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Qiao TT, Liu Y, Peng N, Gong LZ, Dou XL, Wen L, Lu J. [Analysis of clinical manifestations and prognosis of primary systemic light chain amyloidosis with liver involvement]. Zhonghua Gan Zang Bing Za Zhi 2024; 32:222-227. [PMID: 38584103 DOI: 10.3760/cma.j.cn501113-20231108-00185] [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] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Objective: To summarize the clinical manifestations and prognostic factors of patients with hepatic amyloidosis in a single center. Methods: The clinical data of 28 primary systemic light chain amyloidosis cases with liver involvement in our center from October 2012 to January 2023 were retrospectively analyzed. The main clinical manifestations and prognostic factors were studied. Statistical analysis were performed using the χ(2) test, Fisher's exact test, Wilcoxon rank test, or Kaplan-Meier survival curve log-rank test according to the different data. Results: The main clinical manifestations of patients with liver involvement were abdominal distension, hepatomegaly, and edema. CD56 and chemokine receptor 4 protein expression accounted for 52% (13/25) and 56% (14/25). 64.3% (9/14) patients were combined with t (11,14), and 21.4% (3/14) patients were positive for 1q21 (+), and no patients were detected with del(17p). Univariate analysis showed that Mayo 2004 and 2012 stages and total bilirubin (TBil) ≥34.2 μmol/L were associated with progression-free survival and overall survival. The median progression-free survival and overall survival were significantly inferior in patients with TBil≥34.2μmol/L group (0.178 years, 0.195 years) than with the TBil<34.2μmol/L group (0.750 years, 3.586 years) (P < 0.05). Conclusion: Mayo stage and hyperbilirubinemia are inferior prognostic factors for patients with primary systemic light chain amyloidosis accompanied with liver involvement.
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Affiliation(s)
- T T Qiao
- Department of Hematology, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Bejing 100044, China Hebei Provincial Traditional Chinese Medicine Hospital, Shijiazhuang 050033, China
| | - Y Liu
- Department of Hematology, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Bejing 100044, China
| | - N Peng
- Department of Hematology, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Bejing 100044, China
| | - L Z Gong
- Department of Hematology, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Bejing 100044, China
| | - X L Dou
- Department of Hematology, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Bejing 100044, China
| | - L Wen
- Department of Hematology, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Bejing 100044, China
| | - J Lu
- Department of Hematology, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Bejing 100044, China
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Zhao Y, Zhu W, Wang M, Cai L, Zheng X, Jin L. High serum total bilirubin as a potential protective factor for gestational diabetes mellitus: A retrospective cohort study of 92,885 Chinese pregnant women. Diabetes Metab 2024; 50:101523. [PMID: 38341132 DOI: 10.1016/j.diabet.2024.101523] [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] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/04/2024] [Accepted: 02/02/2024] [Indexed: 02/12/2024]
Abstract
AIMS Identifying physiological factors that could reduce pregnant women's risk for developing gestational diabetes mellitus (GDM) is crucial for early prevention and intervention. We aimed to examine whether higher serum levels of total bilirubin (TBIL) were associated with a decreased risk of GDM. METHODS We conducted a retrospective cohort study in a tertiary care hospital in Shanghai, China. A total of 92,885 pregnant women were included. Serum TBIL levels were determined during the first antenatal visit before 24 weeks of gestation and GDM was diagnosed with a 75-g oral glucose tolerance test (OGTT) at 24-28 weeks of gestation. RESULTS A total of 13,037 GDM cases were identified, a prevalence of 14.0 % (13,037/92,885). These women had a higher median TBIL concentration 7.9 versus 7.6 mmol/l (P < 0.001). For the 91,051 women with TBIL within the physiologically normal range (≤ 17.1 μmol/l), a one interquartile range increase in TBIL (3.4 μmol/l) was associated with a decreased risk of GDM: adjusted odds ratio (OR)=0.89 [95 % CI 0.87;0.92]. For these women, the adjusted ORs for GDM across TBIL quartiles were: 0.92 [0.88;0.97] for the second, 0.85 [0.81;0.90] for the third, and 0.78 [0.74;0.83] for the fourth quartile in comparison with the first quartile. CONCLUSION Our study demonstrated that elevated serum TBIL levels were associated with decreased risk of GDM and supported its potential role in the prevention and early intervention of GDM.
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Affiliation(s)
- Yan Zhao
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China; Hospital of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, China
| | - Wenyu Zhu
- Institute of Clinical Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Miao Wang
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Luyi Cai
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xueying Zheng
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
| | - Liping Jin
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China; Hospital of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, China.
