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1.
Front Endocrinol (Lausanne) ; 15: 1396347, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38836232

RESUMO

Background: Associations of liver function with the risk of gestational diabetes mellitus (GDM) remain unclear. This study aimed to examine the relationship and the potential causality between maternal liver biomarkers and the risk of subsequent GDM, as well as to evaluate the interaction between liver biomarkers and lipids on GDM risk. Methods: In an ongoing Zhoushan Pregnant Women Cohort, pregnant women who finished the first prenatal follow-up record, underwent liver function tests in early pregnancy, and completed the GDM screening were included in this study. Logistic regression models were used to investigate the association, and the inverse-variance weighted method supplemented with other methods of two-sample Mendelian randomization (MR) analysis was applied to deduce the causality. Results: Among 9,148 pregnant women, 1,668 (18.2%) developed GDM. In general, the highest quartile of liver function index (LFI), including ALT, AST, GGT, ALP, and hepatic steatosis index, was significantly associated with an increased risk of GDM (OR ranging from 1.29 to 3.15), especially an elevated risk of abnormal postprandial blood glucose level. Moreover, the causal link between ALT and GDM was confirmed by the MR analysis (OR=1.28, 95%CI:1.05-1.54). A significant interaction between AST/ALT and TG on GDM risk was observed (P interaction = 0.026). Conclusion: Elevated levels of LFI in early pregnancy were remarkably associated with an increased risk of GDM in our prospective cohort. Besides, a positive causal link between ALT and GDM was suggested.


Assuntos
Biomarcadores , Diabetes Gestacional , Fígado , Análise da Randomização Mendeliana , Humanos , Feminino , Gravidez , Diabetes Gestacional/epidemiologia , Diabetes Gestacional/sangue , Diabetes Gestacional/genética , Adulto , Estudos Prospectivos , Biomarcadores/sangue , Fígado/metabolismo , Fatores de Risco , Testes de Função Hepática , Estudos de Coortes , Alanina Transaminase/sangue
2.
Biomed Environ Sci ; 37(5): 494-502, 2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38843922

RESUMO

Objective: To explore characteristics of clinical parameters and cytokines in patients with drug-induced liver injury (DILI) caused by different drugs and their correlation with clinical indicators. Method: The study was conducted on patients who were up to Review of Uncertainties in Confidence Assessment for Medical Tests (RUCAM) scoring criteria and clinically diagnosed with DILI. Based on Chinese herbal medicine, cardiovascular drugs, non-steroidal anti-inflammatory drugs (NSAIDs), anti-infective drugs, and other drugs, patients were divided into five groups. Cytokines were measured by Luminex technology. Baseline characteristics of clinical biochemical indicators and cytokines in DILI patients and their correlation were analyzed. Results: 73 patients were enrolled. Age among five groups was statistically different ( P = 0.032). Alanine aminotransferase (ALT) ( P = 0.033) and aspartate aminotransferase (AST) ( P = 0.007) in NSAIDs group were higher than those in chinese herbal medicine group. Interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) in patients with Chinese herbal medicine (IL-6: P < 0.001; TNF-α: P < 0.001) and cardiovascular medicine (IL-6: P = 0.020; TNF-α: P = 0.001) were lower than those in NSAIDs group. There was a positive correlation between ALT ( r = 0.697, P = 0.025), AST ( r = 0.721, P = 0.019), and IL-6 in NSAIDs group. Conclusion: Older age may be more prone to DILI. Patients with NSAIDs have more severe liver damage in early stages of DILI, TNF-α and IL-6 may partake the inflammatory process of DILI.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas , Citocinas , Humanos , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Masculino , Feminino , Pessoa de Meia-Idade , Citocinas/sangue , Citocinas/metabolismo , Adulto , Idoso , Anti-Inflamatórios não Esteroides/efeitos adversos , Medicamentos de Ervas Chinesas/efeitos adversos , Alanina Transaminase/sangue
3.
BMC Cardiovasc Disord ; 24(1): 294, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38849721

RESUMO

BACKGROUND: The incidence of hypertension (HTN) as a worldwide health problem is rising rapidly. Early identification and management of pre-HTN before HTN development can help reduce its related complications. We evaluated the relationship between liver enzymes levels and pre-HTN/HTN in the Azar cohort population. METHOD: This cross-sectional study was based on data from the large Azar cohort study and a total of 14,184 participants were included. Pre-HTN and HTN were defined based on the American Heart Association guideline. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT) levels were measured by Pars Azmoon kits. The relationship between pre-HTN/HTN and liver enzyme levels was evaluated by logistic regression. RESULTS: Of 14,184 participants, 5.7% and 39.6% had pre-HTN and HTN, respectively. In the adjusted model, AST levels of 19-23 IU/l were associated with an elevated risk of pre-HTN (OR [95% CI]: 1.24 [1.04-1.48]). A dose-response increase was seen in pre-HTN in relation to ALT, with the highest OR in the third tertile (1.34 [1.09-1.63]). The odds of pre-HTN also increased with GGT in the third tertile (1.25[1.03-1.52]). In addition, the odds of HTN increased with increased levels of AST, ALT, ALP, and GGT, such that the highest ORs were recorded in the third tertile (OR 1.22 [1.09-1.37], 1.51 [1.35-1.70], 1.19 [1.07-1.34], and 1.68 [1.49-1.89], respectively). Among these enzymes, GGT had the highest OR regarding HTN. CONCLUSION: This study indicates that AST, ALT, ALP and GGT levels were associated with pre-HTN (except for ALP) and HTN, independent of known risk factors. Hence, it may be possible to use liver enzymes to predict the incidence of pre-HTN and HTN, empowering primary care providers to make the necessary interventions promptly.


