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Drummond D, Dana J, Berteloot L, Schneider-Futschik EK, Chedevergne F, Bailly-Botuha C, Nguyen-Khoa T, Cornet M, Le Bourgeois M, Debray D, Girard M, Sermet-Gaudelus I. Lumacaftor-ivacaftor effects on cystic fibrosis-related liver involvement in adolescents with homozygous F508 del-CFTR. J Cyst Fibros 2021; 21:212-219. [PMID: 34454846 DOI: 10.1016/j.jcf.2021.07.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 07/24/2021] [Accepted: 07/28/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The effects of lumacaftor-ivacaftor on cystic fibrosis transmembrane conductance regulator (CFTR)-associated liver disease remain unclear. The objective of the study was to describe the effect of this treatment on features of liver involvement in a cystic fibrosis (CF) adolescent population homozygous for F508del. METHODS Clinical characteristics, liver blood tests, abdominal ultrasonography (US), and pancreas and liver proton density fat fraction (PDFF) by magnetic resonance imaging, were obtained at treatment initiation and at 12 months for all patients. Biomarkers of CFTR activity (sweat chloride test, nasal potential difference, and intestinal current measurement) were assessed at initiation and at 6 months therapy. RESULTS Of the 37 patients who started ivacaftor/lumacaftor treatment, 28 were eligible for analysis. In this group, before treatment initiation, 4 patients were diagnosed with multinodular liver and portal hypertension, 19 with other forms of CF liver involvement, and 5 with no signs of liver involvement. During treatment, no hepatic adverse reactions were documented, and no patient developed liver failure. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gammaglutamyl transferase (GGT) decreased significantly following initiation of lumacaftor-ivacaftor, and remained so after 12 months treatment. This was not correlated with changes in clinical status, liver and pancreas US and PDFF, fecal elastase, or lumacaftor-ivacaftor serum levels. The most "responsive" patients demonstrated a significant increase in biomarkers of CFTR activity. CONCLUSIONS These results may suggest a potential beneficial effect of CFTR modulators on CF liver disease and warrant further investigation in larger, prospective studies.
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Affiliation(s)
- David Drummond
- Service de Pneumologie et Allergologie Pédiatriques, Centre de Référence Maladies Rares Mucoviscidose et Maladies apparentées, Centre de Ressources et de Compétences pour la Mucoviscidose, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP)-Centre, Université de Paris, Paris, France; Université de Paris, Paris, France
| | - Jérémy Dana
- Université de Paris, Paris, France; Service d'Imagerie pédiatrique, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP)-Centre, Université de Paris, Paris, France; Université de Strasbourg, Inserm U1110, Institut de Recherche sur les Maladies Virales et Hépatiques, Strasbourg, France; Institut Hospitalo-Universitaire, Strasbourg, France
| | - Laureline Berteloot
- Service d'Imagerie pédiatrique, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP)-Centre, Université de Paris, Paris, France
| | - Elena K Schneider-Futschik
- Department of Pharmacology & Therapeutics, Lung Health Research Centre, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia; Laboratoire de Biochimie, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP)-Centre, Université de Paris, Paris, France
| | - Frédérique Chedevergne
- Service de Pneumologie et Allergologie Pédiatriques, Centre de Référence Maladies Rares Mucoviscidose et Maladies apparentées, Centre de Ressources et de Compétences pour la Mucoviscidose, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP)-Centre, Université de Paris, Paris, France
| | - Céline Bailly-Botuha
- Service de Pneumologie et Allergologie Pédiatriques, Centre de Référence Maladies Rares Mucoviscidose et Maladies apparentées, Centre de Ressources et de Compétences pour la Mucoviscidose, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP)-Centre, Université de Paris, Paris, France
| | - Thao Nguyen-Khoa
- Service de Pneumologie et Allergologie Pédiatriques, Centre de Référence Maladies Rares Mucoviscidose et Maladies apparentées, Centre de Ressources et de Compétences pour la Mucoviscidose, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP)-Centre, Université de Paris, Paris, France; Laboratoire de Biochimie, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP)-Centre, Université de Paris, Paris, France
| | - Mathieu Cornet
- Service de Pneumologie et Allergologie Pédiatriques, Centre de Référence Maladies Rares Mucoviscidose et Maladies apparentées, Centre de Ressources et de Compétences pour la Mucoviscidose, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP)-Centre, Université de Paris, Paris, France; Université de Paris, Paris, France; INSERM U1151, Institut Necker Enfants Malades, Paris, France
| | - Muriel Le Bourgeois
- Service de Pneumologie et Allergologie Pédiatriques, Centre de Référence Maladies Rares Mucoviscidose et Maladies apparentées, Centre de Ressources et de Compétences pour la Mucoviscidose, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP)-Centre, Université de Paris, Paris, France
| | - Dominique Debray
- Université de Paris, Paris, France; Unité d'Hépatologie pédiatrique, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP)-Centre, Université de Paris, Paris, France
| | - Muriel Girard
- Université de Paris, Paris, France; Department of Pharmacology & Therapeutics, Lung Health Research Centre, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia; Unité d'Hépatologie pédiatrique, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP)-Centre, Université de Paris, Paris, France
| | - Isabelle Sermet-Gaudelus
- Service de Pneumologie et Allergologie Pédiatriques, Centre de Référence Maladies Rares Mucoviscidose et Maladies apparentées, Centre de Ressources et de Compétences pour la Mucoviscidose, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP)-Centre, Université de Paris, Paris, France; Université de Paris, Paris, France; Department of Pharmacology & Therapeutics, Lung Health Research Centre, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia; Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine (CRSA), Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.
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102
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Hua S, Qi Q, Kizer JR, Williams-Nguyen J, Strickler HD, Thyagarajan B, Daviglus M, Talavera GA, Schneiderman N, Cotler SJ, Cai J, Kaplan R, Isasi CR. Association of liver enzymes with incident diabetes in US Hispanic/Latino adults. Diabet Med 2021; 38:e14522. [PMID: 33434318 DOI: 10.1111/dme.14522] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/07/2021] [Accepted: 01/09/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Non-alcoholic fatty liver disease (NAFLD) has been associated with increased risk of incident diabetes. But such evidence is lacking in the Hispanic/Latino population, which has high prevalence of obesity and NAFLD. METHODS We conducted a prospective cohort study of 6,928 adults of Hispanic/Latino background who had no diabetes, did not report excessive alcohol use, and no hepatitis B and C infection at baseline (2008-2011). We estimated risk ratios (RR) for incident diabetes, identified from visit 2 examination by glucose measurements or antidiabetic medication use, with baseline liver enzymes (alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transpeptidase (GGT)). RESULTS A total of 738 adults developed diabetes during 6 years of follow-up. After adjusting for participant characteristics at baseline, versus the lowest quartile, highest quartiles of ALT and GGT were associated with risks for incident diabetes (RR for ALT: 1.51 [95% CI 1.03-2.22], p-trend = 0.006; RR for GGT: 2.39 [1.60-3.55], p-trend = 0.001). Higher GGT levels predicted increased risk of incident diabetes even among those with ALT or AST below the median levels. The associations of ALT and GGT with incident diabetes were similar among most Hispanic background but were not seen among Dominicans (p for interaction <0.05). The association of AST with incident diabetes was found only among light-to-moderate alcohol drinkers (RR = 1.50 [1.20-1.86]) but not abstainers (RR = 0.91 [0.69-1.20], p for interaction = 0.006). CONCLUSION Higher ALT and GGT levels are associated with increased risk of developing diabetes among Latinos. Liver enzyme tests might aid in diabetes prevention by identifying high-risk individuals.
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Affiliation(s)
- Simin Hua
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Qibin Qi
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jorge R Kizer
- San Francisco VA Health Care System and University of California San Francisco, San Francisco, CA, USA
| | | | | | | | - Martha Daviglus
- University of Illinois at Chicago and Northwestern University, Chicago, IL, USA
| | | | | | | | - Jianwen Cai
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Robert Kaplan
- Albert Einstein College of Medicine, Bronx, NY, USA
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Sangsefidi ZS, Mozaffari‐Khosravi H, Sarkhosh‐Khorasani S, Hosseinzadeh M. The effect of anthocyanins supplementation on liver enzymes: A systematic review and meta-analysis of randomized clinical trials. Food Sci Nutr 2021; 9:3954-3970. [PMID: 34262751 PMCID: PMC8269574 DOI: 10.1002/fsn3.2278] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/28/2021] [Accepted: 03/16/2021] [Indexed: 12/15/2022] Open
Abstract
This systematic review and meta-analysis aimed to assess effect of consuming anthocyanins (ACNs; pure ACNs or products containing ACNs) on liver enzymes levels including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT). Although no significant impact was detected on the liver enzymes, a significant reduction was observed on ALT (WMD = -4.932 U/L, 95% CI = -9.848 to -0.015, p = .049) and AST (WMD = -3.464 U/L, 95% CI = -6.034 to -0.894, p = .008) in the studies that examined them as primary outcomes. A significant decrease was found on AST among the healthy subjects (WMD = -4.325 U/L, 95% CI = -8.516 to -0.134, p = .043) and in the studies that used products containing ACNs as intervention (WMD = -2.201 U/L, 95% CI = -4.275 to -0.127, p = .037). Although no significant relation was detected between ACNs dosage and the liver enzymes, significant associations were found between the duration of trial with ALT (ALT: slope: 0.09, 95% CI = 0.040 to 0.139, p = .0003) and AST (slope: 0.076, 95% CI = 0.037 to 0.115, p = .0001). In conclusion, although ACNs had no significant effect on the liver enzymes, a significant decrease was discovered on ALT and AST in the studies that evaluated them as primary outcomes. A significant reduction was observed in AST in the healthy individuals and in the studies used products containing ACNs as intervention. Significant relations were also found between the duration of trial with ALT and AST. Further studies are required to confirm these results.
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Affiliation(s)
- Zohreh Sadat Sangsefidi
- Nutrition and Food Security CenterSchool of Public HealthShahid Sadoughi University of Medical SciencesYazdIran
- Department of NutritionSchool of Public HealthShahid Sadoughi University of Medical SciencesYazdIran
| | - Hassan Mozaffari‐Khosravi
- Nutrition and Food Security CenterSchool of Public HealthShahid Sadoughi University of Medical SciencesYazdIran
- Department of NutritionSchool of Public HealthShahid Sadoughi University of Medical SciencesYazdIran
| | - Sahar Sarkhosh‐Khorasani
- Nutrition and Food Security CenterSchool of Public HealthShahid Sadoughi University of Medical SciencesYazdIran
- Department of NutritionSchool of Public HealthShahid Sadoughi University of Medical SciencesYazdIran
| | - Mahdieh Hosseinzadeh
- Nutrition and Food Security CenterSchool of Public HealthShahid Sadoughi University of Medical SciencesYazdIran
- Department of NutritionSchool of Public HealthShahid Sadoughi University of Medical SciencesYazdIran
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Yousif M, Abd El-Raheem G, Mohamed D. Use of Remdesivir in the treatment of Coronavirus Disease 2019 (COVID-19) infection among Sudanese patients: a case series. F1000Res 2021; 10:512. [PMID: 35387271 PMCID: PMC8941288 DOI: 10.12688/f1000research.51375.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2022] [Indexed: 09/02/2023] Open
Abstract
Introduction: The coronavirus disease 2019 (COVID-19) pandemic is affecting populations worldwide. Remdesivir is an anti-retroviral agent, with a broad spectrum of usage. Remdesivir usage against COVID-19 had been studied both in vitro and in vivo but is still considered a new treatment for COVID-19 and is not available in all countries. The aim of our study was to report several cases of the use of Remdesivir in Sudanese patients and report the adverse events related to the course of treatment. Methods: A case series study was conducted in Imperial Hospital, Khartoum, Sudan reporting two cases who received Remdesivir for treating COVID-19 besides other treatments such as steroids and supportive therapy in December 2020. Cases were males aged over 65 years. Cases presentation: Both patients were severe cases of COVID-19 admitted to the intensive care unit (ICU), who received Remdesivir for treating COVID-19 infection. Several side effects were reported: the first case had increased liver enzymes and then unexpectedly died from severe resistant hypotension; and hypoalbuminemia was noticed in the second case. Conclusions: Remdesivir use among patients in Sudan must be studied extensively in order to determine the unexpected fatal event and assess the association of this event to Remdesivir use, as well as to report the frequency of the side effects.
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Affiliation(s)
- Maysoun Yousif
- Emergency, Imperial Hospital, Khartoum, Khartoum, 11114, Sudan
| | - Ghada Abd El-Raheem
- Pharmacy, Imperial Hospital, Military Hospital, Soba University Hospital, Khartoum, Khartoum, 11114, Sudan
| | - Doaa Mohamed
- Emergency Department, Imperial Hospital, Khartoum, Khartoum, 11114, Sudan
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105
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Lin V, Hamby T, Das S, Chatrath A, Basha R, Fulda KG, Habiba N. Prevalence of elevated liver enzymes and their association with type 2 diabetes risk factors in children. J Pediatr Endocrinol Metab 2021; 34:707-711. [PMID: 33819416 DOI: 10.1515/jpem-2020-0512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 02/22/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Given their established role in hepatic function and insulin resistance for adults, early screening of type 2 diabetes mellitus (T2DM) in the pediatric population may potentially be improved by the assessment of elevated liver enzymes. METHODS Our study enrolled 151 nondiabetic children aged 10-14 years. Patients were assessed for demographics and five risk factors for T2DM. The levels of γ-glutamyl transpeptidase (GGT), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) levels were determined in serum samples. The effects of demographics and risk factors on abnormal liver enzyme levels were assessed with univariate chi-square analyses and also with multivariate logistic regression analyses, which were controlled for gender. RESULTS Frequencies for abnormal liver enzyme values were as follows: 13 (9%) for GGT, 5 (3%) for ALT, and 20 (13%) for ALP. Across analyses, two results were consistently statistically significant. Females were more likely to have abnormal ALP levels, and patients with BMI percentile ≥95% and with acanthosis nigricans were more likely to have abnormal GGT levels. CONCLUSIONS Our study suggests GGT as potential marker for T2DM discovery in children. Subsequent long-term longitudinal studies would help to more clearly delineate GGT's association with T2DM. Additionally, future studies that elucidate the molecular contribution of GGT elevation to T2DM pathogenesis are needed.
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Affiliation(s)
- Victor Lin
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Tyler Hamby
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
- Cook Children's Medical Center, Fort Worth, TX, USA
| | - Siddharth Das
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Amritpaul Chatrath
- University of Texas Health Science Center at San Antonio, Fort Worth, TX, USA
| | - Riyaz Basha
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Kimberly G Fulda
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
- The North Texas Primary Care Practice-Based Research Network (NorTex), Fort Worth, TX, USA
| | - Nusrath Habiba
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
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Rodart IF, Pares MM, Mendes A, Accardo CM, Martins JRM, Silva CB, Carvalho FO, Barreto JA, Reis MG, Tersariol ILS, Nader HB. Diagnostic Accuracy of Serum Hyaluronan for Detecting HCV Infection and Liver Fibrosis in Asymptomatic Blood Donors. Molecules 2021; 26:molecules26133892. [PMID: 34202190 PMCID: PMC8270308 DOI: 10.3390/molecules26133892] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/18/2021] [Accepted: 06/22/2021] [Indexed: 01/04/2023] Open
Abstract
Background: The disease caused by hepatitis C virus (HCV) is asymptomatic, silent, and progressive liver disease. In HCV-infected patients the increase in serum HA is associated with the development of hepatic fibrosis and disease progression. Methods: HCV-RNA detection was performed in all serological samples of blood donors that tested positive using HCV Ultra ELISA. Determination of hyaluronan (HA) was performed in positive HCV samples using ELISA-like fluorometric method. The HA content was compared to HCV viral load, genotype of the virus, liver fibrosis as well as ALT and GGT liver biomarkers. Results: Persistently normal ALT (<40 U/L) and GGT (<50 U/L) serum levels were detected in 75% and 69% of the HCV-Infected blood donors, respectively. Based on ROC analysis, the HA value < 34.2 ng/mL is an optimal cut-off point to exclude HCV viremia (specificity = 91%, NPV = 99%). Applying HA value ≥34.2 ng/mL significant liver fibrosis (≥F2) can be estimated in 46% of the HCV-infected blood donors. HA serum level (≥34.2 ng/mL) associated with a high ALT level (>40 U/mL) can correctly identify HCV infection and probable liver fibrosis (sensitivity = 96% and specificity = 90%) in asymptomatic blood donors. Conclusions: A high level of HA (≥34.2 ng/mL) in association with ALT (≥40 U/L) in serum can provide a good clinical opportunity to detect HCV-infected asymptomatic persons that potentially require a liver biopsy confirmation and antiviral treatment to prevent the development of advanced liver fibrosis or cirrhosis.
