Abstract
BACKGROUND: Liver enzyme abnormalities are early indicators of hepatic dysfunction and are increasingly observed in individuals with non-communicable diseases (NCDs). Globally, liver diseases cause approximately 2 million deaths every year (≈4% of all deaths). In Rwanda, data on liver health and its gender-based stratification among adults with NCDs are scarce. This study assessed the prevalence and gender-specific patterns of liver enzyme abnormalities in this population to inform targeted interventions. METHODS: A descriptive cross-sectional study was conducted at the NCD outpatient clinic of the University Teaching Hospital of Butare (CHUB), involving 185 adult patients with documented NCDs. A structured and pretested questionnaire was used to collect sociodemographic, behavioral, and clinical data. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) were measured using the HumaLyzer 3500 semi-automated analyzer. Gender-stratified analyses were performed to assess prevalence and clustering of liver enzyme abnormalities. RESULTS: Out of the 185 participants, liver enzyme abnormalities were observed in 51 (27.6%), with isolated GGT elevation being the most common pattern (18, 9.7%). Females exhibited significantly higher De Ritis ratios with median = 1.04, interquartile range (IQR) = 0.83-1.4, p = 0.019. Females showed relatively elevated GGT levels, possibly linked to non-alcoholic fatty liver disease or environmental exposures. CONCLUSION: Liver enzyme abnormalities are prevalent among older Rwandan adults with NCDs, with gender and occupational disparities. These findings underscore the need to integrate liver health into NCD care strategies in Rwanda.