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1.
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 Blood 5ml was withdrawn and assessed for alkaline phosphatase, aspartate transaminase, alanine transaminase and ferritin.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
2.
Pak J Pharm Sci ; 37(1(Special)): 199-203, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38747270

RESUMO

This study investigates the combined effect of vitamin C and chromium on BMI, lipid profile, LFTs and HbA1c of Diabetes Mellitus type 2 patients. This is randomized controlled trial study. For this study a total of 60 patients (n=28 female, n=32 male) Diabetes Mellitus type 2 patients were selected. They were divided into treatment group (vitamin C (500mg) Chromium (200µg) and control group (placebo) comprising thirty patients per group. Mean age in control group and treatment group is 33± 5.729 and 33±7.017 respectively. Statistical analysis showed significant results of lipid profile; total cholesterol (mg/dl) 198±66.1 P=0.008, High-Density Lipoprotein 38±7.5, P<0.001, Low Density Lipoprotein (LDL) (mg/dl) 105.1±22.4, P=0.002 and Triglycerides 191±64.3, P=0.02 are respectively. Levels of serum ALT (u/l) (34.7±9.1, P<0.001) and AST (u/l) (31.6 ±8.6, P<0.001) were significantly lower as compared to control group. HbA1c percentages were also normalized (5.45±0.2, P<.001) as compared to group 2. BMI values were also improved (P=0.01) after treatment. Combined supplementation of vitamin C and chromium reduce the plasma lipid percentage, blood glucose levels and also improve the ALT and AST functions.


Assuntos
Ácido Ascórbico , Índice de Massa Corporal , Cromo , Diabetes Mellitus Tipo 2 , Hemoglobinas Glicadas , Humanos , Feminino , Masculino , Ácido Ascórbico/uso terapêutico , Cromo/uso terapêutico , Adulto , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hemoglobinas Glicadas/metabolismo , Hiperglicemia/tratamento farmacológico , Hiperglicemia/sangue , Hiperlipidemias/tratamento farmacológico , Hiperlipidemias/sangue , Lipídeos/sangue , Fígado/efeitos dos fármacos , Fígado/enzimologia , Fígado/metabolismo , Glicemia/efeitos dos fármacos , Glicemia/metabolismo , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Pessoa de Meia-Idade
3.
BMC Gastroenterol ; 24(1): 161, 2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38741060

RESUMO

BACKGROUND AND AIMS: Portal vein thrombosis (PVT) is a common complication of liver cirrhosis that can aggravate portal hypertension. However, there are features of both PVT and cirrhosis that are not recapitulated in most current animal models. In this study, we aimed to establish a stable animal model of PVT and cirrhosis, intervene with anticoagulant, and explore the related mechanism. METHODS: First, 49 male SD rats received partial portal vein ligation (PPVL), and 44 survival rats were divided into 6 groups: PPVL control group; 4-week, 6 -week, 8-week, and 10-week model group; and the rivaroxaban (RIVA)-treated group. The rats were intoxicated with or without carbon tetrachloride (CCl4) for 4-10 weeks. Seven normal rats were used as the normal controls. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels and parameters for blood coagulation were all assayed with kits. Liver inflammation, collagen deposition and hydroxyproline (Hyp) levels were also measured. The extrahepatic macro-PVT was observed via portal vein HE staining, etc. The intrahepatic microthrombi was stained via fibrin immunohistochemistry. The portal blood flow velocity (PBFV) and diameter were detected via color Doppler ultrasound. Vascular endothelial injury was evaluated by von Willebrand Factor (vWF) immunofluorescence. Fibrinolytic activity was estimated by western blot analysis of fibrin and plasminogen activator inhibitor-1 (PAI-1). RESULTS: After PPVL surgery and 10 weeks of CCl4 intoxication, a rat model that exhibited characteristics of both cirrhosis and extra and intrahepatic thrombi was established. In cirrhotic rats with PVT, the PBFV decreased, both factors of pro- and anti-coagulation decreased, but with relative hypercoagulable state, vascular endothelial injured, and fibrinolytic activity decreased. RIVA-treated rats had improved coagulation function, increased PBFV and attenuated thrombi. This effect was related to the improvements in endothelial injury and fibrinolytic activity. CONCLUSIONS: A new rat model of PVT with cirrhosis was established through partial portal vein ligation plus CCl4 intoxication, with the characteristics of macrothrombi at portal veins and microthrombi in hepatic sinusoids, as well as liver cirrhosis. Rivaroxaban could attenuate PVT in cirrhosis in the model rats. The underlying mechanisms of PVT formation in the rat model and pharmacological action of rivaroxaban are related to the regulation of portal blood flow, coagulant factors, and vascular endothelial cell function.