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Affiliation(s)
- Itatiana F. Rodart
- Departamento de Bioquímica, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (I.F.R.); (A.M.); (C.M.A.); (J.R.M.M.)
| | - Madalena M. Pares
- Associação Beneficente de Coleta de Sangue (COLSAN), São Paulo 04038-000, Brazil; (M.M.P.); (C.B.S.); (F.O.C.); (J.A.B.)
| | - Aline Mendes
- Departamento de Bioquímica, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (I.F.R.); (A.M.); (C.M.A.); (J.R.M.M.)
| | - Camila M. Accardo
- Departamento de Bioquímica, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (I.F.R.); (A.M.); (C.M.A.); (J.R.M.M.)
| | - João R. M. Martins
- Departamento de Bioquímica, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (I.F.R.); (A.M.); (C.M.A.); (J.R.M.M.)
| | - Cleidenice B. Silva
- Associação Beneficente de Coleta de Sangue (COLSAN), São Paulo 04038-000, Brazil; (M.M.P.); (C.B.S.); (F.O.C.); (J.A.B.)
| | - Fabrício O. Carvalho
- Associação Beneficente de Coleta de Sangue (COLSAN), São Paulo 04038-000, Brazil; (M.M.P.); (C.B.S.); (F.O.C.); (J.A.B.)
| | - José A. Barreto
- Associação Beneficente de Coleta de Sangue (COLSAN), São Paulo 04038-000, Brazil; (M.M.P.); (C.B.S.); (F.O.C.); (J.A.B.)
| | - Mitermayer G. Reis
- Laboratório de Hepatites Virais, Centro de Pesquisas Gonçalo Muniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil;
| | - Ivarne L. S. Tersariol
- Departamento de Bioquímica, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (I.F.R.); (A.M.); (C.M.A.); (J.R.M.M.)
- Correspondence: (I.L.S.T.); (H.B.N.); Tel.: +55-11-5579-3175 (I.L.S.T.); +55-11-5549-4629 (H.B.N.)
| | - Helena B. Nader
- Departamento de Bioquímica, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (I.F.R.); (A.M.); (C.M.A.); (J.R.M.M.)
- Correspondence: (I.L.S.T.); (H.B.N.); Tel.: +55-11-5579-3175 (I.L.S.T.); +55-11-5549-4629 (H.B.N.)
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Mirzaei E, Sabetian G, Masjedi M, Heidari R, Mirjalili M, Dehghanian A, Vazin A. The effect of silymarin on liver enzymes and antioxidant status in trauma patients in the intensive care unit: a randomized double blinded placebo-controlled clinical trial. Clin Exp Hepatol 2021; 7:149-55. [PMID: 34295981 DOI: 10.5114/ceh.2021.107067] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/24/2021] [Indexed: 01/09/2023] Open
Abstract
Aim of the study This study was conducted to investigate the positive effect of silymarin on liver enzymes and antioxidant status in trauma patients with elevated liver enzymes due to trauma-induced liver injury, admitted to the intensive care unit. Material and methods This one-year, randomized, double-blinded, placebo-controlled clinical trial was conducted on 90 trauma patients. The participants were assigned to either receiving Livergol tablets containing 140 mg of silymarin or 140 mg of placebo three times daily for 14 days. Liver enzymes, including aspartate transaminase (AST), alanine transaminase (ALT) and alkaline phosphatase (ALP), were measured at baseline and days 3, 7, 9 and 14 after intervention. Also, antioxidant markers were measured at baseline and day 14 after treatment. Results Receiving silymarin supplement significantly lowered the liver enzymes, compared to placebo (p < 0.05). The mean serum level of malondialdehyde (MDA) was significantly decreased and the mean serum levels of total antioxidant capacity (TAC) and thiol groups were significantly increased in the silymarin group from baseline to day 14. In the placebo group, mean serum levels of MDA and thiol groups were significantly increased, while serum level of TAC was not significantly changed at day 14, compared to baseline. Also, the mean serum level of MDA was significantly lower, while the serum levels of thiol groups and TAC were significantly higher in the silymarin group. Conclusions Silymarin supplementation significantly improved some antioxidant markers (TAC and thiol) and decreased liver enzymes in patients with trauma-induced liver injury.
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Song T, Chen S, Zhao H, Wang F, Song H, Tian D, Yang Q, Qi L. Meta-analysis of the effect of sodium-glucose cotransporter 2 inhibitors on hepatic fibrosis in patients with type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease. Hepatol Res 2021; 51:641-651. [PMID: 33847462 DOI: 10.1111/hepr.13645] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 03/28/2021] [Accepted: 04/01/2021] [Indexed: 12/12/2022]
Abstract
AIM This study aimed to analyze the effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors on the indexes of liver fibrosis in patients with type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease, and also to observe the effects on liver enzymes and liver fat. METHODS This meta-analysis was performed using RevMan 5.3 statistical software. RESULTS SGLT2 inhibitors could significantly reduce the level of hepatic fibrosis index: fibrosis-4 (mean difference [MD] 0.25, 95% CI -0.39 to -0.11, p = 0.0007); serum type Ⅳ collagen 7s (MD 0.32, 95% CI -0.59 to -0.04, p = 0.02); and ferritin (MD 26.7, 95% CI 50.64, 2.76, p = 0.03). SGLT2 inhibitors could significantly reduce the level of liver enzymes: alanine aminotransferase (MD 3.49, 95% CI -5.1 to 1.58, p < 0.0001); aspartate aminotransferase (MD 3.64, 95% CI -5.10 to -2.18, p < 0.00001); and glutamate aminotransferase (MD 7.13, 95% CI -12.95 to -1.32, p = 0.02). SGLT2 inhibitors could significantly reduce the level of liver fat: liver-to-spleen attenuation ratio (MD 0.16, 95% CI 0.10-0.22, p < 0.00001); magnetic resonance imaging proton density fat fraction (MD 1.97, 95% CI -3.49 to -0.45, p = 0.01); liver controlled attenuation parameter (MD 0.29, 95% CI -26.95 to -13.64, p < 0.00001); liver fat score (MD 0.55, 95% CI 1.04 to -0.05, p = 0.03); and liver fat index (MD 11.21, 95% CI -16.53 to -5.89, p < 0.0001). CONCLUSION SGLT2 inhibitors could improve liver fibrosis, liver enzymes, liver fat, and metabolic indexes in patients with type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease.
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Affiliation(s)
- Tiantian Song
- Graduate School of Hebei Medical University, Shijiazhuang, China.,Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China
| | - Shuchun Chen
- Graduate School of Hebei Medical University, Shijiazhuang, China.,Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China.,Hebei Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, China
| | - Hang Zhao
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China
| | - Fei Wang
- Graduate School of Hebei Medical University, Shijiazhuang, China.,Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China
| | - Huan Song
- Graduate School of Hebei Medical University, Shijiazhuang, China.,The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Dongliang Tian
- Graduate School of Hebei Medical University, Shijiazhuang, China.,The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Qiwen Yang
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China.,Hebei Northern University, Zhangjiakou, China
| | - Licui Qi
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China.,Hebei Northern University, Zhangjiakou, China
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109
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Opoku‐Akyeampong NAAS, Agyei‐Nkansah A, Yorke E. Liver dysfunction associated with hyperthyroidism: Lessons from 2 Case reports. Clin Case Rep 2021; 9:e04067. [PMID: 34136225 PMCID: PMC8190517 DOI: 10.1002/ccr3.4067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/10/2021] [Accepted: 03/05/2021] [Indexed: 11/30/2022] Open
Abstract
Hyperthyroidism may impact liver biochemistry negatively. Clinicians need a high index of suspicion in patients presenting with unexplained deranged liver enzymes or jaundice. Timely initiation of thionamides portends good prognosis.
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Affiliation(s)
| | - Adwoa Agyei‐Nkansah
- Department of Medicine & TherapeuticsUniversity of Ghana Medical SchoolAccraGhana
| | - Ernest Yorke
- Department of Medicine & TherapeuticsUniversity of Ghana Medical SchoolAccraGhana
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110
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An J, Dong Y, Li Y, Han X, Sha J, Zou Z, Niu H. Retrospective analysis of T-lymphocyte subsets and cytokines in malignant obstructive jaundice before and after external and internal biliary drainage. J Int Med Res 2021; 49:300060520970741. [PMID: 33641475 PMCID: PMC7917863 DOI: 10.1177/0300060520970741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To study changes in T lymphocyte subsets, cytokines, and liver enzymes in patients with malignant obstructive jaundice (MOJ) before and after external biliary drainage (percutaneous transhepatic cholangiography drainage, PTCD) and internal biliary drainage (percutaneous transhepatic insertion of biliary stents, PTIBS). Methods MOJ patients undergoing PTCD (n = 44) and PTIBS (n = 38) at our hospital were enrolled in the study from January 2017 until December 2019. Peripheral blood total bilirubin (TBIL), direct bilirubin (DBIL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), CD3+%, CD4+%, CD4+/CD8+ ratio, interleukin (IL)-2, IL-6, and tumor necrosis factor (TNF)-α were measured before and 1 week after biliary drainage. Results There was no significant difference in any parameter between the two groups before biliary drainage. TBIL, DBIL, AST and ALT following PTCD were significantly lower than before PTCD. By contrast, CD3+%, CD4+%, CD4+/CD8+ ratio, IL-2, IL-6 and TNF-α showed no significant difference before and 1 week after PTCD. TBIL, DBIL, AST, ALT, IL-6 and TNF-α were significantly lower following PTIBS than before PTIBS. CD3+%, CD4+%, CD4+/CD8+ ratio and IL-2 were significantly higher following PTIBS than before PTIBS. Conclusion Both PTCD and PTIBS were effective for treatment of MOJ, but PTIBS was more beneficial for recovery of immune function.
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Affiliation(s)
- Jianli An
- Department of Interventional Treatment, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, Hebei Province, PR China
| | - Yanchao Dong
- Department of Interventional Treatment, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, Hebei Province, PR China
| | - Yanguo Li
- Department of Radiology, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, Hebei Province, PR China
| | - Xiaoyu Han
- Department of Cardiovascular Medicine, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, Hebei Province, PR China
| | - Junfeng Sha
- Department of Interventional Treatment, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, Hebei Province, PR China
| | - Zibo Zou
- Department of Interventional Treatment, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, Hebei Province, PR China
| | - Hongtao Niu
- Department of Interventional Treatment, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, Hebei Province, PR China
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111
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Ahmed I, Salman S, Iqbal S, Siddiqui A, Fatima I. Effect of drinking high fluoride water on liver enzymes a comparitive cross-sectional study. J Community Hosp Intern Med Perspect 2021; 11:350-353. [PMID: 34234904 PMCID: PMC8118520 DOI: 10.1080/20009666.2021.1898088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 02/24/2021] [Indexed: 11/12/2022] Open
Abstract
Objective: The aim of this study is to determine the effects of drinking water with high fluoride level on liver functions. Method: This is a descriptive comparative cross-sectional study conducted at Sammu rind village where the drinking water has increase fluoride content. The comparative area was Gadap town where the drinking water has normal fluoride level. Sampling was done randomly and sample size was calculated by WHO calculator and found to be 121 each for exposed and unexposed population. Blood samples taken for liver functions included bilirubin, AST, ALT, Alkaline phosphate, Gamma GT, total protein, albumin and globulin. SPSS version 16 was used for analysis. Mean and SD calculated for quantitative variable and the two comparative groups were cross-tabulated. To check the statistical significance t-test was applied. Results: There was no statistically significant difference with consideration to serum bilirubin, ALT, and AST. However, statistically significant difference was established with respect to alkaline phosphatase, Gamma GT total proteins and A/G ratio between two groups. Conclusion: In our study, there was no evidence of impaired liver function tests in subjects drinking water with high fluoride content.
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Affiliation(s)
- Iftekhar Ahmed
- Medicine, Dow University of Health Science, Karachi, Pakistan
| | - Salma Salman
- Medicine, Dow University of Health Science, Karachi, Pakistan
| | - Sadia Iqbal
- Medicine, Dow University of Health Science, Karachi, Pakistan
| | - Afshan Siddiqui
- Medicine, Dow University of Health Science, Karachi, Pakistan
| | - Ibraj Fatima
- Medicine, Dow University of Health Science, Karachi, Pakistan
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112
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Quintavalla F, Gelsi E, Battaglia L, Aldigeri R, Ramoni R. Mefepronic acid is associated with a decrease in serum liver enzyme activities in dogs with suspected hepatopathy. Vet Med Sci 2021; 7:1542-1550. [PMID: 33955681 PMCID: PMC8464281 DOI: 10.1002/vms3.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/13/2021] [Accepted: 04/22/2021] [Indexed: 11/17/2022] Open
Abstract
Although suspected hepatopathy in dogs can be assessed by the blood levels of both liver enzyme activities and functional liver parameters, very often the precise diagnosis of primary or secondary hepatobiliary diseases can remain uncertain. Therefore, in a number of patients, the therapeutic intervention has the purpose of slowing the progression of fibrosis and provide for optimal hepatic support. Recently the PPARs (peroxisome proliferator‐activated receptors) have been identified as a family of hepatic nuclear hormonal receptors, involved in the regulation of lipid and glucose metabolism. The aim of this work is to assess the effect of mefepronic acid (PMPA), a PPAR agonist, on liver enzyme markers in blood samples of dogs with suspected hepatopathies. Twenty dogs, with suspected hepatopathies, were divided into two groups: ten of them received subcutaneously daily 10 mg/kg of PMPA for 7 days (treated, group T), while the remaining dogs were treated with a conventional supportive treatment for hepatopathies consisting of ursodeoxycholic acid (UDCA) 10 mg/kg PO SID for 45 days (control, group C). PMPA yielded a faster decrease in liver enzyme activities compared to UDCA, that in most cases was maintained after the suspension of the treatment. These data suggest that PMPA might be considered as supportive treatment for dogs with suspected hepatopathy.
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Affiliation(s)
| | | | - Luca Battaglia
- Veterinary Practitioner, Miller Veterinary Clinic, Cavriago - Reggio Emilia, Italy
| | | | - Roberto Ramoni
- Department of Veterinary Science, University of Parma, Italy
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113
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Pritchard H, Hwang JP, Angelidakis G, Yibirin M, Wang L, Miller E, Torres HA. Hepatitis B virus reactivation in cancer patients receiving direct-acting antivirals for hepatitis C virus infection. J Viral Hepat 2021; 28:844-848. [PMID: 33523503 PMCID: PMC8928572 DOI: 10.1111/jvh.13478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 01/15/2021] [Indexed: 12/09/2022]
Abstract
Direct-acting antivirals (DAAs) against hepatitis C virus (HCV) infection can cause hepatitis B virus (HBV) reactivation in HBV/HCV co-infected patients. Cancer patients undergoing immunosuppressant treatment or chemotherapy are at risk for HBV reactivation. To our knowledge, no prospective studies have examined the risk of HBV reactivation during DAA treatment for HCV infection in cancer patients with HBV/HCV co-infection. Here, we report the results of one such study. In a prospective observational study, we enrolled HCV-infected cancer patients undergoing DAA treatment at The University of Texas MD Anderson Cancer Center between January 2015 and March 2018. Data regarding demographics, cancer history, and prior HCV treatment history were collected. Patients were assessed for HBV status before DAA treatment and for HBV-related outcomes, including HBV reactivation, hepatitis flare, and HBV-associated hepatitis, during DAA treatment. Demographic and treatment variables were analyzed using descriptive statistics. One hundred sixty-six patients were analyzed. Forty-eight patients received systemic chemotherapy within 6 months before to 6 months after treatment with DAAs. Ledipasvir plus sofosbuvir was the most common DAA regimen, administered to 88 patients (53%). Fifty-one patients (31%) had past HBV infection, and 4 (2.4%) had chronic HBV infection. No patient experienced HBV reactivation, hepatitis flare, or HBV-associated hepatitis induced by DAA treatment. In HCV-infected cancer patients, DAA treatment is safe regardless of whether patients have past or chronic HBV infection. However, HBV screening is still recommended before the initiation of and during DAA treatment, as is anti-HBV prophylactic treatment in selected cases.