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Chen J, Zhang WC, Tang XQ, Yin RH, Wang T, Wei XY, Pan CJ. Predictive value of bilirubin and serum γ-glutamyltranspeptidase levels in type-2 diabetes mellitus patients with acute coronary syndrome. World J Diabetes 2024; 15:34-42. [PMID: 38313856 PMCID: PMC10835495 DOI: 10.4239/wjd.v15.i1.34] [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: 08/09/2023] [Revised: 11/13/2023] [Accepted: 12/08/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Cardiovascular disease is a major complication of diabetes mellitus (DM). Type-2 DM (T2DM) is associated with an increased risk of cardiovascular events and mortality, while serum biomarkers may facilitate the prediction of these outcomes. Early differential diagnosis of T2DM complicated with acute coronary syndrome (ACS) plays an important role in controlling disease progression and improving safety. AIM To investigate the correlation of serum bilirubin and γ-glutamyltranspeptidase (γ-GGT) with major adverse cardiovascular events (MACEs) in T2DM patients with ACS. METHODS The clinical data of inpatients from January 2022 to December 2022 were analyzed retrospectively. According to different conditions, they were divided into the T2DM complicated with ACS group (T2DM + ACS, n = 96), simple T2DM group (T2DM, n = 85), and simple ACS group (ACS, n = 90). The clinical data and laboratory indices were compared among the three groups, and the correlations of serum total bilirubin (TBIL) levels and serum γ-GGT levels with other indices were discussed. T2DM + ACS patients received a 90-day follow-up after discharge and were divided into event (n = 15) and nonevent (n = 81) groups according to the occurrence of MACEs; Univariate and multivariate analyses were further used to screen the independent influencing factors of MACEs in patients. RESULTS The T2DM + ACS group showed higher γ-GGT, total cholesterol, low-density lipoprotein cholesterol (LDL-C) and glycosylated hemoglobin (HbA1c) and lower TBIL and high-density lipoprotein cholesterol levels than the T2DM and ACS groups (P < 0.05). Based on univariate analysis, the event and nonevent groups were significantly different in age (t = 3.3612, P = 0.0011), TBIL level (t = 3.0742, P = 0.0028), γ-GGT level (t = 2.6887, P = 0.0085), LDL-C level (t = 2.0816, P = 0.0401), HbA1c level (t = 2.7862, P = 0.0065) and left ventricular ejection fraction (LEVF) levels (t=3.2047, P = 0.0018). Multivariate logistic regression analysis further identified that TBIL level and LEVF level were protective factor for MACEs, and age and γ-GGT level were risk factors (P < 0.05). CONCLUSION Serum TBIL levels are decreased and γ-GGT levels are increased in T2DM + ACS patients, and the two indices are significantly negatively correlated. TBIL and γ-GGT are independent influencing factors for MACEs in such patients.
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Affiliation(s)
- Jie Chen
- Radiology Department, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, Jiangsu Province, China
| | - Wan-Chao Zhang
- Radiology Department, The People’s Hospital of WuQia County, Wuqia 845450, Xinjiang Uygur Autonomous Region, China
| | - Xiao-Qiang Tang
- Radiology Department, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, Jiangsu Province, China
| | - Ruo-Han Yin
- Radiology Department, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, Jiangsu Province, China
| | - Tao Wang
- Radiology Department, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, Jiangsu Province, China
| | - Xiao-Yu Wei
- Radiology Department, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, Jiangsu Province, China
| | - Chang-Jie Pan
- Radiology Department, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, Jiangsu Province, China
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Nara K, Yamamoto T, Yamashita H, Yagi K, Takada T, Seto Y, Suzuki H. Prior treatment with oxaliplatin-containing regimens and higher total bilirubin levels are risk factors for neutropenia and febrile neutropenia in patients with gastric or esophagogastric junction cancer receiving weekly paclitaxel and ramucirumab therapy: a single center retrospective study. BMC Cancer 2023; 23:979. [PMID: 37833660 PMCID: PMC10571405 DOI: 10.1186/s12885-023-11469-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] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 10/02/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Weekly paclitaxel + ramucirumab (wPTX + RAM) therapy is recommended as the standard second-line chemotherapy regimen for unresectable advanced/recurrent gastric cancer (GC) or esophagogastric junction cancer. Recent subgroup analysis of the RAINBOW trial revealed a higher frequency of severe neutropenia due to wPTX + RAM in Japanese compared to Western patients. However, no risk factors for severe neutropenia have been identified. METHODS This