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Meneses AJG, Pompeu RCFF, Salles HO, Costa CDS, Rogério MCP, de Andrade IRA, Furtado RN, de Medeiros AN, Pereira PL, Cândido MJD. Nutritional parameters and productive performance of grazing sheep using castor bean cake as supplement or fertilizer. Trop Anim Health Prod 2024; 56:121. [PMID: 38607462 DOI: 10.1007/s11250-024-03967-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 03/22/2024] [Indexed: 04/13/2024]
Abstract
The objective was to evaluate the effect of detoxified castor bean replacing soybean meal in the concentrate diet or as nitrogen organic fertilizer replacing urea on intake and nutrient digestibility, blood parameters and productive performance of sheep finished on irrigated Tamani grass pasture under continuous stocking and variable stocking rate. The treatments were two concentrate diets: standard (ground corn and soybean meal) and alternative diet (ground corn and detoxified castor bean cake), and two nitrogen fertilizers: chemical (urea) and organic (fresh castor bean cake). The randomized complete block design was used in a 2 × 2 factorial arrangement with four replications (500 m² paddocks). Four sheep (2 castrated males and 2 females) were distributed in each experimental unit, totaling 64 animals with an average initial weight of 19.42 ± 3.6 kg. No effects (P > 0.05) were observed on the variables inherent to the evaluation of the pasture. The average stocking rate (SR) among treatments was 85.50 sheep/ha, equivalent to 9.87 Animal Units (AU)/ha. The alternative diet presented lower dry matter digestibility (62.71%), with no negative effects on nutrient intake and kidney parameters. Animals fed the standard and alternative diet showed average daily gain of 103.75 and 86.76 g/day, respectively. A finishing period of up to 100 days is recommended for sheep selected for production systems in semi-arid regions managed intensively on pasture. Detoxified castor bean cake did not alter nutrient intake, liver and kidney parameters of the sheep and can be used in pasture-based sheep farming.
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Affiliation(s)
- Abner José Girão Meneses
- Federal Institute of Education, Science and Technology of Ceará - IFCE, Crato Campus, CE, Brazil.
- Federal University of Ceara, Pici Campus, CE, Brazil.
| | | | - Hévila Oliveira Salles
- Brazilian Agricultural Research Corporation - Embrapa Goats and Sheep, Sobral, CE, Brazil
| | | | | | | | - Rafael Nogueira Furtado
- Federal Institute of Education, Science and Technology of Piauí - IFPI, Paulistana Campus, PI, Brazil
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Nishioka M, Motobayashi M, Fukuyama T, Inaba Y. Risk factors for post-encephalopathic epilepsy in patients with acute encephalopathy with biphasic seizures and late reduced diffusion. Brain Dev 2024; 46:161-166. [PMID: 38114348 DOI: 10.1016/j.braindev.2023.12.002] [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: 07/13/2023] [Revised: 11/29/2023] [Accepted: 12/10/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Post-encephalopathic epilepsy (PEE) is a serious complication of acute encephalopathy syndromes, and is more frequent in patients with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) than in children with acute encephalopathy. However, a risk factor analysis using laboratory findings in the acute phase of AESD has not yet been performed. Therefore, the present study examined risk factors of AESD-related PEE using laboratory parameters in the acute phase of AESD. METHODS We retrospectively screened 27 pediatric patients with AESD for inclusion, and enrolled 20 ("the PEE group", n = 6; "the non-PEE group", n = 14) according to inclusion criteria. RESULTS The incidence of AESD-related PEE was 30 %, and the median duration from the onset of AESD to the development of PEE was 2.5 months (range, 1-32). The most common types of seizures were focal seizures, epileptic spasms, and startle seizures: 4 out of 6 patients (66.7 %) had intractable epilepsy. The median values of alanine aminotransferase (ALT) in the 1st and 2nd seizure phases of AESD and aspartate aminotransferase (AST) in the 2nd seizure phase were significantly higher in the PEE group than in the non-PEE group (p < 0.01). CONCLUSIONS This is the first study to report higher serum levels of ALT and AST at the onset of AESD as risk factors for AESD-related PEE. We also provided a detailed description on the clinical characteristics on AESD-related PEE, which are consistent with previous findings.
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Affiliation(s)
- Makoto Nishioka
- Department of Medical Genetics, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; Division of Neuropediatrics, Nagano Children's Hospital, 3100 Toyoshina, Azumino 399-8288, Japan
| | - Mitsuo Motobayashi
- Division of Neuropediatrics, Nagano Children's Hospital, 3100 Toyoshina, Azumino 399-8288, Japan; Life Science Research Center, Nagano Children's Hospital, 3100 Toyoshina, Azumino 399-8288, Japan; Neuro-Care Center, Nagano Children's Hospital, 3100 Toyoshina, Azumino 399-8288, Japan; Department of Pediatrics, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
| | - Tetsuhiro Fukuyama
- Division of Neuropediatrics, Nagano Children's Hospital, 3100 Toyoshina, Azumino 399-8288, Japan; Department of Pediatrics, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Yuji Inaba
- Department of Medical Genetics, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; Division of Neuropediatrics, Nagano Children's Hospital, 3100 Toyoshina, Azumino 399-8288, Japan; Life Science Research Center, Nagano Children's Hospital, 3100 Toyoshina, Azumino 399-8288, Japan; Neuro-Care Center, Nagano Children's Hospital, 3100 Toyoshina, Azumino 399-8288, Japan
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Çapan ÖY, Türkdoğan D, Atalay S, Çağlayan HS. Developmental and epileptic encephalopathy 82 (DEE82) with novel compound heterozygous mutations of GOT2 gene. Seizure 2024; 116:126-132. [PMID: 37977948 DOI: 10.1016/j.seizure.2023.11.003] [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] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/28/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023] Open
Abstract
PURPOSE Developmental and Epileptic Encephalopathies (DEEs) are rare neurological disorders characterized by early-onset medically resistant epileptic seizures, structural brain malformations, and severe developmental delays. These disorders can arise from mutations in genes involved in vital metabolic pathways, including those within the brain. Recent studies have implicated defects in the mitochondrial malate aspartate shuttle (MAS) as potential contributors to the clinical manifestation of infantile epileptic encephalopathy. Although rare, mutations in MDH1, MDH2, AGC1, or GOT2 genes have been reported in patients exhibiting neurological symptoms such as global developmental delay, epilepsy, and progressive microcephaly. METHOD In this study, we employed exome data analysis of a patient diagnosed with DEE, focusing on the screening of 1896 epilepsy-related genes listed in the HPO and ClinVar databases. Sanger sequencing was subsequently conducted to validate and assess the inheritance pattern of the identified variants within the family. The evolutionary conservation scores of the mutated residues were evaluated using the ConSurf Database. Furthermore, the impacts of the causative variations on protein stability were analyzed through I-Mutant and MuPro bioinformatic tools. Structural comparisons between wild-type and mutant proteins were performed using PyMOL, and the physicochemical effects of the mutations were assessed using Project Hope. RESULTS Exome data analysis unveiled the presence of novel compound heterozygous mutations in the GOT2 gene coding for mitochondrial glutamate aspartate transaminase. Sanger sequencing confirmed the paternal inheritance of the p.Asp257Asn mutation and the maternal inheritance of the p.Arg262Cys mutation. The affected individual exhibited plasma metabolic disturbances, including hyperhomocysteinemia, hyperlactatemia, and reduced levels of methionine and arginine. Detailed bioinformatic analysis indicated that the mutations were located within evolutionarily conserved domains of the enzyme, resulting in disruptions to protein stability and structure. CONCLUSION Herein, we describe a case with DEE82 (MIM: # 618721) with pathologic novel biallelic mutations in the GOT2 gene. Early genetic diagnosis of metabolic epilepsies is crucial for long-term neurodevelopmental improvements and seizure control as targeted treatments can be administered based on the affected metabolic pathways.
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Affiliation(s)
- Özlem Yalçın Çapan
- Department of Medical Biology, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey.
| | - Dilşad Türkdoğan
- Marmara University, Medical Faculty, Department of Pediatric Neurology, Turkey
| | - Sertaç Atalay
- Central Research Laboratory, Tekirdağ Namik Kemal University, Tekirdağ, Turkey
| | - Hande S Çağlayan
- Department of Molecular Biology and Genetics, Boğaziçi University, İstanbul, Turkey
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Gao Y, Yang X, Hua L, Wang M, Ge Q, Wang W, Wang N, Ma J, Ge H. Crystal structure of an aspartate aminotransferase Lpg0070 from Legionella pneumophila. Biochem Biophys Res Commun 2023; 689:149230. [PMID: 37984176 DOI: 10.1016/j.bbrc.2023.149230] [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] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
Legionella pneumophila aspartate aminotransferase (Lpg0070) is a member of the transaminase and belongs to the pyridoxal 5'-phosphate (PLP)-dependent superfamily. It is responsible for the transfer of α-amino between aspartate and α-ketoglutarate to form glutamate and oxaloacetate. Here, we report the crystal structure of Lpg0070 at the resolution of 2.14 Å and 1.7 Å, in apo-form and PLP-bound, respectively. Our structural analysis revealed the specific residues involved in the PLP binding and free form against PLP-bound supported conformational changes before substrate recognition. In vitro enzyme activity proves that the absence of the N-terminal arm reduces the enzyme activity of Lpg0070. These data provide further evidence to support the N-terminal arm plays a crucial role in catalytic activity.
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Affiliation(s)
- Yongshan Gao
- Institutes of Material Science and Information Technology, Anhui University, Hefei, 230601, China; School of Resources and Environmental Engineering, Anhui University, Hefei, 230601, China
| | - Xiaowen Yang
- Institutes of Material Science and Information Technology, Anhui University, Hefei, 230601, China
| | - Lan Hua
- Institutes of Material Science and Information Technology, Anhui University, Hefei, 230601, China
| | - Min Wang
- Institutes of Material Science and Information Technology, Anhui University, Hefei, 230601, China
| | - Qing Ge
- Institutes of Material Science and Information Technology, Anhui University, Hefei, 230601, China
| | - Weiqiang Wang
- Institutes of Material Science and Information Technology, Anhui University, Hefei, 230601, China
| | - Na Wang
- Institutes of Material Science and Information Technology, Anhui University, Hefei, 230601, China
| | - Jinming Ma
- Institutes of Material Science and Information Technology, Anhui University, Hefei, 230601, China.
| | - Honghua Ge
- Institutes of Material Science and Information Technology, Anhui University, Hefei, 230601, China.
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Koyama H, Takahashi Y, Matori S, Kuniyoshi H, Kurose K. A newly identified enzyme from Japanese common squid Todarodes pacificus has the ability to biosynthesize d-aspartate. Arch Biochem Biophys 2023; 750:109809. [PMID: 37925062 DOI: 10.1016/j.abb.2023.109809] [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] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023]
Abstract
Amino acids exist in two chiral forms, namely L and D. Although l-amino acids are predominant in vivo, certain limited circumstances have reported the usage of d-amino acids. d-aspartate (Asp), among them, plays crucial physiological roles in living organisms and is biosynthesized from L-Asp by the enzyme named aspartate racemase (AspRase). D-Asp is known to accumulate in large amounts in the nervous system of cephalopods. To understand the function of D-Asp in nervous system in more detail, it is necessary to elucidate its metabolic pathway; however, AspRase gene has not been identified in cephalopods as in the case of mammals. In this study, we successfully identified a novel gene encoding AspRase from the optic ganglion of Japanese common squid Todarodes pacificus. Our discovery of the squid AspRase challenges the prevailing assumption that AspRases across different animals share similar structures. Surprisingly, the squid AspRase is a unique enzyme that differs significantly from known AspRases, being structurally and phylogenetically related to aspartate aminotransferase (AST) and possessing both AspRase and AST activities. The optimum pH and temperature for AspRase activity using L-Asp as a substrate are approximately 7.0 and 20 °C, respectively. Moreover, we have found that AspRase activity is enhanced in the presence of 2-oxoacids. These findings have far-reaching implications for the understanding of enzymology and suggest that yet-to-be-identified mammalian AspRases may also be phylogenetically related to AST, rather than conventional AspRases. Furthermore, our results provide valuable insights into the evolution of the D-Asp biosynthetic pathway.
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Affiliation(s)
- Hiroki Koyama
- Department of Food Science and Technology, Tokyo University of Marine Science and Technology, Tokyo, 108-8477, Japan.
| | - Yui Takahashi
- Department of Food Science and Technology, Tokyo University of Marine Science and Technology, Tokyo, 108-8477, Japan
| | - San Matori
- Program of Food and AgriLife Science, Graduate School of Integrated Sciences for Life, Hiroshima University Higashi-hiroshima, 739-8528, Japan
| | - Hisato Kuniyoshi
- Program of Food and AgriLife Science, Graduate School of Integrated Sciences for Life, Hiroshima University Higashi-hiroshima, 739-8528, Japan
| | - Kouichi Kurose
- Department of Food Science and Technology, Tokyo University of Marine Science and Technology, Tokyo, 108-8477, Japan
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Zhang L, Yang L, Gao Y, Bi X, Lin Y, Deng W, Jiang T, Lu Y, Hao H, Wan G, Yi W, Xie Y, Li M. Nomogram for evaluating obvious liver inflammation in treatment-naïve HBeAg positive chronic hepatitis B virus infection patients with normal ALT. Virulence 2023; 14:2158710. [PMID: 36600180 PMCID: PMC9828634 DOI: 10.1080/21505594.2022.2158710] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The purpose of this study was to develop an effective and non-invasive nomogram for evaluating liver obvious inflammation in untreated HBeAg positive patients with chronic hepatitis B virus (HBV) infection. A nomogram was established on a model cohort of 292 treatment-naïve HBeAg positive patients with normal alanine aminotransferase (ALT ≤40 U/L) at Beijing Ditan Hospital from January 2008 to March 2018. Then the nomogram was prospectively validated in a cohort of 88 patients from July 2019 to May 2021. Calibration curves and Concordance index were used to evaluate the accuracy of prediction and identification performance of the model. In untreated HBeAg positive chronic hepatitis B virus infection patients with normal ALT, the formula for predicting liver inflammation was Logit (P) =-0.91-0.41×log10 (qHBeAg)+0.11×AST-0.01×PLT. The nomogram had C-index of 0.751 (95% CI, 0.688-0.815), indicating a good consistency between prediction and real observation on the model cohort. The validation cohort confirmed its good performance. In this study, liver inflammation nomograms based on HBeAg, AST, and PLT were established and verified in treatment-naïve HBeAg positive chronic HBV patients with normal ALT.
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Affiliation(s)
- Lu Zhang
- Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Liu Yang
- Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yuanjiao Gao
- Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Xiaoyue Bi
- Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yanjie Lin
- Department of Medical Record Statistics, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Wen Deng
- Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Tingting Jiang
- Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yao Lu
- Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Hongxiao Hao
- Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Gang Wan
- Department of Gynecology and Obstetrics, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Wei Yi
- Department of Hepatology Division 2, Peking University Ditan Teaching Hospital, Beijing, China,Wei Yi
| | - Yao Xie
- Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China,Department of Medical Record Statistics, Beijing Ditan Hospital, Capital Medical University, Beijing, China,CONTACT Yao Xie
| | - Minghui Li
- Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China,Department of Medical Record Statistics, Beijing Ditan Hospital, Capital Medical University, Beijing, China,Minghui Li
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Raya-Cano E, Molina-Luque R, Vaquero-Abellán M, Molina-Recio G, Jiménez-Mérida R, Romero-Saldaña M. Metabolic syndrome and transaminases: systematic review and meta-analysis. Diabetol Metab Syndr 2023; 15:220. [PMID: 37899468 PMCID: PMC10614379 DOI: 10.1186/s13098-023-01200-z] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/24/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a group of metabolic abnormalities characterised by hypertension, central obesity, dyslipidaemia and dysregulation of blood glucose, associated with the risk of diabetes, cardiovascular disease and overall mortality. The presence of elevated liver enzymes may precede the development of MetS, with alterations of the liver being observed that are directly related to metabolic problems. The study aims to provide the best evidence on the association between liver enzymes (ALT, AST, GGT) and MetS by determining the effect size of these biomarkers. METHODS A systematic review and meta-analysis of studies indexed in PubMed and Scopus databases were performed. Study quality was assessed using the STROBE tool. The Grade Pro tool was used to evaluate the evidence, and the quantitative synthesis was performed using RevMan (Cochrane Collaboration). RESULTS Seventeen articles comparing liver enzyme concentrations between 76,686 with MetS (MetS+) and 201,855 without MetS (MetS-) subjects were included. The concentration of ALT, AST and GGT in the MetS + subjects was significantly higher than in the control group 7.13 IU/L (CI95% 5.73-8.54; p < 0.00001; I2 = 96%), 2.68 IU/L (CI95% 1.82-3.54; p < 0.00001; I2 = 96%) and 11.20 IU/L (CI95% 7.11-15.29; p < 0.00001; I2 = 96%), respectively. CONCLUSIONS The evaluation of the relationship of liver enzymes in the pathophysiological process of MetS could lead to new insights into early diagnosis.