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Affiliation(s)
- Haley Pritchard
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas,Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jessica P. Hwang
- Department of General Internal Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Georgios Angelidakis
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Marcel Yibirin
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lan Wang
- Department of Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ethan Miller
- Department of Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Harrys A. Torres
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas,Department of Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas
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114
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Darvish Damavandi R, Shidfar F, Najafi M, Janani L, Masoodi M, Akbari-Fakhrabadi M, Dehnad A. Effect of Portulaca Oleracea (purslane) extract on liver enzymes, lipid profile, and glycemic status in nonalcoholic fatty liver disease: A randomized, double-blind clinical trial. Phytother Res 2021; 35:3145-3156. [PMID: 33880813 DOI: 10.1002/ptr.6972] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 11/08/2020] [Accepted: 11/19/2020] [Indexed: 01/03/2023]
Abstract
Purslane (Portulaca oleracea L.) is the richest green leafy vegetable source of omega-3, especially alpha linolenic acid (ALA). Experimental studies have shown beneficial effects of purslane extract on liver enzymes. The aim of the present study was to examine the effect of purslane hydroalcohoic extract in patients with non-alcoholic fatty liver disease (NAFLD). In a randomized double-blinded clinical trial, 74 patients were randomly assigned to receive either 300 mg purslane extract or placebo capsules for 12 weeks. Compared with baseline, alanine aminotransferase (ALT) (-9 [-17, 0.50] mg/dl; p = .007), aspartate aminotransferase (AST) (-4 [-10, -0.50] mg/dl; p = .001), gamma glutamyltransferase (GGT) (-6.21 ± 9.85 mg/dL; p < .001), fasting blood glucose (FBG) (-8 [-11, -1.50] mg/dl; p < .001) insulin resistance (-0.95 ± 2.23; p = .020), triglyceride (-20 [-67.50, 3.50] mg/dl; p = .010), and low-density lipoprotein cholesterol (LDL-C) (-5 [-12, -1] mg/dl; p < .001) decreased significantly in the purslane group. At the end of study, no significant changes were observed in liver steatosis grade, insulin, liver enzymes, total bilirubin, lipid profile, and blood pressure between the two groups. The findings of our study show that purslane extract at the dose of 300 mg/day for 12 weeks has no significant effects on liver enzymes, lipid profile, and glycemic indices in patients with NAFLD.
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Affiliation(s)
| | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.,Colorectal Research Center, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Najafi
- Department of Biochemistry, School of Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Janani
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Masoodi
- Colorectal Research Center, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Akbari-Fakhrabadi
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Afsaneh Dehnad
- School of Health Management and Information Sciences, Department of Medical Education, Center for Educational Research in Medical Sciences (CERMS), Iran University of Medical Sciences, Tehran, Iran
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115
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Chrysavgis L, Papatheodoridi AM, Chatzigeorgiou A, Cholongitas E. The impact of sodium glucose co-transporter 2 inhibitors on non-alcoholic fatty liver disease. J Gastroenterol Hepatol 2021; 36:893-909. [PMID: 33439540 DOI: 10.1111/jgh.15202] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/29/2020] [Accepted: 07/23/2020] [Indexed: 12/13/2022]
Abstract
Affecting one fourth of the global population, non-alcoholic fatty liver disease (NAFLD) is the commonest chronic liver disorder. It encompasses the simple liver fat accumulation to more progressive steatosis, inflammation, and fibrosis characterized as non-alcoholic steatohepatitis (NASH) and in some cases cirrhosis and hepatocellular carcinoma. NAFLD regularly coexists with metabolic disorders, such as obesity and mostly type 2 diabetes mellitus (T2DM). A relatively new class of antidiabetic drugs, the sodium glucose co-transporter 2 (SGLT2) inhibitors exert their action by increasing the urinary glucose and calorie excretion leading to ameliorated plasma glucose levels and lower bodyweight. Recently, several animal studies and human clinical trial have emphasized the possible beneficial impact of SGLT2 inhibitors on NAFLD and its progression to NASH. In this present review, we summarize the current literature regarding the efficacy of the aforementioned category of drugs on anthropometric, laboratory, and histological features of patients with NAFLD. Conclusively, as SGLT2 inhibitors seem to be an appealing therapeutic opportunity for NAFLD management, we identify the open issues and questions to be addressed in order to clarify the impact in choosing antidiabetic medication to treat NAFLD patients associated with T2DM.
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Affiliation(s)
- Lampros Chrysavgis
- Department of Physiology, Medical School of National and Kapodistrian University of Athens, Athens, Greece
| | | | - Antonios Chatzigeorgiou
- Department of Physiology, Medical School of National and Kapodistrian University of Athens, Athens, Greece
- Institute for Clinical Chemistry and Laboratory Medicine, University Hospital and Faculty of Medicine Carl Gustav Carus of TU Dresden, Dresden, Germany
| | - Evangelos Cholongitas
- First Department of Internal Medicine, Medical School of National and Kapodistrian University, General Hospital of Athens "Laiko", Athens, Greece
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116
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Akhtar MS, Rehman AU, Arshad H, Malik A, Fatima M, Tabassum T, Raza AR, Bukhsh M, Murtaza MA, Mehmood MH, Sultan A, Rasool G, Riaz M. In Vitro Antioxidant Activities and the Therapeutic Potential of Some Newly Synthesized Chalcones Against 4-Acetaminophenol Induced Hepatotoxicity in Rats. Dose Response 2021; 19:1559325821996955. [PMID: 33795997 PMCID: PMC7968038 DOI: 10.1177/1559325821996955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/23/2021] [Accepted: 01/25/2021] [Indexed: 01/14/2023] Open
Abstract
The lack of safety and efficacy of existing hepatoprotective agents urge the need to explore novel hepatoprotective agents. The research work was planned to study the therapeutic potential of some newly synthesized chalcones against 4-acetaminophenol induced hepatotoxicity in rats. Male albino rats (N = 30) were divided into 6 groups of 5 animals each i.e. group I; Toxic control (4-acetaminophenol), group II; normal control (Normal saline), group III; Positive control (silymarin; 50 mg/kg bw) and groups IV-VI (test groups) treated with 3 chalcone analogues i-e 3a, 3f & 3 g (100, 150, 150 mg/kg bw, respectively). All the study group animals were administered with 4-acetaminophenol to induce hepatotoxicity except normal control. Following hepatotoxicity induction, test group animals were administered with selected doses of test compounds and toxic group animals left untreated. Liver enzymes including ALT, AST, ALP and serum bilirubin were determined photometrically. Antioxidant activities of test compounds were also determined. Histopathological examination of liver biopsies was also carried out through H & E staining. The test chalcones (3a, 3f & 3 g) significantly decreased the levels of liver enzymes and serum bilirubin toward normal and the pattern of results in the test group animals were comparable to silymarin administered animals indicating the hepatoprotective potential of test compounds. Moreover, the test chalcones (3a, 3f & 3 g) antagonized the effect of 4-acetaminophenol and thus, raised the catalase (CAT) and superoxide dismutase (SOD) while decreased the malondialdehyde (MDA) in experimental animals. The test chalcones (3a, 3f & 3 g) on histological examination of liver showed improvement of tissue morphology. The study concluded that the tested compounds have antioxidant potential and may act as hepatoprotective agent. However, in-depth studies are required to validate their safety and to elucidate the exact mechanism of action.
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Affiliation(s)
- Muhammad Shoaib Akhtar
- Department of Pharmacology, College of Pharmacy, University of Sargodha, Sargodha, Pakistan
| | - Aziz-Ur- Rehman
- Department of Pathobiology, College of Veterinary and Animal Sciences (Jhang Campus), University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Haroon Arshad
- Health Department, Government of the Punjab, Lahore, Pakistan
| | - Abdul Malik
- Department of Pharmacology, College of Pharmacy, University of Sargodha, Sargodha, Pakistan
| | - Muheer Fatima
- Department of Pharmacology, College of Pharmacy, University of Sargodha, Sargodha, Pakistan
| | - Tahira Tabassum
- Department of Pathology, Sargodha Medical College, University of Sargodha, Sargodha, Pakistan
| | - Abdul Rauf Raza
- Ibn-e-Sina Block, Department of Chemistry, University of Sargodha, Sargodha, Pakistan
| | - Munnaza Bukhsh
- Foundation University Medical College, Islamabad, Pakistan
| | - Mian Anjum Murtaza
- Institute of Food Science and Nutrition, University of Sargodha, Sargodha, Pakistan
| | - Malik Hassan Mehmood
- Department of Pharmacology, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan
| | - Ayesha Sultan
- Department of Chemistry, University of Education, Faisalabad Campus, Faisalabad, Pakistan
| | - Ghulam Rasool
- Department of Allied Health Sciences, Sargodha Medical College, University of Sargodha, Sargodha, Pakistan
| | - Muhammad Riaz
- Department of Allied Health Sciences, Sargodha Medical College, University of Sargodha, Sargodha, Pakistan
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Garduno A, Wu T. Tobacco Smoke and CYP1A2 Activity in a US Population with Normal Liver Enzyme Levels. Int J Environ Res Public Health 2021; 18:2225. [PMID: 33668222 PMCID: PMC7956356 DOI: 10.3390/ijerph18052225] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 11/18/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is common among 30% of American adults. Former and current smokers are at higher risk for NAFLD compared to never smokers. The ratio of urine caffeine metabolites to caffeine intake-namely, urine caffeine metabolite indices-has previously been used as a proxy for CYP1A2 activity, which is one of the main liver metabolizing enzymes. CYP1A2 activity is associated with NAFLD progression. No studies to our knowledge have examined the associations of liver enzymes, smoking intensity, and secondhand smoke (SES) with CYP1A2 activity (using caffeine metabolite indices) across smoking status. We analyzed national representative samples from the 2009-2010 National Health and Nutrition Examination Survey (NHANES). Interestingly, even within a normal range, several liver enzymes were associated with caffeine metabolite indices, and patterns of many of these associations varied by smoking status. For instance, within a normal range, aspartate aminotransferase (AST) in never smokers and bilirubin in current smokers were inversely associated with 1-methyluric acid and 5-acetylamino-6-amino-3-methyluracil (URXAMU). Furthermore, we observed a common pattern: across all smoking statuses, higher AST/alanine aminotransferase (AST/ALT) was associated with 1-methyluric acid and URXAMU. Moreover, in current smokers, increased lifelong smoking intensity was associated with reduced caffeine metabolite indices, but acute cigarette exposure as measured by SES levels was associated with increased caffeine metabolite indices among never smokers. In summary, commonly used liver enzyme tests can reflect the CYP1A2 activity even within a normal range, but the selection of these enzymes depends on the smoking status; the associations between smoking and the CYP1A2 activity not only depend on the intensity but also the duration of tobacco exposure.
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Affiliation(s)
- Alexis Garduno
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, CA 92093, USA;
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA
| | - Tianying Wu
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA
- Moores Cancer Center, School of Medicine, University of California, San Diego, CA 92037, USA
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118
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Ghassemi M, Hosseinchi S, Seirafianpour F, Dodangeh M, Goodarzi A. Non-alcoholic fatty liver and lipid profile status in patients with melasma: A case-control study. J Cosmet Dermatol 2021; 20:3656-3660. [PMID: 33609335 DOI: 10.1111/jocd.14014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/13/2021] [Accepted: 02/16/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND There are pieces of evidence regarding the association between melasma and metabolic syndrome. To assess the prevalence and grade of nonalcoholic fatty liver and lipid profile status in patients with melasma, we designed this case-control study. METHODS This study was performed on 30 consecutive women with melasma who referred to the dermatology clinic of the hospital as the case group and 34 healthy women. For all participants, serum lipid profiles and liver enzymes were checked. Also, the existence of fatty liver was assessed by ultrasonography. RESULTS Except for serum level of LDL (low-density lipoprotein) that was significantly higher in the melasma group than in the healthy group (104.23 ± 25.00 mg/dl versus 89.85 ± 23.00 mg/dl, p = 0.020), the level of other parameters including other lipid profiles, blood sugar, or liver enzymes was similar in both groups. In ultrasonography, the overall prevalence of fatty liver was 23.3% in the melasma group and 20.6% in the control group, and no difference was found between the two groups in grade of fatty liver (p = 0.791). CONCLUSION The study showed a higher serum LDL level in patients with melasma compared to women without melasma, but there was no difference between the groups in prevalence or grade of fatty liver.
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Affiliation(s)
- Mohammadreza Ghassemi
- Dermatology Department, Rasool Akram Medical Complex, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | | | - Farnoosh Seirafianpour
- Student Research Committee, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Milad Dodangeh
- Student Research Committee, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Azadeh Goodarzi
- Dermatology Department, Rasool Akram Medical Complex, Iran University of Medical Sciences (IUMS), Tehran, Iran
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119
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Urbankova L, Skalickova S, Pribilova M, Ridoskova A, Pelcova P, Skladanka J, Horky P. Effects of Sub-Lethal Doses of Selenium Nanoparticles on the Health Status of Rats. Toxics 2021; 9:toxics9020028. [PMID: 33546233 PMCID: PMC7913318 DOI: 10.3390/toxics9020028] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/24/2021] [Accepted: 01/26/2021] [Indexed: 11/30/2022]
Abstract
Selenium nanoparticles (SeNPs) are fast becoming a key instrument in several applications such as medicine or nutrition. Questions have been raised about the safety of their use. Male rats were fed for 28 days on a monodiet containing 0.5, 1.5, 3.0 and 5.0 mg Se/kg. Se content in blood and liver, liver panel tests, blood glucose, total antioxidant capacity (TAC), the activity of superoxide dismutase (SOD) and glutathione peroxidase (GPx) were analysed. Liver and duodenum were subjected to histopathology examination. The weight gain of rats showed no differences between tested groups. Se content in blood was higher in all treated groups compared to the control group. The liver concentration of Se in the treated groups varied in the range from 222 to 238 ng/g. No differences were observed in the activity of AST (aspartate aminotransferase), ALP (alkaline phosphatase) and TAS (total antioxidant status). A significant decrease in ALT activity compared to the control group was observed in the treated groups. GPx activity varied from 80 to 88 U/mL through tested groups. SOD activity in liver was decreased in the SeNP-treated group with 5 mg Se/kg (929 ± 103 U/mL). Histopathological examination showed damage to the liver parenchyma and intestinal epithelium in a dose-dependent manner. This study suggests that short-term SeNP supplementation can be safe and beneficial in Se deficiency or specific treatment.
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Affiliation(s)
- Lenka Urbankova
- Department of Animal Nutrition and Forage Production, Mendel University in Brno, Zemedelska 1, CZ-613 00 Brno, Czech Republic; (L.U.); (M.P.); (J.S.); (P.H.)
| | - Sylvie Skalickova
- Department of Animal Nutrition and Forage Production, Mendel University in Brno, Zemedelska 1, CZ-613 00 Brno, Czech Republic; (L.U.); (M.P.); (J.S.); (P.H.)
- Correspondence:
| | - Magdalena Pribilova
- Department of Animal Nutrition and Forage Production, Mendel University in Brno, Zemedelska 1, CZ-613 00 Brno, Czech Republic; (L.U.); (M.P.); (J.S.); (P.H.)
| | - Andrea Ridoskova
- Department of Chemistry and Biochemistry, Mendel University in Brno, Zemedelska 1, CZ-613 00 Brno, Czech Republic; (A.R.); (P.P.)
- CEITEC-Central European Institute of Technology, Mendel University in Brno, Zemedelska 1, CZ-613 00 Brno, Czech Republic
| | - Pavlina Pelcova
- Department of Chemistry and Biochemistry, Mendel University in Brno, Zemedelska 1, CZ-613 00 Brno, Czech Republic; (A.R.); (P.P.)
| | - Jiri Skladanka
- Department of Animal Nutrition and Forage Production, Mendel University in Brno, Zemedelska 1, CZ-613 00 Brno, Czech Republic; (L.U.); (M.P.); (J.S.); (P.H.)
| | - Pavel Horky
- Department of Animal Nutrition and Forage Production, Mendel University in Brno, Zemedelska 1, CZ-613 00 Brno, Czech Republic; (L.U.); (M.P.); (J.S.); (P.H.)