retrospective observational study included patients with advanced/unresectable gastric or esophagogastric junction cancer who received wPTX + RAM after failure to respond to platinum and fluoropyrimidine doublet chemotherapy between June 2015 and April 2020. We conducted multivariable logistic regression analyses to identify the risk factors associated with grade 4 neutropenia and febrile neutropenia (FN). In addition, we investigated the relationship between the number of risk factors and overall survival (OS) and progression-free survival (PFS). RESULTS Among 66 patients who met the inclusion criteria, grade 4 neutropenia and FN occurred in 21 (31.8%) and 12 (18.2%) patients, respectively. Prior treatment with oxaliplatin-containing regimens was identified as an independent risk factor for developing grade 4 neutropenia (odds ratio (OR) 20.034, 95% confidence interval (95% CI) 3.216-124.807, P = 0.001). Total bilirubin of > 1.5 mg/dL (OR 31.316, 95% CI 2.052-477.843, P = 0.013) and prior treatment with oxaliplatin-containing regimen (OR 12.502, 95% CI 1.141-137.022, P = 0.039) were identified as independent risk factors for developing FN. Next, we classified patients with 0, 1, 2 risk factor(s) as RF-0, RF-1, and RF-2 subgroups, respectively, and compared the PFS and OS among the three subgroups. PFS was not significantly different among the three subgroups, whereas OS was significantly shorter in the RF-2 subgroup (median 1.4 month, 95% CI 0.0-5.3 month) than in the RF-0 subgroup (median 10.2 month, 95% CI 6.8-13.5 month, P < 0.01 vs RF-2) and RF-1 subgroup (median 13.3 month, 95% CI 10.9-15.7 month, P < 0.01 vs RF-2). CONCLUSIONS Careful monitoring for grade 4 neutropenia and FN is needed for patients receiving wPTX + RAM therapy who have a history of treatment with oxaliplatin-containing regimens and higher total bilirubin levels.
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Affiliation(s)
- Katsuhiko Nara
- Department of Pharmacy, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
| | - Takehito Yamamoto
- Department of Pharmacy, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- The Education Center for Clinical Pharmacy, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Hiroharu Yamashita
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Koichi Yagi
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Tappei Takada
- Department of Pharmacy, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Hiroshi Suzuki
- Department of Pharmacy, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
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Qian XJ, Wen ZM, Huang XM, Feng HJ, Lin SS, Liu YN, Li SC, Zhang Y, Peng WG, Yang JR, Zheng ZY, Zhang L, Zhang DW, Lu FM, Liu LJ, Pan WD. Better performance of PIVKA-II for detecting hepatocellular carcinoma in patients with chronic liver disease with normal total bilirubin. World J Gastroenterol 2023; 29:1359-1373. [PMID: 36925461 PMCID: PMC10011960 DOI: 10.3748/wjg.v29.i8.1359] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/30/2022] [Accepted: 02/16/2023] [Indexed: 02/28/2023] Open
Abstract
BACKGROUND Serum protein induced by vitamin K absence or antagonist-II (PIVKA-II) is a promising biomarker for hepatocellular carcinoma (HCC) surveillance.
AIM To identify the contributing factors related to the abnormal elevation of PIVKA-II level and assess their potential influence on the performance of PIVKA-II in detecting HCC.
METHODS This study retrospectively enrolled in 784 chronic liver disease (CLD) patients and 267 HCC patients in Mengchao Hepatobiliary Hospital of Fujian Medical University from April 2016 to December 2019. Logistic regression and the area under the receiver operating characteristic curve (AUC) were used to evaluate the influencing factors and diagnostic performance of PIVKA-II for HCC, respectively.
RESULTS Elevated PIVKA-II levels were independently positively associated with alcohol-related liver disease, serum alkaline phosphatase (ALP), and total bilirubin (TBIL) for CLD patients and aspartate aminotransferase (AST) and tumor size for HCC patients (all P < 0.05). Serum PIVKA-II were significantly lower in patients with viral etiology, ALP ≤ 1 × upper limit of normal (ULN), TBIL ≤ 1 × ULN, and AST ≤ 1 × ULN than in those with nonviral disease and abnormal ALP, TBIL, or AST (all P < 0.05), but the differences disappeared in patients with early-stage HCC. For patients with TBIL ≤ 1 × ULN, the AUC of PIVKA-II was significantly higher compared to that in patients with TBIL > 1 × ULN (0.817 vs 0.669, P = 0.015), while the difference between ALP ≤ 1 × ULN and ALP > 1 × ULN was not statistically significant (0.783 vs 0.729, P = 0.398). These trends were then more prominently perceived in subgroups of patients with viral etiology and HBV alone.
CONCLUSION Serum PIVKA-II has better performance in detecting HCC at an early stage for CLD patients with normal serum TBIL.