Assuntos
Tetracloreto de Carbono , Modelos Animais de Doenças , Inibidores do Fator Xa , Veia Porta , Ratos Sprague-Dawley , Rivaroxabana , Trombose Venosa , Animais , Rivaroxabana/farmacologia , Masculino , Ligadura , Trombose Venosa/etiologia , Trombose Venosa/tratamento farmacológico , Ratos , Inibidores do Fator Xa/farmacologia , Cirrose Hepática/complicações , Cirrose Hepática Experimental/complicações , Fígado/metabolismo , Fígado/irrigação sanguínea , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue
4.
Eur Rev Med Pharmacol Sci ; 28(8): 3104-3111, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38708469

RESUMO

OBJECTIVE: Liver biopsy is the gold standard method to evaluate patients with non-alcoholic fatty liver disease (NAFLD). However, due to its several limitations and complications, a reliable and non-invasive marker is required to assess liver fibrosis. In this study, we compared the performance of the FIB-4 index [based on age, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) levels and platelets count] with the Scheuer scoring system of liver biopsies to evaluate the diagnostic utility of FIB-4 among NAFLD patients with different liver fibrosis severities. PATIENTS AND METHODS: A cross-sectional study was conducted at An-Najah National University Hospital (NNUH) in Palestine. The FIB-4 index was calculated using laboratory data for 128 NAFLD patients who underwent liver biopsies between November 2014 and July 2022. The results of FIB-4 were compared with the Scheuer scoring system of liver biopsies (using F0, F1+F2, F3+F4) to determine the sensitivity and specificity of FIB-4 in detecting and staging liver fibrosis. RESULTS: Out of 128 patients involved in our study, 49 of them had advanced fibrosis according to liver biopsy (F3+F4), where their FIB-4 indices showed 87% sensitivity at 1.45 cut off point and 87% specificity at 3.25 cut off point. CONCLUSIONS: The FIB-4 index may be used as a screening tool in the primary care setting. To raise awareness of liver diseases, this non-invasive, inexpensive, simple, and quick marker could identify people in need of further liver fibrosis evaluation and diagnosis.


Assuntos
Alanina Transaminase , Aspartato Aminotransferases , Cirrose Hepática , Hepatopatia Gordurosa não Alcoólica , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Biomarcadores/sangue , Biópsia , Estudos Transversais , Cirrose Hepática/diagnóstico , Cirrose Hepática/patologia , Cirrose Hepática/sangue , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/patologia , Hepatopatia Gordurosa não Alcoólica/sangue , Contagem de Plaquetas , Estudos Retrospectivos , Índice de Gravidade de Doença , Adolescente , Adulto Jovem , Idoso
5.
BMC Gastroenterol ; 24(1): 147, 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38724942

RESUMO

BACKGROUND: Metabolic-associated fatty liver disease (MAFLD) is defined as the occurrence of hepatic fat accumulation in patients with negligible alcohol consumption or any other cause of hepatic steatosis. This study aimed to correlate the ultrasound-based diagnosis of MAFLD with the histological diagnosis of nonalcoholic steatohepatitis (NASH) and alanine aminotransferase (ALT) levels in patients with MAFLD. METHODS: This was a hospital-based cross-sectional study of 71 patients with MAFLD diagnosed by ultrasound. Percutaneous liver biopsy was performed for histological evidence of NASH in all patients, regardless of liver function test (LFT) values, provided that they had no contraindications. Liver histology was graded using the NASH Clinical Research Network MAFLD Activity Score. The data obtained were entered into SPSS version 21 and analysed using descriptive and inferential statistics. The significance level was set at < 0.05. RESULTS: A total of 71 patients (26 males and 45 females) with MAFLD were included. Thirty-nine (76.5%) patients with MAFLD and normal ALT levels had NASH, while 14 (82.4%) had elevated ALT levels. There was no statistically significant difference in the histological grade of NASH between patients with normal and elevated ALT levels. A weak correlation was found between the severity of steatosis on ultrasound scan and NASH incidence (p = 0.026). The sensitivity and specificity of ALT levels for predicting NASH according to the area under the receiver operating characteristics (AUROC 0.590) at an ALT cut-off value of 27.5 IU/L were 55.8% and 64.7%, respectively. CONCLUSION: NASH can occur in patients with MAFLD, irrespective of alanine transaminase (ALT) levels, and ultrasound grading of the severity of steatosis cannot accurately predict NASH. Liver biopsy remains the investigation of choice.


Assuntos
Alanina Transaminase , Fígado , Hepatopatia Gordurosa não Alcoólica , Ultrassonografia , Humanos , Masculino , Feminino , Alanina Transaminase/sangue , Estudos Transversais , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/patologia , Hepatopatia Gordurosa não Alcoólica/sangue , Pessoa de Meia-Idade , Adulto , Fígado/patologia , Fígado/diagnóstico por imagem , Nigéria , Biópsia , Fígado Gorduroso/diagnóstico por imagem , Fígado Gorduroso/patologia , Fígado Gorduroso/sangue , Idoso , Índice de Gravidade de Doença , Curva ROC
6.
Zhonghua Gan Zang Bing Za Zhi ; 32(4): 325-331, 2024 Apr 20.
Artigo em Chinês | MEDLINE | ID: mdl-38733187