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Montazerifar F, Karajibani M, Lashkaripour M, Sayyad Mollashahi M, Niazi AA, Soltan Mohammadi M, Rahimi Helari S. Blood Lead Levels, Hemoglobin, and Liver Enzymes in Opium-Dependent Addicts. Int J Prev Med 2021; 12:3. [PMID: 34084300 PMCID: PMC8106272 DOI: 10.4103/ijpvm.ijpvm_303_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 08/08/2019] [Indexed: 11/04/2022] Open
Abstract
Background Opium addiction, as a major health problem, has been reported in Middle East countries. Recently, contaminated opium has been reported as a probable source of lead poisoning. Thus, the aim of this study is to evaluate blood lead levels (BLL), liver enzymes, and hemoglobin (Hb) concentrations in opium-dependent addicts with healthy controls. Methods In a cross-sectional study, 75 opium-addicted men (case group) referred to Zahedan Baharan Hospital were evaluated. A group of 75 nonaddicted men were selected as a control group. BLL, Hb, and liver enzymes levels were measured. Body mass index (BMI) was also calculated. Results The case group had elevated BLL compared to the controls (19.1 ± 1.6 vs. 9.1 ± 0.4; P < 0.0001). Hb concentrations were significantly lower in the patients compared to the controls (13.3 ± 1.6 vs. 15.1 ± 1.3; P < 0.0001). A positive correlation was found between BLL and opium addict duration in the case group (r = 0.52, P < 0.0001). Conclusions Due to the contamination of opium to lead, it seems that opiate addicts are at risk of lead poisoning. Thus, it is recommended that the blood lead level is frequently monitored to control the adverse effects of poisoning and prevent lead accumulation.
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Affiliation(s)
- Farzaneh Montazerifar
- Department of Nutrition, Pregnancy Health Research Center, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mansour Karajibani
- Department of Nutrition, Health Promotion Research Center, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Maryam Lashkaripour
- Department of Psychiatric, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Manijeh Sayyad Mollashahi
- Department of Psychiatric, Baharan Psychiatric Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Abbas Ali Niazi
- Department of Pathology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Moghgan Soltan Mohammadi
- Department of Nutrition, Student Scientific Research Center, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Samaneh Rahimi Helari
- Department of Nutrition, Student Scientific Research Center, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
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Ballestri S, Mantovani A, Baldelli E, Lugari S, Maurantonio M, Nascimbeni F, Marrazzo A, Romagnoli D, Targher G, Lonardo A. Liver Fibrosis Biomarkers Accurately Exclude Advanced Fibrosis and Are Associated with Higher Cardiovascular Risk Scores in Patients with NAFLD or Viral Chronic Liver Disease. Diagnostics (Basel) 2021; 11:diagnostics11010098. [PMID: 33435415 PMCID: PMC7827076 DOI: 10.3390/diagnostics11010098] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 12/29/2020] [Accepted: 01/06/2021] [Indexed: 02/07/2023] Open
Abstract
Liver fibrosis predicts liver-related and cardiovascular outcomes in chronic liver disease patients. We compared the diagnostic performance of various liver fibrosis biomarkers for identifying histological significant/advanced fibrosis. Additionally, the correlations of such liver fibrosis biomarkers with cardiovascular risk (CVR) scores were evaluated. 173 patients with viral hepatitis (157 HCV and 16 HBV) and 107 with a non-alcoholic fatty liver disease (NAFLD) were consecutively enrolled. Various liver fibrosis biomarkers: aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (ARR), AST to Platelet Ratio Index (APRI), Fibrosis-4 (FiB-4), Forns index, NAFLD fibrosis score (NFS), BARD (body mass index (BMI), AAR, Diabetes) score, and Hepamet fibrosis score (HFS), were used to identify significant/advanced fibrosis. CVR was assessed by using the SCORE, the Progetto CUORE, or the Framingham risk scoring systems. Liver fibrosis biomarkers performed better in predicting advanced rather than significant liver fibrosis in all patients, regardless of chronic liver disease aetiology. Forns index and HFS performed best in predicting advanced fibrosis in patients with viral chronic liver disease and NAFLD. Lower cut-offs of these liver fibrosis biomarkers had high negative predictive values for advanced fibrosis overall, as well as in patients with NAFLD or viral chronic liver disease. FIB-4, Forns index, NFS, and HFS were positively correlated with SCORE and Framingham risk scores. In conclusion, liver fibrosis biomarkers accurately exclude advanced fibrosis and positively correlate with CVR scores in patients with chronic liver disease.
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Affiliation(s)
- Stefano Ballestri
- Internal Medicine Unit, Pavullo Hospital, Azienda USL, 41026 Modena, Italy;
- Correspondence: ; Tel.: +39-0536-29409
| | - Alessandro Mantovani
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy; (A.M.); (G.T.)
| | - Enrica Baldelli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy;
| | - Simonetta Lugari
- Metabolic Medicine Unit, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria, 41126 Modena, Italy; (S.L.); (M.M.); (F.N.)
| | - Mauro Maurantonio
- Metabolic Medicine Unit, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria, 41126 Modena, Italy; (S.L.); (M.M.); (F.N.)
| | - Fabio Nascimbeni
- Metabolic Medicine Unit, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria, 41126 Modena, Italy; (S.L.); (M.M.); (F.N.)
| | | | - Dante Romagnoli
- Gastroenterology Unit, Ospedale Policlinico di Modena, Azienda Ospedaliero-Universitaria, 41126 Modena, Italy;
| | - Giovanni Targher
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy; (A.M.); (G.T.)
| | - Amedeo Lonardo
- Metabolic Syndrome Unit, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria, 41126 Modena, Italy;
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Laine S, Sjöros T, Vähä-Ypyä H, Garthwaite T, Löyttyniemi E, Sievänen H, Vasankari T, Knuuti J, Heinonen IHA. Body Adiposity, But Not Elements of Objectively Measured Sedentary Behavior or Physical Activity, Is Associated With Circulating Liver Enzymes in Adults With Overweight and Obesity. Front Endocrinol (Lausanne) 2021; 12:655756. [PMID: 33959099 PMCID: PMC8095079 DOI: 10.3389/fendo.2021.655756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/29/2021] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE We studied the associations between accelerometer-measured sedentary behavior (SB) and habitual physical activity (PA) as well as markers of body adiposity and other cardiometabolic risk factors with liver enzymes alanine aminotransferase (ALT), aspartate aminotransferase (AST) and γ-glutamyltransferase (GGT). METHODS A total of 144 middle-aged adults (mean age 57 (SD 6.5) years) with overweight or obesity (mean body mass index [BMI] 31.8 [SD 3.9] kg/m2) participated. Different components of SB (sitting, lying) and PA (standing, breaks in SB, daily steps, light PA, moderate-to-vigorous PA and total PA) were measured with validated hip-worn accelerometers for four consecutive weeks (mean 25 days, [SD 4]). Fasting venous blood samples were analysed using standard assays. The associations were examined with Pearson's partial correlation coefficient test and linear mixed model. RESULTS Among 102 women and 42 men accelerometer measured SB or the elements of PA were not associated with circulating liver enzymes. When adjusted for age and sex, liver enzymes correlated positively with BMI and waist circumference (WC) (ALT r=0.34, p<0.0001, r=0.41, < 0.0001, AST r=0.17, p=0.049, r=0.26, p=0.002, GGT r=0.29, p=0.0005, r=0.32, p < 0.0001, respectively). SB proportion associated positively with BMI (r=0.21, p=0.008) and WC (r=0.27, p=0.001). Components of PA associated negatively with BMI (MVPA r=-0.23, p=0.005, daily steps r=-0.30, p<0.0001 and breaks in sedentary time r=-0.32, p<0.0001), as well as with WC (breaks in SB r=-0.35, p<0.0001, MVPA r=-0.26, p=0.002, daily steps r=-0.31, p<0.0001, standing time r=-0.27, p=0.001). Liver enzymes associated positively with common cardiometabolic markers such as resting heart rate (ALT; β=0.17, p=0.03, AST; β=0.25, p=0.002, GGT; β=0.23, p=0.004) and systolic/diastolic blood pressure (ALT β=0.20, p=0.01, β=0.22, p=0.005, AST (only diastolic) β=0.23, p=0.006, GGT β=0.19, p=0.02, = 0.23, p=0.004, respectively), fasting insulin (ALT β=0.41, p<0.0001, AST β=0.36, p=0.0003, GGT β=0.20, p=0.04) and insulin resistance index (ALT β=0.42, p<0.0001, AST β=0.36, p=0.0003, GGT β=0.21, p=0.03), even after adjustment with BMI. CONCLUSIONS Liver enzymes correlate with body adiposity and appear to cluster with other common cardiometabolic risk factors, even independently of body adiposity. SB and PA appear not to be essential in modulating the levels of circulating liver enzymes.
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Affiliation(s)
- Saara Laine
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
- *Correspondence: Saara Laine,
| | - Tanja Sjöros
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Henri Vähä-Ypyä
- The UKK-Institute for Health Promotion Research, Tampere, Finland
| | - Taru Garthwaite
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | | | - Harri Sievänen
- The UKK-Institute for Health Promotion Research, Tampere, Finland
| | - Tommi Vasankari
- The UKK-Institute for Health Promotion Research, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Juhani Knuuti
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Ilkka H. A. Heinonen
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
- Rydberg Laboratory of Applied Sciences, University of Halmstad, Halmstad, Sweden
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Valle-Martos R, Valle M, Martos R, Cañete R, Jiménez-Reina L, Cañete MD. Liver Enzymes Correlate With Metabolic Syndrome, Inflammation, and Endothelial Dysfunction in Prepubertal Children With Obesity. Front Pediatr 2021; 9:629346. [PMID: 33665176 PMCID: PMC7921725 DOI: 10.3389/fped.2021.629346] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 01/28/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Metabolic syndrome (MetS) can start in children with obesity at very young ages. Non-alcoholic fatty liver disease (NAFLD) is considered to be the hepatic component of metabolic syndrome. If left untreated, the clinical course of NAFLD can be progressive and can become chronic if not detected at an early stage. Objective: We aimed to quantify the differences in liver enzymes between prepubertal children with obesity and children with normal weight to determine any associations between them and parameters related to MetS, adipokines, or markers of endothelial dysfunction and inflammation. Methods: This cross-sectional study included 54 prepuberal children with obesity (aged 6-9 years) and 54 children with normal weight, matched by age and sex. Liver enzymes, C-reactive protein (CRP), interleukin-6, soluble intercellular adhesion molecule-1 (sICAM-1), adipokines, and parameters related to metabolic syndrome (MetS) were all measured. Results: Alanine aminotransferase (ALT) levels, serum butyryl cholinesterase (BChE), leptin, CRP, sICAM-1, triglycerides, blood pressure, and homeostasis model assessment for insulin resistance were significantly higher in children with obesity, while Apolipoprotein A-1, HDL-cholesterol, and adiponectin were significantly lower. In the children with obesity group, ALT and BChE levels correlated with anthropometric measurements, insulin resistance, and lipid parameters, leptin, interleukin-6, CRP, and sICAM-1 while BChE levels negatively correlated with adiponectin. Conclusions: Compared to children with normal weight, prepubertal children with obesity had elevated values for liver enzymes, leptin, markers of insulin resistance, inflammation, and endothelial dysfunction, and variables associated with MetS. There was also a correlation between these disorders and liver enzyme levels.
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Affiliation(s)
- Rosario Valle-Martos
- Maimonides Biomedical Research Institute of Córdoba, University of Cordoba, Córdoba, Spain
| | - Miguel Valle
- Valle de los Pedroches Hospital, Maimonides Biomedical Research Institute of Córdoba, Córdoba, Spain
| | - Rosario Martos
- Health Center of Pozoblanco, Maimonides Biomedical Research Institute of Córdoba, Córdoba, Spain
| | - Ramón Cañete
- Faculty of Medicine, Maimonides Biomedical Research Institute of Córdoba, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, University of Cordoba, Córdoba, Spain
| | - Luis Jiménez-Reina
- Faculty of Medicine, Maimonides Biomedical Research Institute of Córdoba, University of Cordoba, Córdoba, Spain
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Almaeen AH, Alduraywish AA, Mobasher MA, Almadhi OIM, Nafeh HM, El-Metwally TH. Oxidative stress, immunological and cellular hypoxia biomarkers in hepatitis C treatment-naïve and cirrhotic patients. Arch Med Sci 2021; 17:368-375. [PMID: 33747272 PMCID: PMC7959056 DOI: 10.5114/aoms.2019.91451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 11/13/2019] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Hepatitis C virus (HCV) is the main cause of chronic liver disease, with calamitous complications. Its highest rate is recorded in Egypt. This study investigated whether oxidative stress, immunological chaos and cellular hypoxia are implicated in the pathophysiology of the disease. MATERIAL AND METHODS This cross-sectional study aimed to evaluate the changes in blood oxidative stress, cellular hypoxia/angiogenesis and cellular immunological biomarkers in hospital-diagnosed treatment-naïve HCV-infected Upper Egyptian chronic liver disease patients vs. healthy controls (n = 40). The consecutively included patients comprised 120 with normal serum enzymes (HCV-NE) and 130 with high serum enzymes (HCV-HE), along with 120 cirrhotic patients. RESULTS Oxidative stress biomarkers - malondialdehyde (MDA), total peroxides and oxidative stress index (OSI) - were significantly lower in controls vs. each of the patient groups. Cirrhotic patients presented the highest levels. However, total antioxidants (TAO) showed non-significant differences among the four groups. The cellular hypoxia/angiogenesis biomarkers - lactate, vascular endothelial cell growth factor (VEGF) and its soluble receptor 1 (sVEGFR1) - vs. controls were massively increased in patient groups. VEGF was lowest while sVEGFR1 was highest among cirrhotic patients. Immunological biomarkers, - granulocyte/monocyte-colony stimulating factor (GM-CSF) and total immunoglobulin G (IgG) - were massively increased in patient groups vs. controls. GM-CSF was lowest in HCV-HE and IgG was highest in cirrhotic patients. sVEGFR1 correlated with the progression towards cirrhosis. CONCLUSIONS Oxidative stress is implicated in the progress of HCV infection with marked induction of cellular hypoxia and dysfunctional angiogenesis, and a futile immunological reaction. sVEGFR1 level correlated with progression towards HCV-induced liver fibrosis.
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Affiliation(s)
| | | | - Maysa Ahmed Mobasher
- Department of Pathology, Jouf University College of Medicine, Sakaka, Saudi Arabia
| | - Omar I. M. Almadhi
- College of Medicine, Jouf University College of Medicine, Sakaka, Saudi Arabia
| | - Hanan M. Nafeh
- Department of Tropical Medicine and Gastroenterology, Assiut University, Faculty of Medicine, Assiut, Egypt
| | - Tarek Hassan El-Metwally
- Department of Pathology, Jouf University College of Medicine, Sakaka, Saudi Arabia
- Department of Medical Biochemistry, Assiut University, Faculty of Medicine, Assiut, Egypt
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Abstract
COVID-19 causes severe respiratory and multiorgan failure, including liver damage and elevated transaminase levels. This article addresses the potential causes of liver function abnormalities in patients diagnosed with COVID-19 and management approaches for NPs focusing on preventing and alleviating liver injury.
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Affiliation(s)
- Ricketta Clark
- Ricketta Clark is assistant professor at the University of Tennessee Health Science Center, Memphis, Tenn. Bradford Waters is Professor of Medicine, University of Tennessee Health Science Center, Memphis, Tenn., and section chief, Gastroenterology, Memphis VA Medical Center, Memphis, Tenn. Ansley Grimes Stanfill is Associate Dean of Research and associate professor at the University of Tennessee Health Science Center, Memphis, Tenn
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Chi-Cervera LA, Montalvo GI, Icaza-Chávez ME, Torres-Romero J, Arana-Argáez V, Ramírez-Camacho M, Lara-Riegos J. Clinical relevance of lipid panel and aminotransferases in the context of hepatic steatosis and fibrosis as measured by transient elastography (FibroScan®). J Med Biochem 2021; 40:60-66. [PMID: 33584141 PMCID: PMC7857856 DOI: 10.5937/jomb0-24689] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 04/11/2020] [Indexed: 12/12/2022] Open
Abstract
Background Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease and is associated with various co-morbidities. Transient elastography (FibroScan®) is a non-invasive method to detect NAFLD using the controlled attenuation parameter (CAP). We aimed to evaluate the association of the lipid panel and aminotransferases concentrations with the presence or absence of steatosis and fibrosis. Methods One hundred and five patients with NAFLD were included. Hepatic steatosis was quantified by CAP (dB/m) and liver stiffness by Kilopascals (kPa), these values were then analyzed against patient lipid panel and serum concentrations of the liver enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT). A correlation and multiple regression were used. Mann-Whitney U test was used as non-parametric analysis. Results We observed an association between hepatic steatosis and total cholesterol (B = 0.021, p = 0.038, Exp (B) = 1.021, I.C = 1.001-1.041) as well as serum triglycerides (B = 0.017, p = 0.006, Exp (B) = 1.018 and I.C = 1.005-1.030). Similarly, we found an association between significant hepatic fibrosis and lower concentrations of total cholesterol (B = -0.019, p = 0.005, Exp (B) = 0.982 I.C = 0.969-0.995) and elevated AST (B = 0.042, p = 3.25 × 10-4, Exp (B) = 1.043 I.C = 1.019-1.068) independent of age, gender and BMI. Conclusions Our results suggest that, total cholesterol and triglyceride concentrations positively correlate with hepatic steatosis while significant hepatic fibrosis is associated with lower total cholesterol and higher AST concentrations.