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Affiliation(s)
- Xiang-Jun Qian
- Department of Pancreatic Hepatobiliary Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
- Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China
| | - Zhu-Mei Wen
- Department of Laboratory Medicine, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350025, Fujian Province, China
| | - Xiao-Ming Huang
- Department of Pancreatic Hepatobiliary Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
| | - Hui-Juan Feng
- Department of Laboratory Medicine, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350025, Fujian Province, China
| | - Shan-Shan Lin
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, United States
| | - Yan-Na Liu
- Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China
| | - Sheng-Cong Li
- Department of Laboratory Medicine, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350025, Fujian Province, China
| | - Yu Zhang
- Department of Laboratory Medicine, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350025, Fujian Province, China
| | - Wen-Guang Peng
- Department of Pancreatic Hepatobiliary Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
| | - Jia-Rui Yang
- Department of Pancreatic Hepatobiliary Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
| | - Zhe-Yu Zheng
- Department of Pancreatic Hepatobiliary Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
| | - Lei Zhang
- Department of Pancreatic Hepatobiliary Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
| | - Da-Wei Zhang
- Department of Pancreatic Hepatobiliary Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
| | - Feng-Min Lu
- Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China
| | - Li-Juan Liu
- Department of Laboratory Medicine, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350025, Fujian Province, China
| | - Wei-Dong Pan
- Department of Pancreatic Hepatobiliary Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
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Zhang K, Chen Y, Zheng Z, Tang C, Zhu D, Xia X, Huang L, Du Q, Liu Y, Jin Z. Relationship between the expression levels of CD4+ T cells, IL-6, IL-8 and IL-33 in the liver of biliary atresia and postoperative cholangitis, operative age and early jaundice clearance. Pediatr Surg Int 2022; 38:1939-47. [PMID: 36242601 DOI: 10.1007/s00383-022-05258-0] [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] [Accepted: 10/03/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To investigate the expression levels of CD4+ T cells, IL-6, IL-8 and IL-33 in liver tissue of BA, and the relationship with postoperative cholangitis, operative age and early jaundice clearance. METHODS 45 cases of jaundice treated in the hospital from June 2018 to May 2020 were analyzed retrospectively. The expression and distribution of these factors were detected by HE staining and immunohistochemistry, the total bilirubin level and the incidence of cholangitis were recorded, and the relationship between liver inflammation level and the postoperative incidence of cholangitis, age of operation and early jaundice clearance were compared. RESULTS Immunohistochemistry showed that the expression of CD4+ T cells, IL-6, IL-8 and IL-33 in the BA group were higher than those in the CBD group. ROC curve analysis showed the AUC of CD4+ T cells, IL-6 and IL-8 were 0.869, 0.886 and 0.838, respectively. The expression level of CD4+ T cells was negatively correlated with the decline rate of TBIL 3 months after operation, and the expressions of IL-8 and IL-33 were negatively correlated with the decline rate of TBIL 1 week after operation. CONCLUSION The high expression of CD4+ T cells, IL-6, IL-8 and IL-33 in the BA liver tissue may lead to cholangitis and can be used as a predictor of early jaundice clearance. The degree of liver inflammation infiltration had nothing to do with the age of operation and is not a risk factor for postoperative cholangitis.
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Sophiabadi M, Rastgoo N, Haghdoost-Yazdi H. Dopaminergic Neuronal Death in Substantia Nigra Associates with Serum Levels of Total Bilirubin, Selenium, and Zinc: Evidences from 6-Hydroxydopamine Animal Model of Parkinson's Disease. Biol Trace Elem Res 2022; 200:4058-4067. [PMID: 34741694 DOI: 10.1007/s12011-021-03012-6] [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: 08/18/2021] [Accepted: 11/01/2021] [Indexed: 10/19/2022]
Abstract
Mild to moderate dopaminergic (DA) neuronal death in substantia nigra pars compacta (SNc) as the main pathological hallmark of Parkinson's disease (PD) is usually silent and does not produce marked clinical symptoms. In this study, we investigated the association between SNc DA neuronal loss and serum levels of total bilirubin (TB), selenium (Se), and zinc (Zn) in 6-hydroxydopamine (6-OHDA) animal model of PD. The neurotoxin of 6-OHDA was injected into the medial forebrain bundle of right hemisphere by stereotaxic surgery. Two conventional behavioral tests were carried out in several steps after the toxin to confirm the model reproduction and quantify severity and progress of 6-OHDA-induced PD. Blood samples were collected within 1 week before the toxin and in the second, fifth, and eighth weeks thereafter. Immunohistochemistry (IHC) assessments were performed on the rat's brain to determine the severity of DA neuronal loss in SNc. The severity of behavioral symptoms and TB levels were progressively increased in 6-OHDA-treated rats. On the other hand, Se and Zn levels in them were lower than control. These changes were observed in rats with severe or mild behavioral symptoms. Also, IHC revealed that changes in TB, Se, and Zn associate with SNc DA neuronal loss but do not correlate with its severity. Significant changes in serum levels of TB, Se, and Zn in the mild SNc DA neuronal loss suggest them as valuable parameters for establishment of a serum profile for early detection of PD.