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Affiliation(s)
- Elena Raya-Cano
- Faculty of Medicine and Nursing, University of Córdoba, Avd. Menéndez Pidal N/N, Córdoba, 14004, Spain
| | - Rafael Molina-Luque
- Faculty of Medicine and Nursing, University of Córdoba, Avd. Menéndez Pidal N/N, Córdoba, 14004, Spain.
- Lifestyles, Innovation and Health (GA-16), Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain.
| | - Manuel Vaquero-Abellán
- Faculty of Medicine and Nursing, University of Córdoba, Avd. Menéndez Pidal N/N, Córdoba, 14004, Spain
| | - Guillermo Molina-Recio
- Faculty of Medicine and Nursing, University of Córdoba, Avd. Menéndez Pidal N/N, Córdoba, 14004, Spain
- Lifestyles, Innovation and Health (GA-16), Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain
| | - Rocío Jiménez-Mérida
- Faculty of Medicine and Nursing, University of Córdoba, Avd. Menéndez Pidal N/N, Córdoba, 14004, Spain
| | - Manuel Romero-Saldaña
- Faculty of Medicine and Nursing, University of Córdoba, Avd. Menéndez Pidal N/N, Córdoba, 14004, Spain
- Lifestyles, Innovation and Health (GA-16), Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain
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Kasai A, Motobayashi M, Nishioka M, Fukuyama T, Inaba Y. A serial analysis of serum aspartate aminotransferase levels in patients with acute encephalopathy with biphasic seizures and late reduced diffusion and prolonged febrile seizure. Brain Dev 2023; 45:487-494. [PMID: 37357027 DOI: 10.1016/j.braindev.2023.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 12/13/2022] [Revised: 05/31/2023] [Accepted: 06/08/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND There are no established biomarkers for diagnosing acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) in the early acute phase, called "the 1st seizure phase". Based on our clinical experience, we hypothesized that serial examinations of blood levels of aspartate aminotransferase (AST) in children with febrile convulsive status epilepticus (FCSE) revealed higher levels in patients with AESD in the 1st seizure phase than in those with prolonged febrile seizures (PFs). METHODS To test our presented hypothesis, we retrospectively investigated changes in serum AST in patients with FCSE due to AESD (n = 11) or PFs (n = 27) who were serially examined within 48 h of the onset of convulsions. RESULTS The rate of increase in AST was significantly higher in patients with AESD than in those with PFs. The rate of increase in AST correlated with previously reported scoring systems, i.e., Yokochi and Tottori scores, for the prediction of AESD. A positive correlation between the rate of increase in AST and creatinine levels in the first examination were observed; however, creatinine levels did not significantly differ between the AESD and PFs groups in the first or second examination. Blood levels of pH, ammonia, and sugar in the first examination and C-reactive protein in the second examination were significantly higher in the AESD group than in the PFs group. CONCLUSIONS The present study revealed that the rate of increase in AST was significantly higher in patients with AESD than in those with PFs. A novel predictive scoring system needs to be established in combination with the rate of increase in AST and reported clinical parameters, which will improve the prognosis of patients with FCSE.
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Affiliation(s)
- Ayaka Kasai
- Department of Medical Genetics, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; Clinical Laboratory, Nagano Children's Hospital, 3100 Toyoshina, Azumino 399-8288, Japan
| | - Mitsuo Motobayashi
- Division of Neuropediatrics, Nagano Children's Hospital, 3100 Toyoshina, Azumino 399-8288, Japan; Life Science Research Center, Nagano Children's Hospital, 3100 Toyoshina, Azumino 399-8288, Japan; Neuro-Care Center, Nagano Children's Hospital, 3100 Toyoshina, Azumino 399-8288, Japan; Department of Pediatrics, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
| | - Makoto Nishioka
- Department of Medical Genetics, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; Division of Neuropediatrics, Nagano Children's Hospital, 3100 Toyoshina, Azumino 399-8288, Japan; Life Science Research Center, Nagano Children's Hospital, 3100 Toyoshina, Azumino 399-8288, Japan
| | - Tetsuhiro Fukuyama
- Department of Pediatrics, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Yuji Inaba
- Department of Medical Genetics, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; Division of Neuropediatrics, Nagano Children's Hospital, 3100 Toyoshina, Azumino 399-8288, Japan; Life Science Research Center, Nagano Children's Hospital, 3100 Toyoshina, Azumino 399-8288, Japan; Neuro-Care Center, Nagano Children's Hospital, 3100 Toyoshina, Azumino 399-8288, Japan; Department of Pediatrics, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
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Noormohammadi M, Ghorbani Z, Shahinfar H, Shidfar F. Is there any hepatic impact associated with rice bran arabinoxylan compound supplementation? A systematic review and dose-response meta-analysis of randomized controlled trials. Clin Nutr ESPEN 2023; 57:665-675. [PMID: 37739721 DOI: 10.1016/j.clnesp.2023.08.023] [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] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/01/2023] [Accepted: 08/19/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND & AIMS Rice Bran Arabinoxylan Compound (RBAC) results from an enzymatic modification of rice bran, which is reported to have immunomodulatory, anti-oxidant, and anti-inflammatory effects by regulating the production of pro-inflammatory cytokines. The current systematic review and meta-analysis aimed to determine the hepatic adverse effects of RBAC by assessing the effect through liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST). METHODS In the present study, the Medline (PubMed), Web of Sciences, and Scopus databases were searched for relevant publications from the beginning to October 2022. The meta-analysis was based on the Mixed effect model to generate the mean effect sizes in weighted mean differences (WMD) and the 95% confidence intervals (95%CI). The heterogeneity was assessed using the Cochrane Chi-squared test, and the analysis of Galbraith plots was applied. RESULTS Subgroup meta-analysis on five eligible randomized controlled trials (n = 239) showed a significant decrease in serum AST regarding RBAC supplementation in powder form (WMD (95%CI) = -3.52 (-5.62, -1.42) U/L; P-value = 0.001, I2 (%) = 46.9; P heterogeneity = 0.170), three months and more supplementation duration (WMD (95%CI) = -3.71 (-5.95, -1.48) U/L; P-value = 0.001, I2 (%) = 29.9; P heterogeneity = 0.240) and studies with a good quality (WMD (95%CI) = -3.52 (-5.62, -1.42) U/L; P-value = 0.001, I2 (%) = 46.9; P heterogeneity = 0.170). CONCLUSIONS In conclusion, RBAC supplementation seems to not have any hepatic adverse effects and its supplementation as powder or for three months and more may decrease serum AST levels. However, we need further studies to confirm the results. REGISTRY NUMBER FOR SYSTEMATIC REVIEWS OR META-ANALYZES CRD42022361002, registration time: 29/09/2022.
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Affiliation(s)
- Morvarid Noormohammadi
- Student Research Committee, Faculty of Public Health Branch, Iran University of Medical Sciences, Tehran, Iran; Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Zeinab Ghorbani
- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran; Department of Clinical Nutrition, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
| | - Hossein Shahinfar
- Student Research Committee, Faculty of Public Health Branch, Iran University of Medical Sciences, Tehran, Iran; Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
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Zhang L, Ding YJ, Sun XW, Lin YN, Zhou JP, Li SQ, Li QY. Combined aspartate aminotransferase level and PE-SARD score predict 1-month bleeding risk in acute pulmonary embolism. Am J Med Sci 2023; 366:286-290. [PMID: 37481206 DOI: 10.1016/j.amjms.2023.07.008] [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] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 04/11/2023] [Accepted: 07/18/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Anti-coagulation is the cornerstone management of acute pulmonary embolism (PE), which is a double-edged sword, as it increases the risk of bleeding. Thus, predicting bleeding risk is necessary. The liver produces most coagulation factors to maintain the coagulation balance. However, the association between liver dysfunction markers and bleeding risk has not been thoroughly investigated. METHODS A single-center, retrospective analysis of patients with acute PE was performed. First, the authors studied the association between liver dysfunction indexes and the 1-month bleeding risk. Then, they investigated whether it is more effective to predict the bleeding risk using a new joint model, i.e., adding liver dysfunction indexes to the PE-SARD score, which is the first score to assess the bleeding risk of acute PE. RESULTS Among 469 patients with acute PE, 34 patients (7.2%) had bleeding events within 1 month after the onset. The levels of aspartate aminotransferase (AST) were higher in the bleeding group compared with the non-bleeding group (36.0 [18.25-90.0] vs. 23.0 [18.0-31.0], p = 0.008). Compared with AST<40, the odds ratios of 80≤AST<120 and AST≥120 were significant (8.825 [2.449-31.804] and 8.023 [2.543-25.315] respectively, p<0.01), even when adjusted for nine confounding factors (p<0.05). The area under the curve of PE-SARD combined with AST was significantly higher than that of the PE-SARD score (p = 0.02). CONCLUSIONS In PE patients, AST is an independent factor in predicting the 1-month bleeding risk, and a novel joint model that combines AST and PE-SARD score improved the predictive efficiency for the 1-month bleeding risk.
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Affiliation(s)
- Liu Zhang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China; Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Jie Ding
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China; Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xian Wen Sun
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China; Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Ni Lin
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China; Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian Ping Zhou
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China; Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shi Qi Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China; Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Yun Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China; Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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11
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Narayanasamy DK, Arun Babu T, Fredrick J, Kittu D. Clinical profile and outcomes of pediatric scrub typhus associated with elevated hepatic transaminases. Indian J Gastroenterol 2023; 42:347-354. [PMID: 37213043 DOI: 10.1007/s12664-023-01350-y] [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: 07/29/2021] [Accepted: 02/02/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Hepatic transaminase (HT) elevation is frequently seen in children with scrub typhus (ST), but the clinical implication of this common finding is not known. OBJECTIVE To describe the clinical profile and outcome of pediatric ST with elevated hepatic transaminase. METHODS In this prospective cohort study, all children < 12 years of age presenting with fever for ≥ 5 days and positive immunoglobulin M (IgM) serology for ST were included. Clinical findings, laboratory features and outcomes of children with elevated HT were compared with those who had normal HT. RESULTS Of 560 ST positive children included, 257 (45.8%) had associated HT elevation. The common age group affected was 5 to 12 years of age (54.9%). Most of the children came during the second week of fever (68.5%) with mean duration of fever of 9.1 days. The common initial presenting symptoms were cough (77.8%), vomiting (65%) and myalgia (59.1%) and signs were hepatomegaly (64.2%), splenomegaly (57.6%) and generalized lymphadenopathy (54.1%). Eschar was seen in 49.8% of children. Thrombocytopenia (58%) and anemia (49%) were the frequently seen laboratory abnormalities. Severe forms of ST were seen in 45.5% children, of which pneumonia was most common. The fever clearance time (48 ± 19.2 h) and mean duration of hospital stay (6.7 ± 3.3 days) were prolonged in these children. On logistic regression analysis, generalized lymphadenopathy (p = 0.002), ascites (p = 0.037), thrombocytopenia (p < 0.001) and hypoalbuminemia (p = 0.023) were found to be associated with HT elevation in these children. CONCLUSIONS Hepatic transaminase (HT) levels increase with the duration of untreated fever and is found to be associated with severe forms of scrub typhus. Children with elevated HT have delay in fever defervescence and their duration of hospital stay was prolonged.
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Affiliation(s)
- Dinesh Kumar Narayanasamy
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Karaikal, 605 006, India
| | | | - Jean Fredrick
- Mahatma Gandhi Medical College and Research Institute, Puducherry, 607 402, India
| | - Devi Kittu
- Indira Gandhi Medical College and Research Institute, Puducherry, 605 009, India
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12
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Xiao F, Qiu XF, You CW, Xie FP, Cai YY. Influence of liver function after laparoscopy-assisted vs totally laparoscopic gastrectomy. World J Gastrointest Surg 2023; 15:859-870. [PMID: 37342845 PMCID: PMC10277945 DOI: 10.4240/wjgs.v15.i5.859] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/11/2023] [Accepted: 04/04/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Previously, some studies have proposed that total laparoscopic gastrectomy (TLG) is superior to laparoscopic-assisted gastrectomy (LAG) in terms of safety and feasibility based on the related intraoperative operative parameters and incidence of postoperative complications. However, there are still few studies on the changes in postoperative liver function in patients undergoing LG. The present study compared the postoperative liver function of patients with TLG and LAG, aiming to explore whether there is a difference in the influence of TLG and LAG on the liver function of patients.
AIM To investigate whether there is a difference in the influence of TLG and LAG on the liver function of patients.
METHODS The present study collected 80 patients who underwent LG from 2020 to 2021 at the Digestive Center (including the Department of Gastrointestinal Surgery and the Department of General Surgery) of Zhongshan Hospital affiliated with Xiamen University, including 40 patients who underwent TLG and 40 patients who underwent LAG. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyltransferase (GGLT), total bilirubin (TBIL), direct bilirubin (DBIL) and indirect bilirubin (IBIL), and other liver function-related test indices were compared between the 2 groups before surgery and on the 1st, 3rd, and 5th d after surgery.
RESULTS The levels of ALT and AST in the 2 groups were significantly increased on the 1st to 2nd postoperative days compared with those before the operation. The levels of ALT and AST in the TLG group were within the normal range, while the levels of ALT and AST in the LAG group were twice as high as those in the TLG group (P < 0.05). The levels of ALT and AST in the 2 groups showed a downward trend at 3-4 d and 5-7 d after the operation and gradually decreased to the normal range (P < 0.05). The GGLT level in the LAG group was higher than that in the TLG group on postoperative days 1-2, the ALP level in the TLG group was higher than that in the LAG group on postoperative days 3-4, and the TBIL, DBIL and IBIL levels in the TLG group were higher than those in the LAG group on postoperative days 5-7 (P < 0.05). No significant difference was observed at other time points (P > 0.05).
CONCLUSION Both TLG and LAG can affect liver function, but the effect of LAG is more serious. The influence of both surgical approaches on liver function is transient and reversible. Although TLG is more difficult to perform, it may be a better choice for patients with gastric cancer combined with liver insufficiency.