Assuntos
Alanina Transaminase , Fosfatase Alcalina , Aspartato Aminotransferases , Biomarcadores , Pressão Sanguínea , Hipertensão , Fígado , Pré-Hipertensão , gama-Glutamiltransferase , Humanos , Masculino , Hipertensão/epidemiologia , Hipertensão/diagnóstico , Hipertensão/enzimologia , Hipertensão/sangue , Feminino , Estudos Transversais , Pessoa de Meia-Idade , Alanina Transaminase/sangue , gama-Glutamiltransferase/sangue , Biomarcadores/sangue , Fosfatase Alcalina/sangue , Fatores de Risco , Adulto , Aspartato Aminotransferases/sangue , Fígado/enzimologia , Medição de Risco , Pré-Hipertensão/enzimologia , Pré-Hipertensão/epidemiologia , Pré-Hipertensão/diagnóstico , Pré-Hipertensão/sangue , Pré-Hipertensão/fisiopatologia , Ensaios Enzimáticos Clínicos , Incidência , Valor Preditivo dos Testes
4.
BMC Pregnancy Childbirth ; 24(1): 413, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38849722

RESUMO

BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is associated with an increased risk of adverse fetal outcomes, yet its influence on offspring growth remains unclear. Our study dynamically tracks growth rates in children from ICP and healthy mothers and investigates the link between maternal liver function and developmental abnormalities in offspring. METHOD: Our case‒control study involved 97 women with ICP and 152 with uncomplicated pregnancies nested in a cohort of their offspring, including 50 from the ICP group and 87 from the uncomplicated pregnancy group. We collected pediatric growth and development data, with a maximum follow-up duration of 36 months. Stratified analyses of children's height, weight, and head circumference were conducted, and Spearman's rank correlation was applied to examine the relationships between maternal serological markers and pediatric growth metrics. RESULT: Maternal liver and renal functions, along with serum lipid profiles, significantly differed between the ICP and normal groups. In the ICP group, the offspring showed elevated alanine aminotransferase (ALT), direct bilirubin (DBIT), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and apolipoprotein B (APOB) levels. Notably, the length-for-age z score (LAZ), weight-for-age z score (WAZ), and head circumference-for-age z score (HCZ) were lower in ICP offspring compared with those from normal pregnancies within the 1- to 12-month age range (P < 0.05). However, no significant differences in LAZ, weight-for-length z score (WLZ), BMI-for-age z score (BAZ), or HCZ were observed between groups in the 13- to 36-month age range. Maternal maximum lactate dehydrogenase (LDH) and total bile acids (TBA) levels during pregnancy were inversely correlated with LAZ and WAZ in the first year. Furthermore, offspring of mothers with ICP exhibited a greater incidence of stunting (24% vs. 6.9%, P = 0.004) and abnormal HCZ (14% vs. 3.7%, P = 0.034). CONCLUSIONS: Growth disparities in offspring of ICP-affected pregnancies were most significant within the 1- to 12-month age range. During this period, maximum maternal LDH and TBA levels were negatively correlated with LAZ and WAZ values of offspring. The observation of similar growth rates between ICP and control group offspring from 13 to 36 months suggested catch-up growth in the ICP group.


Assuntos
Colestase Intra-Hepática , Complicações na Gravidez , Humanos , Feminino , Colestase Intra-Hepática/sangue , Colestase Intra-Hepática/epidemiologia , Gravidez , Complicações na Gravidez/sangue , Complicações na Gravidez/epidemiologia , Estudos de Casos e Controles , Adulto , Desenvolvimento Infantil/fisiologia , Pré-Escolar , Efeitos Tardios da Exposição Pré-Natal , Lactente , Estudos de Coortes , Alanina Transaminase/sangue , Estatura , Masculino , Bilirrubina/sangue , Testes de Função Hepática
5.
J Med Virol ; 96(6): e29723, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38828911

RESUMO

Hepatitis B virus (HBV) can be completely suppressed after antiviral treatment; however, some patients with chronic hepatitis B (CHB) exhibit elevated alanine aminotransferase (ALT) levels and sustained disease progression. This study provides novel insights into the mechanism and potential predictive biomarkers of persistently elevated ALT (PeALT) in patients with CHB after complete viral inhibition. Patients having CHB with undetectable HBV DNA at least 12 months after antiviral treatment were enrolled from a prospective, observational cohort. Patients with PeALT and persistently normal ALT (PnALT) were matched 1:1 using propensity score matching. Correlations between plasma metabolites and the risk of elevated ALT were examined using multivariate logistic regression. A mouse model of carbon tetrachloride-induced liver injury was established to validate the effect of key differential metabolites on liver injury. Of the 1238 patients with CHB who achieved complete viral suppression, 40 (3.23%) had PeALT levels during follow-up (median follow-up: 2.42 years). Additionally, 40 patients with PnALT levels were matched as controls. Ser-Phe-Ala, Lys-Ala-Leu-Glu, 3-methylhippuric acid, 3-methylxanthine, and 7-methylxanthine were identified as critical differential metabolites between the two groups and independently associated with PeALT risk. Ser-Phe-Ala and Lys-Ala-Leu-Glu levels could be used to discriminate patients with PeALT from those with PnALT. Furthermore, N-acetyl- l-methionine (NALM) demonstrated the strongest negative correlation with ALT levels. NALM supplementation alleviated liver injury and hepatic necrosis induced by carbon tetrachloride in mice. Changes in circulating metabolites may contribute to PeALT levels in patients with CHB who have achieved complete viral suppression after antiviral treatment.