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Affiliation(s)
- Mohammad Sophiabadi
- Cellular and Molecular Research Center, Research Institute for Prevention of Non-Communicable Disease, Qazvin University of Medical Sciences, 3414951414, Qazvin, Iran
| | - Nafiseh Rastgoo
- Cellular and Molecular Research Center, Research Institute for Prevention of Non-Communicable Disease, Qazvin University of Medical Sciences, 3414951414, Qazvin, Iran
| | - Hashem Haghdoost-Yazdi
- Cellular and Molecular Research Center, Research Institute for Prevention of Non-Communicable Disease, Qazvin University of Medical Sciences, 3414951414, Qazvin, Iran.
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Wu J, Su J, Wang Y, Chen J, Shang Y, Li J. Association between total bilirubin and bone mineral density level in adolescents. BMC Musculoskelet Disord 2022; 23:639. [PMID: 35788217 PMCID: PMC9254407 DOI: 10.1186/s12891-022-05592-3] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 06/22/2022] [Indexed: 11/10/2022] Open
Abstract
Background Increasing bone mass accumulation in adolescence and obtaining greater peak bone mass is one of the effective methods to prevent osteoporosis in the future. We aimed to examine the association between total bilirubin and bone mineral density (BMD) level in adolescents. Methods We used the data from 2005–2010 and 2013–2014 cycles of National Health and Nutrition Examination Survey (NHANES). The BMD levels in the region of lumbar spine and femoral regions, including total femur, femoral neck, trochanter, and intertrochanter were measured. Univariable and multivariable linear regression model were used to assess the relationship between total bilirubin concentration and BMD. Results A total of 3741 participants aged 12–19 years were ultimately included in the study. There were 1997 (53.38%) males and 1744 (46.62%) females. Univariate analysis results showed that age, sex, race, education, income, body mass index, dietary calcium intake, and diabetes were correlated with BMD levels. Compared with the lowest quartile of total bilirubin concentration, the highest quartile of total bilirubin concentration was positively associated with BMD levels in the regions of total femur (β = 0.036, 95% CI = 0.021 to 0.050, P < 0.001), femur neck (β = 0.030, 95% CI = 0.016 to 0.044, P < 0.001), trochanter (β = 0.033, 95% CI = 0.019 to 0.046, P < 0.001), intertrochanter (β = 0.040, 95% CI = 0.023 to 0.056, P < 0.001), and lumbar spine (β = 0.032, 95% CI = 0.018 to 0.045, P < 0.001). We also observe the same trend in sensitivity analysis (P for trend < 0.001). Conclusion Our study demonstrated that total bilirubin concentration was positively associated with BMD levels in adolescents in United States. Total bilirubin concentration might be a protective marker against bone loss in adolescents.
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Affiliation(s)
- Jing Wu
- Department of Cadre Ward 2, the Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.
| | - Jiali Su
- Department of Cadre Ward 3, the Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Yangyang Wang
- Department of Cadre Ward 2, the Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Jianfeng Chen
- Department of Experimental Animal Center, the Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, China
| | - Yuanyuan Shang
- Department of Neurosurgical Ward, the Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, China
| | - Jing Li
- Department of Cadre Ward 2, the Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, China.,Department of Traditional Chinese Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, China
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Yang Y, Wang J, Wai Si Ding AJGL, Xu Y, Jiang H, Ma K, Zhu T. Serum total bilirubin and long-term prognosis of patients with new-onset non-ST elevation myocardial infarction: a cohort study. BMC Cardiovasc Disord 2022; 22:165. [PMID: 35413813 PMCID: PMC9004079 DOI: 10.1186/s12872-022-02607-8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/29/2022] [Indexed: 11/17/2022] Open
Abstract
Background The potential prognostic role of total bilirubin (TBIL) in patients with new-onset non-ST elevation myocardial infarction (NSTEMI) is not fully understood. This study aims to evaluate the potential predictive value of TBIL for long-term prognosis in patients with new-onset NSTEMI.
Methods Patients with new-onset NSTEMI that underwent emergency coronary angiography in our department from June 2015 to March 2020 were included. Baseline TBIL was measured at admission. SYNTAX scores were used to indicate the severity of coronary lesions. The association between TBIL and SYNTAX scores was analyzed using multivariate logistic regression. The patients were followed for the incidence of major adverse cardiac and cerebrovascular events (MACCEs). The association between TBIL and MACCEs was analyzed using Kaplan–Meier survival methods. Results In total 327 patients were included in this study. Patients were divided according to tertiles of TBIL (first tertile < 10.23 µmol/L, n = 109; second tertile 10.23–14.30 µmol/L, n = 109; and third tertile ≥ 14.30 µmol/L, n = 109). TBIL was independently associated with the severity of coronary lesions in patients with NSTEMI, with an adjusted odds ratio (OR) and 95% confidence interval (CI) for the third tertile and the second tertile compared with the first tertile of TBIL of 2.259 (1.197–4.263) and 2.167 (1.157–4.059), respectively (both p < 0.05). After a mean follow-up of 30.33 months, MACCE had occurred in 57 patients. TBIL was independently associated with the increased risk of MACCEs, with an adjusted hazard ratio (HR) and 95% CI for the third tertile and the second tertile compared with the first tertile of TBIL of 2.737 (1.161–6.450) and 3.272 (1.408–7.607), respectively (both p < 0.05). Conclusions Higher myocardial infarction admission TBIL might independently predict poor prognosis in patients with NSTEMI.