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Affiliation(s)
| | - Gordon Iaarah Montalvo
- StarMédica Hospital, Gastrointestinal and Liver Speciality Clinic, Mérida, Yucatán, México
| | | | - Julio Torres-Romero
- Universidad Autónoma de Yucatán, Facultad de Química, Biochemistry and Molecular Genetics Laboratory, Mérida, Yucatán, México
| | - Víctor Arana-Argáez
- Universidad Autónoma de Yucatán, Facultad de Química, Pharmacology Laboratory, México
| | - Mario Ramírez-Camacho
- Universidad Autónoma de Yucatán, Facultad de Química, Drug Information Center, México
| | - Julio Lara-Riegos
- Universidad Autónoma de Yucatán, Facultad de Química, Biochemistry and Molecular Genetics Laboratory, Mérida, Yucatán, México
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Squillace N, Ricci E, Menzaghi B, De Socio GV, Passerini S, Martinelli C, Mameli MS, Maggi P, Falasca K, Cordier L, Celesia BM, Salomoni E, Di Biagio A, Pellicanò GF, Bonfanti P. The Effect of Switching from Tenofovir Disoproxil Fumarate (TDF) to Tenofovir Alafenamide (TAF) on Liver Enzymes, Glucose, and Lipid Profile. Drug Des Devel Ther 2020; 14:5515-5520. [PMID: 33364747 PMCID: PMC7751319 DOI: 10.2147/dddt.s274307] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/10/2020] [Indexed: 12/15/2022]
Abstract
Objective We aimed to investigate the effect of switching from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) on the hepatic safety and metabolic profile. Methods Consecutive HIV patients, enrolled in the Surveillance Cohort Long-term Toxicity Antiretrovirals/Antivirals (SCOLTA) project, switching from TDF to TAF were included. Changes from baseline (T0) to 6-month follow-up (T1) were evaluated using paired t-test and signed rank test. Results A total of 190 patients switched from TDF to TAF and had one 6-month follow-up visit. They were 80% male, 74.2% at CDC stage A–B, 93.7% with undetectable HIV-viral load. Mean age was 46.7±10.7 years, body mass index was 25.0±3.9 kg/m2, median CD4 cell count was 634 cell/µL (interquartile range [IQR]=439–900), aspartate aminotransferase (AST) was 23 (IQR=19–30) IU/L, and alanine aminotransferase (ALT) was 24 (IQR=17–34) IU/L. At T1, both AST (median=−1, IQR=−5–2 IU/L, P=0.004) and ALT (median=−2, IQR=−7–3 IU/L, P=0.0004) showed a significant decrease. Among 28 patients with ALT >40 at baseline, reduction was significant both clinically (−17, IQR=−32–−1) and statistically (P=0.0003). Total cholesterol levels (TC) increased (+13.4±3.8 mg/dL, P=0.0006), as well as HDL-cholesterol (HDL-C) (+3.8±1.2 mg/dL, P=0.02), LDL Cholesterol (LDL-C) (+7.6±3.4, P=0.03) and glucose (+4.0±1.8 mg/dL, P=0.02). D:A:D: and Framingham risk score did not change at 6 months after switch. Conclusion A significant reduction of liver enzymes was observed after switching from TDF to TAF, especially in subjects with initial level of ALT >40 IU/L. Glucose, TC, HDL-C, and LDL-C increased, with no effect on cardiovascular risk scores.
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Affiliation(s)
- Nicola Squillace
- Infectious Diseases Unit ASST-MONZA, San Gerardo Hospital-University of Milano-Bicocca, Monza, Italy
| | | | - Barbara Menzaghi
- Unit of Infectious Diseases, ASST della Valle Olona, Busto Arsizio, Italy
| | - Giuseppe Vittorio De Socio
- Department of Internal Medicine 2, Infectious Diseases Unit, "Santa Maria della Misericordia" General Hospital, Perugia, Italy
| | - Simone Passerini
- 1st Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | - Maria Sabrina Mameli
- Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Paolo Maggi
- University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Katia Falasca
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Laura Cordier
- 1st Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | - Elena Salomoni
- Infectious Diseases Unit, Santa Maria Annunziata Hospital, Usl centro, Florence, Italy
| | | | - Giovanni Francesco Pellicanò
- Department of Human Pathology of the Adult and the Developmental Age "G. Barresi", Unit of Infectious Diseases, University of Messina, Messina, Italy
| | - Paolo Bonfanti
- Infectious Diseases Unit ASST-MONZA, San Gerardo Hospital-University of Milano-Bicocca, Monza, Italy
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Taghinejad A, Barani S, Gholijani N, Ghandehari F, Khansalar S, Asadipour M, Davarpanah M, Fattahi M, Kalantar K. Variations in IL-22, IL-27 and IL-35 serum levels in untreated and treated hepatitis C patients. Eur Cytokine Netw 2020; 31:134-139. [PMID: 33648921 DOI: 10.1684/ecn.2020.0455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Hepatitis C virus (HCV) is the leading cause of chronic liver diseases including hepatic fibrosis, cirrhosis, and hepatocellular carcinoma. We aimed to assess serum levels of interleukin (IL)-22, IL-27 and IL-35 in patients with hepatitis C and healthy controls to investigate their possible relationship with viral genotypes and liver enzyme levels. METHOD A total of 30 newly diagnosed hepatitis C patients with no history of antiviral therapy and 30 healthy individuals participated in this study. Serum levels of IL-22, IL-27 and IL-35 were determined by ELISA in peripheral blood samples from patients prior to and following treament with pan-genotypic direct-acting anti-viral therapy. Serum levels of alanine transaminase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP) were measured to determine any possible association between hepatic enzymes and cytokine serum levels concentrations. RESULT The results show elevated serum levels of of IL-35 in HCV-infected patients compared to treated cases and healthy controls, whereas there was no significant difference in IL-22 and IL-27 serum levels among the three groups. Additionally, the cytokine levels were not significantly correlated with certain genotypes and levels of liver enzymes. CONCLUSION Our findings indicate a potential role for IL-35 in chronic HCV infection and therapeutic management of patients with hepatitis C infection.
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Affiliation(s)
- Azam Taghinejad
- Gastroenterology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shaghik Barani
- Department of Immunology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Naser Gholijani
- Autoimmune Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farzad Ghandehari
- Gastroenterology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soolmaz Khansalar
- Department of Immunology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Morvarid Asadipour
- Department of Immunology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammadali Davarpanah
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammadreza Fattahi
- Gastroenterology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kurosh Kalantar
- Department of Immunology, Shiraz University of Medical Sciences, Shiraz, Iran
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129
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Teckman J, Rosenthal P, Hawthorne K, Spino C, Bass LM, Murray KF, Kerkar N, Magee JC, Karpen S, Heubi JE, Molleston JP, Squires RH, Kamath BM, Guthery SL, Loomes KM, Sherker AH, Sokol RJ. Longitudinal Outcomes in Young Patients with Alpha-1-Antitrypsin Deficiency with Native Liver Reveal that Neonatal Cholestasis is a Poor Predictor of Future Portal Hypertension. J Pediatr 2020; 227:81-86.e4. [PMID: 32663593 PMCID: PMC7686087 DOI: 10.1016/j.jpeds.2020.07.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 07/06/2020] [Accepted: 07/08/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To identify predictors of portal hypertension, liver transplantation, and death in North American youth with alpha-1-antitrypsin (AAT) deficiency, and compare with patients with AAT deficiency elsewhere. STUDY DESIGN The Childhood Liver Disease Research Network Longitudinal Observational Study of Genetic Causes of Intrahepatic Cholestasis is a prospective, cohort study of pediatric cholestatic liver diseases, including AAT deficiency, enrolling PIZZ and PISZ subjects 0-25 years of age seen since November 2007 at 17 tertiary care centers in the US and Canada. Data from standard-of-care baseline and annual follow-up visits were recorded from medical records, history, physical examination, and laboratory studies. Participants with portal hypertension were identified based on data collected. RESULTS We enrolled 350 participants (60% male) with a native liver; 278 (79%) entered the cohort without portal hypertension and 18 developed portal hypertension during follow-up. Thirty participants required liver transplantation; 2 patients died during 1077 person-years of follow-up. There was no difference in participants with or without preceding neonatal cholestasis progressing to transplantation or death during the study (12% vs 7%; P = .09), or in experiencing portal hypertension (28% vs 21%; P = .16); the hazard ratio for neonatal cholestasis leading to portal hypertension was P = .04. Development of portal hypertension was associated with a reduced height Z-score. CONCLUSIONS Portal hypertension in youth with AAT deficiency impacts growth measures. Progression to liver transplantation is slow and death is rare, but the risk of complications and severe liver disease progression persists throughout childhood. A history of neonatal cholestasis is a weak predictor of severe disease.
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Affiliation(s)
- Jeffrey Teckman
- Pediatrics and Biochemistry, Saint Louis University, Cardinal Glennon Children’s Medical Center, Saint Louis, MO
| | - Philip Rosenthal
- Pediatrics and Surgery, University of California San Francisco, San Francisco, CA
| | | | - Cathie Spino
- Biostatistics, University of Michigan, Ann Arbor, MI
| | - Lee M. Bass
- Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Karen F. Murray
- Pediatric Gastroenterology and Hepatology, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, WA
| | - Nanda Kerkar
- Pediatric Gastroenterology, Children’s Hospital Los Angeles, Los Angeles, CA
| | - John C. Magee
- Surgery, University of Michigan School of Medicine, Ann Arbor, MI
| | - Saul Karpen
- Pediatrics, Emory University, Children’s Healthcare Atlanta, Atlanta, GA
| | - James E. Heubi
- Pediatric Gastroenterology and Hepatology, Children’s Hospital Medical Center, Cincinnati, OH
| | - Jean P. Molleston
- Pediatric Gastroenterology, Hepatology and Nutrition, James Whitcomb Riley Hospital for Children, Indianapolis, IN
| | | | - Binita M. Kamath
- Pediatric Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Stephen L. Guthery
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, University of Utah, and Intermountain Primary Children’s Hospital, Salt Lake City, UT
| | - Kathleen M. Loomes
- Pediatric Gastroenterology, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Averell H. Sherker
- National Institute of Diabetes, Digestive and Kidney Disease, National Institutes of Health, Baltimore, MD
| | - Ronald J. Sokol
- Pediatric Gastroenterology, Hepatology and Nutrition, University of Colorado School of Medicine, Children’s Hospital Colorado, Aurora, CO
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130
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Kesenogile B, Godman B, Rwegerera GM. Alanine transaminase and hemoglobin appear to predict the occurrence of antituberculosis medication hepatotoxicity; findings and implications in Botswana. Expert Rev Anti Infect Ther 2020; 19:379-391. [PMID: 32909487 DOI: 10.1080/14787210.2020.1822735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Tuberculosis (TB) remains a global health problem, with medications having adverse effects including drug-induced hepatotoxicity. We determined the prevalence of anti-tuberculosis drug-induced hepatotoxicity and associated risk factors. METHODS Retrospective cross-sectional study in Botswana including TB patients admitted from 1 June 2017 to 30 June 2018. Anti-TB drug-induced hepatotoxicity was categorized according to WHO criteria whereas causality assessment was made according to the updated Roussel Uclaf Causality Assessment Method (RUCAM) scale. The association between hepatotoxicity and included variables was undertaken by binary logistic regression. RESULTS Out of 112 patient files, 15 (13.4%) developed hepatotoxicity after an average of 20.4 days from the start of treatment. Grade 3 and 4 hepatotoxicity was found in 66.7% of the cases. According to the updated RUCAM tool, 86.7% of patients were categorized as having possible anti-TB-associated hepatotoxicity. Patients with elevated baseline alanine transaminase (ALT) were more likely to develop hepatotoxicity (OR = 3.484, 95% CI = 1.02-11.90). Patients with normal hemoglobin (Hb ≥ 12 g/dl) were also more likely to develop hepatotoxicity (OR = 4.413, 95% CI = 1.160-14.8). CONCLUSION Overall, normal hemoglobin and elevated baseline ALT levels were significantly associated with anti-TB drug-induced hepatotoxicity. Additional research is needed to explore this association further.
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Affiliation(s)
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK.,School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa.,Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Godfrey Mutashambara Rwegerera
- Department of Medicine, Princess Marina Hospital, Gaborone, Botswana.,Department of Internal Medicine, University of Botswana, Gaborone, Botswana
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131
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Saad-Hussein A, Shahy EM, Shaheen W, Ibrahim KS, Mahdy-Abdallah H, Taha MM, Hafez SF. Hepatotoxicity of aflatoxin B1 and its oxidative effects in wood dust Egyptian exposed workers. Arch Environ Occup Health 2020; 76:561-566. [PMID: 33030118 DOI: 10.1080/19338244.2020.1828246] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The goal of the present study is to estimate the oxidative effects of AFB1 induced hepatotoxicity in furniture wood dust exposed workers. A cross-sectional comparative study was designed for comparing AFB1/albumin (AFB1/alb) levels and liver functions [alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP)], malondialdehyde (MDA), glutathione peroxidase (GPx), catalase (CAT) and superoxide dismutase (SOD) in 88 furniture workers and 78 controls not occupationally exposed to wood dust. The AFB1/Alb, AST, ALT, MDA, and GPx were significantly higher; while, CAT significantly reduced in workers compared with controls. There was a significant correlation between AFB1/Alb and MDA level with the liver enzymes among both groups. CAT was inversely correlated with AFB1/Alb and the liver enzymes, and GPx was inversely correlated with AST in the workers. It was concluded that wood dust exposure is associated with raised serum levels of AFB1 and oxidative stress.
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Affiliation(s)
- Amal Saad-Hussein
- Environmental & Occupational Medicine Department, Environmental Research Division, National Research Centre, Dokki, Cairo, Egypt
| | - Eman M Shahy
- Environmental & Occupational Medicine Department, Environmental Research Division, National Research Centre, Dokki, Cairo, Egypt
| | - Weam Shaheen
- Environmental & Occupational Medicine Department, Environmental Research Division, National Research Centre, Dokki, Cairo, Egypt
| | - Khadiga S Ibrahim
- Environmental & Occupational Medicine Department, Environmental Research Division, National Research Centre, Dokki, Cairo, Egypt
| | - Heba Mahdy-Abdallah
- Environmental & Occupational Medicine Department, Environmental Research Division, National Research Centre, Dokki, Cairo, Egypt
| | - Mona M Taha
- Environmental & Occupational Medicine Department, Environmental Research Division, National Research Centre, Dokki, Cairo, Egypt
| | - Salwa F Hafez
- Environmental & Occupational Medicine Department, Environmental Research Division, National Research Centre, Dokki, Cairo, Egypt
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Abstract
INTRODUCTION The outbreak of COVID-19 is a serious health threat worldwide. Different degrees of liver injury or liver dysfunctions have been reported in patients with COVID-19 infection. However, currently, it remains unclear to what extent liver diseases should be considered as significant risk factors for the severity and mortality of COVID-19. Moreover, the mechanisms involved in liver injury in severe COVID-19 infection are not yet well understood. AREA COVERED This review summarizes the current evidence on liver function abnormalities in COVID-19 patients and the effects of preexisting liver disease on the disease severity. This review also illustrates the possible underlying mechanisms linking COVID-19 to liver injury, as well as provides recommendations to prevent liver damage in COVID-19 infection. EXPERT OPINION The elevated levels of ALT, AST, GGT and bilirubin are common in more severe patients than non-severe or mild COVID-19 patients. Patients with preexisting medical conditions including chronic hepatic diseases are at higher risk for severe illness from COVID-19 infection. The drug's effects, possible viral inclusion in liver cells, systemic inflammation and hypoxia are potential causes of liver injury in severe COVID-19. Nevertheless, further studies are needed focusing on the preexisting hepatic diseases on prevention, treatment and outcome of COVID-19.
