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Imaeda M, Tanaka S, Oya-Ito T, Uematsu M, Fujigaki H, Saito K, Ando M, Ozaki N. Secondary carnitine deficiency during refeeding in severely malnourished patients with eating disorders: a retrospective cohort study. J Eat Disord 2024; 12:97. [PMID: 38982532 PMCID: PMC11232142 DOI: 10.1186/s40337-024-01054-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 06/22/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Secondary carnitine deficiency in patients with anorexia nervosa has been rarely reported. This study aimed to investigate the occurrence of carnitine deficiency in severely malnourished patients with eating disorders during refeeding and assess its potential adverse effects on treatment outcomes. METHOD In a cohort study of 56 female inpatients with eating disorders at a single hospital from March 2010 to December 2020, we measured plasma free carnitine (FC) levels and compared to those of a healthy control group (n = 35). The patients were categorized into three groups based on FC levels: FC deficiency (FC< 20 µmol/L), FC pre-deficiency (20 µmol/L ≤ FC< 36 µmol/L), and FC normal (36 µmol/L ≤ FC). RESULTS Upon admission, the patients had a median age of 26 years (interquartile range [IQR]: 21-35) and a median body mass index (BMI) of 13.8 kg/m2 (IQR: 12.8-14.8). Carnitine deficiency or pre-deficiency was identified in 57% of the patients. Hypocarnitinemia was associated with a decline in hemoglobin levels during refeeding (odds ratio [OR]: 0.445; 95% confidence interval [CI]: 0.214-0.926, p = 0.03), BMI at admission (OR: 0.478; 95% CI: 0.217-0.874, p = 0.014), and moderate or greater hepatic impairment at admission (OR: 6.385; 95% CI: 1.170-40.833, p = 0.032). CONCLUSIONS Hypocarnitinemia, particularly in cases of severe undernutrition (BMI< 13 kg/m2 at admission) was observed in severely malnourished patients with eating disorders during refeeding, a critical metabolic transition phase. Moderate or severe hepatic impairment at admission was considered a potential indicator of hypocarnitinemia. Although hypocarnitinemia was not associated with any apparent adverse events other than anemia during refeeding, the possibility that carnitine deficiency may be a risk factor for more serious complications during sudden increases in energy requirements associated with changes in physical status cannot be denied. Further research on the clinical significance of hypocarnitinemia in severely malnourished patients with eating disorders is warranted.
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Affiliation(s)
- Miho Imaeda
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, 65 Tsurumai, Showa, Nagoya, 466-8550, Aichi, Japan.
- Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, 466-8550, Aichi, Japan.
| | - Satoshi Tanaka
- NHO Higashiowari National Hospital, 1301, Omorikita 2, Moriyama, Nagoya, 463-0802, Aichi, Japan
- NHO Nagoya Medical Center, 1-1, Sannomaru 4, Naka, Nagoya, 460-0001, Aichi, Japan
| | - Tomoko Oya-Ito
- Department of Nutrition, Shubun University, 6 Nikkocho, Ichinomiya, 491-0938, Aichi, Japan
| | - Mariko Uematsu
- Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, 466-8550, Aichi, Japan
| | - Hidetsugu Fujigaki
- Department of Advanced Diagnostic System Development, Fujita Health University Graduate School of Health Sciences, 1-98 dengakugakubo, kutukakecho, Toyoake, 470-1192, Aichi, Japan
| | - Kuniaki Saito
- Department of Advanced Diagnostic System Development, Fujita Health University Graduate School of Health Sciences, 1-98 dengakugakubo, kutukakecho, Toyoake, 470-1192, Aichi, Japan
| | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, 65 Tsurumai, Showa, Nagoya, 466-8550, Aichi, Japan
| | - Norio Ozaki
- Pathophysiology of Mental Disorders, Nagoya University Graduate School of Medicine, Institute for Glyco-core Research (iGCORE), Nagoya University, 65 Tsurumai, Showa, Nagoya, 466-8550, Aichi, Japan
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Yang K, Zeng J, Wu H, Liu H, Ding Z, Liang W, Wu L, Lin Z, Huang W, Xu J, Dong F. Nonalcoholic Fatty Liver Disease: Changes in Gut Microbiota and Blood Lipids. J Clin Transl Hepatol 2024; 12:333-345. [PMID: 38638378 PMCID: PMC11022063 DOI: 10.14218/jcth.2023.00199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 10/10/2023] [Accepted: 11/29/2023] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND AND AIMS The global prevalence of nonalcoholic fatty liver disease (NAFLD) is 25%. This study aimed to explore differences in the gut microbial community and blood lipids between normal livers and those affected by NAFLD using 16S ribosomal deoxyribonucleic acid sequencing. METHODS Gut microbiome profiles of 40 NAFLD and 20 non-NAFLD controls were analyzed. Information about four blood lipids and 13 other clinical features was collected. Patients were divided into three groups by ultrasound and FibroScan, those with a normal liver, mild FL (FL1), and moderate-to-severe FL (FL2). FL1 and FL2 patients were divided into two groups, those with either hyperlipidemia or non-hyperlipidemia based on their blood lipids. Potential keystone species within the groups were identified using univariate analysis and a specificity-occupancy plot. Significant difference in biochemical parameters ion NAFLD patients and healthy individuals were identified by detrended correspondence analysis and canonical correspondence analysis. RESULTS Decreased gut bacterial diversity was found in patients with NAFLD. Firmicutes/Bacteroidetes decreased as NAFLD progressed. Faecalibacterium and Ruminococcus 2 were the most representative fatty-related bacteria. Glutamate pyruvic transaminase, aspartate aminotransferase, and white blood cell count were selected as the most significant biochemical indexes. Calculation of areas under the curve identified two microbiomes combined with the three biochemical indexes that identified normal liver and FL2 very well but performed poorly in diagnosing FL1. CONCLUSIONS Faecalibacterium and Ruminococcus 2, combined with glutamate pyruvic transaminase, aspartate aminotransferase, and white blood cell count distinguished NAFLD. We speculate that regulating the health of gut microbiota may release NAFLD, in addition to providing new targets for clinicians to treat NAFLD.
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Affiliation(s)
| | | | - Huaiyu Wu
- Department of Ultrasound, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen,Guangdong, China
| | - Huiyu Liu
- Department of Ultrasound, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen,Guangdong, China
| | - Zhimin Ding
- Department of Ultrasound, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen,Guangdong, China
| | - Weiyu Liang
- Department of Ultrasound, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen,Guangdong, China
| | - Linghu Wu
- Department of Ultrasound, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen,Guangdong, China
| | - Ziwei Lin
- Department of Ultrasound, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen,Guangdong, China
| | - Wenhui Huang
- Department of Ultrasound, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen,Guangdong, China
| | - Jinfeng Xu
- Department of Ultrasound, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen,Guangdong, China
| | - Fajin Dong
- Department of Ultrasound, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen,Guangdong, China
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Noormohammadi M, Ghorbani Z, Shahinfar H, Shidfar F. Is there any hepatic impact associated with rice bran arabinoxylan compound supplementation? A systematic review and dose-response meta-analysis of randomized controlled trials. Clin Nutr ESPEN 2023; 57:665-675. [PMID: 37739721 DOI: 10.1016/j.clnesp.2023.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/01/2023] [Accepted: 08/19/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND & AIMS Rice Bran Arabinoxylan Compound (RBAC) results from an enzymatic modification of rice bran, which is reported to have immunomodulatory, anti-oxidant, and anti-inflammatory effects by regulating the production of pro-inflammatory cytokines. The current systematic review and meta-analysis aimed to determine the hepatic adverse effects of RBAC by assessing the effect through liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST). METHODS In the present study, the Medline (PubMed), Web of Sciences, and Scopus databases were searched for relevant publications from the beginning to October 2022. The meta-analysis was based on the Mixed effect model to generate the mean effect sizes in weighted mean differences (WMD) and the 95% confidence intervals (95%CI). The heterogeneity was assessed using the Cochrane Chi-squared test, and the analysis of Galbraith plots was applied. RESULTS Subgroup meta-analysis on five eligible randomized controlled trials (n = 239) showed a significant decrease in serum AST regarding RBAC supplementation in powder form (WMD (95%CI) = -3.52 (-5.62, -1.42) U/L; P-value = 0.001, I2 (%) = 46.9; P heterogeneity = 0.170), three months and more supplementation duration (WMD (95%CI) = -3.71 (-5.95, -1.48) U/L; P-value = 0.001, I2 (%) = 29.9; P heterogeneity = 0.240) and studies with a good quality (WMD (95%CI) = -3.52 (-5.62, -1.42) U/L; P-value = 0.001, I2 (%) = 46.9; P heterogeneity = 0.170). CONCLUSIONS In conclusion, RBAC supplementation seems to not have any hepatic adverse effects and its supplementation as powder or for three months and more may decrease serum AST levels. However, we need further studies to confirm the results. REGISTRY NUMBER FOR SYSTEMATIC REVIEWS OR META-ANALYZES CRD42022361002, registration time: 29/09/2022.