Assuntos
Alanina Transaminase , Antivirais , Biomarcadores , Hepatite B Crônica , Humanos , Hepatite B Crônica/tratamento farmacológico , Hepatite B Crônica/sangue , Hepatite B Crônica/virologia , Masculino , Feminino , Alanina Transaminase/sangue , Antivirais/uso terapêutico , Adulto , Estudos Prospectivos , Pessoa de Meia-Idade , Biomarcadores/sangue , Animais , Camundongos , Vírus da Hepatite B , Resposta Viral Sustentada , DNA Viral/sangue , Modelos Animais de Doenças , Fígado/patologia , Fígado/virologia , Carga Viral
6.
Adv Mind Body Med ; 28(2): 4-9, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38837776

RESUMO

Objective: The present study aims to explore whether there is a relationship between the levels of alanine transaminase (ALT) and aspartate transaminase (AST) enzymes and physical activity and diet from the perspective of Iranian traditional medicine to achieve enzymatic balance. Method: The research design is quasi-experimental with three experimental groups and one control group, and includes pre-test and post-test assessments. The sample population consisted of 60 young men aged between 20-40 years attending Asou Sports Club in Ahvaz, who were randomly divided into four 15-member groups, including aerobic exercise, nutrition, combined aerobic exercise and nutrition, and control. The aerobic group received eight weeks of moderate-intensity aerobic exercise, consisting of 3 sessions per week, each lasting 45 minutes at 64%-76% of maximum heart rate. Participants were recommended to take mood assessment tests and a personalized diet plan. Individuals with a cold temperament were eligible to participate in the study. The exercise and nutrition group received both interventions, while the control group received no intervention. Blood levels of ALT and AST were measured at a laboratory. Descriptive indices and statistical tests such as multiple and multivariate covariate analyses were used to analyze the data. Results: The results showed that eight weeks of moderate-intensity aerobic exercise and nutrition with traditional Iranian medicine approach had a significant effect on ALT and AST levels in young boys, resulting in an improved regulation of these enzymes (P < .05). Conclusion: The implementation of dietary restrictions and substitutes, along with appropriate aerobic activities, can be effective in regulating liver enzymes.


Assuntos
Alanina Transaminase , Aspartato Aminotransferases , Exercício Físico , Humanos , Masculino , Exercício Físico/fisiologia , Aspartato Aminotransferases/sangue , Irã (Geográfico) , Adulto Jovem , Alanina Transaminase/sangue , Adulto , Fígado , Medicina Tradicional/métodos
7.
Transpl Int ; 37: 12864, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38832357

RESUMO

Simultaneous pancreas-kidney (SPK) transplantation improves quality of life and limits progression of diabetic complications. There is reluctance to accept pancreata from donors with abnormal blood tests, due to concern of inferior outcomes. We investigated whether donor amylase and liver blood tests (markers of visceral ischaemic injury) predict pancreas graft outcome using the UK Transplant Registry (2016-2021). 857 SPK recipients were included (619 following brainstem death, 238 following circulatory death). Peak donor amylase ranged from 8 to 3300 U/L (median = 70), and this had no impact on pancreas graft survival when adjusting for multiple confounders (aHR = 0.944, 95% CI = 0.754-1.81). Peak alanine transaminases also did not influence pancreas graft survival in multivariable models (aHR = 0.967, 95% CI = 0.848-1.102). Restricted cubic splines were used to assess associations between donor blood tests and pancreas graft survival without assuming linear relationships; these confirmed neither amylase, nor transaminases, significantly impact pancreas transplant outcome. This is the largest, most statistically robust study evaluating donor blood tests and transplant outcome. Provided other factors are acceptable, pancreata from donors with mild or moderately raised amylase and transaminases can be accepted with confidence. The use of pancreas grafts from such donors is therefore a safe, immediate, and simple approach to expand the donor pool to reach increasing demands.


Assuntos
Amilases , Sobrevivência de Enxerto , Transplante de Rim , Transplante de Pâncreas , Doadores de Tecidos , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Amilases/sangue , Estudos de Coortes , Alanina Transaminase/sangue , Reino Unido , Testes Hematológicos , Sistema de Registros
8.
Virol J ; 21(1): 127, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38835029

RESUMO

BACKGROUND: The association of hepatitis B virus (HBV) DNA levels and liver fibrosis in chronic hepatitis B (CHB) patients with immune-tolerant phase remains unclear. We explored the association between liver fibrosis and HBV DNA levels in HBeAg-positive CHB patients with normal alanine transaminase (ALT) with relatively high HBV DNA. METHODS: Six hundred and twenty-two HBeAg-positive CHB patients with normal ALT were included. Patients were divided into three categories: low (6 log10 IU/mL ≤ HBV DNA < 7 log10 IU/mL), moderate (7 log10 IU/mL ≤ HBV DNA < 8 log10 IU/mL), and high (HBV DNA ≥ 8 log10 IU/mL). APRI, FIB-4, transient elastography, or liver biopsy were used to assess liver fibrosis. RESULTS: The median age of patients was 33.0 years and 57.9% patients were male. 18.8%, 52.1%, and 29.1% of patients had low, moderate, and high HBV DNA levels, respectively. The APRI (0.33 vs. 0.26 vs. 0.26, P < 0.001), FIB-4 (1.03 vs. 0.71 vs. 0.68, P < 0.001), and LSM values (7.6 kPa vs. 5.6 kPa vs. 5.5 kPa, P = 0.086) were higher in low HBV DNA group than other two groups. Low HBV DNA group had higher proportions of significant fibrosis (24.8% vs. 9.9% vs. 3.3%, P < 0.001) and cirrhosis (7.7% vs. 2.5% vs. 1.1%, P = 0.004) than moderate and high HBV DNA groups. Moderate (OR 3.095, P = 0.023) and low (OR 4.968, P = 0.003) HBV DNA were independent risk factors of significant fibrosis. CONCLUSION: Lower HBV DNA level was associated with more severe liver fibrosis in HBeAg-positive CHB patients with ALT.