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Affiliation(s)
- Yi Yang
- Department of Cardiology Fourth Ward, The Xinjiang Medical University Affiliated Hospital of Traditional Chinese Medicine, Urumqi, 830011, China.,Xinjiang Medical University, Urumqi, 830011, China
| | - Jun Wang
- Department of Cardiology, The People's Hospital of Xuancheng City, Anhui, 242000, China
| | - A Ji Gu Li Wai Si Ding
- Department of Coronary Heart Disease, The Seventh Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Yanan Xu
- Respiratory Medicine, The People's Hospital of Xuancheng City, Anhui, 242000, China
| | - Haibing Jiang
- Department of Cardiology Fourth Ward, The Xinjiang Medical University Affiliated Hospital of Traditional Chinese Medicine, Urumqi, 830011, China
| | - Kezhong Ma
- Department of Cardiology, Institute of Cardiovascular Diseases, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China.
| | - Tongjian Zhu
- Department of Cardiology, Institute of Cardiovascular Diseases, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China.
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10
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Zhang R, Bai Y, Wang R, Bai Z, Yang J, Chen Y, Li J, Xu L, Li S, Hu Y, Wang M, Cheng Z. Elevated serum bilirubin may significantly reduce coronary heart disease risk in females: A prospective cohort study. Nutr Metab Cardiovasc Dis 2022; 32:648-657. [PMID: 35123857 DOI: 10.1016/j.numecd.2021.12.015] [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: 07/05/2021] [Revised: 10/08/2021] [Accepted: 12/15/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS There is still inconsistent evidence over the protective effect of total bilirubin on the development of coronary heart disease (CHD). Therefore, we aimed to investigate the association between bilirubin in population subtypes and the risks of CHD between different gender and menstruation subgroups. METHODS AND RESULTS In this prospective cohort study, 29,750 participants free of CHD with an average age of 47 ± 14 years were recruited at baseline; of these, 720 CHD first-attack cases were collected after 7-years of follow up. The covariate-adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) of CHD with 95% confidence intervals (CIs). The serum bilirubin concentration was quarterly stratified based on the distribution of healthy population without CHD onset. The HRs of incident CHD decreased with elevated bilirubin in females (ρ trend<0.05), but not males. In postmenopausal females, compared with the lowest quartile of total bilirubin, the adjusted HRs for the third and fourth quartiles were 0.64 (95% CI: 0.45, 0.93) and 0.59 (95% CI: 0.42, 0.86), the adjusted HRs in the third and fourth quartiles of direct bilirubin were 0.56 (0.39, 0.82) and 0.56 (0.38, 0.81), and for indirect bilirubin, corresponding HR in the highest quartile was 0.56 (0.38, 0.83). CONCLUSION Elevated serum bilirubin was inversely associated with adjusted HRs of CHD in females, especially postmenopausal females. The relationship between elevated direct bilirubin and reduced HRs of CHD may be closer than indirect bilirubin in postmenopausal females.
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Affiliation(s)
- Rui Zhang
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu, 730000, China
| | - Yana Bai
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu, 730000, China
| | - Ruonan Wang
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu, 730000, China
| | - Zhao Bai
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu, 730000, China
| | - Jingli Yang
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu, 730000, China
| | - Yarong Chen
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu, 730000, China
| | - Jing Li
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu, 730000, China
| | - Lulu Xu
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu, 730000, China
| | - Siyu Li
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu, 730000, China
| | - Yujia Hu
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu, 730000, China
| | - Mengmei Wang
- The Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Building 181, Grattan Street, Melbourne, VIC, 3010, Australia
| | - Zhiyuan Cheng
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Street, Shenzhen, 518055, China.