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Affiliation(s)
- Morvarid Noormohammadi
- Student Research Committee, Faculty of Public Health Branch, Iran University of Medical Sciences, Tehran, Iran; Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Zeinab Ghorbani
- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran; Department of Clinical Nutrition, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
| | - Hossein Shahinfar
- Student Research Committee, Faculty of Public Health Branch, Iran University of Medical Sciences, Tehran, Iran; Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
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Hung WC, Tang WH, Yu TH, Wu CC, Wang CP, Lu YC, Wei CT, Chung FM, Lee YJ, Hsu CC. Low plasma growth/differentiation factor 1 levels are associated with liver fibrosis in patients with stable angina. J Clin Lab Anal 2022; 36:e24745. [PMID: 36268984 DOI: 10.1002/jcla.24745] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/28/2022] [Accepted: 10/09/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Growth differentiation factor 1 (GDF1) is a member of the transforming growth factor-β (TGF-β) superfamily and a protective mediator against the development of post-infarction cardiac remodeling by negatively regulating MEK-ERK1/2 and Smad signaling pathways in the heart. The TGF-β/SMAD pathway has been shown to play a key role in the development of hepatic fibrosis. In addition, fatty liver disease has been associated with reduced MEK/ERK1/2 signaling. However, no previous study has investigated the association between GDF1 and liver fibrosis. Therefore, the aim of this study was to investigate the association between plasma GDF1 and liver fibrosis in patients with stable angina. METHODS We included 327 consecutive patients with stable angina. ELISA was used to measure circulating levels of GDF1, and the fibrosis-4 index was used to assess liver fibrosis. RESULTS The advanced liver fibrosis group had lower median plasma GDF1 levels than those with minimal liver fibrosis. There was a significant negative association between GDF1 plasma level and fibrosis-4 index (r = -0.135, p = 0.019). A lower concentration of GDF1 was significantly and independently associated with an increased risk of liver fibrosis when concentration was analyzed as a continuous variable and by tertile. In addition, fibrosis-4 index, aspartate aminotransferase (AST)-to-platelet ratio index, and AST/alanine aminotransferase ratio were significantly associated with GDF1 concentration. CONCLUSIONS Our results indicated an association between low plasma GDF1 and liver fibrosis in the enrolled patients. Further investigations into the role of plasma GDF1 in the pathogenesis of liver fibrosis are warranted.
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Affiliation(s)
- Wei-Chin Hung
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Wei-Hua Tang
- Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Yuli Branch, Hualien, Taiwan.,Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Teng-Hung Yu
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Cheng-Ching Wu
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chao-Ping Wang
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.,School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yung-Chuan Lu
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Division of Endocrinology and Metabolism, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Ching-Ting Wei
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Division of General Surgery, Department of Surgery, E-Da Hospital, Kaohsiung, Taiwan.,Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan.,Department of Electrical Engineering, I-Shou University, Kaohsiung, Taiwan
| | - Fu-Mei Chung
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | | | - Chia-Chang Hsu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.,Health Examination Center, E-Da Dachang Hospital, Kaohsiung, Taiwan.,The School of Chinese Medicine for Post Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, Taiwan
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He HC, Han R, Xu BH, Huang C, Li MM, He CY, Lin WQ. Circulating Epstein-Barr virus DNA associated with hepatic impairment and its diagnostic and prognostic role in patients with gastric cancer. Front Med (Lausanne) 2022; 9:1028033. [PMID: 36275793 PMCID: PMC9583533 DOI: 10.3389/fmed.2022.1028033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 09/16/2022] [Indexed: 11/23/2022] Open
Abstract
Epstein–Barr virus (EBV) infection may affect all tissues and organs of the body. Little is known about the impact of this entity on its systematic incorporation in patients with gastric cancer (GC). This study enrolled a total of 113 GC patients with EBV infection (EBVaGC) and 167 GC patients without EBV infection (EBVnGC). It was found that the CRP levels (indicative of inflammatory status) were significantly increased in EBVaGC compared with those in EBVnGC (12.11 mg/L vs. 5.72 mg/L, P = 0.008), but WBC and neutrophils counts were similar in both groups (P > 0.05). Consistent elevations in the levels of liver enzymes, ALP and GGT, with incompatible alterations in ALT or AST were observed in EBVaGC. Slightly prolonged coagulation indices, PT and INR, and decreased albumin consistently suggested impaired synthesis capability of the liver in EBVaGC (all P < 0.05). The level of circulating EBV DNA was positively correlated with the level of GGT, tumor marker CA72-4 and the lymphocyte infiltration in tumor tissues (all P < 0.05). Of note, the EBV associated high-lymphocyte infiltrated tissues presented rich CD8 + T cells. Circulating EBV DNA further showed a predictive role in distinguishing EBVaGC from EBVnGC (AUC 0.79, 95% CI 0.73 to 0.85, P < 0.001), and was associated closely with better overall survival (HR 0.45, 95% CI 0.21 to 0.96, P = 0.039). EBV infection in patients with gastric cancer may be linked to hepatic impairment and immune response. Circulating cell-free EBV DNA is not only a biomarker for the screening of an EBV-related GC subtype but is also an independently prognosis factor for the long-term survival benefit in GC patients.
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Affiliation(s)
- Hui-Chan He
- State Key Laboratory of Oncology in South China, Department of Blood Transfusion, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China,Center for Clinical Laboratory, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Rui Han
- State Key Laboratory of Oncology in South China, Department of Blood Transfusion, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Bo-Heng Xu
- State Key Laboratory of Oncology in South China, Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Chan Huang
- State Key Laboratory of Oncology in South China, Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Min-Min Li
- Center for Clinical Laboratory, The First Affiliated Hospital of Jinan University, Guangzhou, China,*Correspondence: Min-Min Li,
| | - Cai-Yun He
- State Key Laboratory of Oncology in South China, Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China,Cai-Yun He,
| | - Wen-Qian Lin
- State Key Laboratory of Oncology in South China, Department of Blood Transfusion, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China,Wen-Qian Lin,
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Murillo-Villicaña M, Noriega-Cisneros R, Peña-Montes DJ, Huerta-Cervantes M, Aguilera-Méndez A, Cortés-Rojo C, Salgado-Garciglia R, Montoya-Pérez R, Riveros-Rosas H, Saavedra-Molina A. Antilipidemic and Hepatoprotective Effects of Ethanol Extract of Justicia spicigera in Streptozotocin Diabetic Rats. Nutrients 2022; 14:1946. [PMID: 35565913 PMCID: PMC9099835 DOI: 10.3390/nu14091946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/28/2022] [Accepted: 05/04/2022] [Indexed: 02/04/2023] Open
Abstract
Oxidative stress is a factor that contributes to the development of complications in diabetes; however, its effects can be counteracted using exogenous antioxidants that are found in some plants, which is why people turn to traditional medicines in the search for therapeutic treatment. Justicia spicigera has been demonstrated to have the capacity to reduce glycemic levels; however, its effects on non-insulin-dependent organs such as the liver have not been reported. During 30 days of administration of Justicia spicigera ethanol extract, the blood glucose and weight of rats were measured every 5 days. Once the treatment was concluded, the rats were sacrificed. Corporal weight, blood glucose, cholesterol, very-low-density lipoprotein (VLDL), triglycerides, total lipids, and liver profile were reduced in the diabetic condition and normalized with the application of ethanol extract from J. spicigera (EJS). Additionally, there was a significant increase in catalase and superoxide dismutase activity in the control diabetic rats, a decrease in their activity with the extract administration, and no effect on normoglycemic rats. In conclusion, EJS is considered to be capable of reducing oxidative stress by maintaining diminished lipid and liver function profiles in male Wistar rats with streptozotocin-induced diabetes.
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Affiliation(s)
- Marina Murillo-Villicaña
- Instituto de Investigaciones Químico Biológicas, Universidad Michoacana de San Nicolás de Hidalgo, Morelia 58030, Mexico; (M.M.-V.); (D.J.P.-M.); (M.H.-C.); (A.A.-M.); (C.C.-R.); (R.S.-G.); (R.M.-P.)
| | - Ruth Noriega-Cisneros
- Facultad de Enfermería, Universidad Michoacana de San Nicolás de Hidalgo, Morelia 58030, Mexico;
| | - Donovan J. Peña-Montes
- Instituto de Investigaciones Químico Biológicas, Universidad Michoacana de San Nicolás de Hidalgo, Morelia 58030, Mexico; (M.M.-V.); (D.J.P.-M.); (M.H.-C.); (A.A.-M.); (C.C.-R.); (R.S.-G.); (R.M.-P.)
| | - Maribel Huerta-Cervantes
- Instituto de Investigaciones Químico Biológicas, Universidad Michoacana de San Nicolás de Hidalgo, Morelia 58030, Mexico; (M.M.-V.); (D.J.P.-M.); (M.H.-C.); (A.A.-M.); (C.C.-R.); (R.S.-G.); (R.M.-P.)
| | - Asdrubal Aguilera-Méndez
- Instituto de Investigaciones Químico Biológicas, Universidad Michoacana de San Nicolás de Hidalgo, Morelia 58030, Mexico; (M.M.-V.); (D.J.P.-M.); (M.H.-C.); (A.A.-M.); (C.C.-R.); (R.S.-G.); (R.M.-P.)
| | - Christian Cortés-Rojo
- Instituto de Investigaciones Químico Biológicas, Universidad Michoacana de San Nicolás de Hidalgo, Morelia 58030, Mexico; (M.M.-V.); (D.J.P.-M.); (M.H.-C.); (A.A.-M.); (C.C.-R.); (R.S.-G.); (R.M.-P.)
| | - Rafael Salgado-Garciglia
- Instituto de Investigaciones Químico Biológicas, Universidad Michoacana de San Nicolás de Hidalgo, Morelia 58030, Mexico; (M.M.-V.); (D.J.P.-M.); (M.H.-C.); (A.A.-M.); (C.C.-R.); (R.S.-G.); (R.M.-P.)
| | - Rocío Montoya-Pérez
- Instituto de Investigaciones Químico Biológicas, Universidad Michoacana de San Nicolás de Hidalgo, Morelia 58030, Mexico; (M.M.-V.); (D.J.P.-M.); (M.H.-C.); (A.A.-M.); (C.C.-R.); (R.S.-G.); (R.M.-P.)
| | - Héctor Riveros-Rosas
- Departamento de Bioquímica, Facultad de Medicina, Universidad Nacional Autónoma de México, Avenida Universidad 3000, Cd. Universitaria, Ciudad de Mexico 04510, Mexico;
| | - Alfredo Saavedra-Molina
- Instituto de Investigaciones Químico Biológicas, Universidad Michoacana de San Nicolás de Hidalgo, Morelia 58030, Mexico; (M.M.-V.); (D.J.P.-M.); (M.H.-C.); (A.A.-M.); (C.C.-R.); (R.S.-G.); (R.M.-P.)