RESUMO

Objective: To analyze the hepatic tissue inflammatory activity and influencing factors in HBeAg-positive patients during normal alanine aminotransferase (ALT) and indeterminate phases so as to provide a basis for evaluating the disease condition. Methods: Patients with HBeAg-positive with normal ALT and HBV DNA levels below 2 × 10(7) IU/ml from January 2017 to December 2021 were selected as the study subjects. A histopathologic liver test was performed on these patients. Age, gender, time of HBV infection, liver function, HBsAg level, HBV DNA load, genotype, portal vein inner diameter, splenic vein inner diameter, splenic thickness, and others of the patients were collected. Significant influencing factors of inflammation were analyzed in patients using logistic regression analysis, and its effectiveness was evaluated using receiver operating characteristic (ROC) curves. Results: Of the 178 cases, there were 0 cases of inflammation in G0, 52 cases in G1, 101 cases in G2, 24 cases in G3, and one case in G4. 126 cases (70.8%) had inflammatory activity ≥ G2. Infection time (Z=-7.138, P<0.001), γ-glutamyltransferase (t =-2.940, P=0.004), aspartate aminotransferase (t =-2.749, P=0.007), ALT (t =-2.153, P=0.033), HBV DNA level (t =-4.771, P=0.010) and portal vein inner diameter (t =-4.771, P<0.001) between the ≥G2 group and < G2 group were statistically significantly different. A logistic regression analysis showed that significant inflammation in liver tissue was independently correlated with infection time [odds ratio (OR)=1.437, 95% confidence interval (CI): 1.267-1.630; P<0.001)] and portal vein inner diameter (OR=2.738, 95% CI: 1.641, 4.570; P<0.001). The area under the curve (AUROC), specificity, and sensitivity for infection time and portal vein inner diameter were 0.84, 0.71, 0.87, 0.72, 0.40, and 0.95, respectively. Conclusion: A considerable proportion of HBeAg-positive patients have inflammation grade ≥G2 during normal ALT and indeterminate phases, pointing to the need for antiviral therapy. Additionally, inflammatory activity has a close association with the time of infection and portal vein inner diameter.


Assuntos
Alanina Transaminase , Antígenos E da Hepatite B , Vírus da Hepatite B , Fígado , Humanos , Fígado/patologia , Alanina Transaminase/sangue , Antígenos E da Hepatite B/sangue , Inflamação , DNA Viral , Masculino , Hepatite B Crônica/patologia , Feminino , Modelos Logísticos , Curva ROC , Veia Porta , Hepatite B , gama-Glutamiltransferase/sangue , Adulto
7.
Endocrinol Diabetes Metab ; 7(3): e490, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38769719

RESUMO

OBJECTIVE: This study aimed to investigate whether polycystic ovary syndrome (PCOS) status changes the association between insulin resistance (IR) indices and liver function parameters among women. METHODS: This is a cross-sectional, population-based study. We selected 1101 subjects aged ≥20 years from participants of Tehran Lipid and Glucose Study (TLGS). All of them had known the status of PCOS, and all variables were related to the IR indices and liver function parameters. The main outcome measures were TG/HDL-C and triglyceride-glucose (TyG) and liver function parameters (hepatic steatosis index [HSI], alanine transaminase [ALT] and aspartate transaminase [AST]). RESULT: In the present study, there was no significant difference between the PCOS and the non-PCOS regarding the presence of liver function abnormalities. A model adjusted by age and BMI showed that the upper tertile of TyG index was positively associated with high AST (OR = 3.04 [95% CI: 1.20-7.68], p < 0.05), high ALT (4.76 [3.07-7.36], p < 0.05) and high HSI (8.44 [1.82-39.17], p < 0.05). Although the history of diabetes had a positive impact on elevated AST (1.66 [1.15, 2.40], p < 0.05), the third tertile of TG/HDL-C was associated with increased odds of elevated ALT (3.35 [2.21-5.06]) and HSI (6.55 [1.17-36.46]), whereas the second tertile of TG/HDL-C (OR = 2.65, CI 95%: 1.74-4.03) was also positively associated with elevated ALT. PCOS had no significant association with elevated liver function tests. CONCLUSION: The highest tertile of TyG index and the TG/HDL-C ratio as a surrogate of IR might play a role in detecting abnormalities of liver function parameters among women. However, PCOS status cannot change the association between IR and liver dysfunction.


Assuntos
Alanina Transaminase , Resistência à Insulina , Testes de Função Hepática , Fígado , Síndrome do Ovário Policístico , Triglicerídeos , Humanos , Feminino , Síndrome do Ovário Policístico/fisiopatologia , Síndrome do Ovário Policístico/sangue , Síndrome do Ovário Policístico/complicações , Adulto , Estudos Transversais , Fígado/metabolismo , Triglicerídeos/sangue , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Irã (Geográfico)/epidemiologia , Glicemia/metabolismo , Adulto Jovem , HDL-Colesterol/sangue , Fígado Gorduroso/etiologia , Fígado Gorduroso/fisiopatologia
8.
BMC Gastroenterol ; 24(1): 183, 2024 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-38783185