Assuntos
Alanina Transaminase , DNA Viral , Antígenos E da Hepatite B , Vírus da Hepatite B , Hepatite B Crônica , Cirrose Hepática , Humanos , Hepatite B Crônica/complicações , Hepatite B Crônica/virologia , Hepatite B Crônica/patologia , Hepatite B Crônica/sangue , Masculino , Feminino , Adulto , Cirrose Hepática/virologia , Cirrose Hepática/sangue , Cirrose Hepática/patologia , DNA Viral/sangue , Alanina Transaminase/sangue , Antígenos E da Hepatite B/sangue , Vírus da Hepatite B/genética , Pessoa de Meia-Idade , Carga Viral , Adulto Jovem , Fígado/patologia , Fígado/virologia , Biópsia
9.
Front Endocrinol (Lausanne) ; 15: 1393859, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38854689

RESUMO

Background: Current guidelines for nonalcoholic fatty liver disease (NAFLD) recommend high volumes and/or intensities of physical activity (PA), the achievement of which generally requires participation in supervised exercise training programs that however are difficult to implement in routine clinical practice. Conversely, counselling interventions may be more suitable, but result in only modest increases in moderate-to-vigorous-intensity PA (MVPA). This study assessed whether a counseling intervention for increasing PA and decreasing sedentary time (SED-time) is effective in improving NAFLD markers in people with type 2 diabetes. Methods: Three-hundred physically inactive and sedentary patients were randomized 1:1 to receive one-month theoretical and practical counseling once-a-year (intervention group) or standard care (control group) for 3 years. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamyltranspeptidase (γGT) levels were measured and fatty liver index (FLI), hepatic steatosis index (HSI), and visceral adiposity index (VAI) were calculated. Total PA volume, light-intensity PA (LPA), moderate-to-vigorous-intensity PA (MVPA), and SED-time were objectively measured by an accelerometer. Results: Throughout the 3-year period, NAFLD markers did not change in the control group, whereas ALT, γGT, FLI, and HSI decreased in the intervention group, with significant between-group differences, despite modest MVPA increases, which however were associated with larger decrements in SED-time and reciprocal increments in LPA. Mean changes in NAFLD markers varied according to quartiles of (and correlated with) changes in MVPA (all markers) and SED-time, LPA, and PA volume (ALT, γGT, and HSI). Mean changes in MVPA or PA volume were independent predictors of changes in NAFLD markers. When included in the models, change in cardiorespiratory fitness and lower body muscle strength were independently associated with some NAFLD markers. Conclusion: A behavior change involving all domains of PA lifestyle, even if insufficient to achieve the recommended MVPA target, may provide beneficial effects on NAFLD markers in people with type 2 diabetes.


Assuntos
Alanina Transaminase , Aspartato Aminotransferases , Diabetes Mellitus Tipo 2 , Exercício Físico , Hepatopatia Gordurosa não Alcoólica , Comportamento Sedentário , Humanos , Diabetes Mellitus Tipo 2/terapia , Masculino , Feminino , Pessoa de Meia-Idade , Exercício Físico/fisiologia , Hepatopatia Gordurosa não Alcoólica/terapia , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Aspartato Aminotransferases/metabolismo , Fígado/metabolismo , Biomarcadores , Idoso , gama-Glutamiltransferase/sangue , gama-Glutamiltransferase/metabolismo
10.
Addict Sci Clin Pract ; 19(1): 49, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38872214

RESUMO

BACKGROUND: The 15-method is a targeted screening and treatment approach for alcohol problems in primary care. The 15-method used in primary care has proven as effective as specialized treatment for mild to moderate alcohol dependence in Sweden. A feasibility study of the 15-method in Danish primary care found the method acceptable and feasible. AIMS: To evaluate the effectiveness of the 15-method in a Danish primary care setting in (1) lowering the proportion of patients exceeding the Danish low-risk alcohol consumption limit of ten standard units per week and a maximum of four standard units on a single day for men and women, and (2) increasing the likelihood of alcohol use being addressed during a consultation in general practice. Further, the rate of prescribed pharmacological treatment for alcohol problems (Disulfiram, Naltrexone, Acamprosate, and Nalmefene) will be measured along with the use of the biomarkers Alanine Transaminase and Gamma-Glutamyl Transferase. METHODS: Stepped wedge cluster randomized controlled trial in sixteen general practices in the Region of Southern Denmark. Following a three-month baseline, the practices are randomly assigned to launch dates in one of four clusters. General practitioners and nurses receive three hours of training in the 15-method before launch. Patient questionnaires will collect data on alcohol consumption levels among patients affiliated with the practices. The healthcare professionals will register consultations in which alcohol is addressed in their patient filing system. Pharmacological treatment rates and the use of biomarkers will be collected through Danish national registries. The study follows the Medical Research Council's guidelines for developing and evaluating complex interventions. DISCUSSION: From the patient's perspective, the 15-method may help identify alcohol-related problems at an earlier stage with flexible treatment offers in a familiar setting. For healthcare professionals, it addresses a traditionally challenging topic by equipping them with concrete tools, communication training, and clear treatment directives. From a societal perspective, primary care holds a unique position to identify hazardous and harmful alcohol use across different age groups, with potential public health and economic benefits through early identification and intervention. TRIAL REGISTRATION: Clinicaltrials.gov NCT05916027. Retrospectively registered 22 June 2023.


Assuntos
Dissuasores de Álcool , Alcoolismo , Dissulfiram , Naltrexona , Atenção Primária à Saúde , Humanos , Atenção Primária à Saúde/organização & administração , Dinamarca , Naltrexona/uso terapêutico , Naltrexona/análogos & derivados , Alcoolismo/diagnóstico , Alcoolismo/tratamento farmacológico , Alcoolismo/terapia , Masculino , Feminino , Dissuasores de Álcool/uso terapêutico , Dissulfiram/uso terapêutico , Acamprosato/uso terapêutico , Adulto , Taurina/análogos & derivados , Taurina/uso terapêutico , Alanina Transaminase/sangue , gama-Glutamiltransferase/sangue , Pessoa de Meia-Idade , Programas de Rastreamento/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Eur J Sport Sci ; 24(6): 824-833, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38874978

