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Background: Liver cirrhosis is the end result of chronic liver injury and is one of the most common cause of morbidity and mortality. Several scorings are available to predict the severity and prognosis of liver cirrhosis. This study aims to calculate APRI index, MELD score and child Pugh score in cirrhosis patients and to find the correlation between them.Methods: This is the Cross-sectional study on 100 patients confirmed with cirrhosis of liver. Cirrhosis due to alcohol, Hepatitis B and C, autoimmune, Cryptogenic, NAFLD, were included in the study. APRI Index, MELD Score and Child Pugh Score were calculated, and the correlation was obtained.Results: This study found out the relationship between APRI index, MELD Score and Child Pugh Score with significant p value. The study also showed that all the three scores were raised with patients who had complication of cirrhosis like encephalopathy, refractory ascites. Among those who had complication like grade 3 or 4 encephalopathy, APRI index had a mean value of 3.4, Child Pugh had a mean score of 13.2, and MELD had a mean score of 36.08 with standard deviation of 2.0, 1.5, 6.0 respectively.Conclusions: APRI index is an independent predictor of morbidity and mortality. The prognostic performance of all 3 was comparable, Hence APRI index can be used as an alternative scoring which is cost effective and objective method in predicting the severity and prognosis in cirrhosis of liver.
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Aim: This study was aimed at investigating the effects of aqueous extracts of both Nigella sativa and Piper guineense on the liver enzymes; alanine amino transferase (ALT), aspartate amino transferase (AST) and alkaline phosphatase (ALP). Also the effect of Nigella sativa and Piper guineense extracts on the histology of the liver of Wistar rat was also studied. Materials and Methods: A total of twenty five Wistar rats were used for the study. The animals were grouped into five groups, each having five animals. They were induced with sucrose and margarine to cause high sugar levels and hyperlipidemia respectively except the positive control group which was fed normal feed. The groups were: the positive control group, the negative control group which were induced without treatment, the uziza leaf group which were induced and were treated with 2 ml of aqueous extract of uziza leaf, the black seed group which were induced and were treated with 2 ml of aqueous extract of black seed, and the black seed and uziza group which were induced and were treated with 2ml of aqueous extract of black seed and 2 ml of aqueous extract of uziza leaf. Results: The result showed that the extracts decreased the ALT and AST and ALP activities in the rats in a time dependent manner with highest decrease obtained on the third week of treatment with the extracts. The ALT activity (U/L) on the third week of treatment showed for the, negative control (64.48 ± 0.22), uziza leaf (28.82 ± 0.12), black seed (32.65 ± 0.02), black seed and uziza leaf (16.04 ± 0.02) (p≤0.05). The decrease in activity for AST levels (U/L) on the third week of treatment, showed for the negative control (58.00 ± 0.02), uziza leaf (11.00 ± 0.01), black seed (12.00 ± 0.02), black seed and uziza leaf (8.00 ± 0.02). Conclusion: It can be concluded that both uziza leaf and black seed have hepatoprotective effect on the liver.
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Background: Cirrhosis is a condition in which the liver slowly deteriorates and is unable to function normally due to chronic long lasting injury. Liver biopsy is considered as a gold standard for the diagnosis of cirrhosis and has many problems like bleeding, infective peritonitis which limit use of liver biopsies in all patients.Methods: A comparative study was done (90 cases and 90 controls) who fulfilled the inclusion criteria in a tertiary center.Results: The present study was conducted using a total of 180 participants, 90 USG diagnosed cases of liver cirrhosis was compared with 90 healthy controls. The mean AST level in the cirrhosis was 66.50±27.06 as compared to 21.26±6.52 in controls which was statistically significant. In this study the sensitivity and specificity of APRI was found to be 100.0% and 84.44% respectively, and the positive and negative predictive values were 86.54% and 100% respectively with significantly Area under the curve (AUC) (0.999, P>0.01).Conclusions: A simple index like Aspartate platelet ratio index, consisting of 2 readily available laboratory results (AST level and platelet count), can predict cirrhosis with a high degree of accuracy.