RESUMO

OBJECTIVE: To evaluate the diagnostic accuracy of aspartate aminotransferase(AST)/ alanine transaminase (ALT), AST to platelet ratio index (APRI), fibrosis-4 score (FIB-4) and gamma-glutamyl transpeptidase to platelet count ratio (GPR) for hepatic fibrosis in patients with chronic hepatitis B (CHB). METHODS: A total of 1210 CHB patients who underwent liver biopsy were divided into two groups: patients with no significant fibrosis (control group) and patients with significant fibrosis, and routine laboratory tests were retrospectively included. Logistic regression models were used for the prediction, and the area under the receiver operating characteristic (AUROC) was used to assess the diagnostic accuracy. RESULTS: A total of 631 (52.1%) and 275 (22.7%) patients had significant fibrosis (≥ S2) and advanced fibrosis (≥ S3), respectively. The GPR showed significantly higher diagnostic accuracy than that of APRI, FiB-4, and AST/ALT to predict ≥ S2(significant fibrosis) and ≥ S3 fibrosis(advanced fibrosis), with an AUROC was 0.69 (95%CI: 0.66-0.71) and 0.72 (0.69-0.75), respectively. After stratified by the status of HBeAg ( positive or negative), GPR, APRI, and FiB-4 showed improved predicting performance for significant fibrosis and advanced fibrosis in HBeAg positive patients, with the most significant improvement was shown for GPR in predicting significant fibrosis (AUROC = 0.74, 95%CI: 0.70-0.78). CONCLUSIONS: Among the four noninvasive models, GPR has the best performance in the diagnosis of hepatic fibrosis in CHB patients and is more valuable in HBeAg-positive patients.


Assuntos
Alanina Transaminase , Aspartato Aminotransferases , Hepatite B Crônica , Cirrose Hepática , gama-Glutamiltransferase , Humanos , Hepatite B Crônica/complicações , Hepatite B Crônica/patologia , Hepatite B Crônica/sangue , Cirrose Hepática/sangue , Cirrose Hepática/patologia , Cirrose Hepática/diagnóstico , Masculino , Feminino , Contagem de Plaquetas , Aspartato Aminotransferases/sangue , Adulto , Alanina Transaminase/sangue , Estudos Retrospectivos , gama-Glutamiltransferase/sangue , Pessoa de Meia-Idade , Curva ROC , Biópsia , Fígado/patologia , Antígenos E da Hepatite B/sangue , Biomarcadores/sangue , Modelos Logísticos , Valor Preditivo dos Testes , Índice de Gravidade de Doença
9.
Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi ; 40(4): 327-332, 2024 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-38710517

RESUMO

Objective To investigate the liver injury induced by chronic intermittent hypoxia (CIH) activation of NOD-like receptor pyrin domain containing protein 1 (NLRP1) inflammasome. Methods C57BL/6 male mice were randomly divided into control group and CIH group. Mice in CIH group were put into CIH chamber for molding (8 hours a day for 4 weeks). After 4 weeks of molding, liver tissue cells was observed by HE staining, and the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum of mice were detected by kit. The levels of reactive oxygen species (ROS) in liver tissue were detected by dihydroethidine (DHE). The expression and localization of NLRP1, apoptosis speck-like protein containing a caspase activation and recruiting domain (ASC) and caspase-1 were detected by immunohistochemical staining. The protein expressions of NLRP1, ASC, caspase-1, interleukin 1ß (IL-1ß) and tumor necrosis factor α (TNF-α) were detected by Western blot analysis. The serum levels of IL-1ß and TNF-α were detected by ELISA. Results Compared with the control group, the CIH group exhibited significant pathological changes in hepatocytes. Hepatocytes showed signs of rupture and necrosis, accompanied by inflammatory cell aggregation. Furthermore, the levels of ALT, AST, ROS, IL-1ß and TNF-α were elevated, along with increased protein expressions of NLRP1, ASC, caspase-1, IL-1ß and TNF-α. Conclusion CIH causes liver injury by activating NLRP1 inflammasome.


Assuntos
Caspase 1 , Hipóxia , Inflamassomos , Interleucina-1beta , Fígado , Camundongos Endogâmicos C57BL , Espécies Reativas de Oxigênio , Animais , Masculino , Inflamassomos/metabolismo , Hipóxia/metabolismo , Hipóxia/complicações , Espécies Reativas de Oxigênio/metabolismo , Fígado/metabolismo , Fígado/patologia , Caspase 1/metabolismo , Interleucina-1beta/metabolismo , Camundongos , Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Proteínas Reguladoras de Apoptose/metabolismo , Alanina Transaminase/sangue , Proteínas Adaptadoras de Sinalização CARD/metabolismo , Aspartato Aminotransferases/sangue , Hepatopatias/etiologia , Hepatopatias/metabolismo , Hepatopatias/patologia
10.
Ren Fail ; 46(1): 2352127, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38771116