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Kalas MA, Chavez L, Leon M, Taweesedt PT, Surani S. Abnormal liver enzymes: A review for clinicians. World J Hepatol 2021; 13:1688-1698. [PMID: 34904038 PMCID: PMC8637680 DOI: 10.4254/wjh.v13.i11.1688] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 07/24/2021] [Accepted: 08/23/2021] [Indexed: 02/06/2023] Open
Abstract
Liver biochemical tests are some of the most commonly ordered routine tests in the inpatient and outpatient setting, especially with the automatization of testing in this technological era. These tests include aminotransferases, alkaline phosphatase, gamma-glutamyl transferase, bilirubin, albumin, prothrombin time and international normalized ratio (INR). Abnormal liver biochemical tests can be categorized based on the pattern and the magnitude of aminotransferases elevation. Generally, abnormalities in aminotransferases can be classified into a hepatocellular pattern or cholestatic pattern and can be further sub-classified based on the magnitude of aminotransferase elevation to mild [< 5 × upper limit of normal (ULN)], moderate (> 5-< 15 × ULN) and severe (> 15 × ULN). Hepatocellular pattern causes include but are not limited to; non-alcoholic fatty liver disease/non-alcoholic steatohepatitis, alcohol use, chronic viral hepatitis, liver cirrhosis (variable), autoimmune hepatitis, hemochromatosis, Wilson's disease, alpha-1 antitrypsin deficiency, celiac disease, medication-induced and ischemic hepatitis. Cholestatic pattern causes include but is not limited to; biliary pathology (obstruction, autoimmune), other conditions with hyperbilirubinemia (conjugated and unconjugated). It is crucial to interpret these commonly ordered tests accurately as appropriate further workup, treatment and referral can greatly benefit the patient due to prompt treatment which can improve the natural history of several of the diseases mentioned and possibly reduce the risk of progression to the liver cirrhosis.
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Affiliation(s)
- M Ammar Kalas
- Department of Internal Medicine, Texas Tech University Health Science Center, El Paso, TX 79905, United States
| | - Luis Chavez
- Department of Internal Medicine, Texas Tech University Health Science Center, El Paso, TX 79905, United States
| | - Monica Leon
- Department of General Surgery, University of Mexico, Ciudad de Mexico 01120, Mexico
| | - Pahnwat Tonya Taweesedt
- Department of Medicine, Corpus Christi Medical Center, Corpus Christi, TX 78412, United States
| | - Salim Surani
- Department of Medicine, Texas A&M University, College Station, TX 77843, United States
- Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, United States.
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Yoon H. The Relationship between the Serum Aspartate Aminotransferase/Alanine Aminotransferase Ratio and Pulse Pressure in Korean Adults with Hypertension. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2021. [DOI: 10.15324/kjcls.2021.53.3.241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Hyun Yoon
- Department of Clinical Laboratory Science, Wonkwang Health Science University, Iksan, Korea
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Wang JH, Hwang SJ, Son CG. Comparative Analysis of the Antioxidative and Hepatoprotective Activities of Dimethyl Diphenyl Bicarboxylate in Four Animal Models of Hepatic Injury. Antioxidants (Basel) 2021; 10:1508. [PMID: 34679643 PMCID: PMC8533021 DOI: 10.3390/antiox10101508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/13/2021] [Accepted: 09/20/2021] [Indexed: 11/17/2022] Open
Abstract
As a well-known hepatoprotective and antioxidant agent, dimethyl diphenyl bicarboxylate (DDB) has frequently been employed to remedy various liver diseases. However, it is still uncertain whether DDB exerts consistent hepatoprotective and antioxidative activities against varying degrees of hepatic damage. Therefore, DDB (100, 25, 5, or 50 mg/kg depending on the model) was administered to animals in four representative models of liver injury (CCl4 chemical acute model, DMN subchronic model, TAA chronic model, and restraint stress psychological acute model). Horizontal comparative analysis indicated that DDB significantly lowered the excess serum AST and ALT levels in the CCl4 and DMN models but not in the TAA and restraint stress models. In accordance with this result, DDB markedly reduced oxidative stress indices (hepatic MDA and ROS) but restored five main antioxidant components (GSH content, GSH-peroxidase, GSH-reductase, SOD, and catalase activity) in the CCl4 and DMN models. DDB failed to normalize oxidative stressors in the restraint stress-induced injury model and restore these five antioxidant components in the TAA model. Overall, our results produced a comprehensive overview of the effects of DDB on oxidative stressors and the main antioxidative components using four animal models. These findings will provide valuable clues to guide therapeutic clinical applications.
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Affiliation(s)
- Jing-Hua Wang
- Institute of Bioscience & Integrative Medicine, Daejeon University, 75, Daedeok-daero 176, Seo-gu, Daejeon 35235, Korea; (J.-H.W.); (S.-J.H.)
- Liver and Immunology Research Center, Daejeon Korean Medicine Hospital, 75, Daedeok-daero 176, Seo-gu, Daejeon 35235, Korea
| | - Seung-Ju Hwang
- Institute of Bioscience & Integrative Medicine, Daejeon University, 75, Daedeok-daero 176, Seo-gu, Daejeon 35235, Korea; (J.-H.W.); (S.-J.H.)
- Liver and Immunology Research Center, Daejeon Korean Medicine Hospital, 75, Daedeok-daero 176, Seo-gu, Daejeon 35235, Korea
| | - Chang-Gue Son
- Institute of Bioscience & Integrative Medicine, Daejeon University, 75, Daedeok-daero 176, Seo-gu, Daejeon 35235, Korea; (J.-H.W.); (S.-J.H.)
- Liver and Immunology Research Center, Daejeon Korean Medicine Hospital, 75, Daedeok-daero 176, Seo-gu, Daejeon 35235, Korea
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10
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Mehboob S, Rafi SMT, Mejabeen, Tariq N, Khan H, Mehboob M. Risk of hepatic toxicity and drug response in patients with chronic suppurative otitis media. INDIAN JOURNAL OF OTOLOGY 2021. [DOI: 10.4103/indianjotol.indianjotol_25_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Baptista Moreno Martin AC, Tomasin R, Luna-Dulcey L, Graminha AE, Araújo Naves M, Teles RHG, da Silva VD, da Silva JA, Vieira PC, Annabi B, Cominetti MR. [10]-Gingerol improves doxorubicin anticancer activity and decreases its side effects in triple negative breast cancer models. Cell Oncol (Dordr) 2020; 43:915-929. [PMID: 32761561 DOI: 10.1007/s13402-020-00539-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 05/26/2020] [Accepted: 05/28/2020] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Although doxorubicin is widely used to treat cancer, severe side effects limit its clinical use. Combination of standard chemotherapy with natural products can increase the efficacy and attenuate the side effects of current therapies. Here we studied the anticancer effects of a combined regimen comprising doxorubicin and [10]-gingerol against triple-negative breast cancer, which does not respond to hormonal or targeted therapies. METHODS Cytotoxicity was evaluated by MTT assay, cell cycle progression and apoptosis were analyzed by flow cytometry and signaling pathways were analyzed by Western blotting in human and murine triple negative breast cancer cell systems. The anticancer/antimetastatic and toxic effects of the combined regimen was evaluated using syngeneic and xenograft orthotopic models. RESULTS The combination of doxorubicin and [10]-gingerol significantly increased the number of apoptotic cells, compared to each compound alone. In 4T1Br4 cells, the combined regimen was the only condition able to increase the levels of active caspase 3 and γH2AX and to decrease the level of Cdk-6 cyclin. In vivo, doxorubicin (3 mg/Kg, D3) and [10]-gingerol (10 mg/Kg, G10) resulted in a significant reduction in the volume of primary tumors and a decrease in the number of circulating tumor cells (CTCs). Interestingly, only the combined regimen led to decreased tumor burdens to distant organs (i.e., metastasis) and reduced chemotherapy-induced weight loss and hepatotoxicity in tumor-bearing animals. Likewise, in a xenograft model, only the combined regimen was effective in significantly reducing the primary tumor volume and the prevalence of CTCs. CONCLUSIONS Our data indicate that [10]-gingerol has potential to be used as a neoadjuvant or in combined therapy with doxorubicin, to improve its anticancer activity.