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Since metabolic process differs between humans and mice, studies were performed in hamsters, which are generally considered to be a more appropriate animal model for studies of obesity-related metabolic disorders. The modulation of gut microbiota, bile acids and the farnesoid X receptor (FXR) axis is correlated with obesity-induced insulin resistance and hepatic steatosis in mice. However, the interactions among the gut microbiota, bile acids and FXR in metabolic disorders remained largely unexplored in hamsters. In the current study, hamsters fed a 60% high-fat diet (HFD) were administered vehicle or an antibiotic cocktail by gavage twice a week for four weeks. Antibiotic treatment alleviated HFD-induced glucose intolerance, hepatic steatosis and inflammation accompanied with decreased hepatic lipogenesis and elevated thermogenesis in subcutaneous white adipose tissue (sWAT). In the livers of antibiotic-treated hamsters, cytochrome P450 family 7 subfamily B member 1 (CYP7B1) in the alternative bile acid synthesis pathway was upregulated, contributing to a more hydrophilic bile acid profile with increased tauro--muricholic acid (TMCA). The intestinal FXR signaling was suppressed but remained unchanged in the liver. This study is of potential translational significance in determining the role of gut microbiota-mediated bile acid metabolism in modulating diet-induced glucose intolerance and hepatic steatosis in the hamster.
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A Síndrome Metabólica (SM) é uma doença que envolve diversas alterações metabólicas, dentre elas, dislipidemia, intolerância à glicose, obesidade e hipertensão arterial. A alteração nos níveis das enzimas hepáticas tem se mostrado um marcador útil no diagnostico da SM. Há poucos trabalhos avaliando essas enzimas em indivíduos com sobrepeso com e sem SM. O presente trabalho avaliou os níveis séricos das enzimas hepáticas (ALT, AST,GGT) bem como a proteína C reativa (PCR) como marcador inflamatório em indivíduos com sobrepeso, come sem SM. Foram avaliados 97 indivíduos, sendo 41 controles saudáveis eutróficos (EU), 28 indivíduos com sobrepeso sem SM (OSSM) e 28 indivíduos com sobrepeso com SM (OCSM). As análises de colesterol total,HDL-C. LDL-C, triacilglicerol, glicose, ALT, AST e GGT foram efetuadas em um auto-analisador bioquímico.A determinação de PCR foi realizada por enzima imunoensaio em micropartículas (MEIA). Utilizou-se o teste não paramétrico de Kruskal-Wallis e os resultados foram apresentados sob a forma de mediana (mínimo máximo).Correlação de Spearman foi utilizada neste estudo. Os níveis séricos das enzimas hepáticas (ALT, AST e GGT) não diferiram entre o grupo EU e o grupo OSSM, entretanto, houve diferença estatisticamente significativa quando esses parâmetros foram comparados entre EU e OCSM e OSSM e OCSM (p<0,001). Níveis plasmáticos de glicose foram positivamente correlacionados com ALT, AST e GGT. O grupo OCSM apresentou aumento significativo nos níveis séricos de PCR quando comparado aos demais grupos (p<0,001).Conclui-se que o sobrepeso não foi capaz de alterar os níveis das enzimas hepáticas e da PCR e que a elevação dos níveis séricos de GGT pode ser considerada um fator de risco adicional para SM.
Metabolic syndrome (MetS) is a disease that involves several metabolic changes, including dyslipidemia, glucose intolerance, obesity and hypertension. The changes in liver enzyme levels have been shown to be a useful marker in the diagnosis of MetS. There are few studies evaluating these enzymes in overweight individuals with or without MetS. This study evaluated the serum levels of liver enzymes (ALT, AST, and GGT) as well as C-reactive protein (CRP) as inflammatory markers in overweight individuals with and without MS. We studied 97 subjects, 41 eutrophic healthy controls (EU), 28 overweight individuals without MetS (OSSM) and 28 overweight individuals with MetS (OCSM). Analyses of total cholesterol, HDL-C, LDL-C, triacylglycerol, fasting glucose, ALT, AST and GGT were performed in a biochemical auto analyzer. The determination was performed by CRP enzyme in microparticles (MEIA). The nonparametric Kruskal-Wallis test was performed and the results were presented as median (minimum-maximum). Spearman correlation was also performed in this study. Serum levels of liver enzymes (ALT, AST and GGT) did not differ between group EU and group OSSM, however, statistically significant differences when these parameters were compared between EU and OCSM and OSSM and OCSM (p <0.001). Glucose levels were positively correlated with ALT, AST and GGT.The group showed a significant increase in serum CRP when compared to other groups (p <0.001). We conclude that overweight was not able to alter the levels of liver enzymes and CRP levels and the elevation of serum GGT may be considered an additional risk factor for MetS.