RESUMO

Acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT), secondary to cardiovascular disease and sepsis, is associated with high in-hospital mortality. Although studies have examined cardiovascular disease and sepsis in AKI, the association between AKI and hepatic functional impairment remains unclear. We hypothesized that hepatic function markers would predict mortality in patients undergoing CRRT. We included 1,899 CRRT patients from a multi-centre database. In Phase 1, participants were classified according to the total bilirubin (T-Bil) levels on the day of, and 3 days after, CRRT initiation: T-Bil < 1.2, 1.2 ≤ T-Bil < 2, and T-Bil ≥ 2 mg/dL. In Phase 2, propensity score matching (PSM) was performed to examine the effect of a T-Bil cutoff of 1.2 mg/dL (supported by the Sequential Organ Failure Assessment score); creating two groups based on a T-Bil cutoff of 1.2 mg/dL 3 days after CRRT initiation. The primary endpoint was total mortality 90 days after CRRT initiation, which was 34.7% (n = 571). In Phase 1, the T-Bil, aspartate transaminase (AST), alanine transaminase (ALT), and AST/ALT (De Ritis ratio) levels at CRRT initiation were not associated with the prognosis, while T-Bil, AST, and the De Ritis ratio 3 days after CRRT initiation were independent factors. In Phase 2, T-Bil ≥1.2 mg/dL on day 3 was a significant independent prognostic factor, even after PSM [hazard ratio: 2.41 (95% CI; 1.84-3.17), p < 0.001]. T-Bil ≥1.2 mg/dL 3 days after CRRT initiation predicted 90-day mortality. Changes in hepatic function markers in acute renal failure may enable stratification of high-risk patients.


Assuntos
Injúria Renal Aguda , Bilirrubina , Biomarcadores , Terapia de Substituição Renal Contínua , Humanos , Injúria Renal Aguda/terapia , Injúria Renal Aguda/mortalidade , Injúria Renal Aguda/sangue , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/diagnóstico , Masculino , Feminino , Idoso , Pessoa de Meia-Idade , Prognóstico , Biomarcadores/sangue , Bilirrubina/sangue , Estudos Retrospectivos , Escores de Disfunção Orgânica , Aspartato Aminotransferases/sangue , Alanina Transaminase/sangue , Mortalidade Hospitalar , Pontuação de Propensão , Fígado , Idoso de 80 Anos ou mais , Testes de Função Hepática
11.
BMC Gastroenterol ; 24(1): 182, 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38778244

RESUMO

Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) has become the leading cause of chronic liver disease. Liver biopsy, as the diagnostic gold standard, is invasive and has sampling bias, making it particularly important to search for sensitive and specific biomarkers for diagnosis. Cytokeratin 18 (CK18) M30 and M65 are products of liver cell apoptosis and necrosis, respectively, and liver-expressed antimicrobial peptide 2 (LEAP-2) is a related indicator of glucose and lipid metabolism. Correlation studies have found that all three indicators positively correlate with the liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Through comparison of diagnostic values, it was found that CK18 M65 can better distinguish between healthy individuals and MAFLD; LEAP-2 can effectively distinguish MAFLD from other liver diseases, especially ALD.


Assuntos
Alanina Transaminase , Aspartato Aminotransferases , Biomarcadores , Queratina-18 , Fígado , Humanos , Queratina-18/sangue , Biomarcadores/sangue , Fígado/patologia , Biópsia , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Peptídeos Catiônicos Antimicrobianos/sangue , Masculino , Pessoa de Meia-Idade , Feminino , Fígado Gorduroso/diagnóstico , Fígado Gorduroso/patologia , Fígado Gorduroso/sangue , Adulto , Sensibilidade e Especificidade , Fragmentos de Peptídeos
12.
Nutrients ; 16(9)2024 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-38732547

RESUMO

Synbiotics modulate the gut microbiome and contribute to the prevention of liver diseases such as metabolic-dysfunction-associated fatty liver disease (MAFLD). This study aimed to evaluate the effect of a randomized, placebo-controlled, double-blinded seven-week intervention trial on the liver metabolism in 117 metabolically healthy male participants. Anthropometric data, blood parameters, and stool samples were analyzed using linear mixed models. After seven weeks of intervention, there was a significant reduction in alanine aminotransferase (ALT) in the synbiotic group compared to the placebo group (-14.92%, CI: -26.60--3.23%, p = 0.013). A stratified analysis according to body fat percentage revealed a significant decrease in ALT (-20.70%, CI: -40.88--0.53%, p = 0.045) in participants with an elevated body fat percentage. Further, a significant change in microbiome composition (1.16, CI: 0.06-2.25, p = 0.039) in this group was found, while the microbial composition remained stable upon intervention in the group with physiological body fat. The 7-week synbiotic intervention reduced ALT levels, especially in participants with an elevated body fat percentage, possibly due to modulation of the gut microbiome. Synbiotic intake may be helpful in delaying the progression of MAFLD and could be used in addition to the recommended lifestyle modification therapy.