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Affiliation(s)
- Fan Xiao
- The School of Clinical Medicine, Fujian Medical University, Fuzhou 350000, Fujian Province, China
- Department of Gastrointestinal Surgery, Zhongshan Hospital, Xiamen University, Xiamen 361000, Fujian Province, China
| | - Xing-Feng Qiu
- The School of Clinical Medicine, Fujian Medical University, Fuzhou 350000, Fujian Province, China
- Department of Gastrointestinal Surgery, Zhongshan Hospital, Xiamen University, Xiamen 361000, Fujian Province, China
| | - Cai-Wen You
- The School of Clinical Medicine, Fujian Medical University, Fuzhou 350000, Fujian Province, China
- Department of Gastrointestinal Surgery, Zhongshan Hospital, Xiamen University, Xiamen 361000, Fujian Province, China
| | - Fu-Ping Xie
- The School of Clinical Medicine, Fujian Medical University, Fuzhou 350000, Fujian Province, China
- Department of Gastrointestinal Surgery, Zhongshan Hospital, Xiamen University, Xiamen 361000, Fujian Province, China
| | - Yao-Yuan Cai
- The School of Clinical Medicine, Fujian Medical University, Fuzhou 350000, Fujian Province, China
- Department of Gastrointestinal Surgery, Zhongshan Hospital, Xiamen University, Xiamen 361000, Fujian Province, China
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Narciso-Schiavon JL, Schiavon LL. Fatty liver and celiac disease: Why worry? World J Hepatol 2023; 15:666-674. [PMID: 37305374 PMCID: PMC10251279 DOI: 10.4254/wjh.v15.i5.666] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/27/2023] [Accepted: 04/18/2023] [Indexed: 05/24/2023] Open
Abstract
Celiac disease (CD) is a chronic inflammatory intestinal disorder mediated by the ingestion of gluten in genetically susceptible individuals. Liver involvement in CD has been widely described, and active screening for CD is recommended in patients with liver diseases, particularly in those with autoimmune disorders, fatty liver in the absence of metabolic syndrome, noncirrhotic intrahepatic portal hypertension, cryptogenic cirrhosis, and in the context of liver transplantation. Non-alcoholic fatty liver disease is estimated to affect approximately 25% of the world’s adult population and is the world’s leading cause of chronic liver disease. In view of both diseases’ global significance, and to their correlation, this study reviews the available literature on fatty liver and CD and verifies particularities of the clinical setting.
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Affiliation(s)
- Janaina Luz Narciso-Schiavon
- Department of Internal Medicine, Gastroenterology Division, Federal University of Santa Catarina, Florianópolis 88040-900, Santa Catarina, Brazil
| | - Leonardo Lucca Schiavon
- Department of Internal Medicine, Gastroenterology Division, Federal University of Santa Catarina, Florianópolis 88040-900, Santa Catarina, Brazil
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14
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Barton JC, Barton JC, Acton RT. Non-alcoholic fatty liver disease in hemochromatosis probands with iron overload and HFE p.C282Y/p.C282Y. BMC Gastroenterol 2023; 23:137. [PMID: 37118679 PMCID: PMC10148383 DOI: 10.1186/s12876-023-02763-x] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/11/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND The aim of this study was to identify characteristics of non-alcoholic fatty liver disease (NAFLD) in adults with HFE p.C282Y/p.C282Y. METHODS We retrospectively studied non-Hispanic white hemochromatosis probands with iron overload (serum ferritin (SF) > 300 µg/L (M), > 200 µg/L (F)) and p.C282Y/p.C282Y at non-screening diagnosis who did not report alcohol consumption > 14 g/d, have cirrhosis or other non-NAFLD liver disorders, use steatogenic medication, or have diagnoses of heritable disorders that increase NAFLD risk. We identified NAFLD-associated characteristics using univariate and multivariable analyses. RESULTS There were 66 probands (31 men, 35 women), mean age 49 ± 14 (SD) y, of whom 16 (24.2%) had NAFLD. The following characteristics were higher in probands with NAFLD: median SF (1118 µg/L (range 259, 2663) vs. 567 µg/L (247, 2385); p = 0.0192); prevalence of elevated ALT/AST (alanine/aspartate aminotransferase) (43.8% vs. 10.0%; p = 0.0056); and prevalence of type 2 diabetes (T2DM) (31.3% vs. 10.0%; p = 0.0427). Mean age, sex, and prevalences of human leukocyte antigen-A*03 positivity, body mass index ≥ 30.0 kg/m2, hyperlipidemia, hypertension, and metabolic syndrome in probands with/without NAFLD did not differ significantly. Logistic regression on NAFLD using variables SF, elevated ALT/AST, and T2DM revealed: SF (p = 0.0318; odds ratio 1.0-1.0) and T2DM (p = 0.0342; 1.1-22.3). Median iron removed to achieve iron depletion (QFe) in probands with/without NAFLD did not differ significantly (3.6 g (1.4-7.2 g) vs. 2.8 g (0.7-11.0 g), respectively; p = 0.6862). CONCLUSIONS NAFLD in hemochromatosis probands with p.C282Y/p.C282Y is associated with higher median SF and greater T2DM prevalence, after adjustment for other factors. NAFLD does not influence QFe significantly.
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Affiliation(s)
- James C Barton
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
- Southern Iron Disorders Center, Birmingham, AL, USA.
| | | | - Ronald T Acton
- Southern Iron Disorders Center, Birmingham, AL, USA
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL, USA
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15
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Kapoor D, Perwaiz A, Singh A, Kumar AN, Chaudhary A. Factors predicting 30-day mortality after pancreaticoduodenectomy-the impact of elevated aspartate aminotransferase. Langenbecks Arch Surg 2023; 408:130. [PMID: 36991246 DOI: 10.1007/s00423-023-02865-w] [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] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/19/2023] [Indexed: 03/31/2023]
Abstract
PURPOSE High preoperative bilirubin levels and cholangitis are associated with poor peri-operative outcomes following pancreaticoduodenectomy (PD). However, the impact of deranged preoperative aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels on immediate postoperative outcomes is relatively unexplored. We hypothesized that deranged AST and ALT lead to worse postoperative outcomes after PD. The aim of this study was to assess the factors contributing to postoperative mortality (POM) following PD, and to study the impact of deranged aminotransferases. METHODS This is a retrospective analysis of 562 patients. Risk factors for POM were computed using a multivariate logistic regression model. RESULTS The rate of POM was 3.9%. On univariate analysis, the American Society of Anaesthesiologists grades, diabetes mellitus, cardiac comorbidity, preoperative biliary stenting, elevated serum bilirubin, AST, elevated serum creatinine, clinically relevant pancreatic fistula (CRPF), and grade B+C post-pancreatectomy hemorrhage (PPH) were associated with 30-day mortality. On multivariate analysis, preoperative elevated AST was independently predictive of 30-day POM (OR = 6.141, 95%CI 2.060-18.305, p = 0.001). Other factors independently predictive of POM were elevated serum creatinine, preoperative biliary stenting, CRPF and grade B and C PPH. The ratio of AST/ALT > 0.89 was associated with 8 times increased odds of POM. CONCLUSION Elevated preoperative AST emerged as a predictor of 30-day POM after PD, with an 8-times increased odds of death with an AST/ALT ratio > 0.89.
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Affiliation(s)
- Deeksha Kapoor
- Division of GI Surgery, GI Oncology, Minimal Access and Bariatric Surgery, Institute of Digestive and Hepatobiliary Sciences, Medanta - the Medicity, Sector 38, Gurugram, Haryana, 122001, India
| | - Azhar Perwaiz
- Division of GI Surgery, GI Oncology, Minimal Access and Bariatric Surgery, Institute of Digestive and Hepatobiliary Sciences, Medanta - the Medicity, Sector 38, Gurugram, Haryana, 122001, India
| | - Amanjeet Singh
- Division of GI Surgery, GI Oncology, Minimal Access and Bariatric Surgery, Institute of Digestive and Hepatobiliary Sciences, Medanta - the Medicity, Sector 38, Gurugram, Haryana, 122001, India
| | - Arun N Kumar
- Department of Data Science, Alke Research Private Limited, Bengaluru, Karnataka, India
| | - Adarsh Chaudhary
- Division of GI Surgery, GI Oncology, Minimal Access and Bariatric Surgery, Institute of Digestive and Hepatobiliary Sciences, Medanta - the Medicity, Sector 38, Gurugram, Haryana, 122001, India.
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16
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Nadour Z, Rosenbaum B, Blons H, Loriot MA, Paul JL, Pallet N. [Clinical, biochemical and epidemiological features of macro-AST preceding inflammatory bowel disease diagnosis by several years]. Rev Med Interne 2023; 44:259-262. [PMID: 36958982 DOI: 10.1016/j.revmed.2023.03.001] [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] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/05/2023] [Indexed: 03/25/2023]
Abstract
INTRODUCTION An isolated elevation of aspartate aminotransferase (AST) is a diagnostic issue. Macro-aspartate aminotransferase (macro-AST) corresponds to the formation of complexes between AST and immunoglobulins. CASE REPORT We report the case of a patient with macro-AST identified several years before the onset of inflammatory bowel disease (IBD). A 6-year retrospective analysis in our laboratory identified only one case out of 42 540 adult patients. CONCLUSION The objective of this work is to increase awareness of this benign disorder among clinicians and biologists, as well as to aid in prescribing only the required tests.
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Affiliation(s)
- Z Nadour
- Service de biochimie, hôpital européen Georges-Pompidou, assistance publique-hôpitaux de Paris (AP-HP), 75013 Paris, France.
| | - B Rosenbaum
- Service de gastroentérologie et endoscopie digestive, hôpital européen Georges-Pompidou, assistance publique-hôpitaux de Paris (AP-HP), 75013 Paris, France
| | - H Blons
- Service de biochimie, hôpital européen Georges-Pompidou, assistance publique-hôpitaux de Paris (AP-HP), 75013 Paris, France
| | - M A Loriot
- Service de biochimie, hôpital européen Georges-Pompidou, assistance publique-hôpitaux de Paris (AP-HP), 75013 Paris, France
| | - J-L Paul
- Service de biochimie, hôpital européen Georges-Pompidou, assistance publique-hôpitaux de Paris (AP-HP), 75013 Paris, France
| | - N Pallet
- Service de biochimie, hôpital européen Georges-Pompidou, assistance publique-hôpitaux de Paris (AP-HP), 75013 Paris, France
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17
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Li S, Shao Z, Lu C, Duan D. Isolation and functional verification of an aspartate aminotransferase gene from Neoporphyra haitanensis. BMC Plant Biol 2023; 23:150. [PMID: 36941626 PMCID: PMC10029208 DOI: 10.1186/s12870-023-04158-2] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Neoporphyra haitanensis is a commercial laver species in China. Aspartic acid is an important flavor amino acid, and aspartate aminotransferase (AAT) is a crucial enzyme in its biosynthesis. In this study, we cloned one AAT gene (NhAAT) from the red alga N. haitanensis and investigated its sequence structure, transcriptional expression and enzymatic characteristics. The purpose of our research is to obtain a functional AAT responsible for the biosynthesis of aspartic acid from red seaweeds, which has the potential to influence the flavor of N. haitanensis. RESULTS Sequence analysis showed that NhAAT contains a conserved domain of Aminotran_1_2, which belongs to the transaminase superfamily. The secondary structure of NhAAT is dominated by α-helix. The results of enzymatic characterization illustrated that the NhAAT has highest catalytic activity at 45 °C and pH 7.5 in both forward and reverse reactions. The calculated Km values of NhAAT was 5.67 and 6.16 mM for L-glutamic acid and L-aspartic acid, respectively. Quantitative analysis showed that the NhAAT expression of N. haitanensis collected in late harvest (Dec) was 4.5 times that of N. haitanensis collected in early harvest (Oct), while the aspartic acid content of N. haitanensis collected in late harvest (Dec) was 1.2 times that of N. haitanensis collected in early harvest (Oct). CONCLUSION The results of enzyme kinetics indicated that NhAAT prefers to catalyze the reaction in the direction of aspartic acid production. Moreover, the trend of NhAAT expression level was consistent with that of aspartic acid content in N. haitanensis in different harvest periods. Our research is helpful to understand the accumulation and regulation of amino acids in N. haitanensis in different habitats and the taste difference of N. haitanensis in different harvest periods.
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Affiliation(s)
- Shuang Li
- CAS and Shandong Province Key Laboratory of Experimental Marine Biology, Center for Ocean Mega-Science, Institute of Oceanology, Chinese Academy of Sciences, Qingdao, 266071, China
- Laboratory for Marine Biology and Biotechnology, Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266237, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Zhanru Shao
- CAS and Shandong Province Key Laboratory of Experimental Marine Biology, Center for Ocean Mega-Science, Institute of Oceanology, Chinese Academy of Sciences, Qingdao, 266071, China.
- Laboratory for Marine Biology and Biotechnology, Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266237, China.
| | - Chang Lu
- Department of Biological Engineering, College of Life Science, Yantai University, Yantai, 264005, P. R. China
| | - Delin Duan
- CAS and Shandong Province Key Laboratory of Experimental Marine Biology, Center for Ocean Mega-Science, Institute of Oceanology, Chinese Academy of Sciences, Qingdao, 266071, China.
- Laboratory for Marine Biology and Biotechnology, Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266237, China.
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Lai PH, Ding DC. Acute liver injury in a COVID-19 infected woman with mild symptoms: A case report. World J Clin Cases 2023; 11:472-478. [PMID: 36686361 PMCID: PMC9850972 DOI: 10.12998/wjcc.v11.i2.472] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/05/2022] [Accepted: 12/23/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has spread rapidly, resulting in a pandemic in January 2020. Few studies have focused on the natural history and consequences of acute liver injury (ALI) in mild or asymptomatic COVID-19 patients, manifested by elevated aminotransferase levels. ALI is usually expected for severe COVID-19 cases. Here, we present a COVID-19 case with mild respiratory symptoms and significantly elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels.
CASE SUMMARY A 60-year-old woman without medical history or chronic illness received three COVID-19 vaccinations since the start of the pandemic. The patient was infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and presented with mild symptoms on July 12th, 2022. Post-recovery, she underwent an examination at our hospital on August 30th, 2022. AST and ALT levels in the liver function test were 207 U/L (normal value < 39, 5.3-fold increase) and 570 U/L (normal value < 52, 10.9-fold increase), respectively. The patient was diagnosed with ALI, and no treatment was prescribed. The following week, blood tests showed a reduction in both levels (ALT 124 U/L, AST 318 U/L). Two weeks later, AST and ALT levels had decreased to near the expected upper limits (ALT 40 U/L, AST 76 U/L).
CONCLUSION Clinicians should pay attention to liver function testing during COVID-19 recovery regardless of the disease’s severity.
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Affiliation(s)
- Pei-Hsuan Lai
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Hualien 970, Taiwan
| | - Dah-Ching Ding
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Hualien 970, Taiwan
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Narciso-Schiavon JL, Schiavon LL. Celiac disease screening in patients with cryptogenic cirrhosis. World J Gastroenterol 2023; 29:410-412. [PMID: 36687121 PMCID: PMC9846935 DOI: 10.3748/wjg.v29.i2.410] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 10/27/2022] [Revised: 11/26/2022] [Accepted: 12/21/2022] [Indexed: 01/06/2023] Open
Abstract
We write a letter to the editor commenting the article “Who to screen and how to screen for celiac disease”. We discuss the present literature on cirrhosis and celiac disease (CD) and recommend screening and treating CD in individuals with cryptogenic cirrhosis.
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Affiliation(s)
- Janaina Luz Narciso-Schiavon
- Gastroenterology Division, Internal Medicine Department, Federal University of Santa Catarina, Florianopolis 88040-900, SC, Brazil
| | - Leonardo Lucca Schiavon
- Gastroenterology Division, Internal Medicine Department, Federal University of Santa Catarina, Florianopolis 88040-900, SC, Brazil
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Suo Y, Pan Y, Chen W, Jing J, Yan H, Li H, Liu L, Zhao X, Wang Y, Meng X, Wang Y. Aminotransferase Level and the Effects of Dual Antiplatelet in Minor Stroke or Transient Ischemic Attack: A post hoc Analysis of a Randomized Control Trial. Cerebrovasc Dis 2022; 52:442-450. [PMID: 36502795 DOI: 10.1159/000527611] [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] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/05/2022] [Indexed: 09/05/2023] Open
Abstract
INTRODUCTION This study was intended to evaluate whether the safety and efficacy of dual antiplatelet treatment in patients with minor ischemic stroke (MIS) or transient ischemic attack (TIA) could be modified by the aminotransferase level. Also, we sought to assess the interaction between aminotransferase level and CYP2C19 loss-of-function status on the efficacy of dual antiplatelet therapy. METHODS This study is a post hoc analysis of the Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events (CHANCE) study, a double-blinded randomized control trial. We included 5,133 patients with a complete workup of baseline alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. The primary outcome is stroke or TIA recurrence within 90 days. Cox proportional hazard models were used in the evaluation of the efficacy of antiplatelet treatment in patients with different aminotransferase levels and subgroups categorized by the aminotransferase level × CYP2C19 loss-of-function status. RESULTS The median age of all the included patients was 62 years; 66.3% of the patients were male. More recurrent stroke or TIA occurred in patients with elevated ALT and AST levels within 90 days compared to patients with normal ALT and AST levels (14.5 vs. 11.2%, p = 0.029). Dual antiplatelet treatment with aspirin and clopidogrel reduced recurrence compared with aspirin alone in patients with both normal (adjusted hazard ratio [HR], 95% confidence interval [CI]: 0.72 [0.60-0.86], p < 0.001) and elevated (adjusted HR [95% CI]: 0. 57 [0. 35-0. 92], p = 0. 020) ALT and AST levels (p = 0.64 for interaction). No significant difference in treatment efficacy on 90-day all-cause death or bleeding events was found. CONCLUSIONS Dual antiplatelet treatment was safe for minor stroke or high-risk TIA patients with mildly elevated aminotransferase. Mild elevation of ALT or AST did not undermine the protective efficacy of the dual antiplatelet regimen in reducing recurrent stroke or TIA within 90 days after MIS or TIA. The interaction between the CYP2C19 loss-of-function allele carrier status and aminotransferase level on the efficacy of dual antiplatelet treatment was not observed.