RESUMO

We investigated the associations of low handgrip strength (HGS, i.e., a marker of muscular fitness) with liver fat content (LFC) and serum liver enzymes in a population-based setting. We used data from 2700 participants (51.7% women), aged 21-90 years, from two independent cohorts of the population-based Study of Health in Pomerania (SHIP-START-2 and SHIP-TREND-0). Cross-sectional, multivariable adjusted regression models were performed to examine the associations of HGS with LFC, measured by magnetic resonance imaging and serum liver enzymes. We found significant inverse associations of HGS with both LFC and serum liver enzymes. Specifically, a 10-kg lower HGS was associated with a 0.59% (95% confidence interval [CI]: 0.24-0.94; p = 0.001) higher LFC, a 0.051 µkatal/L (95% CI: 0.005-0.097; p = 0.031) higher gamma-glutamyltransferase (GGT) concentration and a 0.010 µkatal/L (95% CI: 0.001-0.020; p = 0.023) higher aspartate aminotransferase (AST) concentration. The adjusted odds-ratio for prevalent hepatic steatosis (defined by a MRI-PDFF ≥5.1%) per 10-kg lower HGS was 1.21 (95% CI: 1.04-1.40; p = 0.014). When considering only obese individuals, those with low HGS had a 1.58% (95% CI: 0.18-2.98; p = 0.027) higher mean LFC and higher chance of prevalent hepatic steatosis (adjusted OR 1.74, 95% CI: 1.15-2.62; p = 0.009) compared to individuals with high HGS. We found similar associations in individuals with overweight, but not in those with normal weight. Lower HGS was strongly associated with both higher LFC and higher serum GGT and AST concentrations. Future studies might clarify whether these findings reflect adverse effects of a sedentary lifestyle or aging on the liver.


Assuntos
Aspartato Aminotransferases , Força da Mão , Fígado , gama-Glutamiltransferase , Humanos , Pessoa de Meia-Idade , Feminino , Masculino , Adulto , Idoso , Estudos Transversais , Aspartato Aminotransferases/sangue , Fígado/enzimologia , Idoso de 80 Anos ou mais , gama-Glutamiltransferase/sangue , Adulto Jovem , Alemanha/epidemiologia , Imageamento por Ressonância Magnética , Comportamento Sedentário , Fígado Gorduroso/sangue , Alanina Transaminase/sangue
12.
Biochem Med (Zagreb) ; 34(2): 020707, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38882581

RESUMO

Introduction: We compared the quality control efficiency of artificial intelligence-patient-based real-time quality control (AI-PBRTQC) and traditional PBRTQC in laboratories to create favorable conditions for the broader application of PBRTQC in clinical laboratories. Materials and methods: In the present study, the data of patients with total thyroxine (TT4), anti-Müllerian hormone (AMH), alanine aminotransferase (ALT), total cholesterol (TC), urea, and albumin (ALB) over five months were categorized into two groups: AI-PBRTQC group and traditional PBRTQC group. The Box-Cox transformation method estimated truncation ranges in the conventional PBRTQC group. In contrast, in the AI-PBRTQC group, the PBRTQC software platform intelligently selected the truncation ranges. We developed various validation models by incorporating different weighting factors, denoted as λ. Error detection, false positive rate, false negative rate, average number of the patient sample until error detection, and area under the curve were employed to evaluate the optimal PBRTQC model in this study. This study provides evidence of the effectiveness of AI-PBRTQC in identifying quality risks by analyzing quality risk cases. Results: The optimal parameter setting scheme for PBRTQC is TT4 (78-186), λ = 0.03; AMH (0.02-2.96), λ = 0.02; ALT (10-25), λ = 0.02; TC (2.84-5.87), λ = 0.02; urea (3.5-6.6), λ = 0.02; ALB (43-52), λ = 0.05. Conclusions: The AI-PBRTQC group was more efficient in identifying quality risks than the conventional PBRTQC. AI-PBRTQC can also effectively identify quality risks in a small number of samples. AI-PBRTQC can be used to determine quality risks in both biochemistry and immunology analytes. AI-PBRTQC identifies quality risks such as reagent calibration, onboard time, and brand changes.


Assuntos
Controle de Qualidade , Humanos , Inteligência Artificial , Tiroxina/sangue , Hormônio Antimülleriano/sangue , Alanina Transaminase/sangue , Colesterol/sangue , Ureia/sangue , Laboratórios Clínicos
13.
Sci Rep ; 14(1): 13961, 2024 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-38886203

RESUMO

Metabolic dysfunction-associated steatotic liver disease (MASLD) is emerging globally as a significant problem. The mainstay of treatment is lifestyle intervention (LSI). We hypothesized that providing information regarding LSI and MASLD through a social media application generally used in the respective society would improve clinical outcomes in MASLD more than standard of care (SOC). This is a randomized controlled study in noncirrhotic MASLD patients aged 18-65 years in Thailand. Eligible patients were randomly assigned to either the control (SOC) or intervention arm. Patients in both groups received standard LSI advice. Infographics about MASLD and LSI information were sent to the intervention group every 3-7 days via the LINE official account. The outcomes are changes in liver steatosis and liver stiffness by FIBROSCAN at 24 weeks, as well as weight loss, body composition, and serum alanine aminotransferase (ALT) level between the two groups. A total of 122 patients were enrolled. The median age of eligible participants was 53 years, 64.7% were female, and median body mass index was 27.3 kg/m2. After a complete 24-week study period, both groups had an improvement in weight, ALT level, liver steatosis, and fat mass, but the differences in those changes between groups were not statistically significant. Interestingly, a significant improvement in liver stiffness was observed in the intervention group than in the control group (- 0.7 ± 1.8 kPa vs. 0.1 ± 2.4 kPa, P = 0.035). Encouraging LSI and delivering MASLD information via a social media application (LINE official account) to patients with MASLD demonstrated a better outcome of liver stiffness measurement than SOC.Clinical trial number: TCTR20210304002 (04/03/2021) ( http://www.thaiclinicaltrials.org/show/TCTR20210304002 ).