Assuntos
Alanina Transaminase , Microbioma Gastrointestinal , Fígado , Simbióticos , Humanos , Simbióticos/administração & dosagem , Masculino , Método Duplo-Cego , Adulto , Fígado/metabolismo , Alanina Transaminase/sangue , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/prevenção & controle , Hepatopatia Gordurosa não Alcoólica/microbiologia , Hepatopatia Gordurosa não Alcoólica/terapia , Fezes/microbiologia , Fezes/química
13.
Arch Iran Med ; 27(5): 248-254, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38690791

RESUMO

BACKGROUND: The main objective of this study is to identify the risk factors of metabolic dysfunction-associated fatty liver disease (MAFLD) in coronary artery disease (CAD) patients. METHODS: The present retrospective cohort study is part of the Pars Cohort Study (PCS). The participants were categorized as having MAFLD or not. The pattern of independent variables in patients was compared with those who did not have MAFLD. All variables were retained in the multivariable logistic regression model. RESULTS: Totally, 1862 participants with CAD were enrolled in this study. MAFLD was diagnosed in 647 (40.1%) participants. Gender, diabetes, hypertension, tobacco, opium, alcohol, age, weight, waist circumference, cholesterol, HDL, triglyceride, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were significantly different in MAFLD and non-MAFLD patients. Also, the results of multivariable logistic regression show male gender (OR=0.651, 95% CI: 0.470‒0.902, P value=0.01) and opium consumption (OR=0.563, 95% CI: 0.328‒0.968, P value<0.001) to be negative risk factors of MAFLD occurrence in CAD patients. Having diabetes (OR=2.414, 95% CI: 1.740-3.349, P value<0.001), high waist circumference (OR=1.078, 95% CI: 1.055‒1.102, P value<0.01), high triglyceride (OR=1.005, 95% CI: 1.001‒1.008, P value=0.006), and high ALT (OR=1.039, 95% CI: 1.026‒1.051, P value<0.01) were positive risk factors of MAFLD in CAD patients. CONCLUSION: Our study found that consuming opium decreases the likelihood of MAFLD in CAD patients, since these patients have decreased appetite and lower body mass index (BMI). On the other hand, female gender, having diabetes, high waist circumference, high triglyceride levels, and high ALT levels increase the probability of MAFLD in CAD patients.


Assuntos
Doença da Artéria Coronariana , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Fatores de Risco , Estudos Retrospectivos , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/etiologia , Modelos Logísticos , Estilo de Vida , Irã (Geográfico)/epidemiologia , Alanina Transaminase/sangue , Adulto , Circunferência da Cintura , Aspartato Aminotransferases/sangue , Idoso , Triglicerídeos/sangue , Análise Multivariada
14.
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
15.
J Pediatr Gastroenterol Nutr ; 78(5): 1017-1026, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38695602

RESUMO

OBJECTIVES: Long-term D-penicillamine (D-pen) therapy in Wilson disease (WD) has numerous adverse effects which advocates its withdrawal, but with an inherent risk of relapse. This prospective observational study was conducted with the objective of evaluating incidence of relapse following withdrawal of D-pen from combination (D-pen + zinc) therapy in maintenance phase of previously symptomatic hepatic WD. METHODS: Hepatic WD patients <18 years of age and on combination therapy for >2 years with 6 months of biochemical remission were included. Biochemical remission was defined as achievement of (i) aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤1.5 times upper limit of normal (ULN), (ii) serum albumin >3.5 g/dL, international normalized ratio (INR) <1.5 and (iii) 24-h urinary copper excretion (UCE) <500 mcg/day, nonceruloplasmin-bound-copper (NCC) <15 mcg/dL. After D-pen withdrawal, monthly liver function test (LFT) and INR and 3 monthly UCE and NCC were done till 1 year or relapse (elevation of AST/ALT/both >2 times ULN or total bilirubin >2 mg/dL), whichever occurred earlier. RESULTS: Forty-five patients enrolled with median combination therapy duration of 36 months. Sixty percent of them had their index presentation as decompensated cirrhosis. Fourteen patients (31.8%) relapsed (cumulative incidence: 4 at 3 months, 11 at 6 months, and 14 at 12 months after D-pen discontinuation). All relapsers had index presentation as decompensated cirrhosis. On Cox-regression, ALT at D-pen withdrawal was an independent predictor of relapse (hazard ratio [HR]: 1.077, 95% confidence interval [CI]: 1.014-1.145, p = 0.017) with area under the receiver operating characteristic (AUROC) of 0.860. ALT ≥40 U/L predicted risk of relapse with 85.7% sensitivity, 70.9% specificity. CONCLUSION: Incidence of relapse after withdrawal of D-pen from combination therapy is 31.8% in hepatic WD. ALT ≥40 U/L, at the time of D-pen stoppage, predicts future relapse.


Assuntos
Quelantes , Quimioterapia Combinada , Degeneração Hepatolenticular , Penicilamina , Recidiva , Humanos , Degeneração Hepatolenticular/tratamento farmacológico , Penicilamina/uso terapêutico , Penicilamina/administração & dosagem , Feminino , Masculino , Estudos Prospectivos , Adolescente , Criança , Quelantes/uso terapêutico , Quelantes/administração & dosagem , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Zinco/administração & dosagem , Zinco/uso terapêutico , Testes de Função Hepática/métodos , Cobre/sangue , Suspensão de Tratamento
16.
Environ Geochem Health ; 46(6): 197, 2024 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-38696118

