[The effect of alcohol and fatty foods on the P-alanine aminotransferase level in rheumatoid- and psoriatic arthritis patients]. / Effekten af alkohol og fed mad på P-alaninaminotranferase hos patienter med reumatoid artritis og psoriasisartritis

INTRODUCTION: The P-alanine aminotransferase level (P-ALAT) is used as a biomarker for drug-induced liver toxicity in rheumatic patients treated with methrotrexate and leflunomide. A rumour at Kong Christian X's Gigthospital states that P-ALAT analysed in the beginning of January should be taken with a pinch of salt due to an increased intake of fatty foods and alcohol through Christmas. MATERIAL AND METHODS: In a retrospective study of P-ALAT, performed on 133 patients diagnosed with either rheumatoid- or psoriatic arthritis (median age 62 years) the change in P-ALAT over Christmas was recorded along with medical treatment and disease activity. A total of 88 patients were included, while 45 were excluded due to disease activity or change of drug-dosage. RESULTS: P-ALAT increased significantly through Christmas. Treatment with methotrexate or leflunomide was not a significant explanatory variable but age was. Lower age predicted higher P-ALAT increase over Christmas. The changes in P-ALAT did not lead to changes in medical treatment. CONCLUSION: A statistical significant increase of P-ALAT was detected. This might be due to exaggerated consumption of fatty food and alcohol during Christmas or less likely due to heavy dancing around the Christmas tree. The increase of P-ALAT during Christmas is of no clinical significance. Although the rumor is true, there is no need for worries. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.

The impact of vitamin D on pregnancy: a systematic review.

Hypovitaminosis D is common in pregnancy. To systematically review the evidence on vitamin D-dependent pregnancy outcomes, PubMed and Embase were searched for randomized control trials, cohort and case-control studies. In randomized control trials (n = 7), larger doses of vitamin D resulted in higher 25-hydroxylated vitamin D (25OHD) levels (n = 6), increased maternal weight gain (n = 1), and fewer classical vitamin D deficiency symptoms (n = 1). In observational studies (n = 32), lower vitamin D intake, or low 25OHD-levels, were associated with adverse fertility parameters (n = 2), preeclampsia (n = 5), gestational diabetes or higher blood glucose (n = 6), bacterial vaginosis (n = 4), primary cesarean section (n = 1), none (n = 3) or a few days' (n = 2) shorter gestation, and postpartum depression (n = 1). Studies with few participants having low 25OHD did not identify an association to preeclampsia (n = 5) or gestational diabetes (n = 2). Increased odds of pregnancy-associated breast cancer with 25OHD >25.8 nmol/L were observed (n = 1). In conclusion, an effect of vitamin D on several pregnancy outcomes is suggested.