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Affiliation(s)
| | - Rebeka Tomasin
- Department of Gerontology, Federal University of São Carlos, Rodovia Washington Luís, Km 235, São Carlos, SP, 13565-905, Brazil
- E-signal Lab, Biochemistry Department, Institute of Chemistry, São Paulo University, Av. Prof. Lineu Prestes 748, São Paulo, SP, 05508-000, Brazil
| | - Liany Luna-Dulcey
- Department of Gerontology, Federal University of São Carlos, Rodovia Washington Luís, Km 235, São Carlos, SP, 13565-905, Brazil
| | - Angélica Elen Graminha
- Department of Gerontology, Federal University of São Carlos, Rodovia Washington Luís, Km 235, São Carlos, SP, 13565-905, Brazil
| | - Marina Araújo Naves
- Department of Gerontology, Federal University of São Carlos, Rodovia Washington Luís, Km 235, São Carlos, SP, 13565-905, Brazil
| | - Ramon Handerson Gomes Teles
- Department of Gerontology, Federal University of São Carlos, Rodovia Washington Luís, Km 235, São Carlos, SP, 13565-905, Brazil
| | - Vinicius Duval da Silva
- Department of Pathology, Barretos Cancer Hospital, R. Antenor Duarte Vilela, 1331 - Dr. Paulo Prata, Barretos, SP, 14784-4003, Brazil
| | - James Almada da Silva
- Departament of Pharmacology, Federal University of Sergipe, Av. Gov. Marcelo Déda, 13, CEP 49400-000, Lagarto, SE, Brazil
| | - Paulo Cezar Vieira
- School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, 14040-903, Ribeirao Preto, SP, Brazil
| | - Borhane Annabi
- Department of Chemistry, Université du Québec à Montréal, Succursale Centre-ville, Case postale 8888, Montréal, Québec, H3C 3P8, Canada
| | - Márcia Regina Cominetti
- Department of Gerontology, Federal University of São Carlos, Rodovia Washington Luís, Km 235, São Carlos, SP, 13565-905, Brazil
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Inappropriate Testing for Acute Viral Hepatitis Is Common-Impact of an Intervention Using the Electronic Health Record in a Tertiary Teaching Hospital in the United States. Ochsner J 2020; 20:293-298. [PMID: 33071662 PMCID: PMC7529134 DOI: 10.31486/toj.19.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Unnecessary laboratory tests contribute to the financial burden placed on hospitals, patients, insurers, and taxpayers. In our institution, we noted acute viral hepatitis serologic testing in patients with chronic liver disease, sometimes done repetitively, in the absence of substantially elevated aminotransferase levels. The goal of this study was to determine the frequency of unnecessary testing for acute hepatitis A and B infections and then reduce testing rates by implementing an intervention in the electronic health record. Methods: In a 2-year period, 2 successive interventions questioning the appropriateness of ordering viral hepatitis serology based on transaminase elevation and prior serology results were implemented in the electronic health record system at Saint Louis University Hospital. The first intervention allowed providers to override the warning without providing a reason; the second intervention required justification to proceed with the order. Preintervention and postintervention appropriate and inappropriate testing proportions were compared using Fisher exact test. Results: The electronic reminders resulted in a statistically significant reduction of inappropriate testing rates; however, testing rates remained high whether the provider had to justify overriding the automatic alert or not. Conclusion: Our research demonstrated that the rates of inappropriate testing for acute viral hepatitis at our institution were unnecessarily high and showed that a simple intervention in the medical record system may be useful in reducing inappropriate testing. Our interventions were feasible and implemented at minimal cost. Similar interventions could be used to target other unnecessary tests, but education and additional interventions will likely be required to reduce unnecessary testing further.
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13
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Serum glutamate dehydrogenase activity enables early detection of liver injury in subjects with underlying muscle impairments. PLoS One 2020; 15:e0229753. [PMID: 32407333 PMCID: PMC7224523 DOI: 10.1371/journal.pone.0229753] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 02/11/2020] [Indexed: 12/18/2022] Open
Abstract
Serum activities of alanine and aspartate aminotransferases (ALT and AST) are used as gold standard biomarkers for the diagnosis of hepatocellular injury. Since ALT and AST lack liver specificity, the diagnosis of the onset of hepatocellular injury in patients with underlying muscle impairments is severely limited. Thus, we evaluated the potential of glutamate dehydrogenase (GLDH) as a liver specific alternative biomarker of hepatocellular injury. In our study, serum GLDH in subjects with Duchene muscular dystrophy (DMD) was equivalent to serum GLDH in age matched healthy subjects, while serum ALT was increased 20-fold in DMD subjects. Furthermore, serum GLDH in 131 subjects with variety of muscle impairments was similar to serum GLDH of healthy subjects while serum ALT corelated with serum creatine kinase, a widely accepted biomarker of muscle impairment. In addition, significant elevations of ALT, AST, and CK were observed in a case of a patient with rhabdomyolysis, while serum GLDH stayed within the normal range until the onset of hypoxia-induced liver injury. In a mouse model of DMD (DMDmdx), serum GLDH but not serum ALT clearly correlated with the degree of acetaminophen-induced liver injury. Taken together, our data support the utility of serum GLDH as a liver-specific biomarker of liver injury that has a potential to improve diagnosis of hepatocellular injury in patients with underlying muscle impairments. In drug development, GLDH may have utility as a biomarker of drug induced liver injury in clinical trials of new therapies to treat muscle diseases such as DMD.
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Mazahreh TS, Aleshawi AJ, Al-Zoubi NA, Altabari M, Aljarrah Q. Comparison of postoperative liver function between different dissection techniques during laparoscopic cholecystectomy. Future Sci OA 2020; 6:FSO462. [PMID: 32257375 PMCID: PMC7117547 DOI: 10.2144/fsoa-2019-0160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: In this study, we investigated and compared the effect of different types of dissector (Maryland vs Hook) on changes in liver function tests (LFTs) after laparoscopic cholecystectomy. Patients & methods: The enrolled patients were divided into two groups. Group A patients underwent dissection by Maryland dissecting forceps, group B by Hook dissecting instrument. LFTs were measured preoperatively and at 1 day and 1 week, postoperatively. Results: For both Maryland and Hook dissection, the 1-day postoperative values for total bilirubin, alanine aminotransferase and aspartate aminotransferase were significantly higher than the preoperative values. Also, there were no statistical differences between Hook and Maryland. Conclusion: The elevation of LFTs seems to be attributed to other factors. Laparoscopic cholecystectomy (LC) is an alternative to laparotomy and has become the standard treatment of benign gallbladder diseases. However, it has been noted that (following LC) the serum level of certain liver function tests (LFT) raises markedly in patients who had preoperatively normal LFT. Pneumoperitoneum is the main contributing factor. This is the first study to evaluate the effect of different dissectors on alteration of LFTs after LC. As there were no statistical differences in the variation of LFTs between the Maryland and Hook, it seems that the dissector type has no effect on the alteration of LFTs.
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Affiliation(s)
- Tagleb S Mazahreh
- Department of General Surgery & Urology, Faculty of Medicine, Jordan University of Science & Technology, Irbid 22110, Jordan
| | - Abdelwahab J Aleshawi
- King Abdullah University Hospital, Jordan University of Science & Technology, Irbid 22110, Jordan
| | - Nabil A Al-Zoubi
- Department of General Surgery & Urology, Faculty of Medicine, Jordan University of Science & Technology, Irbid 22110, Jordan
| | - Mohammad Altabari
- Department of General Surgery & Urology, Faculty of Medicine, Jordan University of Science & Technology, Irbid 22110, Jordan
| | - Qusai Aljarrah
- Department of General Surgery & Urology, Faculty of Medicine, Jordan University of Science & Technology, Irbid 22110, Jordan
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Buonomo AR, Scotto R, Coppola C, Pinchera B, Viceconte G, Rapillo CM, Staiano L, Saturnino M, Scarano F, Portunato F, Pisaturo M, De Pascalis S, Martini S, Tosone G, Nappa S, Coppola N, Gentile I. Direct acting antivirals treatment for hepatitis C virus infection does not increase the incidence of de novo hepatocellular carcinoma occurrence: Results from an Italian real-life cohort (LINA cohort). Medicine (Baltimore) 2020; 99:e18948. [PMID: 32028404 PMCID: PMC7015572 DOI: 10.1097/md.0000000000018948] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The effectiveness of direct-acting antivirals (DAAs) against hepatitis C virus (HCV) infection is ascertained. However, some authors raised the issue of an increased incidence of de novo hepatocellular carcinoma (HCC) in patients treated with DAAs. Aim of the study was to evaluate the rate of HCC occurrence in a real-life cohort of patients who received anti-HCV treatment with DAAs.A prospective multicentre study was conducted. All adult patients with HCV infection who received treatment between March 2015 and December 2017 in 4 hospital of Campania region (South Italy) with at least 6 months of follow-up were enrolled.A total of 323 patients were included in the study. Most patients had HCV genotype 1b (61.8%). The overall SVR12 rate was 95.5%. Median time of observation was 10 months. The incidence rate of HCC was 0.2 per 100 person-months (crude incidence rate 3.4%, 95 confidence interval: 1.5%-5.3%). The median time for HCC occurrence was 11 months. HCC occurrence rate was significantly higher among patients who did not achieve SVR12 compared with patients who did (28.6% vs 2.8%, P < 0.05). No patient with F0-F3 fibrosis developed HCC. Among patients with cirrhosis, at the multivariate time-to-event analysis, no covariates were independently associated with the risk of HCC occurrence.Treatment with DAAs did not increase the risk of HCC occurrence. Patients who achieved SVR12 had a lower rate of HCC occurrence. Further studies are needed to estimate the incidence and the risk for HCC in the long-term follow-up among patients undergoing treatment with DAAs.