RESUMO

Micro/nanoplastics (MNPs) are emerging as environmental pollutants with potential threats to human health. The accumulation of MNPs in the body can cause oxidative stress and increase the risk of cardiovascular disease (CVD). With the aim to systematically evaluate the extent of MNPs-induced oxidative damage and serum biochemical parameters in rats and mice, a total of 36 eligible articles were included in this meta-analysis study. The results reported that MNPs can significantly increase the levels of oxidants such as reactive oxygen species (ROS) and malondialdehyde (MDA) (P < 0.05), and resulted in notable increase in serum biochemical parameters including aspartate aminotransferase (AST) and alanine aminotransferase (ALT) (P < 0.05). Conversely, MNPs significantly reduced levels of antioxidants such as superoxide dismutase (SOD), glutathione (GSH), glutathione peroxidase (GPx) and catalase (CAT) (P < 0.05). Subgroup analysis revealed that smaller MNPs with oral administration and prolonged treatment, were associated with more pronounced oxidative stress and enhanced serum biochemical parameters alteration. In addition, after affected by MNPs, the levels of ALT and AST in liver group (SMD = 2.26, 95% CI = [1.59, 2.94] and SMD = 3.10, 95% CI = [1.25, 4.94]) were higher than those in other organs. These comprehensive results provide a scientific foundation for devising strategies to prevent MNPs-induced damage, contributing to solution of this environmental and health challenge.


Assuntos
Estresse Oxidativo , Animais , Estresse Oxidativo/efeitos dos fármacos , Ratos , Camundongos , Aspartato Aminotransferases/sangue , Microplásticos/toxicidade , Alanina Transaminase/sangue , Antioxidantes/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Fígado/efeitos dos fármacos , Fígado/metabolismo , Poluentes Ambientais/toxicidade , Nanopartículas , Malondialdeído/sangue , Superóxido Dismutase/metabolismo
17.
PLoS One ; 19(5): e0303333, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38758828

RESUMO

Insulin resistance is a common pathophysiology in patients with type 2 diabetes mellitus, cardiovascular disease, and non-alcoholic fatty liver disease. Thus, screening for the risk of insulin resistance is important to prevent disease progression. We evaluated the alanine aminotransferase/aspartate aminotransferase (ALT/AST) ratio to predict insulin resistance in the general population, regardless of comorbidities. Datasets from the 2015, 2019, and 2020 Korea National Health and Nutrition Examination Surveys were used, and the following four indices were implemented to indicate insulin resistance: fasting serum glucose, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), and ß-cell function. We analyzed the degree of association between the liver enzyme profile and insulin resistance indices using Pearson's correlation coefficient and determined the associations using linear or logistic regression analysis. Accordingly, ALT levels in both sexes were positively and consistently correlated with the four aforementioned insulin resistance indices in stratification analyses based on diabetes, dyslipidemia, alcohol consumption, and obesity status. In multivariate linear regression, when comparing with ALT levels, the ALT/AST ratio exhibited superior predictive performance for fasting serum glucose and HOMA-ß in Korean men and improved outcomes for all insulin resistance indices in Korean women. In this analysis that included a large community-based population, the ALT/AST ratio was a more useful predictive marker than the HOMA-IR. Regarding the predicted presence or absence of insulin resistance, the ALT/AST ratio could better predict HOMA-IR than the ALT level alone in Koreans. A simple, precise marker that represents the ALT/AST ratio could be a practical method to screen for insulin resistance in the general population, regardless of diabetes mellitus, alcohol intake, and sex.


Assuntos
Alanina Transaminase , Aspartato Aminotransferases , Resistência à Insulina , Humanos , Masculino , Feminino , República da Coreia/epidemiologia , Alanina Transaminase/sangue , Alanina Transaminase/metabolismo , Pessoa de Meia-Idade , Estudos Transversais , Aspartato Aminotransferases/sangue , Aspartato Aminotransferases/metabolismo , Adulto , Glicemia/metabolismo , Glicemia/análise , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/sangue , Inquéritos Nutricionais , Estudos de Coortes , Idoso
18.
Medicine (Baltimore) ; 103(20): e37953, 2024 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-38758884

RESUMO

To explore the therapeutic effectiveness of tenofovir alafenamide (TAF) and tenofovir disoproxil fumarate (TDF) on the treatment for chronic hepatitis B (CHB). Retrospectively analyzing 241 cases of chronic hepatitis B patients admitted to our hospital from January 2020 to December 2021, they were divided into a TAF group of 180 cases and a TDF group of 61 cases. The liver function, serum virus markers, clinical efficacy, adverse reactions and cost-effectiveness ratio (CER) analysis of 2 groups were compared. Two groups of patients had no statistically significant difference in the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) before treatment. After treatment, the levels of ALT, AST and TBIL were lower than before treatment in both groups (P < .05), but the inter-group difference was not statistically significant (P > .05). After treatment, Hepatitis B surface antigen (HBsAg) conversion rate and Hepatitis B virus DNA (HBV-DNA) conversion rate in the 2 groups had no statistically significant difference. After treatment, the difference in total clinical cure rate between the 2 groups has no statistical significance (P > .05), adverse reactions rate of TAF group was lower than that of TDF group (P < .05). The drug cost median of TAF group was higher than that of TDF (P < .05), but Cost-effectiveness analysis showed the CER of TAF group was similar of TDF group. TAF or TDF therapy can both improve liver function and promote recovery in patients with CHB, achieving the goal of treatment. TAF have more cost but have similar CER to TDF. Moreover, TAF therapy has a higher safety profile.