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Affiliation(s)
- Nurshad Ali
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology , Sylhet, Bangladesh
| | - Khaled Hossain
- Department of Biochemistry and Molecular Biology, Rajshahi University , Rajshahi, Bangladesh
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Wang J, Qu HQ, Huang K, Wu W, Wang C, Liang L, Gong C, Xiong F, Luo F, Liu G, Chen S, Tian L, Hakonarson H, Fu J. High prevalence of elevated serum liver enzymes in Chinese children suggests metabolic syndrome as a common risk factor. J Paediatr Child Health 2020; 56:1590-1596. [PMID: 32767607 DOI: 10.1111/jpc.15038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 05/11/2020] [Accepted: 05/28/2020] [Indexed: 12/22/2022]
Abstract
AIM This study investigated the pattern of liver enzymes in a large cohort of Chinese children and adolescents, including 16 383 individuals aged 4-18 years old recruited at six medical centres in China. METHODS Clinical data were collected including weight, height, blood pressure, alanine aminotransferase, aspartate aminotransferase and fasting lipid panel. We used an unsupervised machine learning algorithm, the K-means clustering method, to identify different patterns of increased liver enzymes. RESULTS Six clusters of elevated enzymes patterns were identified. The most common in 2.18% (325) of youth was elevated transaminases in the absence of features of metabolic syndrome(MetS), and they were thinner, and more likely to be from urban areas. The second cluster, with 1.47% (n = 220) youth had the most notable MetS features. They were older, obese and had central obesity, higher BP, triglycerides cholesterol and lower high-density lipoprotein cholesterol. Cluster 3 (0.6%, N = 90) had mild MetS, and cluster 4 (0.06%, N = 9), 5 (0.03%, N = 5) and 6 (0.007%, N = 1) were not related to MetS. CONCLUSIONS We identified two distinct groups of children with both increased liver enzymes and MetS features in this population sample of Chinese children. One of the two groups had increased liver enzymes as the predominant clinical features at a younger age, suggesting genetic susceptibility to the condition. Further work to understand the increased MetS risk in cluster 2 is warranted.
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Affiliation(s)
- Jinling Wang
- Department of Endocrinology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Hui-Qi Qu
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
| | - Ke Huang
- Department of Endocrinology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Wei Wu
- Department of Endocrinology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Chunlin Wang
- Department of Pediatrics, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Li Liang
- Department of Pediatrics, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chunxiu Gong
- Department of Pediatric Endocrinology, Genetic and Metabolism, Beijing Children's Hospital of Capital Medical University, National Center for Children's Health, Beijing, China
| | - Feng Xiong
- Department of Endocrinology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Feihong Luo
- Department of Endocrinology, Children's Hospital of Shanghai Fudan University, Shanghai, China
| | - Geli Liu
- Department of Pediatrics, General Hospital of Tianjin Medical University, Tianjin, China
| | - Shaoke Chen
- Department of Pediatrics, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Lifeng Tian
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
| | - Hakon Hakonarson
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States.,Department of Pediatrics and Division of Human Genetics, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Junfen Fu
- Department of Endocrinology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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O'Neil CE, Nicklas TA, Saab R, Fulgoni VL. Relationship of added sugars intakes with physiologic parameters in adults: an analysis of national health and nutrition examination survey 2001-2012. AIMS Public Health 2020; 7:450-468. [PMID: 32968670 PMCID: PMC7505778 DOI: 10.3934/publichealth.2020037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/22/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Consumption of added sugars (AS) has been associated with increased risk for liver disease and risk factors for cardiovascular disease. The objective of this study was to further understand the relationship of AS intake with liver enzymes and risk factors for cardiovascular disease in adults (n = 29,687) participating in the National Health and Nutrition Examination Survey (NHANES) 2001–2012. Methods Individual usual intake (IUI) of AS was estimated using the Markov Chain Monte Carlo ratio method using two days of 24-hour dietary recalls gathered using standardized protocols. Subjects were separated into six consumption groups: 0 to <5%, 5 to <10%, 10 to <15%, 15 to <20%, 20 to <25% and ≥25% of energy as added sugars. Linear and group trends were determined using regression analyses for liver enzymes, cardiovascular risk factors, weight parameters, glucose, metabolic syndrome, and C-reactive protein. Logistic regression calculated odds ratios for these biomarkers above established risk levels (p < 0.01). Results There was an inverse group trend association with AS IUI for lower body mass index (beta = −0.12 kg/m2 across AS intake groups); % overweight/obese or % obese also showed inverse group trend (−1.44, −0.77, % units across AS intake groups, respectively). Liver enzymes did not show a significant association with AS IUI. Mean plasma glucose levels (mg/dL) showed an inverse linear (beta = −0.13 mg/dL per AS intake); and group association with energy from AS IUI (beta = −0.71mg/d L across AS intake groups). There was no association of AS intake with the risk of elevated uric acid levels; however, the odds of reduced uric acid levels was 17% lower with increasing intake of energy from AS IUI in group trend analysis only (0.83; 0.72–0.95 [99th CI]). Conclusion Although it is sensible to consume AS in moderation, results suggested that higher intakes of AS were not consistently associated with physiologic parameters. Since the data were cross-sectional, they cannot be used to assess cause and effect. Thus, additional studies are warranted to confirm these findings with more rigorous study designs.
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Affiliation(s)
- Carol E O'Neil
- LSU Agricultural Center Professor Emeritus, Baton Rouge, LA, USA
| | | | - Rabab Saab
- USDA/ARS/CNRC, Baylor College of Medicine, Houston, TX, USA
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Bullón-Vela V, Abete I, Zulet MA, Xu Y, Martínez-González MA, Sayón-Orea C, Ruiz-Canela M, Toledo E, Sánchez VM, Estruch R, Lamuela-Raventós RM, Almanza-Aguilera E, Fitó M, Salas-Salvadó J, Díaz-López A, Tinahones FJ, Tur JA, Romaguera D, Konieczna J, Pintó X, Daimiel L, Rodriguez-Mateos A, Alfredo Martínez J. Urinary Resveratrol Metabolites Output: Differential Associations with Cardiometabolic Markers and Liver Enzymes in House-Dwelling Subjects Featuring Metabolic Syndrome. Molecules 2020; 25:molecules25184340. [PMID: 32971870 PMCID: PMC7570830 DOI: 10.3390/molecules25184340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 02/06/2023] Open
Abstract
Metabolic syndrome (MetS) components are strongly associated with increased risk of non-alcoholic fatty liver disease (NAFLD) development. Several studies have supported that resveratrol is associated with anti-inflammatory and antioxidant effects on health status. The main objective of this study was to assess the putative associations between some urinary resveratrol phase II metabolites, cardiometabolic, and liver markers in individuals diagnosed with MetS. In this cross-sectional study, 266 participants from PREDIMED Plus study (PREvención con DIeta MEDiterránea) were divided into tertiles of total urinary resveratrol phase II metabolites (sum of five resveratrol conjugation metabolites). Urinary resveratrol metabolites were analyzed by ultra- performance liquid chromatography coupled to triple quadrupole mass spectrometry (UPLC-Q-q-Q MS), followed by micro-solid phase extraction (µ-SPE) method. Liver function markers were assessed using serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transferase (GGT). Moreover, lipid profile was measured by triglycerides, very-low-density lipoprotein cholesterol (VLDL-c), and total cholesterol/high-density lipoprotein ratio (total cholesterol/HDL). Linear regression adjusted models showed that participants with higher total urine resveratrol concentrations exhibited improved lipid and liver markers compared to the lowest tertile. For lipid determinations: log triglycerides (βT3= −0.15, 95% CI; −0.28, −0.02, p-trend = 0.030), VLDL-c, (βT3= −4.21, 95% CI; −7.97, −0.46, p-trend = 0.039), total cholesterol/HDL ratio Moreover, (βT3= −0.35, 95% CI; −0.66, −0.03, p-trend = 0.241). For liver enzymes: log AST (βT3= −0.12, 95% CI; −0.22, −0.02, p-trend = 0.011, and log GGT (βT3= −0.24, 95% CI; −0.42, −0.06, p-trend = 0.002). However, there is no difference found on glucose variables between groups. To investigate the risk of elevated serum liver markers, flexible regression models indicated that total urine resveratrol metabolites were associated with a lower risk of higher ALT (169.2 to 1314.3 nmol/g creatinine), AST (599.9 to 893.8 nmol/g creatinine), and GGT levels (169.2 to 893.8 nmol/g creatinine). These results suggested that higher urinary concentrations of some resveratrol metabolites might be associated with better lipid profile and hepatic serum enzymes. Moreover, urinary resveratrol excreted showed a reduced odds ratio for higher liver enzymes, which are linked to NAFLD.
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Affiliation(s)
- Vanessa Bullón-Vela
- Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain; (V.B.-V.); (M.A.Z.); (J.A.M.)
| | - Itziar Abete
- Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain; (V.B.-V.); (M.A.Z.); (J.A.M.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.A.M.-G.); (C.S.-O.); (M.R.-C.); (E.T.); (R.E.); (R.M.L.-R.); (M.F.); (J.S.-S.); (A.D.-L.); (F.J.T.); (J.A.T.); (D.R.); (J.K.); (X.P.)
- Correspondence: ; Tel.: +34-94-842-5600 (ext. 806357)
| | - Maria Angeles Zulet
- Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain; (V.B.-V.); (M.A.Z.); (J.A.M.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.A.M.-G.); (C.S.-O.); (M.R.-C.); (E.T.); (R.E.); (R.M.L.-R.); (M.F.); (J.S.-S.); (A.D.-L.); (F.J.T.); (J.A.T.); (D.R.); (J.K.); (X.P.)
| | - Yifan Xu
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London SE1 9NH, UK; (Y.X.); (A.R.-M.)
| | - Miguel A. Martínez-González
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.A.M.-G.); (C.S.-O.); (M.R.-C.); (E.T.); (R.E.); (R.M.L.-R.); (M.F.); (J.S.-S.); (A.D.-L.); (F.J.T.); (J.A.T.); (D.R.); (J.K.); (X.P.)
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain
| | - Carmen Sayón-Orea
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.A.M.-G.); (C.S.-O.); (M.R.-C.); (E.T.); (R.E.); (R.M.L.-R.); (M.F.); (J.S.-S.); (A.D.-L.); (F.J.T.); (J.A.T.); (D.R.); (J.K.); (X.P.)
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain
| | - Miguel Ruiz-Canela
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.A.M.-G.); (C.S.-O.); (M.R.-C.); (E.T.); (R.E.); (R.M.L.-R.); (M.F.); (J.S.-S.); (A.D.-L.); (F.J.T.); (J.A.T.); (D.R.); (J.K.); (X.P.)
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain
| | - Estefanía Toledo
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.A.M.-G.); (C.S.-O.); (M.R.-C.); (E.T.); (R.E.); (R.M.L.-R.); (M.F.); (J.S.-S.); (A.D.-L.); (F.J.T.); (J.A.T.); (D.R.); (J.K.); (X.P.)
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain
| | - Vicente Martín Sánchez
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain;
- Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
| | - Ramon Estruch
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.A.M.-G.); (C.S.-O.); (M.R.-C.); (E.T.); (R.E.); (R.M.L.-R.); (M.F.); (J.S.-S.); (A.D.-L.); (F.J.T.); (J.A.T.); (D.R.); (J.K.); (X.P.)
- Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain
| | - Rosa María Lamuela-Raventós
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.A.M.-G.); (C.S.-O.); (M.R.-C.); (E.T.); (R.E.); (R.M.L.-R.); (M.F.); (J.S.-S.); (A.D.-L.); (F.J.T.); (J.A.T.); (D.R.); (J.K.); (X.P.)
- Department of Nutrition, Food Sciences and Gastronomy, XaRTA, INSA-UB, School of Pharmacy and Food Sciences, Nutrition and Food Safety Research Institute, University of Barcelona, 08028 Barcelona, Spain
| | - Enrique Almanza-Aguilera
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Research Institute (IMIM), 08007 Barcelona, Spain;
- CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Institute of Health Carlos III, 28029 Madrid, Spain
- Institute of Nutrition and Food Safety (INSA-UB), University of Barcelona, Santa Coloma de Gramenet, 08921 Barcelona, Spain
| | - Montserrat Fitó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.A.M.-G.); (C.S.-O.); (M.R.-C.); (E.T.); (R.E.); (R.M.L.-R.); (M.F.); (J.S.-S.); (A.D.-L.); (F.J.T.); (J.A.T.); (D.R.); (J.K.); (X.P.)
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Research Institute (IMIM), 08007 Barcelona, Spain;
| | - Jordi Salas-Salvadó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.A.M.-G.); (C.S.-O.); (M.R.-C.); (E.T.); (R.E.); (R.M.L.-R.); (M.F.); (J.S.-S.); (A.D.-L.); (F.J.T.); (J.A.T.); (D.R.); (J.K.); (X.P.)
- Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, Unitat de Nutrició Humana, 43201 Reus, Spain
- Institut d’Investigació Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain
| | - Andrés Díaz-López
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.A.M.-G.); (C.S.-O.); (M.R.-C.); (E.T.); (R.E.); (R.M.L.-R.); (M.F.); (J.S.-S.); (A.D.-L.); (F.J.T.); (J.A.T.); (D.R.); (J.K.); (X.P.)
- Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, Unitat de Nutrició Humana, 43201 Reus, Spain
- Institut d’Investigació Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain
| | - Francisco J. Tinahones
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.A.M.-G.); (C.S.-O.); (M.R.-C.); (E.T.); (R.E.); (R.M.L.-R.); (M.F.); (J.S.-S.); (A.D.-L.); (F.J.T.); (J.A.T.); (D.R.); (J.K.); (X.P.)
- Department of Endocrinology, Instituto de Investigación Biomédica de Málaga-IBIMA, University of Málaga, Virgen de la Victoria Hospital, 29010 Málaga, Spain
| | - Josep A. Tur
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.A.M.-G.); (C.S.-O.); (M.R.-C.); (E.T.); (R.E.); (R.M.L.-R.); (M.F.); (J.S.-S.); (A.D.-L.); (F.J.T.); (J.A.T.); (D.R.); (J.K.); (X.P.)
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, 07122 Palma de Mallorca, Spain
| | - Dora Romaguera
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.A.M.-G.); (C.S.-O.); (M.R.-C.); (E.T.); (R.E.); (R.M.L.-R.); (M.F.); (J.S.-S.); (A.D.-L.); (F.J.T.); (J.A.T.); (D.R.); (J.K.); (X.P.)
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma de Mallorca, Spain
| | - Jadwiga Konieczna
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.A.M.-G.); (C.S.-O.); (M.R.-C.); (E.T.); (R.E.); (R.M.L.-R.); (M.F.); (J.S.-S.); (A.D.-L.); (F.J.T.); (J.A.T.); (D.R.); (J.K.); (X.P.)
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma de Mallorca, Spain
| | - Xavier Pintó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.A.M.-G.); (C.S.-O.); (M.R.-C.); (E.T.); (R.E.); (R.M.L.-R.); (M.F.); (J.S.-S.); (A.D.-L.); (F.J.T.); (J.A.T.); (D.R.); (J.K.); (X.P.)
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Lidia Daimiel
- Precision Nutrition Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain;
| | - Ana Rodriguez-Mateos
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London SE1 9NH, UK; (Y.X.); (A.R.-M.)
| | - José Alfredo Martínez
- Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain; (V.B.-V.); (M.A.Z.); (J.A.M.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.A.M.-G.); (C.S.-O.); (M.R.-C.); (E.T.); (R.E.); (R.M.L.-R.); (M.F.); (J.S.-S.); (A.D.-L.); (F.J.T.); (J.A.T.); (D.R.); (J.K.); (X.P.)
- Precision Nutrition Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain;
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Soliman R, Yacoub A, Abdellatif M. Comparative effect of desflurane and sevoflurane on liver function tests of patients with impaired hepatic function undergoing cholecystectomy: A randomized clinical study. Indian J Anaesth 2020; 64:383-390. [PMID: 32724246 PMCID: PMC7286405 DOI: 10.4103/ija.ija_168_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/21/2020] [Accepted: 04/08/2020] [Indexed: 11/10/2022] Open
Abstract
Background and Aim: Desflurane and sevoflurane are the most common volatile anesthetics used during laparoscopic and hepatic surgery. The objective of the study was to evaluate the effect of desflurane and sevoflurane in patients with elevated preoperative liver functions undergoing laparoscopic cholecystectomy. Methods: The study was a randomized study and included 162 patients classified randomly into two groups: Desflurane group: The patients received desflurane (end-tidal concentration 4%–6%) as an inhalational agent during the whole procedure. Sevoflurane group: The patients received sevoflurane (end-tidal concentration 2%–4%) as an inhalational agent during the whole procedure. The investigations included serum level of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyltransferase (GGT), and total bilirubin. The values were serially collected at the following timepoints; T0:at the preoperative period, T1:directly after surgery, T2:1st postoperative day, T3:2nd postoperative day, T4:3rd postoperative day, T5:5th postoperative day, T6:7th postoperative day, and T7:10th postoperative day. The statistics were described in terms of mean ± standard deviation, frequencies, and percentages. Results: The preoperative liver enzymes and total bilirubin were higher than the normal range in patients of the two groups. Postoperatively, there was a decrease in the AST and ALT with desflurane more than sevoflurane from T1 to T6(P < 0.05). The ALP, GGT, and bilirubin decreased in patients of the two groups, but the comparison was insignificant (P > 0.05). Conclusion: The desflurane is a safe inhalational volatile for maintenance of anesthesia in patients with impaired liver function undergoing laparoscopic cholecystectomy. It was associated with a decrease in the liver enzymes more than the sevoflurane.