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Affiliation(s)
- Yue Suo
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,
- China National Clinical Research Center for Neurological Diseases, Beijing, China,
- Tiantan Neuroimaging Center of Excellence, Beijing, China,
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Weiqi Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Jing Jing
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Tiantan Neuroimaging Center of Excellence, Beijing, China
| | - Hongyi Yan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Hao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Liping Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Tiantan Neuroimaging Center of Excellence, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
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Liu J, Zhang R, Wang D, Lin Y, Bai C, Nie N, Gao S, Zhang Q, Chang H, Ren C. Elucidating the role of circNFIB in myocardial fibrosis alleviation by endogenous sulfur dioxide. BMC Cardiovasc Disord 2022; 22:492. [PMID: 36404310 PMCID: PMC9677687 DOI: 10.1186/s12872-022-02909-x] [Citation(s) in RCA: 1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/21/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND To investigate the role of circNFIB in the alleviation of myocardial fibrosis by endogenous sulfur dioxide (SO2). METHODS We stimulated cultured neonatal rat cardiac fibroblasts with transforming growth factor-β1 (TGF-β1) and developed an in vitro myocardial fibrosis model. Lentivirus vectors containing aspartate aminotransferase 1 (AAT1) cDNA were used to overexpress AAT1, and siRNA was used to silence circNFIB. The SO2, collagen, circNFIB, Wnt/β-catenin, and p38 MAPK pathways were examined in each group. RESULTS In the in vitro TGF-β1-induced myocardial fibrosis model, endogenous SO2/AAT1 expression was significantly decreased, and collagen levels in the cell supernatant and type I and III collagen expression, as well as α-SMA expression, were all significantly increased. TGF-β1 also significantly reduced circNFIB expression. AAT1 overexpression significantly reduced myocardial fibrosis while significantly increasing circNFIB expression. Endogenous SO2 alleviated myocardial fibrosis after circNFIB expression was blocked. We discovered that circNFIB plays an important role in the alleviation of myocardial fibrosis by endogenous SO2 by inhibiting the Wnt/β-catenin and p38 MAPK pathways. CONCLUSION Endogenous SO2 promotes circNFIB expression, which inhibits the Wnt/β-catenin and p38 MAPK signaling pathways, consequently alleviating myocardial fibrosis.
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Affiliation(s)
- Jia Liu
- grid.412521.10000 0004 1769 1119Department of pediatric nephrology and rheumotology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ranran Zhang
- grid.412521.10000 0004 1769 1119Department of pediatric nephrology and rheumotology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Dahai Wang
- grid.412521.10000 0004 1769 1119Department of pediatric nephrology and rheumotology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yi Lin
- grid.412521.10000 0004 1769 1119Department of pediatric nephrology and rheumotology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Cui Bai
- grid.412521.10000 0004 1769 1119Department of pediatric nephrology and rheumotology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Nana Nie
- grid.412521.10000 0004 1769 1119Department of pediatric nephrology and rheumotology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Shan Gao
- grid.412521.10000 0004 1769 1119Department of pediatric nephrology and rheumotology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Qiuye Zhang
- grid.412521.10000 0004 1769 1119Department of pediatric nephrology and rheumotology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hong Chang
- grid.412521.10000 0004 1769 1119Department of pediatric nephrology and rheumotology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chongmin Ren
- grid.412521.10000 0004 1769 1119Department of orthopedic oncology, The Affiliated Hospital of Qingdao University, Qingdao, China
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22
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Ndrepepa G, Holdenrieder S, Kastrati A. Prognostic value of De Ritis ratio in patients with acute myocardial infarction. Clin Chim Acta 2022; 535:75-81. [PMID: 35985502 DOI: 10.1016/j.cca.2022.08.016] [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] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 08/12/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND The association between aspartate aminotransferase to alanine aminotransferase ratio (De Ritis ratio) and prognosis of patients with acute myocardial infarction (AMI) remains poorly investigated. METHODS This study included 3000 patients with AMI undergoing percutaneous coronary intervention. Patients were categorized in groups according to tertiles of the De Ritis ratio: tertile 1 (De Ritis ratio < 1.11; 905 patients), tertile 2 (De Ritis ratio 1.11 to 1.95; 1003 patients) and tertile 3 (De Ritis ratio > 1.95; 1002 patients). The primary endpoint was 3-year all-cause mortality. RESULTS At 3 years, all-cause deaths occurred in 487 patients: 119 deaths (13.2%) in patients of 1st tertile, 164 deaths (17.8%) in patients of 2nd tertile and 204 deaths (21.9%) in patients of 3rd tertile of the De Ritis ratio (adjusted hazard ratio [HR] = 1.16, 95% confidence interval [CI] 1.02 to 1.31], P = 0.023 per unit increment in the logarithmic scale of the De Ritis ratio); cardiac deaths occurred in 328 patients: 76 deaths (8.2%) in patients of 1st tertile, 110 deaths (12.0%) in patients of 2nd tertile and 142 deaths (15.4%) in patients of 3rd tertile of the De Ritis ratio (adjusted HR = 1.20 [1.04-1.40], P = 0.014 per unit increment in the logarithmic scale of De Ritis ratio). The C-statistic of the multivariable model(s) with baseline data without and with De Ritis ratio was 0.822 [0.805-0.839] and 0.823 [0.805-0.840], (P = 0.419) for all-cause mortality and 0.831[0.811-0.852] and 0.832 [0.811-0.853], P = 0.621) for cardiac mortality. CONCLUSIONS In patients with AMI, elevated De Ritis ratio was associated with increased risk of 3-year mortality.
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Affiliation(s)
- Gjin Ndrepepa
- Deutsches Herzzentrum München, Technical University of Munich, Munich, Germany.
| | - Stefan Holdenrieder
- Institut für Laboratoriumsmedizin, Deutsches Herzzentrum München, Technical University of Munich, Munich, Germany
| | - Adnan Kastrati
- Deutsches Herzzentrum München, Technical University of Munich, Munich, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Germany
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23
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Xu Q, Zhang X, Li H, Tian X, Zuo Y, Zhang Y, Zhang X, Wang Y, Wang A, Meng X. Aspartate aminotransferase to alanine aminotransferase ratio and clinical outcomes after acute ischemic stroke: the CNSR-III registry. Intern Emerg Med 2022; 17:1987-1996. [PMID: 35986833 DOI: 10.1007/s11739-022-03059-w] [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: 05/11/2022] [Accepted: 07/18/2022] [Indexed: 11/05/2022]
Abstract
Elevated aspartate aminotransferase-to-alanine aminotransferase ratio (AAR) has been associated with cardiovascular diseases and mortality. The clinical significance of AAR in the prognosis of stroke has yet to be established. We aimed to investigate the associations between AAR levels and clinical outcomes in acute ischemic stroke (AIS) or transient ischemic attack (TIA). Patients with AIS or TIA in the Third China National Stroke Registry (CNSR-III) were divided into four groups by quartiles of AAR, and two groups according to AAR < 1 and AAR ≥ 1. Multivariable Cox regression for all-cause mortality and logistic regression for poor functional outcome (modified Rankin Scale, mRS 3-6/2-6) were adopted to explore the associations between AAR and clinical outcomes at 3 months and 1 year. Among 10,877 included patients, the median AAR was 1.06 (interquartile range [IQR], 0.82 to 1.36). In the multivariable-adjusted model, patients in the fourth AAR quartile had higher risk of all-cause mortality within 3 months and 1 year (hazard ratio [HR] 2.08, 95% confidence interval [CI] 1.25 to 3.47; HR 2.26, 95% CI 1.55 to 3.27), and mRS 3-6/2-6 at 1 year (odds ratio [OR] 1.29, 95% CI 1.07 to 1.55; OR 1.20, 95% CI 1.02 to 1.42), compared with those in the first quartile. Similar associations were also observed when AAR ≥ 1 compared with AAR < 1. Elevated AAR was associated with higher risk of all-cause mortality and poor functional outcome after AIS or TIA, and should be carefully assessed after admission.
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Affiliation(s)
- Qin Xu
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaofan Zhang
- The Affiliated Jinyang Hospital of Guizhou Medical University, Guiyang, China
| | - Hao Li
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xue Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yingting Zuo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yijun Zhang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaoli Zhang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yongjun Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Anxin Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| | - Xia Meng
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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Masouri L, Bagherzadeh-Kasmani F, Mehri M, Rokouei M, Masouri B. Mentha piperita as a promising feed additive used to protect liver, bone, and meat of Japanese quail against aflatoxin B 1. Trop Anim Health Prod 2022; 54:254. [PMID: 35947246 DOI: 10.1007/s11250-022-03257-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 07/29/2022] [Indexed: 10/15/2022]
Abstract
The present study was conducted to evaluate aflatoxin B1 (AFB1) detoxification effects of some medicinal plants under both in vitro and in vivo. The in vitro experiment was performed with 25 treatments in 5 replications. The samples of medicinal plants were incubated with AFB1 for 72 h, and the toxin residual in the supernatant was determined. The highest aflatoxin elimination was found to be related to peppermint (81%). Thereafter, in vivo experiment was conducted to investigate the effects of peppermint dried leaves, essential oil, and menthol on liver, bone, and meat, as well as the performance of growing Japanese quail fed diet contaminated with AFB1. A total of 640 7-day-old Japanese quails were assigned using a completely randomized design as 2 × 4 factorial arrangement with two levels of AFB1 (including 0 and 2.5 mg/kg diet) and four treatments (including no additive; peppermint powder, 20 g/kg; peppermint essential oil, 800 mg/kg; and menthol powder, 400 mg/kg). Those birds fed AFB1-contaminated diet with no additives showed the worst liver health status by considering super oxide dismutase (P = 0.0399), glutathione peroxidase (P = 0.0139), alanine aminotransferase (P < 0.0001), and aspartate aminotransferase levels (P = 0.0512). However, the supplementation of AFB1 contaminated diet with additives improved their liver health status. Menthol receiving birds showed the highest tibia strength, while the birds fed with AFB1-contaminated diet with no additives had the weakest bone strength (P < 0.0001). A significant increase was also observed in malondialdehyde level of meat by dietary inclusion of AFB1, which was well-repressed by the dietary supplementation of peppermint essential oil and menthol (P = 0.0075). Body weight gain dramatically decreased by adding AFB1 to the diet, which was recovered with the dietary supplementation of additives (P = 0.0585). According to the results of the current study, peppermint and its derivatives can be used to suppress aflatoxin effects on the liver, bone, and meat quality and to improve the performance of Japanese quails.
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25
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Tam FI, Chocholi I, Hellerhoff I, Kloepfer M, Weidner K, Roessner V, Mirtschink P, Poitz DM, Ehrlich S. Liver and vitamin B(12) parameters in patients with anorexia nervosa before and after short-term weight restoration. Psychiatry Res 2022; 314:114673. [PMID: 35751997 DOI: 10.1016/j.psychres.2022.114673] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 11/20/2022]
Abstract
Hepatic involvement in anorexia nervosa (AN) has been previously reported, but a link to elevated vitamin B12 concentrations, which can be a sign for liver damage, has not been thoroughly examined. We measured liver enzymes (alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase) and vitamin B12 parameters (total B12, holotranscobalamin, methylmalonic acid) in the plasma of young female patients with acute AN (n=77) and after short-term weight restoration (n=58, median body mass increase=25%), in comparison to healthy control participants (n=63). For a comprehensive assessment of vitamin B12 status, the combined marker cB12 was calculated. In acute AN, activities of alanine aminotransferase and gamma-glutamyltransferase as well as holotranscobalamin concentrations were elevated, and alanine aminotransferase activities positively correlated with total B12, holotranscobalamin and cB12 in patients with elevated liver enzyme activities. After weight restoration, alanine aminotransferase activities and holotranscobalamin concentrations were elevated, and cB12 increased above the level of the healthy control group. The present study provides further evidence for a hepatic involvement in acute AN in concert with vitamin B12 parameters and points to refeeding-associated alterations of liver and vitamin B12 parameters. Future studies should include non-invasive methods to characterize hepatic involvement and evaluate vitamin B12 status as a potential marker of liver damage/irritation.
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Li Y, Yuan X, Wei J, Sun Y, Ni W, Zhang H, Zhang Y, Wang R, Xu R, Liu T, Yang C, Chen G, Xu J, Liu Y. Long-term exposure to ambient air pollution and serum liver enzymes in older adults: a population-based longitudinal study. Ann Epidemiol 2022; 74:1-7. [PMID: 35680103 DOI: 10.1016/j.annepidem.2022.05.011] [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] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 05/29/2022] [Accepted: 05/31/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE To investigate the association of long-term exposure to ambient air pollution with serum liver enzymes in older adults. METHODS In this longitudinal study, we investigated 318,911 adults aged ≥65 years and assessed their long-term residential exposure to particulate matter with an aerodynamic diameter ≤2.5 µm (PM2.5), particulate matter with an aerodynamic diameter ≤10 µm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3). Linear mixed models and generalized linear mixed models were implemented for exposure-response analyses. RESULTS Each interquartile range (IQR) increase of PM2.5, PM10, SO2, NO2, CO, and O3 exposures was significantly associated with a 4.6%, 4.6%, 5.6%, 4.6%, 6.2%, and 3.6% increase in alanine aminotransferase (ALT), and a 4.6%, 5.2%, 3.6%, 3.3%, 6.1%, and 4.0% increase in aspartate aminotransferase (AST), respectively. Each IQR increase of PM2.5, PM10, SO2, NO2, CO, and O3 exposures was significantly associated with a 23%, 24%, 28%, 17%, 31%, and 19% increase in odds of elevated ALT (>40 U/L), and a 32%, 39%, 40%, 32%, 57%, and 25% increase in odds of elevated AST (>40 U/L), respectively. CONCLUSIONS Long-term exposure to ambient air pollution was significantly associated with increased serum liver enzyme levels in older adults, suggesting that air pollution exposures may induce hepatocellular injury.
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Key Words
- AST, aspartate aminotransferase
- Alanine aminotransferase
- Ambient air pollution
- Aspartate aminotransferase
- BMI, body mass index
- CHAP, ChinaHighAirPollutants
- CI, confidence interval
- CO, carbon monoxide
- FBG, fasting blood glucose
- HDL-C, high-density lipoprotein cholesterol
- IQR, interquartile range
- LDL-C, low-density lipoprotein cholesterol
- Liver enzymes
- NO(2), nitrogen dioxide
- O(3), ozone
- OR, odds ratio
- Older adults Abbreviations: ALT, alanine aminotransferase
- PM(10), particulate matter with an aerodynamic diameter ≤10 µm
- PM(2.5), particulate matter with an aerodynamic diameter ≤2.5 µm
- SD, standardized deviation
- SO(2), sulfur dioxide
- TC, total cholesterol
- TG, triglyceride
- WC, waist circumference
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Affiliation(s)
- Yingxin Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
| | - Xueli Yuan
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong 518020, China
| | - Jing Wei
- Department of Chemical and Biochemical Engineering, Iowa Technology Institute, and Center for Global and Regional Environmental Research, The University of Iowa, Iowa City, IA 52242, USA
| | - Yuanying Sun
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong 518020, China
| | - Wenqing Ni
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong 518020, China
| | - Hongmin Zhang
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong 518020, China
| | - Yan Zhang
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong 518020, China
| | - Rui Wang
- Luohu Center for Chronic Disease Control, Shenzhen, Guangdong 518000, China
| | - Ruijun Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Tingting Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Chunyu Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Gongbo Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Jian Xu
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong 518020, China.