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Affiliation(s)
- Antonio Riccardo Buonomo
- Department of Clinical Medicine and Surgery – Section of Infectious Diseases, University of Naples Federico II
| | - Riccardo Scotto
- Department of Clinical Medicine and Surgery – Section of Infectious Diseases, University of Naples Federico II
| | - Carmine Coppola
- Department of Internal Medicine - Unit of Hepatology and Interventional Ultrasonography. OORR Area Stabiese, Plesso Nuovo Gragnano, Naples
| | - Biagio Pinchera
- Department of Clinical Medicine and Surgery – Section of Infectious Diseases, University of Naples Federico II
| | - Giulio Viceconte
- Department of Clinical Medicine and Surgery – Section of Infectious Diseases, University of Naples Federico II
| | - Costanza Maria Rapillo
- Department of Clinical Medicine and Surgery – Section of Infectious Diseases, University of Naples Federico II
| | - Laura Staiano
- Department of Internal Medicine - Unit of Hepatology and Interventional Ultrasonography. OORR Area Stabiese, Plesso Nuovo Gragnano, Naples
| | - Mariarosaria Saturnino
- Department of Internal Medicine - Unit of Hepatology and Interventional Ultrasonography. OORR Area Stabiese, Plesso Nuovo Gragnano, Naples
| | - Ferdinando Scarano
- Department of Internal Medicine - Unit of Hepatology and Interventional Ultrasonography. OORR Area Stabiese, Plesso Nuovo Gragnano, Naples
| | - Federica Portunato
- Department of Mental Health and Public Medicine – Infectious Diseases Unit, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Mariantonietta Pisaturo
- Department of Mental Health and Public Medicine – Infectious Diseases Unit, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Stefania De Pascalis
- Department of Mental Health and Public Medicine – Infectious Diseases Unit, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Salvatore Martini
- Department of Mental Health and Public Medicine – Infectious Diseases Unit, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Grazia Tosone
- Department of Clinical Medicine and Surgery – Section of Infectious Diseases, University of Naples Federico II
| | - Salvatore Nappa
- Department of Clinical Medicine and Surgery – Section of Infectious Diseases, University of Naples Federico II
| | - Nicola Coppola
- Department of Mental Health and Public Medicine – Infectious Diseases Unit, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Ivan Gentile
- Department of Clinical Medicine and Surgery – Section of Infectious Diseases, University of Naples Federico II
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Coppola N, Portunato F, Buonomo AR, Staiano L, Scotto R, Pinchera B, De Pascalis S, Amoruso DC, Martini S, Pisaturo M, Coppola C, Gentile I. Interferon-free regimens improve kidney function in patients with chronic hepatitis C infection. J Nephrol 2019; 32:763-773. [PMID: 30977055 DOI: 10.1007/s40620-019-00608-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/03/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND AIM The impact of directly acting antiviral agent (DAA) regimens on renal function is not well defined and quite controversial. We evaluated the effect of DAAs on kidney function and the factors associated with an improvement or worsening. PATIENTS AND METHODS The changes in estimated glomerular filtration rate (eGFR) in a cohort of 403 patients treated with a DAA regimen were evaluated. RESULTS The overall sustained virological response (SVR12) rate was 98%. The median eGFR progressively increased throughout treatment from 84.54 ml/min/1.73 m2 (IQR 70.8-97.3) to 88.12 ml/min/1.73 m2. Conversely, rates of patients with a eGFR more than 60 ml/min/1.73 m2 progressively increased from 83.1% at baseline to 87.8% at 12 weeks post-treatment (p < 0.05). Considering the change in eGFR according to the different factors, a significant improvement in eGFR was observed in the patients without diabetes (p < 0.001), in those with cirrhosis (p < 0.05), in those receiving a Sof-based regimen (p < 0.01) or not receiving RBV (p < 0.05), in those with a baseline eGFR less than 60 ml/min/1.73 m2 (p < 0.001) and in those with SVR (p < 0.05). An improvement in eGFR (defined as an increase in baseline eGFR of at least 10 ml/min/1.73 m2) was observed in 148 patients (36.7%). At multivariate analysis, age (aHR 0.96; 95 CI 0.93-0.99, p < 0.01) and a diagnosis of diabetes (aHR 0.02; 95 CI 0.20-0.87, p < 0.05) were inversely and independently associated with improvement in renal function, while the presence of Child-Pugh B cirrhosis at baseline was associated with an improvement in renal function (aHR 3.07; 95 CI 1.49-6.30, p < 0.01). CONCLUSIONS DAAs correlate with an improvement in renal function, underlining the importance of hepatitis C virus eradication to achieve also an improvement in extra-hepatic disorders.
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Affiliation(s)
- Nicola Coppola
- Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Caserta, Italy.
- Department of Mental and Public Health, Section of Infectious Diseases, University of Camapania, Via L. Armanni 5, 80133, Naples, Italy.
| | - Federica Portunato
- Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Antonio Riccardo Buonomo
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Laura Staiano
- Unit of Hepatology and Interventional Ultrasonography, Department of Internal Medicine, OORR Area Stabiese, Plesso Nuovo Gragnano, Naples, Italy
| | - Riccardo Scotto
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Biagio Pinchera
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Stefania De Pascalis
- Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Daniela Caterina Amoruso
- Unit of Hepatology and Interventional Ultrasonography, Department of Internal Medicine, OORR Area Stabiese, Plesso Nuovo Gragnano, Naples, Italy
| | | | - Mariantonietta Pisaturo
- Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Carmine Coppola
- Unit of Hepatology and Interventional Ultrasonography, Department of Internal Medicine, OORR Area Stabiese, Plesso Nuovo Gragnano, Naples, Italy
| | - Ivan Gentile
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Zhai X, Zhu C, Zhang Y, Sun J, Alim A, Yang X. Chemical characteristics, antioxidant capacities and hepatoprotection of polysaccharides from pomegranate peel. Carbohydr Polym 2018; 202:461-469. [DOI: 10.1016/j.carbpol.2018.09.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/23/2018] [Accepted: 09/05/2018] [Indexed: 01/12/2023]
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18
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Shah R, Reyes-Gordillo K, Cheng Y, Varatharajalu R, Ibrahim J, Lakshman MR. Thymosin β4 Prevents Oxidative Stress, Inflammation, and Fibrosis in Ethanol- and LPS-Induced Liver Injury in Mice. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:9630175. [PMID: 30116499 PMCID: PMC6079392 DOI: 10.1155/2018/9630175] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 03/25/2018] [Accepted: 04/18/2018] [Indexed: 12/14/2022]
Abstract
Thymosin beta 4 (Tβ4), an actin-sequestering protein, is involved in tissue development and regeneration. It prevents inflammation and fibrosis in several tissues. We investigated the role of Tβ4 in chronic ethanol- and acute lipopolysaccharide- (LPS-) induced mouse liver injury. C57BL/6 mice were fed 5% ethanol in liquid diet for 4 weeks plus binge ethanol (5 g/kg, gavage) with or without LPS (2 mg/kg, intraperitoneal) for 6 hours. Tβ4 (1 mg/kg, intraperitoneal) was administered for 1 week. We demonstrated that Tβ4 prevented ethanol- and LPS-mediated increase in liver injury markers as well as changes in liver pathology. It also prevented ethanol- and LPS-mediated increase in oxidative stress by decreasing ROS and lipid peroxidation and increasing the antioxidants, reduced glutathione and manganese-dependent superoxide dismutase. It also prevented the activation of nuclear factor kappa B by blocking the phosphorylation of the inhibitory protein, IκB, thereby prevented proinflammatory cytokine production. Moreover, Tβ4 prevented fibrogenesis by suppressing the epigenetic repressor, methyl-CpG-binding protein 2, that coordinately reversed the expression of peroxisome proliferator-activated receptor-γ and downregulated fibrogenic genes, platelet-derived growth factor-β receptor, α-smooth muscle actin, collagen 1, and fibronectin, resulting in reduced fibrosis. Our data suggest that Tβ4 has antioxidant, anti-inflammatory, and antifibrotic potential during alcoholic liver injury.
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Affiliation(s)
- Ruchi Shah
- Lipid Research Laboratory, VA Medical Center, 50 Irving Street NW, Washington, DC, USA
- Department of Biochemistry and Molecular Medicine, The George Washington University Medical Center, 2300 I Street NW, Washington, DC, USA
- Institute of Biomedical Sciences, The George Washington University, 2300 I Street NW, Washington, DC, USA
| | - Karina Reyes-Gordillo
- Lipid Research Laboratory, VA Medical Center, 50 Irving Street NW, Washington, DC, USA
- Department of Biochemistry and Molecular Medicine, The George Washington University Medical Center, 2300 I Street NW, Washington, DC, USA
| | - Ying Cheng
- Lipid Research Laboratory, VA Medical Center, 50 Irving Street NW, Washington, DC, USA
- Department of Biochemistry and Molecular Medicine, The George Washington University Medical Center, 2300 I Street NW, Washington, DC, USA
| | - Ravi Varatharajalu
- Lipid Research Laboratory, VA Medical Center, 50 Irving Street NW, Washington, DC, USA
- Department of Biochemistry and Molecular Medicine, The George Washington University Medical Center, 2300 I Street NW, Washington, DC, USA
| | - Joseph Ibrahim
- Lipid Research Laboratory, VA Medical Center, 50 Irving Street NW, Washington, DC, USA
- Department of Biochemistry and Molecular Medicine, The George Washington University Medical Center, 2300 I Street NW, Washington, DC, USA
| | - M. Raj Lakshman
- Lipid Research Laboratory, VA Medical Center, 50 Irving Street NW, Washington, DC, USA
- Department of Biochemistry and Molecular Medicine, The George Washington University Medical Center, 2300 I Street NW, Washington, DC, USA
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The Effect of a Hydrolyzed Polysaccharide Dietary Supplement on Biomarkers in Adults with Nonalcoholic Fatty Liver Disease. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:1751583. [PMID: 29853945 PMCID: PMC5960521 DOI: 10.1155/2018/1751583] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 04/12/2018] [Indexed: 02/07/2023]
Abstract
The primary objective of the study was to evaluate the effect of a hydrolyzed polysaccharide, Rice Bran Arabinoxylan Compound (RBAC), on biomarkers in adults with nonalcoholic fatty liver disease (NAFLD). A 90-day randomized double-blind placebo-controlled trial examined the effect of RBAC on complete blood count, liver enzymes, lipids, oxidative stress markers, cytokines, and growth factors. Twenty-three adults with NAFLD were enrolled and randomly assigned to one of the two study conditions (n = 12 RBAC and n = 11 placebo) and consumed 1 gram/day of either compound for 90 days. Subjects were assessed at baseline and 45 and 90 days. No adverse effects were reported. Alkaline phosphatase significantly decreased (−3.1%; SD = 19.9; F[1,19] = 5.1, p = 0.03) in the RBAC group compared to placebo. Percent monocytes (17.9%; SD = 18.3; F[1,19] = 5.9, p = 0.02) and percent eosinophils (30.6%; SD = 30.5; F[1,19] = 12.3, p < 0.01) increased in the RBAC group. IFN-γ (156%; SD = 131.8; F[1,19] = 4.2, p = 0.06) and IL-18 (29.1%; SD = 64; F[1,19] = 5.3, p = 0.03) increased in the RBAC group compared to placebo. Other improvements were noted for platelets, neutrophils, neutrophil-lymphocyte ratio, γ-glutamyl transferase, and 4-hydroxynonenal. RBAC had beneficial effects on several biomarkers that add to the known immunomodulatory activities of RBAC, which may be promising for people with NAFLD.
