Elevated Liver Enzymes in Metabolic Syndrome Are Associated with Coronary Stenosis in a Tunisian Population

Alterations in the liver histology and markers of metabolic syndrome associated with inflammation and liver damage in L-arginine exposed female Wistar albino rats

Metabolic Syndrome (MES), a cluster of metabolic disorders, is pandemic and more prevalent in females. It was associated with inflammation, liver damage and reduced nitric oxide concentration. Since L-arginine (ARG) may enhance nitric oxide synthesis, this study investigated the effect of ARG on the liver histology and selected serum markers of MES related to inflammation and liver damage. Two groups (n = 8) of female Wistar albino rats were exposed to 60 mg kg(-1) b. wt. of ARG and 3 mL kg(-1) b.wt. of distilled water, respectively as treated and control groups. Per oral exposure to ARG for twenty eight days caused a non-significant increase (p > 0.05) in the neutrophils count (22.50 +/- 10.35%, representing 38.46%) but a decrease (p > 0.05) in the lymphocytes count (77.50 +/- 10.35%, representing 8.82%) and in the total bilirubin concentration (0.40 +/- 0.19 mg/100 mL, representing 52.38%) of the rats, suggesting non-treatment related influence on these parameters. However, the exposure elicited a significant decrease (p < 0.01) in the serum alanine aminotransferase (ALT) activity (66.47 +/- 0.37 IU L(-1), representing 18.55%) and in the total White Blood Cell (WBC) count (2.73 +/- 0.75 x 10(9) L(-1), representing 43.24%), suggesting absence of inflammation and liver damage. ALT had a significant positive correlation with WBC (r = 0.01), while the liver histology revealed possible benefit in the ARG-fed rats, seeminlgly confirming benefit on these markers of inflammation and liver damage that could improve related MES features in the rats. Further studies using ARG rich nuts are required to harness insight gained from this study.

The Heart and Medicine: Exploring the Interconnectedness of Cardiometabolic-related Concerns Through a Systems Biology Approach

Patients do not just wake up one morning with cardiac disease. Instead there is an extended preclinical phase during which lifestyle choices determine outcome. Recent advances in our understanding of oxidative stress, endocrine signaling, immune/inflammatory balance, and energy production illuminate opportunities for efficacious intervention. A thorough exploration of these pathophysiologies will allow physicians the opportunity to offer their patients a journey away from illness and disease to optimal wellness.

The association of liver transaminase activity with presence and severity of premature coronary artery disease

There is growing clinical interest in liver transaminases as novel biomarkers of cardiovascular risk. We investigated the possible association of serum liver transaminase activity with the presence and angiographic severity of premature coronary artery disease (CAD). A cross-sectional study was conducted on 187 younger patients (females < 55 years and males < 45 years) who underwent coronary angiography and had serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and high-sensitivity C-reactive protein (hsCRP) measured. Evaluation of coronary stenosis was by Gensini score. Both ALT and AST were significantly correlated with the presence of CAD in univariate and multivariate analyses. Both ALT and AST were also significantly correlated with Gensini score even after adjustment for potential confounders. Serum ALT and AST levels are independently positively associated with the risk and severity of premature CAD, suggesting that these enzymes could serve as surrogate markers for cardiovascular risk in this specific group of patients.