ALT), is frequently observed during infection. However, previous studies report inconsistent associations between transaminase elevation and severe dengue, particularly across diverse geographical settings. This study investigates the relationship between liver enzyme elevation and dengue severity in Nepalese patients, leveraging a pre-existing dataset to assess their potential as biomarkers for severe disease. A cross-sectional study was conducted among 325 laboratory-confirmed dengue patients at a four tertiary care hospitals in Koshi province Nepal. Liver enzyme levels (AST and ALT) were categorized based on the upper limit of normal (AST > 48 U/L, ALT > 55 U/L), and dengue severity was classified according to the WHO 2009 guidelines. Associations between elevated transaminases and dengue with warning signs (DWS) were evaluated using Chi-square or Fisher’s exact test and multivariable logistic regression, adjusted for age and sex. Spearman’s rank correlations were performed to assess associations between liver enzyme level, clinical features, and disease severity. Multicollinearity was assessed using the variance inflation factor (VIF). Among the 325 dengue patients, 40.0% had dengue with warning signs (DWS). Elevated AST was significantly…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 325 participants or records.
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