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
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Sugiyama A, Kurisu A, E B, Ouoba S, Ko K, Rakhimov A, Akita T, Harakawa T, Sako T, Koshiyama M, Kumada T, Tanaka J. Distribution of FIB-4 index in the general population: analysis of 75,666 residents who underwent health checkups. BMC Gastroenterol 2022; 22:241. [PMID: 35562658 PMCID: PMC9101936 DOI: 10.1186/s12876-022-02290-1] [Citation(s) in RCA: 1] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 04/20/2022] [Indexed: 12/15/2022] Open
Abstract
Background Fatty liver is frequently found in a general population, and it is critical to detect advanced fibrosis. FIB-4 index is considered a useful marker for evaluating liver fibrosis but the distribution of FIB-4 index in the general population remains unknown. Methods This cross-sectional study included residents who underwent ultrasonography at health checkups in Hiroshima or Iwate prefectures. The distribution of FIB-4 index in the total study population (N = 75,666) as well as in non-alcoholic fatty liver disease (NAFLD) populations (N = 17,968) and non-drinkers without fatty liver populations (N = 47,222) was evaluated. The distribution of aspartate aminotransferase (AST) levels, alanine aminotransferase (ALT) levels was also evaluated. Results The mean FIB-4 index in the total study population was 1.20 ± 0.63. FIB-4 index ≥ 2.67, which indicates a high risk of liver fibrosis, was found in 16.4% of those aged ≥ 70 years. In the NAFLD population, 58.1% of those in their 60 s and 88.1% of those ≥ 70 years met the criteria for referral to hepatologists by using the recommended FIB-4 index cutoff value (≥ 1.3). The mean FIB-4 index in the NAFLD population (1.12 ± 0.58) was significantly lower than in the non-drinkers without fatty liver (1.23 ± 0.63, p < 0.0001). The non-drinkers without fatty liver tended to have higher AST relative to ALT levels (60.0% with AST/ALT > 1.0), whereas the results in the NAFLD population were opposite (14.8% with AST/ALT > 1.0). AST > ALT resulted in a higher FIB-4 index in non-drinkers without fatty liver due to the nature of FIB-4 index formula. Conclusions The cutoff value of FIB-4 index (≥ 1.3) for triaging the elderly people with fatty liver for referral to hepatologists should be reconsidered to avoid over-referral. Due to the impact of age and characteristics of AST/ALT ratios, there is no prospect of using FIB-4 index for primary screening for liver fibrosis in a general population of unknown presence or absence of liver disease, even though it can be easily calculated using routine clinical indices. It is desired to develop a non-invasive method for picking up cases with advanced fibrosis latent in the general population. Supplementary Information The online version contains supplementary material available at 10.1186/s12876-022-02290-1.
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Affiliation(s)
- Aya Sugiyama
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Akemi Kurisu
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Bunthen E
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.,Payment Certification Agency (PCA), Ministry of Health, Phnom Penh, Cambodia
| | - Serge Ouoba
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.,Unite De Recherche Clinique De Nanoro (URCN), Institut de Recherche en Science de La Sante (IRSS), Nanoro, Burkina Faso
| | - Ko Ko
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Anvarjon Rakhimov
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Tomoyuki Akita
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Takayuki Harakawa
- General Affairs, Foundation for Community Health and Medicine Promotion in Hiroshima Prefecture, Hiroshima, Japan
| | - Toru Sako
- General Affairs, Foundation for Community Health and Medicine Promotion in Hiroshima Prefecture, Hiroshima, Japan
| | | | - Takashi Kumada
- Department of Nursing, Faculty of Nursing, Gifu Kyoritsu University, Ogaki, Gifu, Japan
| | - Junko Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
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Krishnasamy N, Rajendran K, Barua P, Ramachandran A, Panneerselvam P, Rajaram M. Elevated Liver Enzymes along with Comorbidity Is a High Risk Factor for COVID-19 Mortality: A South Indian Study on 1,512 Patients. J Clin Transl Hepatol 2022; 10:120-127. [PMID: 35233380 PMCID: PMC8845151 DOI: 10.14218/jcth.2020.00100] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/30/2021] [Accepted: 05/20/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND AND AIMS Liver enzyme abnormalities in coronavirus 2019 (COVID-19) are being addressed in the literature. The predictive risk of elevated liver enzymes has not been established for COVID-19 mortality. In this study, we hypothesized that elevated liver enzymes at admission can predict the outcome of COVID-19 disease with other known indicators, such as comorbidities. METHODS This retrospective study included all the consecutive hospitalized patients with confirmed COVID-19 disease from March 4th to May 31st, 2020. The study was conducted in Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India. We assessed demography, clinical variables, COVID-19 severity, laboratory parameters, and outcome. RESULTS We included 1,512 patients, and median age was 47 years (interquartile range: 34-60) with 36.9% being female. Liver enzyme level (aspartate aminotransferase and/or alanine aminotransferase) was elevated in 450/1,512 (29.76%) patients. Comorbidity was present in 713/1,512 (47.16%) patients. Patients with liver enzymes' elevation and presence of comorbidity were older, more frequently hospitalized in ICU and had more severe symptoms of COVID-19 at the time of admission. Presence of liver enzymes' elevation with comorbidity was a high risk factor for death (OR: 5.314, 95% CI: 2.278-12.393), as compared to patients with presence of comorbidity (OR: 4.096, 95% CI: 1.833-9.157). CONCLUSIONS Comorbidity combined with liver enzymes' elevation at presentation independently increased the risk of death in COVID-19 by at least 5-fold.
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Affiliation(s)
- Narayanasamy Krishnasamy
- Institute of Hepatobiliary Sciences, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
- Correspondence to: Narayanasamy Krishnasamy, Institute of Hepatobiliary Sciences, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu 600003, India. Tel: +91-9841170145, Fax: +91-4425305115, E-mail: ; Karthick Rajendran, Multidisciplinary Research Unit, Madras Medical College, Chennai, Tamil Nadu 600003, India. ORCID: https://orcid.org/0000-0003-3938-3347. Tel: +91-9790787578, Fax: +91-4425305115, E-mail:
| | - Karthick Rajendran
- Multidisciplinary Research Unit (MRU), Madras Medical College, Chennai, Tamil Nadu, India
- Correspondence to: Narayanasamy Krishnasamy, Institute of Hepatobiliary Sciences, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu 600003, India. Tel: +91-9841170145, Fax: +91-4425305115, E-mail: ; Karthick Rajendran, Multidisciplinary Research Unit, Madras Medical College, Chennai, Tamil Nadu 600003, India. ORCID: https://orcid.org/0000-0003-3938-3347. Tel: +91-9790787578, Fax: +91-4425305115, E-mail:
| | - Parimita Barua
- Institute of Hepatobiliary Sciences, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - Arunkumar Ramachandran
- Multidisciplinary Research Unit (MRU), Madras Medical College, Chennai, Tamil Nadu, India
| | | | - Muthukumaran Rajaram
- Multidisciplinary Research Unit (MRU), Madras Medical College, Chennai, Tamil Nadu, India
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Krishnan A, Prichett L, Tao X, Alqahtani SA, Hamilton JP, Mezey E, Strauss AT, Kim A, Potter JJ, Chen PH, Woreta TA. Abnormal liver chemistries as a predictor of COVID-19 severity and clinical outcomes in hospitalized patients. World J Gastroenterol 2022; 28:570-587. [PMID: 35316959 PMCID: PMC8905016 DOI: 10.3748/wjg.v28.i5.570] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 05/17/2021] [Revised: 07/21/2021] [Accepted: 01/20/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Abnormal liver chemistries are common findings in patients with Coronavirus Disease 2019 (COVID-19). However, the association of these abnormalities with the severity of COVID-19 and clinical outcomes is poorly understood
AIM We aimed to assess the prevalence of elevated liver chemistries in hospitalized patients with COVID-19 and compare the serum liver chemistries to predict the severity and in-hospital mortality.
METHODS This retrospective, observational study included 3380 patients with COVID-19 who were hospitalized in the Johns Hopkins Health System (Baltimore, MD, United States). Demographic data, clinical characteristics, laboratory findings, treatment measures, and outcome data were collected. Cox regression modeling was used to explore variables associated with abnormal liver chemistries on admission with disease severity and prognosis
RESULTS A total of 2698 (70.4%) had abnormal alanine aminotransferase (ALT) at the time of admission. Other more prevalent abnormal liver chemistries were aspartate aminotransferase (AST) (44.4%), alkaline phosphatase (ALP) (16.1%), and total bilirubin (T-Bil) (5.9%). Factors associated with liver injury were older age, Asian ethnicity, other race, being overweight, and obesity. Higher ALT, AST, T-Bil, and ALP levels were more commonly associated with disease severity. Multivariable adjusted Cox regression analysis revealed that abnormal AST and T-Bil were associated with the highest mortality risk than other liver injury indicators during hospitalization. Abnormal AST, T-Bil, and ALP were associated with a need for vasopressor drugs, whereas higher levels of AST, T-Bil, and a decreased albumin levels were associated with mechanical ventilation
CONCLUSION Abnormal liver chemistries are common at the time of hospital admission in COVID-19 patients and can be closely related to the patient’s severity and prognosis. Elevated liver chemistries, specifically ALT, AST, ALP, and T-Bil levels, can be used to stratify risk and predict the need for advanced therapies in these patients.
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Affiliation(s)
- Arunkumar Krishnan
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Laura Prichett
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Xueting Tao
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Saleh A Alqahtani
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
- Liver Transplant Center, King Faisal Specialist Hospital & Research Center, Riyadh 12713, Saudi Arabia
| | - James P Hamilton
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Esteban Mezey
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Alexandra T Strauss
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Ahyoung Kim
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - James J Potter
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Po-Hung Chen
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Tinsay A Woreta
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
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Taneva G, Dimitrov D, Velikova T. Liver dysfunction as a cytokine storm manifestation and prognostic factor for severe COVID-19. World J Hepatol 2021; 13:2005-2012. [PMID: 35070004 PMCID: PMC8727206 DOI: 10.4254/wjh.v13.i12.2005] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/09/2021] [Accepted: 11/18/2021] [Indexed: 02/06/2023] Open
Abstract
Liver damage in severe acute respiratory coronavirus 2 infection occurs in patients with or without preexisting liver disorders, posing a significant complication and mortality risk. During coronavirus disease 2019 (COVID-19), abnormal liver function is typically observed. However, liver injury may occur because of the treatment as well. Ischemia, cytokine storm, and hypoxia were identified as the three major factors contributing to liver damage during COVID-19. Indeed, raised liver enzymes during hospitalizations may be attributed to medications used, as well as sepsis and shock. As a result, the proportion of hospitalized patients afflicted with COVID-19 and pathological liver biomarkers varies from 14% to 53%. Aminotransferases and bilirubin are found most often elevated. Usually, increased gamma-glutamyltransferase, alkaline phosphatase, and decreased serum albumin levels are demonstrated. Additionally, although there is no specific treatment for COVID-19, many of the drugs used to treat the infection are hepatotoxic. In this mini-review, we focus on how liver dysfunction can be one of the features associated with the COVID-19 cytokine storm. Furthermore, data show that liver injury can be an independent predictor of severe COVID-19, the need for hospitalization, and death.
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Affiliation(s)
- Gergana Taneva
- Department of Gastroenterology, Sveta Sofia Hospital, Sofia 1618, Bulgaria
| | - Dimitar Dimitrov
- Department of Gastroenterology, Sveta Sofia Hospital, Sofia 1618, Bulgaria
| | - Tsvetelina Velikova
- Department of Clinical Immunology, University Hospital Lozenetz, Sofia 1407, Bulgaria
- Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
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Pahwa P, Chu L, Karunanayake C, Aich P, Hecker M, Saxena A, Griebel P, Niyogi S. Predictive biomarkers of cardiovascular disease in adult Canadian population. J Diabetes Metab Disord 2021; 20:1199-1209. [PMID: 34900772 DOI: 10.1007/s40200-021-00842-y] [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: 05/06/2021] [Accepted: 06/21/2021] [Indexed: 01/26/2023]
Abstract
Background Elevated levels of the enzymes gamma-glutamyltransferase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and C-reactive protein (CRP) have been shown to be associated with increased risk of cardiovascular disease (CVD). Objective: To assess cross-sectional relationships between biomarkers GGT, ALT, AST, ALP and CVD in adult Canadian population. Methods The Canadian Health Measures Surveys (CHMSs) are a series of cross-sectional national surveys and collect information on indicators of general health and wellness of Canadians. The CHMS has four components. We used data from the first three components (for Study participants ≥ 20 years) from CHMS cycles 1 through 5. RESULTS Multivariable logistic regression revealed: immigration status [Odds ratio (OR)(95% Confidence Interval (95% CI)) = 0.67 (0.53-0.85), reference category (RC)-no-immigrant] education [1.38(1.10-1.75), RC- > secondary education]; smoking status [ex-smokers: 1.16(0.89-1.51); current smokers: 1.41(0.98-2.05), RC-non-smoker]; and income [middle income: 0.69(0.43-1.10); high income: 0.49(0.29-0.83); RC-lower income] were significantly associated with CVD prevalence. Conclusion The relationship of GGT with CVD prevalence changed among age groups and body mass index categories; was different for males and females; and diabetes was an effect modifier in the relationship between AST and CVD prevalence. Socio-economic factors were significantly associated with CVD prevalence.
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Affiliation(s)
- Punam Pahwa
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
| | - Luan Chu
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
| | - Chandima Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
| | - Palok Aich
- School of Biological Sciences, National Institute of Science Education and Research (NISER), HBNI, PO: Khurda, 752050 Jatni, Odisha India
| | - Markus Hecker
- School of Environment & Sustainability & Toxicology Centre, University of Saskatchewan, Saskatoon, Canada
| | - Anurag Saxena
- College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Philip Griebel
- School of Public Health, University of Saskatchewan, Saskatoon, Canada
| | - Som Niyogi
- Department of Biology and Toxicology Centre, University of Saskatchewan, , Saskatoon, Canada
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Cao L, Tang YJ, Gang M, Ma J, Qian WG, Xu QQ, Lv HT. AST-to-ALT ratio and coronary artery lesions among patients with Kawasaki disease. World J Pediatr 2021; 17:659-668. [PMID: 34792780 DOI: 10.1007/s12519-021-00479-0] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/27/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The aim of this study was to explore the associations between the aspartate aminotransferase-to-alanine aminotransferase ratio (AST/ALT) and coronary artery lesions (CALs) among patients with Kawasaki disease (KD). METHODS Medical records of KD patients presenting to a single center between January 2019 and December 2020 were retrospectively collected and analyzed. Univariate, multivariable-adjusted analyses, subgroup analyses, restricted cubic spline test, and fitted curves were used to evaluate the associations between AST/ALT and CALs. RESULTS A total of 831 patients were enrolled, of which 201 (24.2%) had CALs on admission and 21 (2.5%) developed CALs de novo after intravenous immunoglobulin (IVIG). Multivariable-adjusted analyses models revealed that a lower AST/ALT was associated with an increased risk of CALs on admission when AST/ALT was a continuous variable (P = 0.007) and when it was a categorical variable (P for trend = 0.004). Each unit increase in AST/ALT was associated with a 22% lower risk of CALs on admission (odds ratio = 0.78, 95% confidence interval 0.65-0.94). A negative linear relationship was noted between AST/ALT and the risk of CALs on admission in both observed and fitted models. However, such associations were not observed in AST/ALT and CALs de novo after IVIG. None of the variables significantly modified the association between AST/ALT and CALs on admission and CALs de novo after IVIG (P > 0.05). CONCLUSION Our findings suggested that AST/ALT was a risk factor of CALs, but was not associated with progressive CALs.