Assuntos
Smartphone , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Idoso , Estilo de Vida , Adulto Jovem , Adolescente , Fígado Gorduroso/terapia , Tailândia , Alanina Transaminase/sangue , Índice de Massa Corporal , Mídias Sociais , Resultado do Tratamento
14.
PLoS One ; 19(6): e0303583, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38843219

RESUMO

BACKGROUND: Thers is limited research examining modifiable cardiometabolic risk factors with a single-item health behavior question obtained during a clinic visit. Such information could support clinicians in identifying patients at risk for adverse cardiometabolic health. We investigated if children meeting physical activity or screen time recommendations, collected during clinic visits, have better cardiometabolic health than children not meeting recommendations. We hypothesized that children meeting either recommendation would have fewer cardiometabolic risk factors. METHODS AND FINDINGS: This cross-sectional study used data from electronic medical records (EMRs) between January 1, 2013 through December 30, 2017 from children (2-18 years) with a well child visits and data for ≥1 cardiometabolic risk factor (i.e., systolic and diastolic blood pressure, glycated hemoglobin, alanine transaminase, high-density and low-density lipoprotein, total cholesterol, and/or triglycerides). Physical activity and screen time were patient/caregiver-reported. Analyses included EMRs from 63,676 well child visits by 30,698 unique patients (49.3% female; 41.7% Black, 31.5% Hispanic). Models that included data from all visits indicated children meeting physical activity recommendations had reduced risk for abnormal blood pressure (odds ratio [OR] = 0.91, 95%CI 0.86, 0.97; p = 0.002), glycated hemoglobin (OR = 0.83, 95%CI 0.75, 0.91; p = 0.00006), alanine transaminase (OR = 0.85, 95%CI 0.79, 0.92; p = 0.00001), high-density lipoprotein (OR = 0.88, 95%CI 0.82, 0.95; p = 0.0009), and triglyceride values (OR = 0.89, 95%CI 0.83, 0.96; p = 0.002). Meeting screen time recommendations was not associated with abnormal cardiometabolic risk factors. CONCLUSION: Collecting information on reported adherence to meeting physical activity recommendations can provide clinicians with additional information to identify patients with a higher risk of adverse cardiometabolic health.


Assuntos
Fatores de Risco Cardiometabólico , Exercício Físico , Humanos , Feminino , Masculino , Adolescente , Criança , Estudos Transversais , Pré-Escolar , Registros Eletrônicos de Saúde/estatística & dados numéricos , Pressão Sanguínea , Hemoglobinas Glicadas/análise , Hemoglobinas Glicadas/metabolismo , Doenças Cardiovasculares/epidemiologia , Tempo de Tela , Fatores de Risco , Alanina Transaminase/sangue , Alanina Transaminase/metabolismo , Triglicerídeos/sangue
15.
Medicina (Kaunas) ; 60(5)2024 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-38792966

RESUMO

Background and Objectives: Erdosteine (Erd) is an antioxidant and anti-inflammatory drug. Vitamin B has been reported to exert anti-inflammatory and antioxidant effects. In this study, we investigated the effect of erdosteine and vitamin B complex on a liver ischemia/reperfusion (I/R) model. Materials and Methods: Thirty-two Wistar Albino male rats weighing 350-400 g were used. The animals were randomly selected and divided into four groups. The groups are as follows: first group (Sham), second group (I/R), third group (I/R + vit B), and fourth group (I/R + vit B + Erd). Rats were subjected to 45 min of hepatic ischemia, followed by a 45 min reperfusion period in the I/R and Vitamin B + Erd groups. An amount of 150 mg/kg/day of erdosteine was given orally for 2 days, and 0.05 mL/kg of i.p. vitamin B complex was given 30 min before the reperfusion. Serum biochemical parameters were measured. Serum Total Antioxidant Status (TAS) and Total Oxidant Status (TOS) were measured, and the Oxidative Stress Index (OSI) was calculated. Hepatic tissue samples were taken for the evaluation of histopathological features. Results: In terms of all histopathological parameters, there were significant differences in the I/R + vit B group and I/R + vit B + Erd group compared with the I/R group (p < 0.01). In terms of aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), TNF-alpha, and IL-6 levels, there were significant differences between the I/R group and treatment groups (p < 0.01). The lowest TOS and OSI levels were obtained in the treatment groups, and these groups had statistically significantly higher TAS levels compared with the sham and I/R groups (p < 0.01). Conclusions: As a preliminary experimental study, our study suggests that these agents may have potential diagnostic and therapeutic implications for both ischemic conditions and liver-related diseases. These results suggest that the combination of vit B + Erd may be used to protect against the devastating effects of I/R injury. Our study needs to be confirmed by clinical studies with large participation.


Assuntos
Antioxidantes , Modelos Animais de Doenças , Fígado , Estresse Oxidativo , Ratos Wistar , Traumatismo por Reperfusão , Tioglicolatos , Tiofenos , Animais , Tioglicolatos/uso terapêutico , Tioglicolatos/farmacologia , Traumatismo por Reperfusão/tratamento farmacológico , Masculino , Tiofenos/uso terapêutico , Tiofenos/farmacologia , Ratos , Fígado/efeitos dos fármacos , Fígado/metabolismo , Antioxidantes/uso terapêutico , Antioxidantes/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Complexo Vitamínico B/uso terapêutico , Complexo Vitamínico B/farmacologia , Aspartato Aminotransferases/sangue , Aspartato Aminotransferases/análise , Alanina Transaminase/sangue
16.
Cell Mol Biol (Noisy-le-grand) ; 70(5): 59-68, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38814234

RESUMO

Development of novel functional foods is trending as one of the hot topics in food science and food/beverage industries. In the present study, the anti-diabetic, anti-hyperlipidemic and histo-protective effects of the extra virgin olive oil (EVOO) enriched with the organosulfur diallyl sulfide (DAS) (DAS-rich EVOO) were evaluated in alloxan-induced diabetic mice. The ingestion of EVOO (500µL daily for two weeks) attenuated alloxan-induced elevated glucose, alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase, lactate dehydrogenase (LDH), urea and creatinine. It also normalized the levels of triglycerides (TG), total cholesterols (TC), low-density lipoprotein-cholesterol (LDL-c) and their consequent atherogenic index of plasma (AIP) in diabetic animals. Additionally, EVOO prevented lipid peroxidation (MDA) and reduced the level of hydrogen peroxide (H2O2) in diabetic animals. Concomitantly, it enhanced the activity of the antioxidant enzymes catalase (CAT), glutathione peroxidase (GPx) and superoxide dismutase (SOD), reducing thereby tissue oxidative stress injury. The overall histologic (pancreas, liver, and kidney) alterations were also improved after EVOO ingestion. The manifest anti-diabetic, lipid-lowering and histo-protective properties of EVOO were markedly potentiated with DAS-rich EVOO suggesting possible synergistic interactions between DAS and EVOO lipophilic bioactive ingredients. Overall, EVOO and DAS-rich EVOO show promise as functional foods and/or adjuvants for the treatment of diabetes and its complications.