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11
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Yin G, Liu L, Mohammed AQ, Jiang R, Abdu FA, Che W. Association between Initial Serum Total Bilirubin and Clinical Outcome in Myocardial Infarction with Non-Obstructive Coronary Arteries. Int J Med Sci 2022; 19:986-992. [PMID: 35813292 PMCID: PMC9254374 DOI: 10.7150/ijms.70833] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 05/18/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Liver function parameters, particularly serum total bilirubin (TB), are closely associated with cardiovascular diseases. However, the impact of serum TB among patients with myocardial infarction and non-obstructive coronary (MINOCA) remains unknown. Our study investigated the relationship between serum TB at admission and long-term adverse clinical outcomes in MINOCA patients. Methods: A total of 273 consecutive MINOCA patients were categorized into low and high serum TB groups based on the optimal cut-off of 0.9 mg/dl. The primary endpoint was major adverse cardiovascular events (MACE), including cardiac death, non-fatal MI, heart failure, and angina rehospitalization. Receiver-operating characteristic, Cox regression, and Kaplan-Meier analyses were used to evaluate the association of high serum TB with cardiovascular outcomes. Results: High serum TB was found in 68 (24.9%) patients. The incidence of MACE was higher in the high TB group than in the low TB group after a median follow-up of 28 months (30.9 vs. 17.1%, P=0.015). The Kaplan-Meier curve analysis also indicated that patients in the high TB group had a higher risk of developing MACE (log-rank P=0.023). Cox regression analysis showed that high serum TB (>0.9mg/dl) significantly correlated with increased MACE risk (HR=1.90, 95%CI: 1.12-3.22, P=0.018). After adjusting for numerous clinical variables, the high serum TB remained significantly associated with an increased risk of MACE (HR=2.04, 95%CI: 1.05-3.94, P=0.034). Conclusion: High initial serum TB (>0.9mg/dl) is a robust predictor of poor clinical outcomes among MINOCA patients. In clinical settings, assessing serum TB at admission may help identify high-risk patients presenting with MINOCA.
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Affiliation(s)
- Guoqing Yin
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai, China
| | - Lu Liu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai, China
| | - Abdul-Quddus Mohammed
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai, China
| | - Rong Jiang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai, China
| | - Fuad A Abdu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai, China
| | - Wenliang Che
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai, China.,Department of Cardiology, Shanghai Tenth People's Hospital Chongming branch, Shanghai, China
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12
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He S, Li Y, Li T, Xu F, Zeng D, Shi Y, Zhao N, Zhang L, Ma YZ, Wang Q, Yu W, Shen Y, Huang J, Li H. Sex differences between serum total bilirubin levels and cognition in patients with schizophrenia. BMC Psychiatry 2021; 21:396. [PMID: 34376171 PMCID: PMC8353745 DOI: 10.1186/s12888-021-03407-8] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 08/03/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Cognitive deficits are common in patients with schizophrenia (SCZ). Abnormal serum total bilirubin (TBIL) levels have been involved in cognitive deficits associated with neuropsychiatric diseases such as mild cognitive impairment and subcortical ischemic vascular disease. However, this relationship has not yet been fully investigated in patients with SCZ. Therefore, the aim of this study was to investigate the association between the serum TBIL concentration and cognitive deficits in SCZ patients and to determine whether a sex difference exists in the association. METHODS A total of 455 participants were eligible and included in this cross-sectional study. Cognition was evaluated using the Montreal Cognitive Assessment. Serum TBIL concentration was measured with an automatic biochemistry analyzer according to the routine protocol in the hospital medical laboratory. RESULTS Serum TBIL levels were lower in the cognition impairment group than in the cognition normal group in male patients. In contrast, serum TBIL levels tended to be increased in the cognition impairment group in female patients, although the difference was not significant. Further stepwise multiple regression analysis stratified by sex showed that serum TBIL was independently and positively associated with cognitive function in male patients but not in female patients. Moreover, the association between serum TBIL level and cognitive function was also identified by the propensity score matching (PSM) method in male patients, but not in female patients. CONCLUSION These findings suggest that lower serum TBIL levels may be associated with cognitive impairment in male SCZ patients.
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Affiliation(s)
- Shen He
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yange Li
- Department of Psychiatry, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Tian Li
- Air Force Medical University, No. 169 Changle West Rd, Xi'an, 710032, China
| | - Feikang Xu
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Duan Zeng
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yue Shi
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Nan Zhao
- Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
| | - Lei Zhang
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yin Zhu Ma
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiang Wang
- Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
| | - Wenjuan Yu
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Clinical Research Center for Mental Health, Shanghai, China
| | - Yifeng Shen
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Clinical Research Center for Mental Health, Shanghai, China
| | - Jingjing Huang
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai Clinical Research Center for Mental Health, Shanghai, China.
| | - Huafang Li
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai Clinical Research Center for Mental Health, Shanghai, China.