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Affiliation(s)
- Lei Cao
- Department of Cardiology, Children's Hospital of Soochow University, No. 92, Zhongnan Street, Suzhou, China
| | - Yun-Jia Tang
- Department of Cardiology, Children's Hospital of Soochow University, No. 92, Zhongnan Street, Suzhou, China
| | - Miao Gang
- Department of Cardiology, Children's Hospital of Soochow University, No. 92, Zhongnan Street, Suzhou, China
| | - Jin Ma
- Department of Pharmacy, Children's Hospital of Soochow University, No 92, Zhongnan Street, Suzhou, China
| | - Wei-Guo Qian
- Department of Cardiology, Children's Hospital of Soochow University, No. 92, Zhongnan Street, Suzhou, China
| | - Qiu-Qin Xu
- Department of Cardiology, Children's Hospital of Soochow University, No. 92, Zhongnan Street, Suzhou, China
| | - Hai-Tao Lv
- Department of Cardiology, Children's Hospital of Soochow University, No. 92, Zhongnan Street, Suzhou, China.
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Denova-Gutiérrez E, Lara-Castor L, Hernández-Alcaraz C, Hernández-Ávila M, Aguilar-Salinas C, Kershenobich D, Barquera S. Prevalence and predictors of elevated liver enzyme levels in Mexico: The Mexican National Health and Nutrition Survey, 2016. Ann Hepatol 2021; 26:100562. [PMID: 34653686 DOI: 10.1016/j.aohep.2021.100562] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVE To determine the prevalence of elevated liver enzyme levels and the fatty liver index according to specific sociodemographic, clinical, anthropometric, and metabolic risk factors in Mexican adult population. MATERIAL AND METHODS The present analysis was conducted using data from the Mexican National Health and Nutrition Survey 2016. For the present study, 3,490 adults with complete information on liver enzymes, sociodemographic, lifestyle, and metabolic factors were analyzed. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) levels were determined from blood samples. We computed the fatty liver Index (FLI), as a surrogate marker of non-alcoholic fatty liver disease. The associations are reported as adjusted odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS At the national level, the prevalence of high serum levels of ALT, AST, and GGT were 7.9%, 13.5, and 12.9 respectively. We observed that men had higher prevalences of altered ALT, GGT and FLI compared to women. Additionally, we observe that individuals with obesity, metabolic syndrome and insulin resistance are significantly more likely to present elevated concentrations of AST, ALT, GGT and FLI. Finally, we found that the subjects of the lowest socioeconomic level and indigenous population were more likely to present elevated levels of AST, ALT, GGT, and FLI. CONCLUSION In Mexico, non-alcoholic fatty liver disease affect people with obesity, diabetes, and metabolic syndrome as well as men, subjects of low socioeconomic status, subjects who live in rural areas and indigenous population. Interventions to reduce this condition should be a public health priority.
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Affiliation(s)
- Edgar Denova-Gutiérrez
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico.
| | - Laura Lara-Castor
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico; Friedman School of Nutrition Science and Policy, Tufts University, Boston, USA
| | - Cesar Hernández-Alcaraz
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Mauricio Hernández-Ávila
- Dirección de prestaciones económicas y sociales, Instituto Mexicano del Seguro Social (Mexican Institute of Social Security)
| | - Carlos Aguilar-Salinas
- National Institute of Medical Sciences and Nutrition, "Salvador Zubirán", Mexico City, Mexico
| | - David Kershenobich
- National Institute of Medical Sciences and Nutrition, "Salvador Zubirán", Mexico City, Mexico
| | - Simón Barquera
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico.
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Song Y, Song J, Zhu Z, Peng H, Ding X, Yang F, Li K, Yu X, Yang G, Tao Y, Bu D, Tang C, Huang Y, Du J, Jin H. Compensatory role of endogenous sulfur dioxide in nitric oxide deficiency-induced hypertension. Redox Biol 2021; 48:102192. [PMID: 34818607 PMCID: PMC8626683 DOI: 10.1016/j.redox.2021.102192] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/11/2021] [Accepted: 11/17/2021] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE This study aimed to determine the communicational pattern of gaseous signaling molecules sulfur dioxide (SO2) and nitric oxide (NO) between vascular endothelial cells (VECs) and vascular smooth muscle cells (VSMCs), and elucidate the compensatory role and significance of endogenous SO2 in the development of hypertension due to NO deficiency. APPROACH AND RESULTS Blood pressure was monitored by the tail-cuff and implantable physiological signal telemetry in L-nitro-arginine methyl ester (l-NAME)-induced hypertensive mice, and structural alterations of mouse aortic vessels were detected by the elastic fiber staining method. l-NAME-treated mice showed decreased plasma NO levels, increased SO2 levels, vascular remodeling, and increased blood pressure, and application of l-aspartate-β-hydroxamate, which inhibits SO2 production, further aggravated vascular structural remodeling and increased blood pressure. Moreover, in a co-culture system of HAECs and HASMCs, NO from HAECs did not influence aspartate aminotransferase (AAT)1 protein expression but decreased AAT1 activity in HASMCs, thereby resulting in the inhibition of endogenous SO2 production. Furthermore, NO promoted S-nitrosylation of AAT1 protein in HASMCs and purified AAT1 protein. Liquid chromatography with tandem mass spectrometry showed that the Cys192 site of AAT1 purified protein was modified by S-nitrosylation. In contrast, dithiothreitol or C192S mutations in HASMCs blocked NO-induced AAT1 S-nitrosylation and restored AAT1 enzyme activity. CONCLUSION Endothelium-derived NO inhibits AAT activity by nitrosylating AAT1 at the Cys192 site and reduces SO2 production in HASMCs. Our findings suggest that SO2 acts as a compensatory defense system to antagonize vascular structural remodeling and hypertension when the endogenous NO pathway is disturbed.
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Affiliation(s)
- Yunjia Song
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Jiaru Song
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Zhigang Zhu
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Hanlin Peng
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Xiang Ding
- Key Laboratory of Protein and Peptide Pharmaceuticals & Laboratory of Proteomics, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101, China
| | - Fuquan Yang
- Key Laboratory of Protein and Peptide Pharmaceuticals & Laboratory of Proteomics, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101, China
| | - Kun Li
- Key Laboratory of Green Chemistry and Technology, Ministry of Education, College of Chemistry, Sichuan University, Chengdu, 610064, China
| | - Xiaoqi Yu
- Key Laboratory of Green Chemistry and Technology, Ministry of Education, College of Chemistry, Sichuan University, Chengdu, 610064, China
| | - Guosheng Yang
- Laboratory Animal Facility, Peking University First Hospital, Beijing, 100034, China
| | - Yinghong Tao
- Laboratory Animal Facility, Peking University First Hospital, Beijing, 100034, China
| | - Dingfang Bu
- Central Laboratory, Peking University First Hospital, Beijing, 100034, China
| | - Chaoshu Tang
- Key Laboratory of Molecular Cardiology, Ministry of Education, Beijing, China
| | - Yaqian Huang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Junbao Du
- Department of Pediatrics, Peking University First Hospital, Beijing, China; Key Laboratory of Molecular Cardiology, Ministry of Education, Beijing, China
| | - Hongfang Jin
- Department of Pediatrics, Peking University First Hospital, Beijing, China.
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Hasani M, Malekahmadi M, Rezamand G, Estêvão MD, Pizarro AB, Heydari H, Hoong WC, Arafah OA, Barakeh ARR, Rahman A, Alrashidi MSK, Abu-Zaid A. Effect of saffron supplementation on liver enzymes: A systematic review and meta-analysis of randomized controlled trials. Diabetes Metab Syndr 2021; 15:102311. [PMID: 34678576 DOI: 10.1016/j.dsx.2021.102311] [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: 06/15/2021] [Revised: 09/13/2021] [Accepted: 10/08/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS Possible protective effects of saffron (Crocus sativus L) have been reported in several randomized clinical trials (RCTs). Current systematic review was performed to summarize the efficacy of saffron intake on liver enzymes. METHODS An electronic database search was conducted on PubMed/Medline, Scopus, Web of Science, and Cochrane for RCTs comparing effect of saffron and placebo on liver enzymes from inception to July 2021. There was no restriction in language of included studies and we calculated the standardized mean difference (SMD) and 95% Confidence Intervals (CI) for each variable. Random-effect model was used to calculate effect size. RESULTS Eight studies (n = 463 participants) were included in the systematic review. The saffron intake was associated with a statistically significant decrease in aspartate aminotransferase (AST) (SMD: -0.18; 95% CI: -0.34, -0.02; I2 = 0%) in comparison to placebo intake. Our results also indicated that saffron consumption did not have a significant effect on alanine aminotransferase (ALT) (SMD: -0.14; 95% CI: -0.36, 0.09; I2 = 47.0%) and alkaline phosphatase (ALP) levels (SMD: 0.14; 95% CI: -0.18, 0.46; I2 = 42.9%) compared to placebo. CONCLUSIONS Saffron intake showed beneficial impacts on circulating AST levels. However, larger well-designed RCTs are still needed to clarify the effect of saffron intake on these and other liver enzymes.
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Affiliation(s)
- Motahareh Hasani
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mahsa Malekahmadi
- Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran; Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Rezamand
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - M Dulce Estêvão
- Universidade do Algarve, Escola Superior de Saúde, Campus de Gambelas, Faro, Portugal.
| | | | - Hafez Heydari
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran.
| | - Wong Chun Hoong
- Department of Pharmacy, Sultanah Aminah Hospital, Johor Bahru, Johor, Malaysia.
| | | | | | - Areej Rahman
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
| | | | - Ahmed Abu-Zaid
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Department of Pharmacology, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN, United States.
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Ilias I, Thomopoulos C. Non-alcoholic fatty liver disease, diabetes medications and blood pressure. World J Diabetes 2021; 12:1809-1811. [PMID: 34754380 PMCID: PMC8554364 DOI: 10.4239/wjd.v12.i10.1809] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/22/2021] [Accepted: 09/06/2021] [Indexed: 02/06/2023] Open
Abstract
New glucose-lowering agents reduce liver enzyme levels and blood pressure (BP). Whether this finding can be extended to non-alcoholic fatty liver disease (NAFLD) patients, in whom a bidirectional association of NAFLD measures and BP has been also demonstrated, remains by and large unknown.
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Affiliation(s)
- Ioannis Ilias
- Department of Endocrinology, Diabetes and Metabolism, Elena Venizelou Hospital, Athens 11521, Greece
| | - Costas Thomopoulos
- Department of Cardiology, Elena Venizelou Hospital, Athens 11521, Greece
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Zhu L, Fang Z, Jin Y, Chang W, Huang M, He L, Chen Y, Yao Y. Association between serum alanine and aspartate aminotransferase and blood pressure: a cross-sectional study of Chinese freshmen. BMC Cardiovasc Disord 2021; 21:472. [PMID: 34598675 PMCID: PMC8485510 DOI: 10.1186/s12872-021-02282-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/24/2021] [Indexed: 12/15/2022] Open
Abstract
Background High blood pressure is a well-recognized risk factor for cardiovascular events, and the incidence of hypertension is increasing among young people. This study investigated the relationship between ALT and AST levels and hypertension among freshmen in China. Methods This cross-sectional study was conducted in the Anhui Province from September to November 2018. A total of 3114 freshmen underwent a physical examination including testing of biochemical indicators and a standardized questionnaire. Results The overall prevalence of elevated ALT and AST were 6.8% and 2.3% among freshmen. The mean ALT and AST levels were higher in males (22.59 ± 21.98 vs.12.62 ± 10.30 U/L; 23.55 ± 12.24 vs. 20.02 ± 5.75 U/L, respectively). The prevalence of hypertension was significantly higher in men (16.1%) than in women (1.9%). The mean values of BMI, SBP, DBP, TC, TG, and LDL-C were found to be increased with elevated levels of serum ALT and AST in the quartiles (P for trend < 0.05). After adjusting for covariates, the risk of hypertension was significantly higher in the highest ALT quartile than in the lowest quartile (OR (95% CI) of 1.681 (1.028, 2.751) in males; 2.802 (1.102, 7.124) in females). A strong linear relationship was found between serum ALT levels and the odds of hypertension after adjustment for potential confounders only in total population and females (P for trend < 0.05). Conclusions These findings suggest that ALT level is significantly associated with hypertension both in male and female freshmen.
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Affiliation(s)
- Lijun Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Wannan Medical College, No. 22, Wenchang Road, Wuhu, 241002, Anhui, China.,Institute of Chronic Disease Prevention and Control, Wannan Medical College, No. 22, Wenchang Road, Wuhu, 241002, Anhui, China
| | - Zhengmei Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Wannan Medical College, No. 22, Wenchang Road, Wuhu, 241002, Anhui, China.,Institute of Chronic Disease Prevention and Control, Wannan Medical College, No. 22, Wenchang Road, Wuhu, 241002, Anhui, China
| | - Yuelong Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Wannan Medical College, No. 22, Wenchang Road, Wuhu, 241002, Anhui, China.,Institute of Chronic Disease Prevention and Control, Wannan Medical College, No. 22, Wenchang Road, Wuhu, 241002, Anhui, China
| | - Weiwei Chang
- Department of Epidemiology and Biostatistics, School of Public Health, Wannan Medical College, No. 22, Wenchang Road, Wuhu, 241002, Anhui, China.,Institute of Chronic Disease Prevention and Control, Wannan Medical College, No. 22, Wenchang Road, Wuhu, 241002, Anhui, China
| | - Mengyun Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Wannan Medical College, No. 22, Wenchang Road, Wuhu, 241002, Anhui, China.,Institute of Chronic Disease Prevention and Control, Wannan Medical College, No. 22, Wenchang Road, Wuhu, 241002, Anhui, China
| | - Lianping He
- School of Medicine, Taizhou University, Taizhou, 318000, China
| | - Yan Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Wannan Medical College, No. 22, Wenchang Road, Wuhu, 241002, Anhui, China. .,Institute of Chronic Disease Prevention and Control, Wannan Medical College, No. 22, Wenchang Road, Wuhu, 241002, Anhui, China.
| | - Yingshui Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Wannan Medical College, No. 22, Wenchang Road, Wuhu, 241002, Anhui, China. .,Institute of Chronic Disease Prevention and Control, Wannan Medical College, No. 22, Wenchang Road, Wuhu, 241002, Anhui, China. .,Department of Medicine, Anhui College of Traditional Chinese Medicine, No.18, Wuxia Shanxi Road, Wuhu, 241002, Anhui, China.
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Aloisio E, Colombo G, Arrigo C, Dolci A, Panteghini M. Sources and clinical significance of aspartate aminotransferase increases in COVID-19. Clin Chim Acta 2021; 522:88-95. [PMID: 34411557 PMCID: PMC8366047 DOI: 10.1016/j.cca.2021.08.012] [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: 07/19/2021] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Aspartate aminotransferase (AST) is often increased in COVID-19 and, in some studies, AST abnormalities were associated with mortality risk. METHODS 2054 hospitalized COVID-19 patients were studied. To identify sources of AST release, correlations between AST peak values and other biomarkers of tissue damage, i.e., alanine aminotransferase (ALT) for hepatocellular damage, creatine kinase (CK) for muscle damage, lactate dehydrogenase for multiorgan involvement, alkaline phosphatase and γ-glutamyltransferase for cholestatic injury, and C-reactive protein (CRP) for systemic inflammation, were performed and coefficients of determination estimated. The role of AST to predict death and intensive care unit admission during hospitalization was also evaluated. All measurements were performed using standardized assays. RESULTS AST was increased in 69% of patients. Increases could be fully explained by summing the effects of hepatocellular injury [AST dependence from ALT, 66.8% [95% confidence interval (CI): 64.5-69.1)] and muscle damage [AST dependence from CK, 42.6% (CI: 39.3-45.8)]. We were unable to demonstrate an independent association of AST increases with worse outcomes. CONCLUSION The mechanisms for abnormal AST in COVID-19 are likely multifactorial and a status related to tissue suffering could play a significant role. The clinical significance of AST elevations remains unclear.