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Malakouti M, Kataria A, Ali SK, Schenker S. Elevated Liver Enzymes in Asymptomatic Patients - What Should I Do? J Clin Transl Hepatol 2017; 5:394-403. [PMID: 29226106 PMCID: PMC5719197 DOI: 10.14218/jcth.2017.00027] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 06/22/2017] [Accepted: 07/12/2017] [Indexed: 12/14/2022] Open
Abstract
Elevated liver enzymes are a common scenario encountered by physicians in clinical practice. For many physicians, however, evaluation of such a problem in patients presenting with no symptoms can be challenging. Evidence supporting a standardized approach to evaluation is lacking. Although alterations of liver enzymes could be a normal physiological phenomenon in certain cases, it may also reflect potential liver injury in others, necessitating its further assessment and management. In this article, we provide a guide to primary care clinicians to interpret abnormal elevation of liver enzymes in asymptomatic patients using a step-wise algorithm. Adopting a schematic approach that classifies enzyme alterations on the basis of pattern (hepatocellular, cholestatic and isolated hyperbilirubinemia), we review an approach to abnormal alteration of liver enzymes within each section, the most common causes of enzyme alteration, and suggest initial investigations.
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Affiliation(s)
- Mazyar Malakouti
- Division of Gastroenterology and Nutrition, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- *Correspondence to: Archish Kataria, Department of Internal Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7878, San Antonio, TX 78229, USA. Tel: +1-210-665-7038, Fax: +1-210-567-4856, E-mail: ; Mazyar Malakouti, Division of Gastroenterology and Nutrition, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7878, San Antonio, TX 78229, USA. Tel: +1-204-803-2523, Fax: +1-210-567-4856, E-mail:
| | - Archish Kataria
- Department of Internal Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- *Correspondence to: Archish Kataria, Department of Internal Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7878, San Antonio, TX 78229, USA. Tel: +1-210-665-7038, Fax: +1-210-567-4856, E-mail: ; Mazyar Malakouti, Division of Gastroenterology and Nutrition, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7878, San Antonio, TX 78229, USA. Tel: +1-204-803-2523, Fax: +1-210-567-4856, E-mail:
| | - Sayed K. Ali
- Department of Internal Medicine, University of Central Florida, College of Medicine, Orlando, FL, USA
| | - Steven Schenker
- Division of Gastroenterology and Nutrition, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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A palladium(II)–saccharinate complex of terpyridine exerts higher anticancer potency and less toxicity than cisplatin in a mouse allograft model. Anticancer Drugs 2017; 28:898-910. [DOI: 10.1097/cad.0000000000000531] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Zhai X, Ren D, Luo Y, Hu Y, Yang X. Chemical characteristics of an Ilex Kuding tea polysaccharide and its protective effects against high fructose-induced liver injury and vascular endothelial dysfunction in mice. Food Funct 2017. [DOI: 10.1039/c7fo00490g] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The present study was designed to investigate the protective effects of Ilex Kuding tea polysaccharides (IKTP) on high fructose (HF)-induced liver injury and vascular endothelial dysfunction in mice.
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Affiliation(s)
- Xichuan Zhai
- Shaanxi Engineering Laboratory for Food Green Processing and Safety Control
- and Key Laboratory of Ministry of Education for Medicinal Resource and Natural Pharmaceutical Chemistry
- College of Food Engineering and Nutritional Science
- Shaanxi Normal University
- Xi'an 710062
| | - Daoyuan Ren
- Shaanxi Engineering Laboratory for Food Green Processing and Safety Control
- and Key Laboratory of Ministry of Education for Medicinal Resource and Natural Pharmaceutical Chemistry
- College of Food Engineering and Nutritional Science
- Shaanxi Normal University
- Xi'an 710062
| | - Yiyang Luo
- Shaanxi Engineering Laboratory for Food Green Processing and Safety Control
- and Key Laboratory of Ministry of Education for Medicinal Resource and Natural Pharmaceutical Chemistry
- College of Food Engineering and Nutritional Science
- Shaanxi Normal University
- Xi'an 710062
| | - Yuanyuan Hu
- Chongqing Collaborative Innovation Center for Functional Food
- Chongqing University of Education
- Chongqing 400067
- China
| | - Xingbin Yang
- Shaanxi Engineering Laboratory for Food Green Processing and Safety Control
- and Key Laboratory of Ministry of Education for Medicinal Resource and Natural Pharmaceutical Chemistry
- College of Food Engineering and Nutritional Science
- Shaanxi Normal University
- Xi'an 710062
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Oh JS, Choi JS, Lee YH, Ko KO, Lim JW, Cheon EJ, Lee GM, Yoon JM. The Relationships between Respiratory Virus Infection and Aminotransferase in Children. Pediatr Gastroenterol Hepatol Nutr 2016; 19:243-250. [PMID: 28090469 PMCID: PMC5234413 DOI: 10.5223/pghn.2016.19.4.243] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 09/02/2016] [Accepted: 09/24/2016] [Indexed: 12/16/2022] Open
Abstract
PURPOSE We sought to examine the relationship between the clinical manifestations of nonspecific reactive hepatitis and respiratory virus infection in pediatric patients. METHODS Patients admitted to the pediatric unit of Konyang University Hospital for lower respiratory tract disease between January 1, 2014 and December 31, 2014 and who underwent reverse transcriptase polymerase chain reaction tests were examined. The patients were divided into those with increased levels of alanine aminotransferase (ALT) or aspartate aminotransferase (AST) and those with normal ALT or AST levels. Further, patients with increased ALT and AST levels were individually compared with patients in the normal group, and the blood test results were compared according to the type of respiratory virus. RESULTS Patients with increased ALT or AST levels had one more day of hospital stay, on average, compared with patients in the normal group (5.3±3.1 days vs. 4.4±3.0 days, p=0.019). Patients in the increased ALT level group were younger and had a longer mean hospital stay, compared with patients in the normal group (p=0.022 and 0.003, respectively). The incidences of increased ALT or AST were the highest in adenovirus infections (6/24, 25.0%), followed by enterovirus (2/11, 18.2%) and respiratory syncytial virus A (21/131, 16.0%) infections. CONCLUSION Nonspecific reactive hepatitis is more common among patients with adenovirus, enterovirus and respiratory syncytial virus infection, as well as among those infected at a younger age. Compared with AST levels, ALT levels are better indicators of the severity of nonspecific reactive hepatitis.
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Affiliation(s)
- Jun Suk Oh
- Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea
| | - Jun Sik Choi
- Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea
| | - Young Hyuk Lee
- Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea
| | - Kyung Og Ko
- Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea
| | - Jae Woo Lim
- Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea
| | - Eun Jung Cheon
- Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea
| | - Gyung Min Lee
- Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea
| | - Jung Min Yoon
- Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea
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Vincenzi B, Imperatori M, Picardi A, Vespasiani Gentilucci U, Gallo P, Fausti V, Spalato Ceruso M, Santini D, Tonini G. Liver toxicity in colorectal cancer patients treated with first-line FOLFIRI-containing regimen: a single institution experience. Expert Rev Anticancer Ther 2015; 15:971-976. [PMID: 26112080 DOI: 10.1586/14737140.2015.1061937] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Chemotherapy-induced toxic liver injury is a relevant issue in the clinical management of patients affected with metastatic colorectal cancer (mCRC). This retrospective study evaluated patterns of liver toxicity in patients treated with FOLinic acid, Fluorouracil, IRInotecan (FOLFIRI)-based regimens. METHODS One hundred and fifty-six mCRC patients treated at the University Campus Bio-Medico between January 2003 and January 2013 were included in this retrospective analysis. All patients received a FOLFIRI backbone-based chemotherapy. Basal liver enzymes levels were assessed before starting the treatment and before every therapy course. R ratio and the aspartate aminotransferase/alanine aminotransferase ratio were calculated. RESULTS Ninety-one patients were male versus 55 female, and the median age of the population was 62 years (range: 38-83). Most patients had liver involvement at the beginning of first-line regimen (101 patients, 64.74%) and 59 patients had received a previous 5-FU based therapy in the adjuvant setting (37.82%). Aspartate aminotransferase level (167.87 vs 41.05 U/l; p < 0.001), Alanine aminotransferase level (94.48 vs 39.80 U/l; p = 0.004) and alkaline phosphatase (289.0 vs 172.44 U/l; p = 0.02) were significantly increased during the first 3 months of treatment. In the entire population, the calculated R ratio was 3.96 (95% CI: 3.25-4.51). In all three regimens, the calculated R ratio was between 2 and 5, without any statistical differences. CONCLUSIONS FOLFIRI-based hepatotoxicity has been indirectly defined as a mixed pattern injury in all three regimens evaluated.
