Clinical Significance of Serum Adiponectin and Resistin Levels in Liver Cirrhosis.

INTRODUCTION: Adiponectin and resistin levels are increased in patients with cirrhosis, but it prognostic significance is unknown. We sought to investigate the factors associated with adiponectin and resistin levels and its clinical significance in patients with cirrhosis. MATERIALS AND METHODS: This was a prospective cohort study that included 122 subjects with cirrhosis who attended an outpatient clinic and were initially evaluated in 2012. Serum adiponectin and resistin levels were measured in samples collected in 2012 (adiponectin and resistin) and 2014 (adiponectin). Thirty healthy subjects served as a control group. RESULTS: Higher adiponectin (21.59 µ g/mL vs. 12.52 µg/mL, P < 0.001) and resistin levels (3.83 ng/mL vs. 2.66 ng/mL, P < 0.001) were observed among patients with cirrhosis compared to controls. Patients classified as Child-Pugh B/C had higher adiponectin levels in relation to Child-Pugh A patients. At second measurement, adiponectin levels increased significantly in non-transplant patients and decreased in liver transplant recipients. Univariate Cox analysis showed that among patients with alcoholic liver disease, adiponectin levels were associated with lower transplant-free survival (HR = 1.034, 95% CI 1.006 - 1.062, P = 0.016). The transplant-free survival was significantly lower among patients with alcoholic liver disease and adiponectin ≥ 17 µg/mL (26.55 months, 95% CI 21.40-31.70) as compared to those with levels < 17 µg/mL (33.76 months, 95% CI 30.70-36.82) (P = 0.045). No relationship was found between the levels of resistin and survival. CONCLUSION: Adiponectin but not resistin levels were associated with intensity of liver dysfunction and worse prognosis in patients with alcoholic liver disease, suggesting a potential as a prognostic biomarker.

Study on mechanism of total flavonoids from hemerocallis fulva on oxidative stress and hepatocyte apoptosis in alcoholic liver injury / 重庆医学

Objective To study the influence of total flavonoids of hemerocallis fulva(TFHF) on hepatocyte apoptosis and related protein expression in mice with alcoholic hepatic injury.Methods A total of 40 mice were randomly divided into four groups:blank control,model control andsmall and high dose TFHF groups,10 cases in each group.The mice were given the continuous gavage administration for 7 d.Then the model group was given once gavage by 50％ ethanol 12.0 mL/kg after 1 h of the last administration.The blank control group was given the equal volume of distilled water.The activity levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum as well as the superoxide dismutase(SOD) activity and malondialdehyde (MDA) content in liver tissue hemogenate were detected.Hematoxylin and Eosin(HE) staining was performed for observing the pathological changes of the liver tissue.The flow cytometer was used to test the apoptosis ratio in hepatocyte suspension.The expressions of caspase-3,Bcl-2 and Bax protein were detected by Western blot.Results The various TFHF groups could decrease the activities of ALT and AST in serum (P＜0.05),while could decrease the MDA content in liver tissue hemogenate (P＜0.01) and increased the SOD activity;the liver tissue pathological examination showed that the high dose TFHF group could make the liver cell degeneration,alleviated the necrosis degree and relieved the pathological change of hepatic tissue;compared with the model group,the hepatocyte apoptosis rate in each TFHF group was decreased significantly;Western blotting results showed that the caspase-3 protein level in each TFHF group was decreased,expression of Bcl-2 protein was increased,whereas which of Bax protein was decreased and Bax/Bcl-2 ratio was reduced.Conclnsion TFHF has obvious protective effect on mice acute hepatic injury induced by ethanol,and can inhibit the hepatocyte apptosis,its action mechanism may be related to its antioxidation and regulation of caspase-3,Bcl-2 and Bax expression.

Protection of Qimei Fermented Beverage against alcohol-induced liver injury in mice / 重庆医学

Objective To explore the protective effect of Qimei Fermented Beverage against alcohol‐induced liver injury in mice .Methods Alcohol‐induced liver injury mouse model was established by continuously intragastric administration .Totally 60 male mice were randomly divided into five groups ,blank control group ,model group ,low ,middle and high doses groups(adding 5 , 25 ,50 mL/kg Qimei Fermented Beverage) .After continuous intragastric administration for 9 weeks ,the levels of serum aspartate transaminases(AST ) and alanine transaminases (ALT ) were detected in each group ,moreover the levels of malondialdehyde (MDA) ,triglyceride(TG) ,glutathione(GSH) and alcohol dehydrogenase(ADH) ,aldehyde dehydrogenase (ALDH) of liver ho‐mogenate ,and liver index change were measured .Liver histopathological changes were observed .Results The alcohol‐induced liver injury model in mice was successfully established .Compared wit model group ,different doses groups of Qimei Fermented Beverage could effectively reduce the levels of serum AST ,ALT and liver tissue TG ,increased the levels of ADH ,ALDH ,GSH .In addition , the pathological examination results of liver were consistent with those in enzymology .Conclusion Qimei Fermented Beverage has certain protective effect against alcohol‐induced liver injury and can obviously improve the alcohol‐induced liver injury .

