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Objective To evaluate the effect of different cold ischemia time (CIT) on early graft function and acute rejection (AR) after liver transplantation. Methods Clinical data of 218 donors and recipients undergoing liver transplantation were collected and analyzed. All patients were divided into three groups according to the CIT of donor liver: group A (CIT≤6 h, n=60), group B (6 h < CIT≤10 h, n=89) and group C (CIT > 10 h, n=69). Blood samples were collected on the 1, 7 and 14 d after liver transplantation. The changes of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and adenosine triphosphate (ATP) in CD4+T cells were detected. The incidence of AR and the positive rate of C4d deposition were analyzed. Results The ALT, AST and LDH levels in each group reached the peak on the 1 d after operation, and then gradually decreased. The indexes in each group were almost equivalent on the 14 d. An interaction effect existed between postoperative time and group. After liver transplantation, ATP levels in CD4+T cells were gradually increased in each group, peaked at postoperative 7 d, and then decreased gradually. An interaction effect was noted between postoperative time and group. The incidence of AR in groups A, B and C was 10%, 12% and 28%. Compared with group C, the incidence of AR in groups A and B was decreased significantly (both P < 0.05/3). The positive rate of C4d deposition in AR recipients of groups A, B and C was 1/3, 45% and 89% respectively. Compared with group C, the positive rate of C4d deposition in group A was decreased significantly (P=0.015). Conclusions The prolongation of CIT may lead to aggravation of early-stage liver function injury after liver transplantation, which is more easily to induce humoral AR.
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@#Introduction: The prevalence of diabetes mellitus (DM) in Malaysia is drastically increasing. Subjects with DM are more likely to have deranged liver function tests (LFT). This study aimed to determine the prevalence of abnormal liver enzymes [(alanine aminotransferase (ALT) and alkaline phosphatase (ALP)] and its associated factors among type 2 DM (T2DM) subjects visiting a referral diabetic clinic in a tertiary government hospital. Methods: This retrospective, cross-sectional study included electronic data of 300 T2DM subjects ≥18 years old in the outpatient specialist clinic from January 2011 to December 2014. Statistical analysis was performed using SPSS version 22. Results: The study population at large included Malays, of age >60 years with comparable gender percentage. Most subjects had long-standing DM, poor glycaemic control and were on treatment. The prevalence of abnormal ALT and ALP was 27.3% and 13%; with 90.2% and 97.4% having mild ALT and ALP elevations, respectively. Significant associations noted for age, body mass index (BMI) and duration of T2DM for ALT whereas for ALP, anti-diabetic medication was significant between groups of normal and abnormal levels. Deranged liver enzymes were associated significantly with dyslipidaemia. Conclusion: Our study on the crude prevalence of raised liver enzymes may help identify T2DM patients at increased risk of non-alcoholic fatty liver disease (NAFLD). Modification of metabolic risk factors, such as weight loss, control of dyslipidaemia rather than just tighter glycaemic control should be emphasised to reduce morbidity and mortality. Liver enzymes remain a simple and non- invasive marker of liver pathology in daily medical practice
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Diabetes MellitusABSTRACT
Background: Perinatal asphyxia is an insult to the fetus or newborn due to lack of oxygen (hypoxia) and /or a lack of perfusion (ischemia) to various organs. The diagnosis of perinatal asphyxia is mostly established retrospectively. But it is difficult to diagnose perinatal asphyxia retrospectively in the absence of perinatal records. As because of hypoxaemia, different organ systems of the body are affected in perinatal asphyxia, this study was done to assess the hepatic function in the cases of perinatal asphyxia which could prove useful in diagnosing perinatal asphyxia. Methods: The study included 25 asphyxiated neonates as cases and 25 healthy neonates as control group. Venous blood was analyzed between 2nd and 5th day of life to estimate serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP), serum total bilirubin (STB), direct bilirubin (DSB) and prothrombin time (PT). Unpaired student’s ‘t’ test was used for data analysis and P value of <0.05 were considered significant. Results: Serum ALT and AST were found significantly higher in asphyxiated babies compared to reference groups (p<0.001). The mean ALT and AST of asphyxiated babies were 100.17±35.50 and 84.13±44.49 U/L, respectively and those of normal babies were 30.25±9.49 U/L and 41.97±11.49 U/L respectively. Conclusions: Estimation of liver enzymes can prove helpful in diagnosing perinatal asphyxia in absence of birth details especially in developing country like India.