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Affiliation(s)
- Bruno Vincenzi
- Medical Oncology, University Campus Bio-Medico, via Alvaro del portillo 200, Roma 00128, Italy
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Dehghani SM, Erjaee A, Haghighat M, Imanieh MH, Ahmadi R. Upper Limits of Normal Aminotransferases in Children of Southern Iran. JOURNAL OF COMPREHENSIVE PEDIATRICS 2014; 5. [DOI: 10.17795/compreped-15274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Hamidi MS, Corey PN, Cheung AM. Effects of vitamin E on bone turnover markers among US postmenopausal women. J Bone Miner Res 2012; 27:1368-80. [PMID: 22308007 DOI: 10.1002/jbmr.1566] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Increased oxidative stress and inflammation resulting from aging and declining estrogen levels can lead to increased bone loss in postmenopausal women. Alpha-tocopherol and gamma-tocopherol, the two predominant isomers of vitamin E, have antioxidant and anti-inflammatory properties, but their effects on bone metabolism have not been well studied in humans. We examined the associations between dietary and total (diet and supplements) alpha-tocopherol intake, serum alpha-tocopherol and gamma-tocopherol levels and their ratio, and bone turnover markers (BTMs) among postmenopausal women aged ≥45 years. We used cross-sectional data from the National Health and Nutrition Examination Survey 1999–2002. Multiple regression models with adjustments for relevant confounders were used to examine the associations between intake and serum levels of tocopherols, and serum bone-specific alkaline phosphatase (BAP), a biomarker of bone formation, and urinary N-telopeptides/creatinine (uNTx/Cr), a biomarker of bone resorption. The study sample included 497 postmenopausal women who were not taking estrogen, steroids, or osteoporosis medications, were free from kidney and liver disease, cancer, and rheumatoid arthritis, and were fasting >9 hours prior to examination. Participants had a mean age of 65.5 ± 0.6 years and over 45% used vitamin E (alpha-tocopherol) supplements in the past month. Vitamin E supplement users had significantly lower serum gamma-tocopherol, higher serum alpha-tocopherol levels, and higher ratio of serum alpha-tocopherol to gamma-tocopherol than nonusers. High serum gamma-tocopherol levels and low ratio of serum alpha-tocopherol to gamma-tocopherol were associated with increased BAP levels (p < 0.01 for both). There were no associations between any of the vitamin E variables and uNTx/Cr. In conclusion, we hypothesize that gamma-tocopherol may uncouple bone turnover, resulting in more bone formation than resorption. Vitamin E supplements in the form of alpha-tocopherol suppress serum gamma-tocopherol levels and may have negative effects on bone formation. Further research is needed to investigate the potential anabolic effect of gamma-tocopherol from food sources on bone.
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Affiliation(s)
- Maryam S Hamidi
- Women's Health and Osteoporosis Programs, University Health Network, 200 Elizabeth Street, 7 Eaton North 221, Toronto, Ontario, Canada
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Hamidi M, Tarasuk V, Corey P, Cheung AM. Association between the Healthy Eating Index and bone turnover markers in US postmenopausal women aged ≥45 y. Am J Clin Nutr 2011; 94:199-208. [PMID: 21562084 DOI: 10.3945/ajcn.110.009605] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Some studies have reported that overall diet quality affects bone status in postmenopausal women; however, the findings are inconsistent. OBJECTIVES Our primary objective was to examine the association between overall diet quality and bone turnover markers (BTMs) in postmenopausal women aged ≥45 y by using the Healthy Eating Index 2005 (HEI-2005)-a diet quality-assessment tool-developed by the US Department of Agriculture. Our secondary objective was to explore the associations between the components of the HEI-2005 and the MyPyramid food groups and BTMs. DESIGN We used cross-sectional data from NHANES 1999-2002. Multiple regression models with adjustments for relevant confounders were used to examine the relation between the total HEI-2005 score and its components and food groups and serum bone-specific alkaline phosphatase (BAP), a biomarker of bone formation, and urinary N-telopeptides/creatinine (uNTx/Cr), a biomarker of bone resorption. RESULTS No association was found between the total HEI-2005 score and BTMs. The milk group component of HEI-2005 had a significant negative linear relation with uNTx/Cr. Women in the lowest tertile of the MyPyramid milk group had the highest uNTx/Cr. Those in the highest tertile of energy-adjusted added sugar intake had the highest BAP. CONCLUSIONS Our results support the ability of a healthy diet with adequate dairy intake to promote bone health in aging women. However, we found that the HEI-2005 is not a good measure of healthy eating for optimal bone health. Further research is needed to develop an overall dietary assessment tool in relation to bone health for postmenopausal women.
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Affiliation(s)
- Maryam Hamidi
- Women's Health and Osteoporosis Programs, University Health Network, University of Toronto, Toronto, Canada
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Hsu YC, Chen HL, Wu MZ, Liu YJ, Lee PH, Sheu JC, Chen CH. Adult progressive intrahepatic cholestasis associated with genetic variations in ATP8B1 and ABCB11. Hepatol Res 2009; 39:625-31. [PMID: 19260995 DOI: 10.1111/j.1872-034x.2009.00499.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Severe intrahepatic cholestasis with low serum gamma-glutamyltranspeptidase (gamma-GT) activity is exceptionally rare in adult patients, and its association with multi-genetic alterations of bile salt transporters has not been reported. We investigated a 25-year-old man presenting with a four-year history of jaundice. Laboratory and radiographic examinations revealed clinical pictures of progressive intrahepatic cholestasis with low gamma-GT. Serial liver histopathology demonstrated cirrhosis resulting from progressive persistent cholestatic injury. Genetic sequencing studies for the entire coding exons of ATP8B1 and ABCB11 uncovered a heterozygous missense mutation 1798 C->T (R600W) in ATP8B1, and a homozygous nucleotide substitution 1331 T->C (V444A) in ABCB11. In conclusion, this is a rare case of adult onset progressive intrahepatic cholestasis with low gamma-GT associated with heterozygous ATP8B1 mutation and homozygous ABCB11 polymorphism. Further studies are necessary to investigate the impact of heterozygous R600W mutation and whether other cholestatic disorders are multi-genetic.
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Affiliation(s)
- Yao-Chun Hsu
- Division of Gastroenterology, Department of Internal Medicine, Lo-Tung Pohai Hospital, I-Lan
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Non-alcoholic fatty liver disease and its relationship with the nutritional status of vitamin A in individuals with class III obesity. Obes Surg 2008; 18:378-85. [PMID: 18264740 DOI: 10.1007/s11695-007-9361-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2007] [Accepted: 11/06/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND The objective of the present study was to investigate vitamin A nutritional status in individuals with class III obesity through a biochemical indicator (retinol and beta-carotene serum levels), correlating these findings with non-alcoholic fatty liver disease (NAFLD) presence and its risk factors. METHODS The studied population was composed of 145 patients with morbid obesity [body mass index, BMI > or = 40 kg/m(2)) of both sexes. Retinol and beta-carotene serum levels were assessed by high performance liquid chromatography. The cutoff values used for serum retinol and beta-carotene inadequacy were <1.05 micromol/l and < or =40 microg/dl, respectively. Insulin resistance (IR) was assessed through homeostasis model assessment index (HOMA) method. Biochemical parameters of liver enzymes, lipid profile, and glycemia were analyzed. Anthropometric measurements were conducted. NAFLD diagnosis was performed through magnetic resonance. RESULTS NAFLD prevalence in the group was 71%. An inadequacy of 11.3 and 41.7% of retinol and beta-carotene serum levels, respectively, was found when NAFLD was present. A significant correlation of serum retinol with albumin liver and total bilirubin was found. As regards beta-carotene, a positive correlation for HDL-c variable and a negative correlation for the HOMA-IR, weight, and BMI variables were observed. There was a significant association between IR presence and retinol and beta-carotene inadequacy. CONCLUSION The high inadequacy of retinol and beta-carotene nutritional status in the sample, with a higher inadequacy in those with NAFLD, suggests an increase in the utilization of vitamin A in this group related to the fight against the oxidative stress to what they are exposed to. The significant association between retinol and beta-carotene with IR supports the hypothesis that vitamin A may have a protector effect on IR pathogenesis.
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Abstract
First described over 40 years ago, alcoholic hepatitis (AH) (an acute inflammation of the liver) is a common condition seen in 10-35% of heavy drinkers. In its severest form acute AH carries a high short-term mortality of up to 60%. Although the current treatment options are limited, many of the complications associated with increased mortality, such as hepatorenal syndrome, are preventable. The incidence of AH in the UK is set to rise as a result of the increase in heavy drinking. This article aims to increase awareness of the disease aetiology and to review current management strategies and nursing care.