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Humans , Male , Female , Adult , Aspartate Aminotransferases , Faculty , C-Reactive Protein , Overweight , Metabolic Syndrome , gamma-GlutamyltransferaseABSTRACT
Objective To analyse the clinical value of aspartate aminotransferase mitochondrial isoenzyme (m‐AST ) determina‐tion in patients with alcoholic liver disease .Methods 61 cases of patients with alcoholic liver disease (observe group) receiving treatment in this hospital from March 2013 to March 2015 and 61 cases of healthy individuals(control group) were enrolled in this study ,and serum levels of m‐AST ,alanine amino transferase(ALT) ,aspartate amino transferase(AST) and γ‐glutamyl transferase (GGT) were detected .Results Compared with the control group ,serum levels of of m‐AST ,ALT ,AST and GGT were increased in the observe group ,there were statistically significant differences (P<0 .05) .In patients with alcoholic liver disease ,after treatment , serum levels of m‐AST ,ALT ,AST and GGT were different among patients with hepatic adipose infiltration ,patients with hepatitis and patients with liver cirrhosis ,there were statistically significant differences(P<0 .05) .Conclusion Combined with ALT ,AST and GGT ,m‐AST could be utilized as an indicator for diagnosing alcoholic liver disease ,which has clinical significance .
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The effect of an adventure sprint race (ASR) on T-cell proliferation, leukocyte count and muscle damage was evaluated. Seven young male runners completed an ASR in the region of Serra do Espinhaço, Brazil. The race induced a strong leukocytosis (6.22±2.04×103 cells/mm3 before vs 14.81±3.53×103 cells/mm3 after the race), marked by a significant increase of neutrophils and monocytes (P<0.05), but not total lymphocytes, CD3+CD4+ or CD3+CD8+ cells. However, the T-cell proliferative response to mitogenic stimulation was increased (P=0.025) after the race, which contradicted our hypothesis that ASR, as a high-demand competition, would inhibit T-cell proliferation. A positive correlation (P=0.03, r=0.79) was observed between the proliferative response of lymphocytes after the race and the time to complete the race, suggesting that the proliferative response was dependent on exercise intensity. Muscle damage was evident after the race by increased serum levels of aspartate amino transferase (24.99±8.30 vs 50.61±15.76 U/L, P=0.003). The results suggest that humoral factors and substances released by damaged muscle may be responsible for lymphocyte activation, which may be involved in muscle recovery and repair.
Subject(s)
Adult , Humans , Male , Cell Proliferation/physiology , Leukocytosis/immunology , Muscle, Skeletal/injuries , Physical Endurance/immunology , Running/injuries , T-Lymphocytes/immunology , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Flow Cytometry , Immunosuppression Therapy , Leukocyte Count , Leukocytosis/etiology , Monocytes/immunology , Muscle, Skeletal/immunology , Neutrophils/immunology , Physical Endurance/physiology , Running/physiology , T-Lymphocytes, Cytotoxic/physiology , T-Lymphocytes, Helper-Inducer/physiology , Time FactorsABSTRACT
Alcoholism is a serious health issue with major socioeconomic consequences. Significant morbidity is related to chronic alcohol use, and alcoholics seek advice only when complications of drinking set in. The diagnosis is often based on patients self-reporting of alcohol consumption, which is unreliable and requires high degree of clinical suspicion. However, if alcohol problems are recognized at an early stage, the physician may be able to prevent their further development and progression. The present study compares the mean corpuscular volume (MCV) with other traditional biochemical markers in alcohol abuse patients and healthy controls. It is a prospective study, and 40 cases and 30 controls were evaluated for biochemical parameters over a period of one year. The study revealed MCV to be possessing 87.5% sensitivity, 83.33% specificity, 87.5% of positive predictive value, 48.39% of negative predictive value and 54.29% of diagnostic accuracy, which makes it a reliable marker. The mean gamma glutamyl transferase (GGT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) concentrations in alcohol dependent subjects were higher as compared to controls. Though clinical histories and questionnaires are the commonest initial means of detection of alcohol abuse, laboratory markers such as MCV should be used for confirming the diagnosis of alcohol abuse. They are also helpful in follow-up of patients undergoing treatment, and monitoring of abstinence