Assuntos
Compostos Alílicos , Diabetes Mellitus Experimental , Hipoglicemiantes , Hipolipemiantes , Azeite de Oliva , Sulfetos , Animais , Azeite de Oliva/química , Azeite de Oliva/farmacologia , Diabetes Mellitus Experimental/tratamento farmacológico , Diabetes Mellitus Experimental/metabolismo , Compostos Alílicos/farmacologia , Compostos Alílicos/uso terapêutico , Sulfetos/farmacologia , Sulfetos/uso terapêutico , Sulfetos/química , Hipoglicemiantes/farmacologia , Hipoglicemiantes/uso terapêutico , Camundongos , Hipolipemiantes/farmacologia , Masculino , Antioxidantes/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Peroxidação de Lipídeos/efeitos dos fármacos , Glicemia/metabolismo , Glicemia/efeitos dos fármacos , Fígado/efeitos dos fármacos , Fígado/metabolismo , Fígado/patologia , Pâncreas/efeitos dos fármacos , Pâncreas/patologia , Pâncreas/metabolismo , Glutationa Peroxidase/metabolismo , Catalase/metabolismo , Peróxido de Hidrogênio/metabolismo , Superóxido Dismutase/metabolismo , Rim/efeitos dos fármacos , Rim/metabolismo , Rim/patologia , Alanina Transaminase/sangue , Alanina Transaminase/metabolismo , Aspartato Aminotransferases/metabolismo , Aspartato Aminotransferases/sangue , Triglicerídeos/sangue , Triglicerídeos/metabolismo
17.
Clin Res Hepatol Gastroenterol ; 48(6): 102369, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38719147

RESUMO

BACKGROUND AND AIM: Hepatitis B virus (HBV) infection presents with indicators of varying clinical significance. We aimed to evaluate the correlation among HBV Pre-S1 antigen (HBV PreS1-Ag), HBV e antigen (HBeAg), HBV DNA, and alanine aminotransferase (ALT) levels. METHODS: We retrospectively analyzed 6180 serum samples collected between 2020 and 2022 at the Shanghai General Hospital, China. Data regarding PreS1-Ag, HBeAg, ALT, and HBV DNA were compiled. Correlation analyses and cross-tabulations were employed to explore the diagnostic indicators. RESULTS: The detection rates of both antigen indicators showed a proportional increase with HBV DNA loads. The correlation between PreS1-Ag and HBV DNA (r = 0.616) was stronger than that between HBeAg and HBV DNA (r = 0.391). The specificity of PreS1-Ag (84.30 %) was lower than that of HBeAg (97.44 %), whereas the sensitivity of HBeAg (91.13 %) significantly surpassed that of PreS1-Ag (29.56 %). Among the HBV DNA positive patients, 92.04 % tested positive for at least one indicator, which exceeded the rate of PreS1+HBeAg- and PreS1-HBeAg+ (52. 28 % and 68. 56 %, respectively). Only 1.75 % of the patients exhibited double negativity, which was lower than the percentage of patients with single negativity (1.95 % and 12.00 % for PreS1-Ag and HBeAg, respectively). The PreS1 levels correlated with ALT levels (r = 0.317); patients with PreS1-positive status had higher ALT levels than patients with PreS1-negative status. CONCLUSION: PreS1-Ag is a more robust HBV replication indicator than HBeAg. PreS1-Ag displayed high sensitivity, whereas HBeAg demonstrated high specificity. Moreover, PreS1-Ag levels correlated with ALT levels. A combination of these indicators demonstrated dependable clinical value for detecting HBV infection and evaluating liver function.


Assuntos
Alanina Transaminase , DNA Viral , Antígenos de Superfície da Hepatite B , Antígenos E da Hepatite B , Vírus da Hepatite B , Humanos , Estudos Retrospectivos , Antígenos E da Hepatite B/sangue , DNA Viral/sangue , Alanina Transaminase/sangue , Feminino , Masculino , Antígenos de Superfície da Hepatite B/sangue , Adulto , Pessoa de Meia-Idade , Vírus da Hepatite B/genética , Vírus da Hepatite B/imunologia , Hepatite B/sangue , Hepatite B/diagnóstico , Adulto Jovem , Idoso , Precursores de Proteínas
18.
Cryobiology ; 115: 104904, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38734364

RESUMO

Increasing shortage of donor organs leads to the acceptance of less than optimal grafts for transplantation, up to and including organs donated after circulatory standstill of the donor. Therefore, protective strategies and pharmacological interventions destined to reduce ischemia induced tissue injury are considered a worthwhile focus of research. The present study evaluates the potential of a multidrug pharmacological approach as single flush at the end of static preservation to protect the liver from reperfusion injury. Livers were retrieved from male Wistar rats 20 min after cardiac standstill. The organs were cold stored for 18 h, flushed with 20 ml of saline, kept at room temperature for 20 min, and reperfused at 37 °C with oxygenated Williams E solution. In half of the cases, the flush solution was supplemented with a cocktail containing metformin, bucladesine and cyclosporin A. Upon reperfusion, treated livers disclosed a massive mitigation of hepatic release of alanine aminotransferase and aspartate aminotransferase, along with a significant approximately 50 % reduction of radical mediated lipid peroxidation, caspase activation and release of TNF-alpha. Even after preceding cold preservation, a pharmacological cocktail given as single flush is capable to mitigate manifestations of reperfusion injury in the present model.