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Affiliation(s)
- Suzanne Sargent
- Institute of Liver Studies, King's College Hospital, Denmark Hill, London
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Hasukic S, Kosuta D, Muminhodzic K. Comparison of postoperative hepatic function between laparoscopic and open cholecystectomy. Med Princ Pract 2005; 14:147-50. [PMID: 15863986 DOI: 10.1159/000084630] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2004] [Accepted: 07/28/2004] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE In this prospective study, we evaluated the effects of pneumoperitoneum on hepatic function during laparoscopic (LC) and open cholecystectomy (OC). SUBJECTS AND METHODS One hundred patients who underwent LC (n = 50) or OC (n = 50) were included in the study. The groups were similar in age, sex, weight and height. Following liver function tests (total bilirubin; gamma-glutamyltransferase, GGT; alkaline phosphatase, ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) were obtained preoperatively and at 24 and 48 h postoperatively. Similar anesthesiologic protocol was used for both LC and OC. During LC, the intra-abdominal pressure was maintained within the conventional range of 12-14 mm Hg. RESULTS Total bilirubin, ALP, GGT and LDH levels remained unchanged from baseline in both groups without significant difference between them. A higher number of patients had increased values of ALT (26/50 vs. 5/50) and AST (23/50 vs. 6/50) in LC compared to OC group. Although the difference was statistically significant (p < 0.000 for ALT and p = 0.0004 for AST) the increased level decreased at 48 compared to 24 h. CONCLUSION The results indicate that LC is associated with transient elevation of ALT and AST. The disturbances in the function of the liver after LC are self-limited and not associated with any morbidity in patients with a normal liver function.
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Affiliation(s)
- Sefik Hasukic
- Department of Surgery, University Clinical Center, Faculty of Medicine, University of Tuzla, Tuzla, Bosnia-Herzegovina.
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Abstract
Isolated alterations of biochemical markers of liver damage in a seemingly healthy patient can present a challenge for the clinician. In this review we provide a guide to interpreting alterations to liver enzyme levels. The functional anatomy of the liver and pathophysiology of liver enzyme alteration are briefly reviewed. Using a schematic approach that classifies enzyme alterations as predominantly hepatocellular or predominantly cholestatic, we review abnormal enzymatic activity within the 2 subgroups, the most common causes of enzyme alteration and suggested initial investigations.
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Affiliation(s)
- Edoardo G Giannini
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy.
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Abstract
CONTEXT Hepatotoxicity is a potential complication from the usage of various illicit drugs, possibly consequent to their liver metabolism, but information on this is scarce in the medical literature. OBJECTIVE To study the occurrence of clinical and laboratory hepatic alterations in chronic marijuana users, from the use of marijuana on its own or in association with other legal or illicit drugs. TYPE OF STUDY transversal study SETTING Hospital Espírita de Marília, Marília, São Paulo, Brazil PARTICIPANTS The study was made among 123 patients interned in the Hospital Espírita de Marília from October 1996 to December 1998, divided into 3 groups: 26 (21%) using only marijuana, 83 (67.5%) using marijuana and crack, and 14 (11.4%) consuming marijuana and alcohol. PROCEDURES AND MAIN MEASUREMENTS: Patients were examined clinically with special emphasis on types of drugs used, drug intake route, age when consumption began, length and pattern of usage, presence of tattooing, jaundice, hepatomegaly and splenomegaly. Serum determinations of total proteins, albumin, globulin, total and fractions of bilirubin, aspartate (AST) and alanine (ALT) aminotransferases, alkaline phosphatase (AP), gamma-glutamyltransferase and prothrombin activity were performed. RESULTS Among users of only marijuana, hepatomegaly was observed in 57.7% and splenomegaly in 73.1%, and slightly elevated AST (42.3%), ALT (34.6%) and AP (53.8%). The three groups did not differ significantly in the prevalence of hepatomegaly, splenomegaly and hepatosplenomegaly. The group using both marijuana and alcohol showed the highest prevalence of alterations and highest levels of aminotransferases. Mean AP levels were above normal in all groups. CONCLUSIONS Chronic marijuana usage, on its own or in association with other drugs, was associated with hepatic morphologic and enzymatic alterations. This indicates that cannabinoids are possible hepatotoxic substances.
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Affiliation(s)
- Paulo Borini
- Hospital Espírita de Marília, Marília, São Paulo, Brazil.
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Borini P, Guimarães RC, Borini SB. Histopathologic and biochemical liver test abnormalities in chronic asymptomatic or oligosymptomatic alcoholics: a review. REVISTA DO HOSPITAL DAS CLINICAS 2003; 58:147-56. [PMID: 12894311 DOI: 10.1590/s0041-87812003000300004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE To review the medical literature regarding the histopathologic and biochemical liver test abnormalities in chronic asymptomatic or oligosymptomatic alcoholics. METHODS Review of articles in the MEDLINE and LILACS databases regarding serum levels and prevalence of alterations in aspartate-aminotransferase, alanine-aminotransferase, alkaline phosphatase, and total bilirubin, in relation to liver histopathology, with or without discrimination of types of histopathologic alteration. RESULTS Global mean prevalence rates of aspartate-aminotransferase and alanine-aminotransferase alterations were 86.3% and 51.1%; in cases with steatosis they were 79.1% and 38.5%; and in cases of hepatitis, 90.1% and 58%. In all studies, prevalence rates of aspartate-aminotransferase alterations were significantly higher with lower variability than those of alanine-aminotransferase. Mean aspartate-aminotransferase levels were higher than 2N (N is the upper normal limit of the method employed) in all cases with hepatitis histopathology, while those of alanine-aminotransferase were 1.48N, in the same cases. Prevalence of alkaline phosphatase and total bilirubin abnormalities were 74.5% and 74.9% globally; in cases of steatosis, they were 70.9% and 67.9%; and in cases of hepatitis, 75.9% and 77.7%. Mean alkaline phosphatase levels were above the upper normal limit in all cases, but those of total bilirubin were above normal in 4 of 7 hepatitis studies. CONCLUSIONS Prevalence of aspartate-aminotransferase alteration was consistently related to presence of histopathologic abnormalities; an enzyme level higher than 2N suggests the diagnosis of alcoholic hepatitis.
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Affiliation(s)
- Paulo Borini
- Faculty of Medicine of Mar lia, Marília, São Paulo, Brazil
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Jacobs P, Ng YC, Stafinski T, Dodd R, Larke B, Wong W. Labour force participation among individuals with hepatitis C in the US. PHARMACOECONOMICS 2003; 21:565-572. [PMID: 12751914 DOI: 10.2165/00019053-200321080-00003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND In 1996, the number of persons newly infected with hepatitis C virus (HCV) in the US was estimated to be 36 000. As a chronic disease that primarily affects younger persons, hepatitis C has the potential to influence employment considerably. OBJECTIVE To estimate employment effects associated with hepatitis C morbidity. DESIGN An economic model of labour supply, which used the outcome measure workforce participation (yes/no), was applied. STUDY PARTICIPANTS The study samples (by gender) were comprised of persons 18-65 years of age, with and without serological evidence of HCV infection, and with normal or elevated levels of alanine aminotransferase (ALT) who participated in the National Health and Nutrition Examination Survey III from 1988-1994. RESULTS After controlling for the potential confounding effects of demographic, social, and economic factors, positive HCV status/normal ALT level in males was associated with a 10.7% reduction in labour force participation (when compared with negative HCV status). Positive HCV status and elevated ALT levels was associated with a 17.5% reduction in employment. The results for females were not statistically significant. CONCLUSIONS Nationally, the employment response for HCV-positive status and elevated ALT levels translates into an excess non-employment of 48 000 males annually.
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Affiliation(s)
- Philip Jacobs
- Department of Public Health Sciences, University of Alberta and Institute of Health Economics, #1200-10405 Jasper Avenue, Edmonton, Alberta T5J 3N4, Canada.
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Fikar CR. Making sense of liver enzymes, liver function tests, and hepatobiliary disorders at the reference desk. Med Ref Serv Q 2003; 22:15-22. [PMID: 14527136 DOI: 10.1300/j115v22n03_02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
This paper discusses concepts and terminology of some aspects of the laboratory diagnosis of liver (hepatic) disease and biliary tract disease (hepatobiliary disease) as it relates to medical reference work. Details of anatomic, biochemical, and pathologic processes are not discussed. Knowledge of the specific terminology involved in this area may help to ensure a good approach to developing prudent strategies for database searching of the medical literature and therefore is reviewed. MeSH and EMBASE thesauri terms are discussed and textword synonyms are presented that provide tools for thorough searching techniques. Commonly used medical jargon for this area is also explained. Examples of specific search strategies are illustrated.
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Affiliation(s)
- Charles R Fikar
- Health Sciences Library, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY 11554, USA.
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Abstract
Liver function tests are used to detect, specifically diagnose, and estimate the severity of hepatic disease. Effective interpretation of the hepatic function panel requires knowledge of underlying pathophysiology and the characteristics of panel tests. This article includes a working classification of liver disease, a list of liver functions with the tests appropriate to each function, and a guide to panel interpretation and further laboratory investigation.
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Affiliation(s)
- M Desmond Burke
- Department of Pathology, Division of Laboratory Medicine, Weill Medical College, Cornell University, 525 East 68th Street, New York, NY 10021, USA.
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38
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Abstract
Serum liver tests are important but often problematic in evaluating patients with and without symptoms of hepatic disease. The common term "liver function tests" is misleading because most tests used in clinical practice measure hepatocellular damage not function. True liver function tests are those that measure synthesis of proteins made by the liver (albumin, clotting factors) or the liver's capacity to metabolize drugs. A commonly ordered panel of automated tests includes bilirubin, aminotransferases, alkaline phosphatase, and gamma-glutamyl transpeptidase. This article reviews patterns of elevated enzyme values encountered in liver diseases and their diagnostic limitations and provides an algorithm for evaluating abnormal liver test results.
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Affiliation(s)
- F A Rochling
- Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA
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