Assuntos
Antivirais , Hepatite B Crônica , Tenofovir , Humanos , Tenofovir/uso terapêutico , Tenofovir/efeitos adversos , Tenofovir/análogos & derivados , Hepatite B Crônica/tratamento farmacológico , Masculino , Feminino , Estudos Retrospectivos , Antivirais/uso terapêutico , Antivirais/efeitos adversos , Adulto , Pessoa de Meia-Idade , Resultado do Tratamento , Análise Custo-Benefício , Alanina/uso terapêutico , DNA Viral/sangue , Alanina Transaminase/sangue , Antígenos de Superfície da Hepatite B/sangue
19.
Pediatrics ; 153(5)2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38567424

RESUMO

OBJECTIVES: Guidelines for monitoring of medications frequently used in the gender-affirming care of transgender and gender-diverse (TGD) adolescents are based on studies in adults or other medical conditions. In this study, we aimed to investigate commonly screened laboratory measurements in TGD adolescents receiving gender-affirming hormone therapy (GAHT). METHODS: TGD adolescents were recruited from 4 study sites in the United States before beginning GAHT. Hemoglobin, hematocrit, hemoglobin A1c, alanine transaminase, aspartate aminotransferase, prolactin, and potassium were abstracted from the medical record at baseline and at 6, 12, and 24 months after starting GAHT. RESULTS: Two-hundred and ninety-three participants (68% designated female at birth) with no previous history of gonadotropin-releasing hormone analog use were included in the analysis. Hemoglobin and hematocrit decreased in adolescents prescribed estradiol (-1.4 mg/dL and -3.6%, respectively) and increased in adolescents prescribed testosterone (+1.0 mg/dL and +3.9%) by 6 months after GAHT initiation. Thirteen (6.5%) participants prescribed testosterone had hematocrit > 50% during GAHT. There were no differences in hemoglobin A1c, alanine transaminase, or aspartate aminotransferase. There was a small increase in prolactin after 6 months of estradiol therapy in transfeminine adolescents. Hyperkalemia in transfeminine adolescents taking spironolactone was infrequent and transient if present. CONCLUSIONS: Abnormal laboratory results are rare in TGD adolescents prescribed GAHT and, if present, occur within 6 months of GAHT initiation. Future guidelines may not require routine screening of these laboratory parameters beyond 6 months of GAHT in otherwise healthy TGD adolescents.


Assuntos
Testosterona , Pessoas Transgênero , Humanos , Adolescente , Feminino , Masculino , Testosterona/sangue , Testosterona/uso terapêutico , Testosterona/efeitos adversos , Alanina Transaminase/sangue , Estradiol/sangue , Hematócrito , Aspartato Aminotransferases/sangue , Procedimentos de Readequação Sexual , Hemoglobinas Glicadas/análise , Prolactina/sangue , Hemoglobinas/análise , Transexualidade/tratamento farmacológico , Terapia de Reposição Hormonal/métodos
20.
Cell Mol Biol (Noisy-le-grand) ; 70(4): 23-28, 2024 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-38678635

RESUMO

The main risk factors for non-alcoholic fatty liver disease (NAFLD) are strongly associated with obesity, diabetes, hyperlipidemia, and metabolic syndrome. The best clinical evaluation of the liver is done through studying changes in liver enzymes' activity, especially alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase. Therefore, this study aimed to investigate the relationship between changes in factors such as blood glucose, cholesterol, glycosylated hemoglobin, and triglyceride and changes in hepatic enzymes in patients who visited Fajr Hospital in Tehran. Samples with SGPT levels > 40 U/L were selected and blood samples from the same individuals were collected in the next testing which was six months later. The changes in four factors of blood glucose, glycosylated hemoglobin, cholesterol, and triglyceride were calculated in these two consecutive visits, and finally, they were compared with changes in the hepatic enzymes and the relationship between them was evaluated by SPSS V. 23. Fifty-seven individuals with a mean age of 48 ± 15 years and SGPT > 40 U/L were included in the present study. Six samples were female (10.52 %) and 51 samples were male (89.48 %). The results showed that there was no significant relationship between blood glucose and glycosylated hemoglobin changes and hepatic enzymes. However, there was a significant relationship between cholesterol and triglyceride changes and hepatic enzymes of SGPT and SGOT (p ˂ 0.05). Based on the results of the current study, changes in FBS and HbA1c in two consecutive visits cannot be used to follow up on the treatment of fatty liver. However, changes in cholesterol and triglyceride can be used for monitoring the treatment in people with abnormal levels of hepatic enzymes.


Assuntos
Glicemia , Colesterol , Hemoglobinas Glicadas , Fígado , Triglicerídeos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Glicemia/metabolismo , Glicemia/análise , Colesterol/sangue , Hemoglobinas Glicadas/metabolismo , Hemoglobinas Glicadas/análise , Fígado/enzimologia , Hepatopatia Gordurosa não Alcoólica/sangue , Triglicerídeos/sangue
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