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Affiliation(s)
- Rabie Soliman
- Department of Anesthesia, Aldar Hospital, Almadinah Almonwarah, Saudi Arabia.,Department of Anesthesia, Faculty of Medicine, Cairo University, Egypt
| | - Abdelbadee Yacoub
- Department of Anesthesia, Aldar Hospital, Almadinah Almonwarah, Saudi Arabia.,Department of Anesthesia, Faculty of Medicine, Al Azhar University, Cairo, Egypt
| | - Mostafa Abdellatif
- Department of Surgery Aldar Hospital, Almadinah Almonwarah, Saudi Arabia.,Department of Surgery, Faculty of Medicine, Ein Shams University, Cairo, Egypt
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Ahmed J, Rizwan T, Malik F, Akhter R, Malik M, Ahmad J, Khan AW, Chaudhary MA, Usman MS. COVID-19 and Liver Injury: A Systematic Review and Meta-Analysis. Cureus 2020; 12:e9424. [PMID: 32864250 PMCID: PMC7450889 DOI: 10.7759/cureus.9424] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 07/27/2020] [Indexed: 01/09/2023] Open
Abstract
Background and Aims The prevalence and extent of liver damage in coronavirus disease 2019 (COVID-19) patients remain poorly understood, primarily due to small-sized epidemiological studies with varying definitions of "liver injury". We conducted a meta-analysis to derive generalizable, well-powered estimates of liver injury prevalence in COVID-19 patients. We also aimed to assess whether liver injury prevalence is significantly greater than the baseline prevalence of chronic liver disease (CLD). Our secondary aim was to study whether the degree of liver injury was associated with the severity of COVID-19. Materials and Methods Electronic databases (PubMed and Scopus) were systematically searched in June 2020 for studies reporting the prevalence of baseline CLD and current liver injury in hospitalized COVID-19 patients. Liver injury was defined as an elevation in transaminases >3 times above the upper limit of normal. For the secondary analysis, all studies reporting mean liver enzyme levels in severe versus non-severe COVID-19 patients were included. A random-effects model was used for meta-analysis. Proportions were subjected to arcsine transformation and pooled to derive pooled proportions and corresponding 95% confidence intervals (CIs). Subgroup differences were tested for using the chi-square test and associated p-value. Means and their standard errors were pooled to derive weighted mean differences (WMDs) and corresponding 95% CIs. Results Electronic search yielded a total of 521 articles. After removal of duplicates and reviewing the full-texts of potential studies, a total of 27 studies met the inclusion criteria. Among a cohort of 8,817 patients, the prevalence of current liver injury was 15.7% (9.5%-23.0%), and this was significantly higher than the proportion of patients with a history of CLD (4.9% [2.2%-8.6%]; p < 0.001). A total of 2,900 patients in our population had severe COVID-19, and 7,184 patients had non-severe COVID-19. Serum ALT (WMD: 7.19 [4.90, 9.48]; p < 0.001; I2 = 69%), AST (WMD: 9.02 [6.89, 11.15]; p < 0.001; I2 = 73%) and bilirubin levels (WMD: 1.78 [0.86, 2.70]; p < 0.001; I2 = 82%) were significantly higher in patients with severe COVID-19 when compared to patients with non-severe disease. Albumin levels were significantly lower in patients with severe COVID-19 (WMD: -4.16 [-5.97, -2.35]; p < 0.001; I2 = 95%). Conclusions Patients with COVID-19 have a higher than expected prevalence of liver injury, and the extent of the injury is associated with the severity of the disease. Further studies are required to assess whether hepatic damage is caused by the virus, medications, or both.
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Affiliation(s)
- Jawad Ahmed
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Tehlil Rizwan
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Farheen Malik
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Raniyah Akhter
- Pulmonology, Fazaia Ruth Phau Medical College, Pakistan Air Force (PAF) Hospital, Karachi, PAK
| | | | - Junaid Ahmad
- Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Abdul Wasay Khan
- Pediatrics, University of Kansas School of Medicine - Wichita, Wichita, USA
| | - Muhammad A Chaudhary
- Family Medicine, WellSpan Good Samaritan Hospital, Lebanon, USA
- Center for Surgery and Public Health, Harvard Medical School/Harvard T. H. Chan School of Public Health, Boston, USA
| | - Muhammad Shariq Usman
- Internal Medicine, Civil Hospital Karachi, Dow University of Health Sciences, Karachi, PAK
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Ali N. Relationship Between COVID-19 Infection and Liver Injury: A Review of Recent Data. Front Med (Lausanne) 2020; 7:458. [PMID: 32793619 PMCID: PMC7385135 DOI: 10.3389/fmed.2020.00458] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/09/2020] [Indexed: 01/08/2023] Open
Abstract
The COVID-19 outbreak is a great threat to public health worldwide. Lung injury is the main outcome of COVID-19 infection; however, damage can occur in other organs including the liver. Currently, limited data are available that link underlying liver injury with the severe SARS-CoV-2 infection. This review summarizes the available data on liver test abnormalities in COVID-19 patients; critically evaluates the possible causes of liver injury and provides recommendations for clinicians. In laboratory tests, serum levels of liver test markers notably transaminase, gamma-glutamyl transferase and total bilirubin were significantly higher in severe patients with COVID-19 infection. The use of certain drugs especially lopinavir and ritonavir showed an association with the progression of liver damage in severe cases. Available data suggest that liver injury in COVID-19 patients may result from direct effect by the virus, immune-mediated inflammation or drug-induced toxicity. Some studies demonstrated that COVID-19 patients with pre-existing liver disease are at higher risk for hospitalizations and mortality. Therefore, the impact of pre-existing liver disease on treatment and clinical outcomes of COVID-19 should be determined. Large-scale clinical studies are needed to identify the causes of liver injury in patients with COVID-19 infection.
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Affiliation(s)
- Nurshad Ali
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
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Gholizadeh P, Safari R, Marofi P, Zeinalzadeh E, Pagliano P, Ganbarov K, Esposito S, Khodadadi E, Yousefi M, Samadi Kafil H. Alteration of Liver Biomarkers in Patients with SARS-CoV-2 (COVID-19). J Inflamm Res 2020; 13:285-292. [PMID: 32669866 PMCID: PMC7335895 DOI: 10.2147/jir.s257078] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/16/2020] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) emerged in China and spread worldwide. In this study, we assessed the characteristics of markers of the liver in patients with COVID-19 to provide new insights in improving clinical treatment. PATIENTS AND METHODS We recruited 279 patients who confirmed COVID-19 and the data of liver biomarkers and complete blood count of patients were defined as the day onset when the patients admitted to the hospital. RESULTS The average of LDH value was 621.29 U/L in all patients with COVID-19, and CPK was 286.90 U/L. The average AST was 44.03 U/L in all patients, and ALT was 31.14 U/L. The AST/ALT ratio was 1.64 in all patients. The measurement of CRP was increased by 79.93% in all patients. Average ALT and AST values of patients with elevated ALT were significantly increased in comparison to patients with normal ALT (P-value = 0.001), while AST/ALT ratio was significantly decreased compared to patients with normal ALT (P-value= 0.014). In addition, the average LDH of patients with elevated ALT was significantly increased compared to patients with normal ALT (P-value = 0.014). CONCLUSION Hepatic injury and abnormal liver enzymes related to COVID-19 infection is an acute non-specific inflammation alteration.
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Affiliation(s)
- Pourya Gholizadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rohollah Safari
- Department of Microbiology, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parham Marofi
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elham Zeinalzadeh
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Khudaverdi Ganbarov
- Department of Microbiology, Baku State University, Baku, Republic of Azerbaijan
| | | | - Ehsaneh Khodadadi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Yousefi
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Samadi Kafil
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Joni SS, Cheshmavar M, Shoureshi P, Zamani Z, Taoosi N, Akbari M, Afzali M. Effects of fingolimod treatments on alanine transaminase and aspartate transaminase levels in patients with multiple sclerosis. Int J Physiol Pathophysiol Pharmacol 2020; 12:88-94. [PMID: 32714497 PMCID: PMC7364390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/01/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Multiple Sclerosis (MS) is a chronic neurological disorder with no known cause or cure. Fingolimod (FTY720) is an oral medication recently approved for the treatment of MS as well as other diseases with autoimmune aspects. However, the drug is not without side effects. The severity and prevalence of these side effects are not completely understood. One of the most common causes for the patient cessation of fingolimod is an increase in liver enzymes, indicating possible inflammation or damage to liver cells. Alanine transaminase (ALT) and aspartate transaminase (AST) are the most common liver enzymes used as indicators of hepatic health. OBJECTIVES This three-month prospective cohort study selected patients who were diagnosed with relapsing-remitting MS (RRMS) and who were not taking fingolimod oral treatment. ALT and AST levels were determined for these patients at baseline and then after three months of taking FTY720 to determine if these liver enzymes were changed. METHODS 36 RRMS patients completed this study, which lasted three months. They were started on 0.5 oral FTY720 after approval from a physician and completion of an AST/ALT blood test. Baseline levels were determined and then taken again three months later. Statistical analysis of these values was performed using P<0.05 as a significance threshold. RESULTS In this sample of patients, only ALT levels were significantly increased after fingolimod treatment in the general cohort (P=0.00). The general cohort showed an insignificant increase in AST levels. In male and female populations separately, AST was not significantly increased. ALT was only significantly increased in men (P=0.00) and insignificantly increased in women. CONCLUSION This study further confirms our concerns about fingolimod's possible effects on the liver. While these numbers do support the claim that the drug does on average increase ALT in patient populations, it is important to note that most of these patients have no real hepatic side effects. In addition, previous studies have cited a return to normal ALT and AST levels after cessation of fingolimod, suggesting its effects are temporary and not severely damaged in the usual patient.
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Affiliation(s)
- Saeid Sadeghi Joni
- Department of Radiology, Razi Hospital, Guilan University of Medical SciencesRasht, Iran
| | - Masoumeh Cheshmavar
- Department of Neurology, Isfahan University of Medical SciencesIsfahan, Iran
| | - Pouria Shoureshi
- Department of Internal Medicine, Orange Park Medical CenterFlorida, USA
| | - Zohreh Zamani
- Department of Neurology, Firoozgar Hospital, Iran University of Medical SciencesTehran, Iran
| | | | - Morteza Akbari
- School of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
| | - Mahdieh Afzali
- Department of Neurology, Isfahan University of Medical SciencesIsfahan, Iran
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Shi XY, Fan SM, Shi GM, Yao J, Gao Y, Xia YG, Chen Q. Efficacy and safety of omega-3 fatty acids on liver-related outcomes in patients with nonalcoholic fatty liver disease: A protocol for a systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e20624. [PMID: 32541499 PMCID: PMC7302599 DOI: 10.1097/md.0000000000020624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD), especially non-alcoholic steatohepatitis, which is considered as the hepatic manifestation of metabolic syndrome, has a great prevalence all over the world. New drugs are urgently needed for the treatment of NAFLD. This review will be to assess the efficacy and safety of omega-3 polyunsaturated fatty acids (n-3 PUFAs) on liver-related outcomes (liver histology and liver enzymes) in patients with NAFLD. METHODS We will search 5 databases for relative studies: Medline, the Cochrane Library, EMBASE, Web of Science, and ClinicalTrials.gov and identified all reports of randomized controlled trials published prior to July 2020. Two authors will independently scan the articles searched, extract the data from articles included, and assess the risk of bias by Cochrane tool of risk of bias. Disagreements will be resolved by discussion among authors. All analysis will be performed based on the Cochrane Handbook for Systematic Reviews of Interventions. Fixed-effects model or random-effects model will be used to calculate pooled estimates of weighted mean difference with 95% confidence intervals. RESULTS This systematic review aims to examine the effect of n-3 PUFAs on liver histology and liver enzymes in patients with NAFLD. CONCLUSIONS These findings will provide guidance to clinicians and patients on the use of n-3 PUFAs for NAFLD. ETHICS AND DISSEMINATION This study is a protocol for a systematic review of n-3 PUFAs as a treatment of NAFLD patients. This review will be published in a journal and disseminated in print by peer-review. SYSTEMATIC REVIEW REGISTRATION INPLASY202050008.
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Affiliation(s)
- Xiao-yan Shi
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province
| | - Si-min Fan
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province
| | - Guo-mei Shi
- School of Information Science and Technology, Northeast Normal University, Changchun, Jilin Province, P.R. China
| | - Jia Yao
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province
| | - Yang Gao
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province
| | - Yu-guo Xia
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province
| | - Qiu Chen
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province
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Mahdavi A, Naeini AA, Najafi M, Maracy M, Ghazvini MA. Effect of levetiracetam drug on antioxidant and liver enzymes in epileptic patients: case-control study. Afr Health Sci 2020; 20:984-990. [PMID: 33163067 PMCID: PMC7609075 DOI: 10.4314/ahs.v20i2.55] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There is a limited amount of data regarding levetiracetam (LEV), an antiepileptic drug. OBJECTIVE This study was conducted to assess the effect of LEV on antioxidant status and liver enzymes. METHODS In this case-control study, 33 epileptic patients under treatment with LEV for at least 6 months were compared with 35 healthy subjects. We measured serum total antioxidant capacity (TAC), salivary superoxide dismutase (SOD), alanine aminoteransferase (ALT), and aspartate aminoteransferase (AST) levels in both groups. Dietary intakes were collected using a Food Frequency Questionnaire (FFQ). RESULT The level of TAC in the healthy subjects was significantly higher than it was in the patients (P=0.02), but the mean of ALT (P=0.02) and AST (P=0.03) was significantly higher in the patients in comparison with the controls. Mean salivary SOD showed no difference between the two groups. In the patients, the duration of drug use was inversely correlated with serum TAC (p=0.04) and had a direct correlation with ALT (p=0.01) and AST (p=0.03.). CONCLUSION The results of our study indicated that LEV increased liver enzymes Also, treatment with this drug did not improve oxidative stress, but this could be due to the different in the dietary antioxidant intake. Routine screening of the liver and antioxidant enzymes in patients with chronic use of LEV is recommended.
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Affiliation(s)
- Atena Mahdavi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amirmansour Alavi Naeini
- Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammadreza Najafi
- Department of Neurology, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran
| | - Mohammadreza Maracy
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Talathi S, Barnes M, Aban I, Dimmitt R, Askenazi DJ. Serum Transaminases at Presentation and Association with Acute Dialysis in Children with Hemolytic Uremic Syndrome. Kidney360 2020; 1:337-342. [PMID: 35369368 PMCID: PMC8809299 DOI: 10.34067/kid.0000222020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 03/10/2020] [Indexed: 06/14/2023]
Abstract
BACKGROUND To determine whether serum transaminases at presentation predict the need for dialysis in children with hemolytic uremic syndrome (HUS). METHODS Single-center, retrospective chart review of pediatric patients with HUS. Data collected included demographics, clinical and laboratory parameters, and need for dialysis. These factors were compared between two groups: "dialysis" versus "no dialysis." Continuous data were compared using a t test whereas categoric data were compared by the chi-squared test. Multivariate logistic regression was performed on a prior set of variables to determine if serum transaminases independently predict the need for dialysis. RESULTS A total of 70 children were included in the study, of which, 39 (27%) received dialysis. The no-dialysis group had a higher proportion of white patients compared with the dialysis group (74% dialysis versus 94% no dialysis). The only clinical sign at admission associated with dialysis was reduced urine output (56% versus 16%, P<0.001). Univariate logistic regression identified admission serum creatinine, aspartate transaminase (AST), and alanine transaminase (ALT) to be associated with the need for dialysis. Multivariate logistic regression showed serum AST and ALT to be independent predictors of the need for dialysis, with both improving the performance of the regression model. Sensitivity analysis showed a cutoff of 129 U/L for AST and 83 U/L for ALT with high specificity. CONCLUSIONS Serum transaminases at presentation are independently associated with the subsequent need for dialysis in patients with HUS. Our study suggests that when both serum ALT and AST are normal, the likelihood to need dialysis is very low; alternatively, when both serum ALT and AST are more than two times the upper level of normal, the need for dialysis is very high.