Clinical characteristics and prognostic impact of bacterial infection in hospitalized patients with alcoholic liver disease.

Bacterial infection is an important cause of death in patients with liver cirrhosis. The aim of this study was to investigate the clinical characteristics and prognostic impact of bacterial infection in hospitalized patients with alcoholic liver disease (ALD). We retrospectively analyzed data from 409 patients consecutively admitted to a tertiary referral center with ALD diagnosis. Of a total of 544 admissions, 133 (24.4%) cases presented with bacterial infection, of which 116 were community-acquired whereas 17 were hospital-acquired. The common types of infection were pneumonia (38%), biliary tract infection (17%), soft tissue infection (12%), and spontaneous bacterial peritonitis (9%). Diabetes, serum Na <135 mM/L, albumin <2.5 g/dL, C-reactive protein ≥20 mg/L, systemic inflammatory response syndrome (SIRS) positivity were independently associated with bacterial infection in patients with ALD. Overall 30-day and 90-day mortalities in patients with bacterial infection were significantly (P < 0.001) higher than those without infection (22.3% vs. 5.1% and 32.3% vs. 8.2%, respectively). Furthermore, bacterial infection (HR, 2.2; 95% CI, 1.049-4.579, P = 0.037), SIRS positivity (HR, 2.5; 95% CI, 1.240-4.861, P = 0.010), Maddrey's discriminant function score ≥32 (HR, 2.3; 95% CI, 1.036-5.222, P = 0.041), and hemoglobin <12 g/dL (HR, 2.4; 95% CI, 1.081-5.450, P = 0.032) were independent predictors of short-term mortality. In conclusion, bacterial infection and SIRS positivity predicted short-term prognosis in hospitalized patients with ALD. A thorough evaluation at admission or on clinical deterioration is required to detect possible infection with prompt management.

Clinical Characteristics and Prognostic Impact of Bacterial Infection in Hospitalized Patients with Alcoholic Liver Disease

Bacterial infection is an important cause of death in patients with liver cirrhosis. The aim of this study was to investigate the clinical characteristics and prognostic impact of bacterial infection in hospitalized patients with alcoholic liver disease (ALD). We retrospectively analyzed data from 409 patients consecutively admitted to a tertiary referral center with ALD diagnosis. Of a total of 544 admissions, 133 (24.4%) cases presented with bacterial infection, of which 116 were community-acquired whereas 17 were hospital-acquired. The common types of infection were pneumonia (38%), biliary tract infection (17%), soft tissue infection (12%), and spontaneous bacterial peritonitis (9%). Diabetes, serum Na or =20 mg/L, systemic inflammatory response syndrome (SIRS) positivity were independently associated with bacterial infection in patients with ALD. Overall 30-day and 90-day mortalities in patients with bacterial infection were significantly (P or =32 (HR, 2.3; 95% CI, 1.036-5.222, P = 0.041), and hemoglobin <12 g/dL (HR, 2.4; 95% CI, 1.081-5.450, P = 0.032) were independent predictors of short-term mortality. In conclusion, bacterial infection and SIRS positivity predicted short-term prognosis in hospitalized patients with ALD. A thorough evaluation at admission or on clinical deterioration is required to detect possible infection with prompt management.

The relationship between serum leptin and fibrosis in patients with chronic hepatitis B incorporate alcoholic liver disease / 中国基层医药

Objective To study the relationship between serum leptin and fibrosis in chronic hepatitis B incorporate alcoholic liver disease(CHB + ALD) patients.Methods Select 17 male patients with CHB+ALD,15 male patients with liver cirrhosis(LC) ,19 male patients with chronic hepatitis B(CHB) and 12 male healthy persons as normal control(NC).Serum leptin is detected by ELISA in 63 patients.Serum levels of fibrosis markers(HA,LN,PC HI ,IV-C) are determined at the same time.Results Serum leptin level in CHB +ALD are significantly higher than those of the NC(6.79±24.12) μg/L vs (4.27±7.18 ) μg/L (P＜0.05).There is no significant difference between patients with CHB and the NC.The four fibrosis markers in CHB + ALD patients are significantly higher than that of men both in the CHB and the NC.There are significant correlations between both serum leptin level and quadrinomial fibrosis markers(P＜0.05 or P＜0.01 ).Conclusion That serum leptin level is one aecelerate gene in the fibrosis formation in patients with CHB+ALD.

Study on the association between CYP2E1 enzymes and susceptibility of alcoholic liver disease / 中国实用内科杂志

Objective To investigate the correlation between the CYP2E1 enzymes and alcoholic liver disease.Methods Polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)method was used to determine polymorphism of CYP2E1.A case control study of 183 subjects was carried out including 40 cases of alcoholic liver disease,40 alcohol dependent group,40 nonalcoholic liver disease and 63 controls.Results The frequency of B genotype or C2 allele gene was significantly higher in alcoholic liver disease than in control(P