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Introduction: The prevalence of rifampicin, isoniazid and pyrazinamide induced elevations in serum alanine aminotransferase (ALT) levels were compared in a cohort of Nigerians with and without HIV seropositivity. Methods: Records of all the patients with pulmonary tuberculosis (251 HIV positive and 205 HIV negative), aged above 15 years treated in the TB program of the Federal Medical Centre, Yenagoa from January 2013 to December 2014 were analysed for this study. The WHO 4 grades of hepatotoxicity using ALT were used. ALT of less than 50 U/L was taken as normal. Grade 1 (very mild hepatotoxicity): <2.5 x upper limit of normal (ULN) i.e. ALT 51-125 U/L. Grade 2 (mild): 2.6 – 5 x the ULN (ALT 126-250 U/L). Grade 3 (moderate): 5-10 x the ULN (ALT 251 – 500 U/L). Grade 4 (severe) >10 x the ULN (ALT > 500 U/L). Results: No patient with or without HIV seropositivity had ALT value in the grade 3 and 4 category ≥251 U/L. There was no statistically significant difference in ALT values between cohorts with or without HIV in the 3 ALT categories obtained while on antituberculous drugs (P = 0.761, 0.367 and 0.197). Conclusion: All the observed hepatotoxicity were mild. The average rate of hepatotoxicity in the HIV uninfected pulmonary tuberculosis cohort was 16.6%, 9.8% and 5.4% for ALT1, ALT2 and ALT3 respectively. The rate in the HIV infected cohorts was 15.5%, 8.8% and 16.4% for ALT1, ALT2 and ALT3. It is encouraging to find a low rate of antituberculosis drug induced hepatotoxicity than one would expect based on the high prevalence of risk factors in our environment.
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Tobacco use is widely spread throughout the world. The effect of smoking on human health are serious and in many cases, deadly. The present study was done to investigate the effect of cigarette smoking on some liver functions in male population in El-beida city, Libya. The study was carried out on thirty Libyan male smokers, who smoked at least 10 cigarettes per day for at least15 years. The group includes smokers with age range between 30-60 years. Non-smokers, (control, n= 30) group were collected with the same range of age for statistical comparison. The whole blood samples were drawn by venipuncture from each member and liver functions test were estimated by a kit method on automatic analyzer (Beckman BUN analyzer, USA). The results of the study revealed a significant increase of malondialdehyde (MDA), which is an indicator of lipid peroxidation and oxidative stress significantly increased in cigarette smokers in groups when compared with control group. While the plasma level of total protein, albumin and total bilirubin decreased during smoking. Cigarette smoking raised alkaline phosphatase (ALP), alanine aminotrans-ferase (ALT), aspartate aminotransferase (AST), plasma total cholesterol and triglycerides in smoker group when compared with non-smoker group. To conclude, cigarette smoking leads to oxidative stress by free radical generation by the mechanism of lipid peroxidation. Smoking exerts negative influence on liver functions test should be carefully interpreted, and further study on the mechanism of the effects is warranted.
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Tobacco use is widely spread throughout the world. The effect of smoking on human health are serious and in many cases, deadly. The present study was done to investigate the effect of cigarette smoking on some liver functions in male population in El-beida city, Libya. The study was carried out on thirty Libyan male smokers, who smoked at least 10 cigarettes per day for at least15 years. The group includes smokers with age range between 30-60 years. Non-smokers, (control, n= 30) group were collected with the same range of age for statistical comparison. The whole blood samples were drawn by venipuncture from each member and liver functions test were estimated by a kit method on automatic analyzer (Beckman BUN analyzer, USA). The results of the study revealed a significant increase of malondialdehyde (MDA), which is an indicator of lipid peroxidation and oxidative stress significantly increased in cigarette smokers in groups when compared with control group. While the plasma level of total protein, albumin and total bilirubin decreased during smoking. Cigarette smoking raised alkaline phosphatase (ALP), alanine aminotrans-ferase (ALT), aspartate aminotransferase (AST), plasma total cholesterol and triglycerides in smoker group when compared with non-smoker group. To conclude, cigarette smoking leads to oxidative stress by free radical generation by the mechanism of lipid peroxidation. Smoking exerts negative influence on liver functions test should be carefully interpreted, and further study on the mechanism of the effects is warranted.