Assuntos
Ciclosporina , Peroxidação de Lipídeos , Fígado , Preservação de Órgãos , Ratos Wistar , Traumatismo por Reperfusão , Fator de Necrose Tumoral alfa , Animais , Traumatismo por Reperfusão/prevenção & controle , Traumatismo por Reperfusão/tratamento farmacológico , Masculino , Ratos , Fígado/efeitos dos fármacos , Fígado/metabolismo , Fígado/irrigação sanguínea , Preservação de Órgãos/métodos , Ciclosporina/farmacologia , Peroxidação de Lipídeos/efeitos dos fármacos , Fator de Necrose Tumoral alfa/metabolismo , Metformina/farmacologia , Metformina/uso terapêutico , Alanina Transaminase/metabolismo , Alanina Transaminase/sangue , Aspartato Aminotransferases/metabolismo , Reaquecimento/métodos , Soluções para Preservação de Órgãos/farmacologia
19.
J Pak Med Assoc ; 74(4): 656-660, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38751257

RESUMO

Objectives: To ascertain the significance of serum ferritin and De Ritis ratio as diagnostic markers in patients of nonalcoholic fatty liver disease with and without type 2 diabetes mellitus. METHODS: The comparative cross-sectional study was conducted from February to October 2022 at the Radiology Department of Combined Military Hospital, Rawalpindi, Pakistan, and comprised individuals aged 30-65 who were divided into 3 groups. Healthy controls formed group I, non-alcoholic fatty liver disease patients without type 2 diabetes mellitus formed group II and non-alcoholic fatty liver disease patients with type 2 diabetes mellitus were in group III. Blood 5ml was withdrawn and assessed for alkaline phosphatase, aspartate transaminase, alanine transaminase and ferritin. De Ritis ratio was calculated and subjected to intergroup comparison. Data was analysed using SPSS 22. RESULTS: Of the 210 subjects, 110(52.4%) were males and 100(47.6%) were females, with 70(33.3%) in each of the three groups. Group I had 38(54.3%) females and 32(45.7%) males with mean age 37.50±4.513. In group II, there were 27(38.6%) females and 43(61.4%) males with mean age 45.86±9.646, while in group III there were 35(50%) females and 35(50%) males with mean age 54.01±9.243 years. Serum ferritin levels were significantly increased in patient groups II and III compared to control group I (p<0.05). De Ritis ratio was markedly raised in groups II and III compared to group I (p<0.05). Ferritin was significantly correlated to age, weight, height, fasting blood glucose, haemoglobin, alkaline phosphatase, aspartate aminotransferase, alanine transaminase and bilirubin (p<0.05). De Ritis ratio had a significant correlation with body mass index and fasting blood glucose (p<0.05). CONCLUSIONS: Serum ferritin and De Ritis ratio were found to be useful diagnostic indicators for non-alcoholic fatty liver disease, highlighting their importance in improving disease screening.


Assuntos
Alanina Transaminase , Aspartato Aminotransferases , Biomarcadores , Diabetes Mellitus Tipo 2 , Ferritinas , Hepatopatia Gordurosa não Alcoólica , Humanos , Ferritinas/sangue , Masculino , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Feminino , Pessoa de Meia-Idade , Adulto , Estudos Transversais , Biomarcadores/sangue , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Estudos de Casos e Controles , Fosfatase Alcalina/sangue , Idoso , Paquistão/epidemiologia
20.
Int J Immunopathol Pharmacol ; 38: 3946320241250286, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38764158

RESUMO

Background: Aluminum phosphide (AlP) poisoning is prevalent in numerous countries, resulting in high mortality rates. Phosphine gas, the primary agent responsible for AlP poisoning, exerts detrimental effects on various organs, notably the heart, liver and kidneys. Numerous studies have documented the advantageous impact of Coenzyme Q10 (CoQ10) in mitigating hepatic injuries. The objective of this investigation is to explore the potential protective efficacy of CoQ10 against hepatic toxicity arising from AlP poisoning. Method: The study encompassed distinct groups receiving almond oil, normal saline, exclusive CoQ10 (at a dosage of 100 mg/kg), AlP at 12 mg/kg; LD50 (lethal dose for 50%), and four groups subjected to AlP along with CoQ10 administration (post-AlP gavage). CoQ10 was administered at 10, 50, and 100 mg/kg doses via Intraparietal (ip) injections. After 24 h, liver tissue specimens were scrutinized for mitochondrial complex activities, oxidative stress parameters, and apoptosis as well as biomarkers such as aspartate transaminase (AST) and alanine transaminase (ALT). Results: AlP induced a significant decrease in the activity of mitochondrial complexes I and IV, as well as a reduction in catalase activity, Ferric Reducing Antioxidant Power (FRAP), and Thiol levels. Additionally, AlP significantly elevated oxidative stress levels, indicated by elevated reactive oxygen species (ROS) production, and resulted in the increment of hepatic biomarkers such as AST and ALT. Administration of CoQ10 led to a substantial improvement in the aforementioned biochemical markers. Furthermore, phosphine exposure resulted in a significant reduction in viable hepatocytes and an increase in apoptosis. Co-treatment with CoQ10 exhibited a dose-dependent reversal of these observed alterations. Conclusion: CoQ10 preserved mitochondrial function, consequently mitigating oxidative damage. This preventive action impeded the progression of heart cells toward apoptosis.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas , Fígado , Estresse Oxidativo , Fosfinas , Ubiquinona , Fosfinas/intoxicação , Ubiquinona/análogos & derivados , Ubiquinona/farmacologia , Ubiquinona/uso terapêutico , Doença Hepática Induzida por Substâncias e Drogas/prevenção & controle , Doença Hepática Induzida por Substâncias e Drogas/tratamento farmacológico , Doença Hepática Induzida por Substâncias e Drogas/metabolismo , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Animais , Estresse Oxidativo/efeitos dos fármacos , Masculino , Fígado/efeitos dos fármacos , Fígado/metabolismo , Fígado/patologia , Apoptose/efeitos dos fármacos , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Ratos , Aspartato Aminotransferases/sangue , Aspartato Aminotransferases/metabolismo , Compostos de Alumínio/toxicidade , Alanina Transaminase/sangue , Alanina Transaminase/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Ratos Wistar
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