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Affiliation(s)
- Elena Aloisio
- Clinical Pathology Unit, ASST Fatebenefratelli-Sacco, Milan, Italy.
| | - Giulia Colombo
- Clinical Pathology Unit, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Claudia Arrigo
- Clinical Pathology Unit, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Alberto Dolci
- Clinical Pathology Unit, ASST Fatebenefratelli-Sacco, Milan, Italy; Department of Biomedical and Clinical Sciences 'Luigi Sacco', Università degli Studi, Milan, Italy
| | - Mauro Panteghini
- Clinical Pathology Unit, ASST Fatebenefratelli-Sacco, Milan, Italy; Department of Biomedical and Clinical Sciences 'Luigi Sacco', Università degli Studi, Milan, Italy
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Zeng QL, Yu ZJ, Ji F, Li GM, Zhang GF, Xu JH, Lin WB, Zhang GQ, Li GT, Cui GL, Wang FS. Dynamic changes in liver function parameters in patients with coronavirus disease 2019: a multicentre, retrospective study. BMC Infect Dis 2021; 21:818. [PMID: 34399709 PMCID: PMC8365287 DOI: 10.1186/s12879-021-06572-z] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 05/19/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Liver injuries have been reported in patients with coronavirus disease 2019 (COVID-19). This study aimed to investigate the clinical role played by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS In this multicentre, retrospective study, the parameters of liver function tests in COVID-19 inpatients were compared between various time-points in reference to SARS-CoV-2 shedding, and 3 to 7 days before the first detection of viral shedding was regarded as the reference baseline. RESULTS In total, 70 COVID-19 inpatients were enrolled. Twenty-two (31.4%) patients had a self-medication history after illness. At baseline, 10 (14.3%), 7 (10%), 9 (12.9%), 2 (2.9%), 15 (21.4%), and 4 (5.7%) patients already had abnormal alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), albumin, and total bilirubin (TBIL) values, respectively. ALT and AST abnormal rates and levels did not show any significant dynamic changes during the full period of viral shedding (all p > 0.05). The GGT abnormal rate (p = 0.008) and level (p = 0.033) significantly increased on day 10 of viral shedding. Meanwhile, no simultaneous significant increases in abnormal ALP rates and levels were observed. TBIL abnormal rates and levels significantly increased on days 1 and 5 of viral shedding (all p < 0.05). Albumin abnormal decrease rates increased, and levels decreased consistently from baseline to SARS-CoV-2 clearance day (all p < 0.05). Thirteen (18.6%) patients had chronic liver disease, two of whom died. The ALT and AST abnormal rates and levels did not increase in patients with chronic liver disease during SARS-CoV-2 shedding. CONCLUSIONS SARS-CoV-2 does not directly lead to elevations in ALT and AST but may result in elevations in GGT and TBIL; albumin decreased extraordinarily even when SARS-CoV-2 shedding ended.
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Affiliation(s)
- Qing-Lei Zeng
- Department of Infectious Diseases and Hepatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Eastern Jianshe Road, Zhengzhou, 450052, Henan, China.
| | - Zu-Jiang Yu
- Department of Infectious Diseases and Hepatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Eastern Jianshe Road, Zhengzhou, 450052, Henan, China
| | - Fanpu Ji
- Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,Key Laboratory of Environment and Genes Related To Diseases, Ministry of Education of China, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Guang-Ming Li
- Department of Infectious Diseases, The Sixth People's Hospital of Zhengzhou City, Zhengzhou, Henan, China
| | - Guo-Fan Zhang
- The Department of Infectious Diseases, The First Affiliated Hospital of Nanyang Medical College, Nanyang, Henan, China
| | - Jiang-Hai Xu
- The Department of Infectious Diseases, The Fifth People's Hospital of Anyang City, Anyang, Henan, China
| | - Wan-Bao Lin
- The Department of Infectious Diseases, Xinyang Central Hospital, Xinyang, Henan, China
| | - Guo-Qiang Zhang
- The Department of Infectious Diseases, Luoyang Central Hospital, Luoyang, Henan, China
| | - Guo-Tao Li
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Guang-Lin Cui
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Fu-Sheng Wang
- Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Centre for Infectious Diseases, No. 100 Western 4th Middle Ring Road, Fengtai District, Beijing, China.
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40
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Lu JY, Anand H, Frager SZ, Hou W, Duong TQ. Longitudinal progression of clinical variables associated with graded liver injury in COVID-19 patients. Hepatol Int 2021; 15:1018-1026. [PMID: 34268650 PMCID: PMC8280574 DOI: 10.1007/s12072-021-10228-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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] [Received: 03/20/2021] [Accepted: 06/18/2021] [Indexed: 01/18/2023]
Abstract
Background Hospital-acquired liver injury is associated with worse outcomes in COVID-19. This study investigated the temporal progression of clinical variables of in-hospital liver injury in COVID-19 patients. Methods COVID-19 patients (n = 1361) were divided into no, mild and severe liver injury (nLI, mLI and sLI) groups. Time courses of laboratory variables were time-locked to liver-injury onset defined by alanine aminotransferase level. Predictors of liver injury were identified using logistic regression. Results The prevalence of mLI was 39.4% and sLI was 9.2%. Patients with escalated care had higher prevalence of sLI (23.2% vs. 5.0%, p < 0.05). sLI developed 9.4 days after hospitalization. sLI group used more invasive ventilation, anticoagulants, steroids, and dialysis (p < 0.05). sLI, but not mLI, had higher adjusted mortality odds ratio (= 1.37 [95% CI 1.10, 1.70], p = 0.005). Time courses of the clinical variables of the sLI group differed from those of the nLI and mLI group. In the sLI group, alanine aminotransferase, procalcitonin, ferritin, and lactate dehydrogenase showed similar temporal profiles, whereas white-blood-cell count, D-dimer, C-reactive protein, respiration and heart rate were elevated early on, and lymphocyte and SpO2 were lower early on. The top predictors of sLI were alanine aminotransferase, lactate dehydrogenase, respiration rate, ferritin, and lymphocyte, yielding an AUC of 0.98, 0.92, 0.88 and 0.84 at 0, − 1, − 2 and − 3 days prior to onset, respectively. Conclusions This study identified key clinical variables predictive of liver injury in COVID-19, which may prove useful for management of liver injury. Late onset of sLI and more aggressive care are suggestive of treatment-related hepatotoxicity.
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Affiliation(s)
- Justin Y Lu
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 E 210th St, Bronx, NY, 10467, USA
| | - Harnadar Anand
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 E 210th St, Bronx, NY, 10467, USA
| | - Shalom Z Frager
- Department of Medicine, Division of Liver Transplant, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Wei Hou
- Department of Family, Population and Preventive Medicine, Stony Brook Medicine, Stony Brook, NY, USA
| | - Tim Q Duong
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 E 210th St, Bronx, NY, 10467, USA.
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Srivastava S, Garg I. Post COVID-19 infection: Long-term effects on liver and kidneys. World J Meta-Anal 2021; 9:220-233. [DOI: 10.13105/wjma.v9.i3.220] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/07/2021] [Accepted: 06/04/2021] [Indexed: 02/06/2023] Open
Abstract
Coronavirus disease 2019 is a pandemic, which has affected millions of people across the globe in the year 2020. This disease is caused by a virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that belongs to the family of coronaviruses and primarily affects the respiratory system. This infection has a wide spectrum of clinical manifestations ranging from asymptomatic form to mild, moderate and severe forms depending upon the age, comorbidity and immunity of an affected individual. Hyper-inflammatory response due to SARS-CoV-2 adversely affect several internal organs. Besides lung injury, which is the main outcome of SARS-CoV-2 infection, it has been reported to adversely impact other organs including the liver and kidneys. SARS-CoV-2 virus can also have a direct adverse impact on liver as well as kidneys due to systemic inflammatory response or drug toxicity, leading to elevated levels of liver injury markers and acute kidney injury. Clinical outcomes of SARS-CoV-2 infection could be worse in patients suffering from pre-existing liver and kidney disease. So far, there have been several reports on the mechanism of liver and kidney injury during SARS-CoV-2 viral attack. However, the long-term impact of this infection on these organs is yet to be understood. This review summarizes the possible causes and effects of SARS-CoV-2 on the liver and kidneys during the infection and post recovery based on available literature.
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Affiliation(s)
- Swati Srivastava
- Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, New Delhi 110054, Indiana, India
| | - Iti Garg
- Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, New Delhi 110054, Indiana, India
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42
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Pant V, Pradhan S, Gautam K, Pyakurel D. Isolated Increase in Serum Aspartate Aminotransferase in an Asymptomatic Young Nepalese Female. J Appl Lab Med 2021; 5:426-428. [PMID: 32445393 DOI: 10.1093/jalm/jfz004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/01/2019] [Indexed: 11/12/2022]
Affiliation(s)
- Vivek Pant
- Clinical Biochemistry, Samyak Diagnostic Pvt Ltd, Kathmandu, Nepal
| | - Santosh Pradhan
- Clinical Biochemistry, Samyak Diagnostic Pvt Ltd, Kathmandu, Nepal
| | - Keyoor Gautam
- Pathology, Samyak Diagnostic Pvt Ltd, Kathmandu, Nepal
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Ding ZY, Li GX, Chen L, Shu C, Song J, Wang W, Wang YW, Chen Q, Jin GN, Liu TT, Liang JN, Zhu P, Zhu W, Li Y, Zhang BH, Feng H, Zhang WG, Yin ZY, Yu WK, Yang Y, Zhang HQ, Tang ZP, Wang H, Hu JB, Liu JH, Yin P, Chen XP, Zhang B. Association of liver abnormalities with in-hospital mortality in patients with COVID-19. J Hepatol 2021; 74:1295-1302. [PMID: 33347952 PMCID: PMC7749734 DOI: 10.1016/j.jhep.2020.12.012] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 11/25/2020] [Accepted: 12/01/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS The evolution and clinical significance of abnormal liver chemistries and the impact of hepatitis B infection on outcome in patients with COVID-19 is not well characterized. This study aimed to explore these issues. METHODS This large retrospective cohort study included 2,073 patients with coronavirus disease 2019 (COVID-19) and definite outcomes in Wuhan, China. Longitudinal liver function tests were conducted, with associated factors and risk of death determined by multivariate regression analyses. A prognostic nomogram was formulated to predict the survival of patients with COVID-19. The characteristics of liver abnormalities and outcomes of patients with COVID-19, with and without hepatitis B, were compared after 1:3 propensity score matching. RESULTS Of the 2,073 patients, 1,282 (61.8%) had abnormal liver chemistries during hospitalization, and 297 (14.3%) had a liver injury. The mean levels of aspartate aminotransferase (AST) and direct bilirubin (D-Bil) increased early after symptom onset in deceased patients and showed disparity compared to levels in discharged patients throughout the clinical course of the disease. Abnormal AST (adjusted hazard ratio [HR] 1.39; 95% CI 1.04-1.86, p = 0.027) and D-Bil (adjusted HR 1.66; 95% CI 1.22-2.26; p = 0.001) levels at admission were independent risk factors for mortality due to COVID-19. A nomogram was established based on the results of multivariate analysis and showed sufficient discriminatory power and good consistency between the prediction and the observation. HBV infection in patients did not increase the risk of poor COVID-19-associated outcomes. CONCLUSIONS Abnormal AST and D-Bil levels at admission were independent predictors of COVID-19-related mortality. Therefore, monitoring liver chemistries, especially AST and D-Bil levels, is necessary in hospitalized patients with COVID-19. LAY SUMMARY Liver test abnormalities (in particular elevations in the levels of aspartate aminotransferase [AST] and direct bilirubin [D-Bil]) were observed after symptom onset in patients who went on to die of coronavirus disease 2019 (COVID-19). Abnormal levels of AST and D-Bil at admission were independent predictors of COVID-19-related mortality. HBV infection in patients did not increase the risk of poor COVID-19-associated outcomes.
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Affiliation(s)
- Ze-Yang Ding
- Hepatic Surgery Center, and Hubei Key Laboratory of Hepato-Pancreatic-Biliary Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Gan-Xun Li
- Hepatic Surgery Center, and Hubei Key Laboratory of Hepato-Pancreatic-Biliary Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Lin Chen
- Hepatic Surgery Center, and Hubei Key Laboratory of Hepato-Pancreatic-Biliary Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Chang Shu
- Hepatic Surgery Center, and Hubei Key Laboratory of Hepato-Pancreatic-Biliary Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Jia Song
- Hepatic Surgery Center, and Hubei Key Laboratory of Hepato-Pancreatic-Biliary Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Wei Wang
- Hepatic Surgery Center, and Hubei Key Laboratory of Hepato-Pancreatic-Biliary Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Yu-Wei Wang
- Hepatic Surgery Center, and Hubei Key Laboratory of Hepato-Pancreatic-Biliary Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Qian Chen
- Department of Gastroenterology and Hepatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Guan-Nan Jin
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430033, Hubei, China
| | - Tong-Tong Liu
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Jun-Nan Liang
- Hepatic Surgery Center, and Hubei Key Laboratory of Hepato-Pancreatic-Biliary Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Peng Zhu
- Hepatic Surgery Center, and Hubei Key Laboratory of Hepato-Pancreatic-Biliary Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Wei Zhu
- Department of Emergency and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Yong Li
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Bin-Hao Zhang
- Hepatic Surgery Center, and Hubei Key Laboratory of Hepato-Pancreatic-Biliary Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Huan Feng
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Wan-Guang Zhang
- Hepatic Surgery Center, and Hubei Key Laboratory of Hepato-Pancreatic-Biliary Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Zhen-Yu Yin
- Medical team supporting Hubei and Department of Hepatobiliary Surgery, ZhongShan Hospital of Xiamen University, Xiamen, 361004, Fujian, China
| | - Wen-Kui Yu
- First branch of medical teams from Nanjing to support Hubei and Department of Critical Care Medicine, the Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, Jiangsu, China
| | - Yang Yang
- Medical team supporting Hubei and Department of Hepatic Surgery and Liver transplantation Center, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, Guangdong, China
| | - Hua-Qiu Zhang
- Department of Neurosurgery, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Zhou-Ping Tang
- Department of Neurology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Hui Wang
- Department of Gynecological Oncology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Jun-Bo Hu
- Department of Gastrointestinal Surgery, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430033, Hubei, China.
| | - Ji-Hong Liu
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
| | - Ping Yin
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Xiao-Ping Chen
- Hepatic Surgery Center, and Hubei Key Laboratory of Hepato-Pancreatic-Biliary Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
| | - Bixiang Zhang
- Hepatic Surgery Center, and Hubei Key Laboratory of Hepato-Pancreatic-Biliary Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
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Pondugula SR, Salamat JM, Abbott KL, Flannery PC, Majrashi M, Almaghrabi M, Govindarajulu M, Ramesh S, Onteru SK, Sandey M, Huang CC, Gill K, Narayanan N, McElroy E, Desai D, Nadar R, Moore T, Nagabhushanam K, Majeed M, Dhanasekaran M. Oroxylum indicum extract, at a physiologically relevant dosage, does not induce hepatotoxicity in C57BL/6J mice. Nat Prod Commun 2021; 16. [PMID: 34306298 DOI: 10.1177/1934578x211016966] [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: 11/16/2022] Open
Abstract
Background Botanical supplements have been proven to provide beneficial health effects. However, they can induce unintended adverse events such as hepatotoxicity. Oroxylum indicum extract (OIE, Sabroxy®) has several health benefits including anti-inflammatory, anti-arthritic, antifungal, antibacterial, and neuroprotective effects. It is currently unknown whether OIE has the potential to induce hepatotoxicity. Purpose In the current study, we sought to determine whether OIE can induce hepatotoxicity in C57BL/6J mouse model. Methods The male mice were fed powdered rodent food (control group) or powdered rodent food mixed with OIE (Sabroxy®, 500mg/kg) daily for 4 weeks. Following the treatment, we assessed liver histology and serum levels of biomarkers commonly associated with liver damage, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP). Results No significant alterations were observed in liver histology, and serum levels of ALT, AST, ALP, bilirubin, albumin, globulin and total protein in the OIE fed mice compared to the control mice. Conclusion Taken together, our results suggest that OIE, when fed at its physiologically relevant dosage, does not induce hepatotoxicity in C57BL/6J mice.