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Se determinaron los cambios séricos de ALT, AST, FA, promovidos por veneno de ejemplares jóvenes Crotalus durissus cumanensis. Ratones Balb/C inoculados con 0,75 mg proteínas de veneno/kg vía intraperitoneal y controles con ssf. Se obtuvieron muestras a diferentes intervalos post-inyección (1, 3, 6, 12 y 24 h) determinándose los niveles séricos de: ALT, AST, y FA, posterior al sacrificio se tomaron muestras de hígado para la valoración histopatológica. Los valores de ATL, AST y FA se incrementaron significativamente, siendo más temprano el aumento de AST (1h) y más tardío el de la FA (24). El hallazgo histopatológico del tejido hepático revelo tumefacción celular severa, células de Kuffer activadas y necrosis coagulativa focal. El incremento de los marcadores enzimáticos ALT, AST, y FA, paralelo a los daños histológicos encontrados en este estudio, sugieren daño hepato-biliar, adicionalmente, los niveles séricos de AST podrían indicar daño al tejido muscular esquelético y/o cardíaco
To determinate the effect of the venom of young Crotalus durissus cumanensis on levels of ALT, AST and AP, Balb/C mice were inoculated intraperitoneal with 0,75 mg/Kg of purified venom. Serum samples were obtained at different post-injection intervals (1, 3, 6, 12, 24h) and serum levels of ALT, AST and AP were determined. A significative difference (P 0,01) was observed in serum levels of ALT at 6h and at 24h post-venom injection, with a maximum of 587,64 U/L at 24 h, when compared with controls. In addition, AST shows a significative elevation between 1h and 12h post venom injection, with a maximum level of 2327 U/L at 3 h, while AP only showed significant differences at 24 h post-venom injection. These results suggest that the venom of young Crotalus durissus cumanensis induced liver-biliar injury, with a possible effect on skeletal muscle and/ or cardiac tissue
Subject(s)
Rats , Crotoxin , Liver , Snake Venoms , Pharmacology, ClinicalABSTRACT
A comparative study of serum sialic acid concentration and traditional biochemical markers such as serum gamma glutamyl transferase (GGT), aspartate amino transferase (AST), alanine amino transferase (ALT), and AST/ALT ratio, as well as prognostic markers such as serum total protein and serum albumin in alcohol abuse was done. A total of 70 male subjects aged between 20 and 60 years, with 40 cases diagnosed as alcoholics, and 30 healthy controls were included in the study. Serum GGT, AST, ALT, total protein and serum albumin were estimated using auto analyzer Dade Behring clinical chemistry system. Serum sialic acid was estimated manually by modified Warren's colourimetric method. An increased concentration of serum sialic acid and other traditional biochemical markers GGT, AST, ALT was observed in cases compared to that of controls. Overall, GGT demonstrated good sensitivity and specificity. The other traditional markers used in alcohol abuse varied considerably in their specificities and sensitivities. The AST/ALT ratio was increased in cases compared to controls, but not high enough to confirm alcoholic liver disease. The albumin concentration in cases was decreased when compared to controls, while total protein concentration did not show any statistical significance in both the groups indicating that it has negligible effect. In this study, sialic acid proved to be a reliable test with sensitivity of 70% and specificity of 90%, with a diagnostic accuracy of 80%, showing that it can be used as a biochemical marker in alcohol abuse, where secondary effects of liver disease hamper the use of traditional markers.
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The objective of the present study was to investigate the effect of administration of 1 mM methylene blue (MB) in drinking water for 30 days on hepatic and renal antioxidant status in female adult Wistar strain rats (n=5). MB failed to induce significant change in any of the measured antioxidant defence parameters namely, superoxide dismutase (SOD), catalase (CAT) and reduced glutathione (GSH). However, a marginally significant (P<0.05) increase in the level of lipid peroxidation (LPx) was recorded in liver, while a reduction (P<0.05) in its level in the kidney was noticed. Serum alanine amino transferase (AlaAT) and creatinine levels significantly (P<0.001) decreased in MB treated rats without any change in blood urea nitrogen (BUN) level. Our findings suggest that the effect of MB as administered in the present study was tissue specific with regard to the level of LPx, however, in general, it does not impair liver and kidney functions as evidenced by serum parameters.
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A prospective study was underteken as a part of postgraduate thesis work on quantitative serum enzymal changes after death in the Deptt. of Forensic Medicine GMC Bhopal (M.P.) in 1999-2002. A total of one hundred study cases and ten control cases were randomly selected after screening. The sera was assayed biochemically by photoelectric colorimetry for an imotransfereases (AST & ALT) and serum acid phosphatase. The enzymal levels were plotted against known postmortem interval. The graphical records were studied with a view to ascertain whether such assyas could be of any help to calculate time since death routinely.