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Affiliation(s)
- Saurabh Talathi
- Division of Pediatric Gastroenterology, Department of Pediatrics, Hepatology and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Margaux Barnes
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Inmaculada Aban
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Reed Dimmitt
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - David J. Askenazi
- Division of Pediatric Nephrology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
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Abstract
PURPOSE OF REVIEW Over the past decade, imaging modalities and serological tests have emerged as important tools in the evaluation of liver diseases, in many cases supplanting the use of liver biopsy and histological examination. Nonetheless, the accuracy and diagnostic value of these methods may not always be conclusive and the assessment of liver histology often remains the gold standard for diagnostic evaluation. The purpose of this review is to summarize the current role of liver biopsy in contemporary hepatology practice. RECENT FINDINGS Technical factors were found to influence the diagnostic value of liver biopsy and histological examination of the liver, including specimen number and size (preferably ≥3 nonfragmented specimens of >20 mm in length), needle diameter (1.6 mm Menghini), number of passes (mean 2.5), imaging-guidance, and operator experience. Liver biopsy was demonstrated to be diagnostically valuable in the evaluation of persistently abnormal liver tests of unclear cause, with histology pointing to a specific diagnosis in 84% of patients. Although coagulation abnormalities continue to be an important concern when performing liver biopsy, their influence on complication risk remains unclear. Implementation of less stringent preprocedural coagulation thresholds decreased preprocedural transfusions without increasing the bleeding rate. Serious complications associated with percutaneous liver-biopsy (PLB) and transjugular liver-biopsy are similar, but pain appears to be more common with PLB. SUMMARY Histopathological evaluation continues to be fundamentally important in assessing hepatic disease, and liver histology remains the most accurate approach to assess fibrosis and assign prognosis.
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Affiliation(s)
- Ali Khalifa
- Department of Internal Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
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145
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Nwankwo RC, Ibegbu MD, Onyekwelu KC, Ejezie CS, Ikekpeazu JE, Ejezie FE. Biochemical and histopathological effects of sub-acute exposure of albino rats to fumigants - dichlorvos and cypermethrin. Interdiscip Toxicol 2019; 12:180-5. [PMID: 32461721 DOI: 10.2478/intox-2019-0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 03/27/2019] [Indexed: 12/05/2022] Open
Abstract
Cypermethrin (CYP) is one of the most common active ingredients in most insecticides, mosquito coils and powder used in Nigeria. dichlorvos (DDVP) is the most indiscriminately used fumigant in most rural and sub-urban areas in Nigeria. These fumigants can easily be accessed without proper method of usage thus exposing the population to their toxic effects. As a result, this study was initiated to determine the effects of sub-acute exposure of CYP and DDVP on some biochemical and histopathological parameters of albino rats. In this study, forty (40) albino rats of 10 groups of 4 rats per group, with one group serving as control, were exposed to these fumigants in a poorly ventilated area for 4hours per day over 2, 4 and 6 weeks. The results showed observable changes in liver enzyme activities (p<0.05) in groups exposed to DDVP for 2, 4 and 6 weeks. The groups exposed to CYP showed mild changes in liver enzyme activities when compared with the DDVP groups. Increase in activity of the liver enzymes was also observed in the groups exposed to a mixture of DDVP+CYP for 2, 4 and 6 weeks. The urea, creatinine and electrolytes levels in all the groups exposed to DDVP, CYP and DDVP+CYP for 2, 4 and 6weeks were significantly (p<0.05) increased. Also WBC and platelets in all the groups exposed to DDVP and CYP recorded significant changes. The histology report of the lungs and liver showed moderate lymphocytic infiltration and hepatocytic steatosis which progressed with duration of exposure to the fumigants, while the kidneys showed no remarkable changes. The results of this study suggest that DDVP and CYP have relative toxic effects in the exposed animals and should be used with caution to avoid human exposure to their visible toxicities.
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146
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Harchegani AB, Khor A, Niha MM, Kaboutaraki HB, Shirvani H, Shahriary A. The hepatoprotective and antioxidative effect of saffron stigma alcoholic extract against vincristine sulfate induced toxicity in rats. Interdiscip Toxicol 2019; 12:186-91. [PMID: 32461722 DOI: 10.2478/intox-2019-0023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 03/01/2019] [Indexed: 12/12/2022] Open
Abstract
Vincristine (VCR) is an important anti-cancer drug, which is highly toxic for the liver. This study aimed at evaluating the protective effect of alcoholic extract of saffron stigma against vincristine hepatotoxicity in the rat. A total number of 50 rats were randomly divided into 10 groups, including controls, rats receiving 0.25 mg/kg (A group), 0.5 mg/kg (B group), 0.75 mg/kg (C group) VCR, 0.25 mg/kg VCR + 0.5 mg/kg saffron (D group), 0.5 mg/kg VCR + 0.5 mg/kg saffron (E group), 0.75 mg/kg VCR + 0.5 mg/kg saffron (F group), 0.25 mg/kg VCR + 1mg/kg saffron (G group), 0.5 mg/kg VCR + 1 mg/kg saffron (H group), and 0.75 mg/kg VCR + 1 mg/kg saffron (I group) groups. Serum level of liver enzymes, including aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), and bilirubin were measured using specific kits at the end of the experimental period. Serum total antioxidant capacity (TAC) and malondialdehyde (MDA) values were measured using ferric reducing antioxidant of power (FRAP) and thiobarbituric acid reaction (TBAR) methods, respectively. Administration of VCR, especially at the concentration of 0.75mg/kg, caused severe hepatic injury with significant increase in the levels of AST (582.0±39.45 UI), ALT (124.0±5.92 UI), ALP (939.8±89.8 UI) enzymes and bilirubin (0.17±0.008). VCR administration also significantly increased the serum MDA level (0.49±0.021 nmol/ml), while TAC value was declined significantly (241.27±18.27 μmol/l). These effects were dose-dependent. Treatment with saffron extract decreased the activity of liver enzymes and MDA values in hepatotoxic rats with a significant enhancement in serum TAC content. These effects were notable for rats that received 1mg/kg plant extract. Administration of saffron, especially at higher concentration, can reduce VCR-induced hepatotoxicity, antioxidant depletion and lipid peroxidation, presumably due to its antioxidative properties.
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147
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Park EO, Bae EJ, Park BH, Chae SW. The Associations between Liver Enzymes and Cardiovascular Risk Factors in Adults with Mild Dyslipidemia. J Clin Med 2020; 9:jcm9041147. [PMID: 32316417 PMCID: PMC7230762 DOI: 10.3390/jcm9041147] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/11/2020] [Accepted: 04/15/2020] [Indexed: 12/30/2022] Open
Abstract
Hypertension and dyslipidemia often occur as comorbidities, with both being strong risk factors for developing cardiovascular diseases (CVD). Abnormal liver function test could reflect a potential CVD risk even in patients with mild dyslipidemia. The aim of this study was to assess the compounding relationship between liver enzymes and cardiovascular risk factors in subjects with mild dyslipidemia. The present analysis was performed among 438 participants who had enrolled in at least one of the nine clinical studies done at the Chonbuk National University Hospital between 2009 and 2019. Significant linear increasing trends were observed in blood pressure level and other cardiovascular risk factors across quartiles of serum γ-glutamyltransferase (GGT) or alanine aminotransferase (ALT), with the increment in hypertension prevalence occurring across the quartiles of GGT and ALT. On multivariate logistic regression analyses, the odds ratios for hypertension, adjusted for smoking, drinking and obesity, in the highest quartiles of GGT, ALT, aspartate aminotransferase, and alkaline phosphatase were 3.688, 1.617, 1.372, and 1.166, respectively. Our study indicates that GGT is a superior marker for predicting CVD risk among liver enzymes. Routine screening of plasma GGT levels in patients with mild dyslipidemia will allow for early detection of CVD.
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Affiliation(s)
- Eun-Ock Park
- Clinical Trial Center for Functional Foods, Chonbuk National University Hospital, Jeonju 54907, Jeonbuk, Korea;
| | - Eun Ju Bae
- College of Pharmacy, Chonbuk National University, Jeonju 54896, Jeonbuk, Korea;
| | - Byung-Hyun Park
- Department of Biochemistry and Molecular Biology, Chonbuk National University Medical School, Jeonju 54896, Jeonbuk, Korea
- Correspondence: (B.-H.P.); (S.-W.C.); Tel.: +82-63-270-3139 (B.-H.P.); +82-63-259-3040 (S.-W.C.); Fax: +82-63-274-9833 (B.-H.P.); +82-63-259-3060 (S.-W.C.)
| | - Soo-Wan Chae
- Clinical Trial Center for Functional Foods, Chonbuk National University Hospital, Jeonju 54907, Jeonbuk, Korea;
- Correspondence: (B.-H.P.); (S.-W.C.); Tel.: +82-63-270-3139 (B.-H.P.); +82-63-259-3040 (S.-W.C.); Fax: +82-63-274-9833 (B.-H.P.); +82-63-259-3060 (S.-W.C.)
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148
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Abdel-Aal NM, Elerian AE, Elmakaky AM, Alhamaky DMA. Systemic Effects of Cryolipolysis in Central Obese Women: A Randomized Controlled Trial. Lasers Surg Med 2020; 52:971-978. [PMID: 32293044 DOI: 10.1002/lsm.23250] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 04/04/2020] [Accepted: 04/06/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND AND OBJECTIVES To investigate the adding effect of Cryolipolysis to a low-calorie diet program on lipid profile, liver enzymes, body mass index, waist-to-hip ratio, and volume reduction of subcutaneous fat tissue in central obese women. STUDY DESIGN/MATERIALS AND METHODS Sixty central obese women were randomly divided into two equal groups. Women in the control group received prescribed low-calorie diet regimen only, while women in the study group received three Cryolipolysis sessions plus the same dietary regimen for 3 months. Assessment of women in each group for weight, height to obtain the body mass index, waist-to-hip ratio, and abdominal subcutaneous fat thickness as well as evaluation of lipid profile and liver enzymes was done just before starting the treatment procedures and immediately after ending the study duration. RESULTS There were statistically significant improvements of waist-to-hip ratio, body mass index, total cholesterol, triglycerides, low- and high-density lipoprotein, as well as liver enzymes in favor of the study group (P < 0.001). CONCLUSION Women who underwent Cryolipolysis and diet program had better improvement in components of lipid profile and liver enzymes than women who were maintained over diet program alone. Measures to decrease waist circumference, associated with abdominal subcutaneous fat reduction, enhanced the systemic effects of Cryolipolysis. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
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Affiliation(s)
- Nabil M Abdel-Aal
- Department of Physical Therapy, Basic Science, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Ahmed E Elerian
- Department of Physical Therapy, Basic Science, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Ayman M Elmakaky
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, South Valley University, Qena, Egypt
| | - Dina M A Alhamaky
- Department of Physical Therapy for Musculoskeletal Disorders and Its Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
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Lim SL, Johal J, Ong KW, Han CY, Chan YH, Lee YM, Loo WM. Lifestyle Intervention Enabled by Mobile Technology on Weight Loss in Patients With Nonalcoholic Fatty Liver Disease: Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e14802. [PMID: 32281943 PMCID: PMC7186867 DOI: 10.2196/14802] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 03/09/2020] [Accepted: 03/20/2020] [Indexed: 02/07/2023] Open
Abstract
Background The prevalence of nonalcoholic fatty liver disease (NAFLD) reaches up to 30% in the Asian adult population, with a higher prevalence in obese patients. Weight reduction is typically recommended for patients at high risk or diagnosed with NAFLD, but is a challenge to achieve. Objective We aimed to evaluate the effect of a lifestyle intervention with a mobile app on weight loss in NAFLD patients. Methods This prospective randomized controlled trial included 108 adults with NAFLD confirmed by steatosis on ultrasound and a body mass index ≥23 kg/m2 who were recruited from a fatty liver outpatient clinic. The patients were randomly allocated to either a control group (n=53) receiving standard care, consisting of dietary and lifestyle advice by a trained nurse, or an intervention group (n=55) utilizing the Nutritionist Buddy (nBuddy) mobile app in addition to receiving dietary and lifestyle advice by a dietitian. Body weight, alanine aminotransferase (ALT), aspartate aminotransferase (AST), waist circumference, and blood pressure were measured at baseline, and then at 3 and 6 months. Intention-to-treat and per-protocol analyses were used for statistical comparisons. Results The intervention group had a 5-fold higher likelihood (relative risk 5.2, P=.003, 95% CI 1.8-15.4) of achieving ≥5% weight loss compared to the control group at 6 months. The intervention group also showed greater reductions in weight (mean 3.2, SD 4.1 kg vs mean 0.5, SD 2.9 kg; P<.001), waist circumference (mean 2.9, SD 5.0 cm vs mean –0.7, SD 4.4 cm; P<.001), systolic blood pressure (mean 12.4, SD 14.8 mmHg vs mean 2.4, SD 12.4 mmHg; P=.003), diastolic blood pressure (mean 6.8, SD 8.9 mmHg vs mean –0.9, SD 10.0 mmHg; P=.001), ALT (mean 33.5, SD 40.4 IU/L vs mean 11.5, SD 35.2 IU/L; P=.004), and AST (mean 17.4, SD 27.5 U/L vs mean 7.4, SD 17.6 IU/L, P=.03) at 6 months. Conclusions Lifestyle intervention enabled by a mobile app can be effective in improving anthropometric indices and liver enzymes in patients with NAFLD. This treatment modality has the potential to be extended to a larger population scale. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12617001001381;
https://tinyurl.com/w9xnfmp
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Affiliation(s)
- Su Lin Lim
- Dietetics Department, National University Hospital, National University Health System, Singapore, Singapore
| | - Jolyn Johal
- Dietetics Department, National University Hospital, National University Health System, Singapore, Singapore
| | - Kai Wen Ong
- Dietetics Department, National University Hospital, National University Health System, Singapore, Singapore
| | - Chad Yixian Han
- Dietetics Department, National University Hospital, National University Health System, Singapore, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yin Mei Lee
- Department of Medicine, Gastroenterology and Hepatology, National University Hospital, National University Health System, Singapore, Singapore
| | - Wai Mun Loo
- Department of Medicine, Gastroenterology and Hepatology, National University Hospital, National University Health System, Singapore, Singapore
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150
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Asghari S, Hamedi-Shahraki S, Amirkhizi F. Systemic redox imbalance in patients with nonalcoholic fatty liver disease. Eur J Clin Invest 2020; 50:e13211. [PMID: 32017057 DOI: 10.1111/eci.13211] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 01/09/2020] [Accepted: 02/01/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Oxidative stress is one of the major pathologic mechanisms for the progression of nonalcoholic fatty liver disease (NAFLD). The aim of this study was to evaluate the relationship between the extent of steatosis and oxidative stress parameters in patients with NAFLD. METHODS The data obtained from 122 patients with NAFLD and 106 healthy controls aged 20-60 years with body mass index (BMI) ranging from 25 to 35 kg/m2 . Abdominal ultrasonography was performed in participants in order to the grading of hepatic steatosis. Fasting blood samples and anthropometric measurements were collected for all study subjects. Oxidative stress was evaluated by measurement of serum malondialdehyde (MDA), oxidized low-density lipoprotein (ox-LDL), total antioxidant capacity (TAC) and erythrocyte superoxide dismutase (SOD) as well as glutathione peroxidase (GPx) activities. RESULTS Serum levels of liver enzymes (P < .0001) and MDA (P = .018), as well as erythrocyte SOD activity (P < .0001), were significantly higher in patients with NAFLD compared to healthy controls. Furthermore, patients with NAFLD had significantly lower serum TAC levels compared to healthy controls (P < .0001). No significant differences were observed in serum ox-LDL level and erythrocyte GPx activity between the groups. The probability of being NAFLD increased with increasing serum levels of MDA (P = .020) and SOD activity (P < .0001). In contrast, decreased serum TAC levels predicted the probability of being NAFLD (P < .0001). CONCLUSIONS Increased extent of hepatic steatosis could be considered as a pathological mechanism for enhancing oxidative stress in patients with NAFLD, independent of obesity, and is exacerbated further in patients with more severe condition.
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Affiliation(s)
- Somayyeh Asghari
- Department of Community Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Soudabeh Hamedi-Shahraki
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Farshad Amirkhizi
- Department of Nutrition, Faculty of Public Health, Zabol University of Medical Sciences, Zabol, Iran
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