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Affiliation(s)
- Satyanarayana R Pondugula
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA
| | - Julia M Salamat
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA
| | - Kodye L Abbott
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA
| | - Patrick C Flannery
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA
| | - Mohammed Majrashi
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL 36849, USA
| | - Mohammed Almaghrabi
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL 36849, USA
| | - Manoj Govindarajulu
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL 36849, USA
| | - Sindhu Ramesh
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL 36849, USA
| | - Suneel K Onteru
- Animal Biochemistry Division, National Dairy Research Institute, ICAR-NDRI, Karnal, Haryana 132001, India
| | - Maninder Sandey
- Department of Pathobiology, College of Veterinary Medicine, Auburn Univeristy, AL 36849, USA
| | - Chen-Che Huang
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA
| | - Kristina Gill
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA
| | - Natasha Narayanan
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA
| | - Edwin McElroy
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA
| | - Darshini Desai
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL 36849, USA
| | - Rishi Nadar
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL 36849, USA
| | - Timothy Moore
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL 36849, USA
| | | | | | - Muralikrishnan Dhanasekaran
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL 36849, USA
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Azizi N, Amini MR, Djafarian K, Shab-Bidar S. The Effects of Nigella sativa Supplementation on Liver Enzymes Levels: a Systematic Review and Meta-analysis of Randomized Controlled Trials. Clin Nutr Res 2021; 10:72-82. [PMID: 33564654 PMCID: PMC7850820 DOI: 10.7762/cnr.2021.10.1.72] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/26/2021] [Accepted: 01/26/2021] [Indexed: 12/30/2022] Open
Abstract
The present systematic review and meta-analysis aimed to investigate the effects of Nigella sativa (N. sativa) supplementation on liver enzymes levels including aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Relevant studies, published from inception up to January 2020, were searched through PubMed, Scopus and Google Scholar conducted on randomized controlled trials (RCTs) investigating the effect of N. sativa on serum AST and ALT levels. Meta-analysis was applied using a random-effects model. Eight studies met inclusion criteria (n=281 in the N. sativa and n = 279 in placebo group). This meta-analysis showed that N. sativa supplementation significantly reduced AST level (weighted mean difference [WMD], −8.11 IU/L; 95% confidence interval [CI], −13.6, −2.53; p = 0.004) with significant heterogeneity (I-squared, 95.9%; p < 0.001) while the decrease in ALT level was not statistically significant (WMD, −7.26 IU/L; 95% CI, −15.4, 0.04; p = 0.051) with significant heterogeneity (I-squared, 97.8%; p < 0.001). This meta-analysis suggests that N. sativa supplementation may improve AST levels and ALT levels, however more RCTs with larger sample size are needed to found effects of N. sativa on liver enzymes in patients with non-alcoholic fatty liver disease.
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Affiliation(s)
- Neda Azizi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14167-53955, Iran
| | - Mohammad Reza Amini
- Department of Clinical Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 19839-63113, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14167-53955, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14167-53955, Iran
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Shafiq M, Walmann T, Nutalapati V, Gibson C, Zafar Y. Effects of proprotein convertase subtilisin/kexin type-9 inhibitors on fatty liver. World J Hepatol 2020; 12:1258-1167. [PMID: 33442452 PMCID: PMC7772734 DOI: 10.4254/wjh.v12.i12.1258] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/07/2020] [Accepted: 11/13/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Many studies have investigated the progression of nonalcoholic fatty liver disease (NAFLD) and its predisposing risk factors, but the conclusions from these studies have been conflicting. More challenging is the fact that no effective treatment is currently available for NAFLD.
AIM To determine the effects of proprotein convertase subtilisin/kexin type-9 (PCSK9) inhibitors on fatty infiltration of the liver.
METHODS This retrospective, chart review-based study was conducted on patients, 18-year-old and above, who were currently on PCSK9 inhibitor drug therapy. Patients were excluded from the study according to missing pre- or post-treatment imaging or laboratory values, presence of cirrhosis or rhabdomyolysis, or development of acute liver injury during the PCSK9 inhibitor treatment period; the latter being due to false elevation of liver function markers, alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Radiographic improvement was assessed by a single radiologist, who read both the pre- and post-treatment images to minimize reading bias. Fatty infiltration of the liver was also assessed by changes in ALT and AST, with pre- and post-treatment levels compared by paired t-test (alpha criterion: 0.05).
RESULTS Of the 29 patients included in the study, 8 were male (27.6%) and 21 were female (72.4%). Essential hypertension was present in 25 (86.2%) of the patients, diabetes mellitus in 18 (62.1%) and obesity in 15 (51.7%). In all, patients were on PCSK9 inhibitors for a mean duration of 23.69 ± 11.18 mo until the most recent ALT and AST measures were obtained. Of the 11 patients who received the radiologic diagnosis of hepatic steatosis, 8 (72.73%) achieved complete radiologic resolution upon use of PCSK9 inhibitors (mean duration of 17.6 mo). On average, the ALT level (IU/L) decreased from 21.83 ± 11.89 at pretreatment to 17.69 ± 8.00 at post-treatment (2-tailed P = 0.042) and AST level (IU/L) decreased from 22.48 ± 9.00 pretreatment to 20.59 ± 5.47 post-treatment (2-tailed P = 0.201).
CONCLUSION PCSK9 inhibitors can slow down or even completely resolve NAFLD.
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Affiliation(s)
- Muhammad Shafiq
- General and Geriatric Medicine, University of Kansas Medical Center, Kansas City, KS 66160, United States
| | - Timothy Walmann
- Department of Diagnostic Radiology, University of Kansas Medical Center, Kansas City, KS 66160, United States
| | - Venkat Nutalapati
- Department of Gastroenterology, University of Kansas Medical Center, Kansas City, KS 66160, United States
| | - Cheryl Gibson
- General and Geriatric Medicine, University of Kansas Medical Center, Kansas City, KS 66160, United States
| | - Yousaf Zafar
- Internal Medicine, NCH Health Care System, Naples, FL 34102, United States
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Ndrepepa G, Holdenrieder S, Cassese S, Xhepa E, Fusaro M, Laugwitz KL, Schunkert H, Kastrati A. Aspartate aminotransferase and mortality in patients with ischemic heart disease. Nutr Metab Cardiovasc Dis 2020; 30:2335-2342. [PMID: 32917497 DOI: 10.1016/j.numecd.2020.07.033] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 05/12/2020] [Accepted: 07/21/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND AIMS Evidence on the association between aspartate aminotransferase (AST) activity and mortality of patients with ischemic heart disease (IHD) is limited. We investigated whether there is an association between AST activity and mortality in IHD patients. METHODS AND RESULTS The study included 6857 patients with coronary angiography-proven IHD and AST activity within the reference range. AST activity measurements were available in all patients. The primary outcome was 3-year cardiac mortality. Patients were categorized in groups according to the AST activity tertiles: a group with AST within the 1st tertile (AST < 17.0 U/L), a group with AST within the 2nd tertile (AST > 17-24.5 U/L) and a group with AST within the 3rd tertile (AST > 24.5 U/L). Cardiac death (n = 297) occurred in 109, 69 and 119 patients in the 1st to 3rd AST tertiles (Kaplan-Meier estimates of mortality: 5.3%, 3.6% and 5.9%; univariable hazard ratio [HR] = 1.75, 95% confidence interval [CI] 1.30-2.36, P < 0.001 for tertile 3 vs. 2; HR = 1.13 [0.87-1.46], P = 0.370 for tertile 3 vs. 1; and HR = 0.65 [0.48-0.87], P = 0.004 for tertile 2 vs. 1). The association between AST and cardiac mortality was U-shaped. AST values <15 U/L (HR = 1.118 [1.009-1.238]) and >23 U/L (HR = 1.029 [1.003-1.056]) were associated with higher cardiac mortality compared with the reference value (21 U/L). After adjustment, the association between AST and cardiac mortality was attenuated (P = 0.133) but remained non-linear (P = 0.047). CONCLUSIONS In patients with IHD, AST activity was associated with the risk of cardiac mortality with a U-shaped relationship. After adjustment, the association between AST and mortality was attenuated.
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Affiliation(s)
- Gjin Ndrepepa
- Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
| | - Stefan Holdenrieder
- Institut für Laboratoriumsmedizin, Deutsches Herzzentrum München, Technische Universität, Munich, Germany
| | - Salvatore Cassese
- Deutsches Herzzentrum München, Technische Universität, Munich, Germany
| | - Erion Xhepa
- Deutsches Herzzentrum München, Technische Universität, Munich, Germany
| | | | - Karl-Ludwig Laugwitz
- 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Heribert Schunkert
- Deutsches Herzzentrum München, Technische Universität, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Adnan Kastrati
- Deutsches Herzzentrum München, Technische Universität, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
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Lin X, Yang M, Liu X, Cheng Z, Ge F. Characterization of Lysine Monomethylome and Methyltransferase in Model Cyanobacterium Synechocystis sp. PCC 6803. Genomics Proteomics Bioinformatics 2020; 18:289-304. [PMID: 33130100 PMCID: PMC7801250 DOI: 10.1016/j.gpb.2019.04.005] [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] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 03/03/2019] [Accepted: 04/19/2019] [Indexed: 12/25/2022]
Abstract
Protein lysine methylation is a prevalent post-translational modification (PTM) and plays critical roles in all domains of life. However, its extent and function in photosynthetic organisms are still largely unknown. Cyanobacteria are a large group of prokaryotes that carry out oxygenic photosynthesis and are applied extensively in studies of photosynthetic mechanisms and environmental adaptation. Here we integrated propionylation of monomethylated proteins, enrichment of the modified peptides, and mass spectrometry (MS) analysis to identify monomethylated proteins in Synechocystis sp. PCC 6803 (Synechocystis). Overall, we identified 376 monomethylation sites in 270 proteins, with numerous monomethylated proteins participating in photosynthesis and carbon metabolism. We subsequently demonstrated that CpcM, a previously identified asparagine methyltransferase in Synechocystis, could catalyze lysine monomethylation of the potential aspartate aminotransferase Sll0480 both in vivo and in vitro and regulate the enzyme activity of Sll0480. The loss of CpcM led to decreases in the maximum quantum yield in primary photosystem II (PSII) and the efficiency of energy transfer during the photosynthetic reaction in Synechocystis. We report the first lysine monomethylome in a photosynthetic organism and present a critical database for functional analyses of monomethylation in cyanobacteria. The large number of monomethylated proteins and the identification of CpcM as the lysine methyltransferase in cyanobacteria suggest that reversible methylation may influence the metabolic process and photosynthesis in both cyanobacteria and plants.
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Affiliation(s)
- Xiaohuang Lin
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China; Key Laboratory of Algal Biology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China; University of Chinese Academy of Sciences, Beijing 100039, China
| | - Mingkun Yang
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China; Key Laboratory of Algal Biology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China
| | - Xin Liu
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China; Key Laboratory of Algal Biology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China; University of Chinese Academy of Sciences, Beijing 100039, China
| | - Zhongyi Cheng
- Jingjie PTM BioLab (Hangzhou) Co. Ltd, Hangzhou 310018, China
| | - Feng Ge
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China; Key Laboratory of Algal Biology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China.
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Suresh Kumar VC, Harne PS, Mukherjee S, Gupta K, Masood U, Sharma AV, Lamichhane J, Dhamoon AS, Sapkota B. Transaminitis is an indicator of mortality in patients with COVID-19: A retrospective cohort study. World J Hepatol 2020; 12:619-627. [PMID: 33033568 PMCID: PMC7522557 DOI: 10.4254/wjh.v12.i9.619] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 07/03/2020] [Accepted: 08/25/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Since its discovery in Wuhan, China in December of 2019, the novel coronavirus has progressed to become one of the worst pandemics seen in the last 100 years. Recently, there has been an increased interest in the hepatic manifestations of coronavirus disease 19 (COVID-19).
AIM To describe the demographic and clinical characteristics of COVID-19 positive patients and study the association between transaminitis and all-cause mortality.
METHODS This is a descriptive retrospective cohort study of 130 consecutive patients with a positive COVID PCR test admitted between March 16, 2020 to May 14, 2020 at a tertiary care University-based medical center. The Wilcoxon-rank sum test and paired t-test were used for comparing non-parametric and parametric continuous variables respectively and a multivariable logistic regression models to study the association between transaminitis and mortality using SAS version 9.4 (SAS Institute, Cary, NC, United States).
RESULTS Out of the 130 patients, 73 (56%) patients were found to have transaminitis and 57 (44%) did not. When compared to patients without transaminitis, the transaminitis group was found to have a higher median body mass index (30.2 kg/m2vs 27.3 kg/m2, P = 0.04). In the multivariate analysis those with transaminitis were found to have 3.4 times higher odds of dying as compared to those without transaminitis adjusting for gender, the Age-adjusted Charlson Comorbidity Index and admission to the intensive care unit (P = 0.03).
CONCLUSION Our study showed that transaminitis on admission was associated with severe clinical outcomes such as admission to the intensive care unit, need for mechanical ventilation, and mortality.
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Affiliation(s)
| | - Prateek Suresh Harne
- Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY 13202, United States
| | - Samiran Mukherjee
- Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY 13202, United States
| | - Kashvi Gupta
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, United States
| | - Umair Masood
- Division of Gastroenterology, SUNY Upstate Medical University, Syracuse, NY 13202, United States
| | - Anuj Vikrant Sharma
- Division of Gastroenterology, SUNY Upstate Medical University, Syracuse, NY 13202, United States
| | - Jivan Lamichhane
- Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY 13202, United States
| | - Amit Singh Dhamoon
- Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY 13202, United States
| | - Bishnu Sapkota
- Division of Gastroenterology, SUNY Upstate Medical University, Syracuse, NY 13202, United States
- Division of Gastroenterology, Syracuse VA medical Center, Syracuse, NY 13202, United States
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50
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Abstract
The activities of the transaminases (aminotransferases) alanine aminotransferase and aspartate aminotransferase in the blood (serum or plasma) are widely used as sensitive markers of possible tissue damage and, in particular for liver toxicity. On the other hand, an increase in transaminase activities is not always accompanied by findings suggestive of hepatotoxicity. Transaminases are some of the key enzymes in the gluconeogenesis and glycolysis pathways and exist in many organs and tissues which have high activities of the gluconeogenesis and glycolysis. The activities of transaminases are altered not only in the liver but also in other organs by modification of gluconeogenesis by nutritional or hormonal factors and this phenomenon leads to alteration of transaminase activity in the blood. Drugs, which are considered to directly or secondarily modify gluconeogenesis through lowering blood glucose levels or activating lipid metabolism, such as α-glucosidase inhibitors and fibrates, slightly increase transaminase activities in the blood but there is little evidence that the phenomenon is related to drug-induced liver injury (DILI). This type of elevations can be called pharmacology-related elevation. The pharmacology-related elevation of transaminase activities sometimes makes it difficult to assess precisely the potential hepatotoxicity of new investigational drugs. Considering the characteristic of transaminases, concomitant use of new biomarkers more specific to hepatic injury is needed in the assessment of DILI both in non-clinical and clinical studies. In this review, we will discuss the specificity of transaminases to DILI and future perspectives for transaminases in the estimation of risk of DILI.
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Affiliation(s)
- Akio Kobayashi
- Toxicology Research Lab., Central Pharmaceutical Research Institute, JAPAN TOBACCO INC
| | - Yusuke Suzuki
- Toxicology Research Lab., Central Pharmaceutical Research Institute, JAPAN TOBACCO INC
| | - Shoichiro Sugai
- Toxicology Research Lab., Central Pharmaceutical Research Institute, JAPAN TOBACCO INC
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