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Objective To explore the influencing factors of ALT abnormality among workers from food industry and related people from public places in Shenzhen and influencing factors.Methods 2,411 workers from food industry and people from public places who had physical examinations in our department from May to October in 2013 were involved in the investigation.ALT abnormality rate and the influencing factors were analyzed.Results The incidence of ALT abnormalities among workers from food industry and related people from public places in Shenzhen was 9.37%.The ALT abnormalities were correlated with censue register,gender,age,marital status,work duration in Shenzhen,education level and monthly income respectively(all P<0.05). Conclusion The ALT abnormality has a higher rate among people from cities,of male gender and old age,with longer work duration in Shenzhen and relatively high level of education and higher monthly income.Therefore,for the population,the health education should be strengthened and the healthy lifestyles should be advocated to effectively reduce the ALT abnormality rate.
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Although glycyrrhizin (SNMC), and ursodeoxycholic acid (UDCA), alone or in combination have been administered in patients with active HCV-associated chronic hepatitis (HCV-CH) or liver cirrhosis (HCV-LC), there are many patients who do not respond well to these anti-inflammatory treatments. In this study, we examined retrospectively the possibility for juzentaihoto to alleviate inflammation in such patients. We calculated average ALT levels every 6 months for all 67 patients. If we assume an improvement in average serum ALT levels of more than 25% after juzentaihoto administration to be significantly effective, as compared with average ALT levels before juzentaihoto administration, 23 out of 40 patients (57.5%) showed significant improvement within one year. In the 32 patients with HCV-associated liver disease who were treated with combination SNMC and UDCA therapy, and whose average ALT levels did not decline to less than 80 IU/L, 18 (56.3%) showed significant improvement when juzentaihoto was added. Juzentaihoto was effective in 62.5% of patients with CH, and 54.2% of those with LC. Moreover, juzentaihoto was effective in 41.2% of male, and 69.6% of female patients. And in about 40% of patients, average ALT levels lowered increasingly over time, out to 2 years. Juzentaihoto may be an effective anti-inflammatory agent for intractable cases of active HCV-CH, or HCV-LC.
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PURPOSE: To investigate the physical and biochemical parameters related with elevated serum alanine aminotransferase (ALT) levels in obese children. METHODS: One hundred forty-two obese or overweight children who visited the out-patient clinics of Chungnam National University Hospital between January 2006 and August 2008 were enrolled. Physical measures and biochemical tests were performed in all patients. Liver sonography was performed in 43 patients. They were divided into the following 2 groups based on ALT levels: group I, normal ALT levels (n=65); and group II, elevated ALT levels (n=77). We compared the physical measures, biochemical results, and ultrasonographic findings of the livers in both groups. Other causes of elevated serum ALT levels were ruled out. RESULTS: The male-to-female ratios were 1.6:1 in group I and 7.6:1 in group II. Among physical parameters, the waist circumference-to-height ratio and hip circumference-to-height ratio were significantly higher in group II (p=0.001 and 0.046, respectively). Among biochemical parameters, aspartate aminotransferase (AST), gamma-glutamyltransferase (gamma-GT), and total cholesterol levels were significantly higher in group II (p<0.001, 0.001, and 0.001, respectively). The AST/ALT ratio was <1 (mean, 0.55) and statistically lower in group II. There was a positive correlation between the serum ALT level and gamma-GT (p<0.001, r=0.750), and a positive correlation between the serum ALT level and the waist circumference-to-height ratio in group II (p<0.001, r=0.401). CONCLUSION: The results suggest that the waist circumference-to-height ratio and gamma-GT may be associated with elevated alanine aminotransferase activity in obese children.
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Child , Humans , Alanine , Alanine Transaminase , Aspartate Aminotransferases , Cholesterol , gamma-Glutamyltransferase , Hip , Liver , Outpatients , OverweightABSTRACT
PURPOSE: The prevalence of obesity and nonalcoholic steatohepatitis(NASH) was increased in adolescents. This study was performed to observe the prevalence of elevated aminotransferase levels in adolescents and to assess the correlations between aminotransferase levels and obesity related parameters(body mass index, waist circumference, hip circumference, waist to hip ratio and insulin level). METHODS: We obtained weight, height, waist circumference and hip circumference from 2,417 male and 1,219 female adolescents. Mean age was 15.7+/-0.7 years old. We measured fasting insulin, aspartate aminotransferase(AST) and alanine aminotransferase(ALT). Obese and overweight were defined as body mass indices(BMI) of more than the 95th, and 85th-94th percentiles, respectively, for age and sex. RESULTS: The number of adolescents with obesity is 324(8.9 percent). 414(11.4 percent) subjects belonged to the overweight group. The average ALT level of obese, overweight and control groups were significantly different(obese : 32.1+/-34.3 U/L, overweight : 19.6+/-13.6 U/L, control : 12.7+/-6.7 U/L, P<0.001). The average AST level was also different according to group(obese : 27.8+/-16.5 U/L, overweight : 22.8+/-8.6 U/L, control : 20.8+/-8.5 U/L, P<0.001). AST and ALT were correlated with anthropometric parameters and insulin level. After multiple regression analysis, waist circumference was the significant predictive value for AST(r=0.234, P<0.001). Waist circumference, BMI and insulin levels were significant predictive values for ALT(r=0.435, P<0.001). CONCLUSION: The prevalence of abnormal aminotransferase was higher in the obese and overweight groups than control group. Waist circumference was useful to predict abnormal aminotransferase le
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Adolescent , Humans , Male , Alanine , Aspartic Acid , Fasting , Hip , Insulin , Obesity , Overweight , Pediatric Obesity , Prevalence , Waist CircumferenceABSTRACT
Objective To observe the therapeutic effect of Swertia mussotii Franch is extracted by alcohol on immunological liver injury in mice,and further evaluate its immun-regulating effect in decreasing aminotransferase and protecting heptocytes. Methods BCG vaccine and lipopolysaccharide were intravenously injected to establish liver injury model.The effects of Swertia mussotii Franch on liver injury were contrasted. Results The high-,medium-and low-dose Swertia mussotii Franch groups which had been administered for 10 consecutive days,had significantly inhibited serum ALT and AST acticities of immunological liver injury;Swertia mussotii Franch could effectively prevent immunological liver injury by BCG+LPS. Conclusion Swertia mussotii Franch can protect mice from immunological liver injury and protect the function of liver.
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PURPOSE: The aim of this research is to examine the abnormal liver function complicated with Kawasaki disease (KD) and to analyze its clinical characteristics and complications. METHODS: Ninty eight cases were diagnosed as having KD, among which thirty four cases had abnormal alanine aminotransferase (ALT) (>30 IU/L). These abnormal ALT cases were evaluated in terms of age and sex distribution, major symptoms, complications, laboratory and histopathologic findings. RESULTS: Male to female ratio was 2.4 : 1 and most patients (91.2%) were under 5 years of age. Cervical lymphadenopathy was observed in 3 cases (8.8%); and recurred cases were two (5.8%). Average fever duration was 8 days: average length of hospitalization was 9 days; and average recovery period was 13 days. Immediately after admission, positive CRP was observed in 31 cases (91.2%), leukocytosis (>10,000/mm(3)) in 26 cases (76.0%), thrombocytosis (>450,000/mm(3)) in 7 cases (20.6%), and anemia (<10 gm/dl) in 7 cases (20.6%), respectively. GB hydrops or cholecystitis were noted in 3 cases (8.8%) abnormal ECG finding in 1 case (2.9%), coronary dilatation or aneurysm in 2 cases (5.9%). Liver biopsy was done in four cases and revealed mild infiltration of lymphocytes on the portal area and mild bile duct proliferations. CONCLUSION: The abnormal liver function was noted in 34.7% of KD patients, and subsided all within one month. But the liver function test should be checked closely in patients of the abnormal liver function test complicated with KD despite of its good prognosis.