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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13
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Adachi K, Beppu S, Terashima M, Kobari W, Shimizu M, Yamazaki H. Pharmacokinetic modeling of over-the-counter drug diphenhydramine self-administered in overdoses in Japanese patients admitted to hospital. J Pharm Health Care Sci 2021; 7:32. [PMID: 34334133 PMCID: PMC8327444 DOI: 10.1186/s40780-021-00215-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 05/11/2021] [Accepted: 07/04/2021] [Indexed: 12/13/2022] Open
Abstract
Background Although the over-the-counter H1 receptor antagonist diphenhydramine is not a common drug of abuse, it was recently recognized as one of the substances causing acute poisoning in patients attempting suicide that led to admissions to our hospital emergency room. Case presentation Two patients [women aged 21 and 27 years (cases 1 and 2)] were emergently admitted after intentionally taking overdoses of 900 and 1200 mg diphenhydramine, respectively. The plasma diphenhydramine concentrations in case 1 were 977 and 425 ng/mL at 2.5 and 11.5 h after single oral overdose, and those in case 2 were 1320 and 475 ng/mL at 3 and 18 h after administration, respectively. We set up a simplified physiologically based pharmacokinetic (PBPK) model that was established using the reported pharmacokinetic data for a microdose of diphenhydramine. The two virtual plasma concentrations and the area under the curve (AUC) values extrapolated using the PBPK model were consistent with the observed overdose data. This finding implied linearity of pharmacokinetics over a wide dosage range for diphenhydramine. Conclusions The determined plasma concentrations of diphenhydramine of around 1000 ng/mL at ~ 3 h after orally administered overdoses in cases 1 and 2 may not have been high enough to cause hepatic impairment because levels of aspartate aminotransferase and alanine aminotransferase were normal; however, there was an increase in total bilirubin in case 1. Nonetheless, high virtual liver exposures of diphenhydramine were estimated by the current PBPK model. The present results based on drug monitoring data and pharmacokinetic predictions could serve as a useful guide when setting the duration of treatment in cases of diphenhydramine overdose.
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Affiliation(s)
- Koichiro Adachi
- Laboratory of Drug Metabolism and Pharmacokinetics, Showa Pharmaceutical University, 3-3165 Higashi-tamagawa Gakuen, Machida, Tokyo, 194-8543, Japan.,Kyoto Medical Center, Fushimi-ku, Kyoto, 612-8555, Japan.,Present address, Himeji Medical Center, Himeji, Hyogo, 670-8520, Japan
| | - Satoru Beppu
- Kyoto Medical Center, Fushimi-ku, Kyoto, 612-8555, Japan
| | | | - Wataru Kobari
- Laboratory of Drug Metabolism and Pharmacokinetics, Showa Pharmaceutical University, 3-3165 Higashi-tamagawa Gakuen, Machida, Tokyo, 194-8543, Japan
| | - Makiko Shimizu
- Laboratory of Drug Metabolism and Pharmacokinetics, Showa Pharmaceutical University, 3-3165 Higashi-tamagawa Gakuen, Machida, Tokyo, 194-8543, Japan
| | - Hiroshi Yamazaki
- Laboratory of Drug Metabolism and Pharmacokinetics, Showa Pharmaceutical University, 3-3165 Higashi-tamagawa Gakuen, Machida, Tokyo, 194-8543, Japan.
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14
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Lyu S, Wang F, Cao D, He Q. Correlation analysis of CA19-9/Glutamyltransferase ratio and long-term survival for patients with distal cholangiocarcinoma under different bilirubin levels. Asian J Surg 2021; 44:1421-1422. [PMID: 34315666 DOI: 10.1016/j.asjsur.2021.07.016] [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: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
- Shaocheng Lyu
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongtinan Road, Chaoyang District, 100020, Beijing, China
| | - Fangfei Wang
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongtinan Road, Chaoyang District, 100020, Beijing, China
| | - Di Cao
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongtinan Road, Chaoyang District, 100020, Beijing, China
| | - Qiang He
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongtinan Road, Chaoyang District, 100020, Beijing, China.
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15
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Chu X, Liu L, Ye J, Wen Y, Li P, Cheng B, Cheng S, Zhang L, Qi X, Ma M, Liang C, Kafle OP, Wu C, Wang S, Wang X, Ning Y, Zhang F. Insomnia affects the levels of plasma bilirubin and protein metabolism: an observational study and GWGEIS in UK Biobank cohort. Sleep Med 2021; 85:184-190. [PMID: 34343768 DOI: 10.1016/j.sleep.2021.05.040] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 05/11/2021] [Accepted: 05/31/2021] [Indexed: 10/21/2022]
Abstract
STUDY OBJECTIVES We aim to explore the mechanism of relationship between insomnia and liver metabolism by examining the gene × insomnia interactions. METHODS Individual level genotypic and phenotypic data were obtained from the UK Biobank cohort. Regression analysis was first conducted to test the association of insomnia with plasma total bilirubin (TBil; n = 186,793), direct bilirubin (DBil; n = 159,854) and total protein (TP; n = 171,574) in UK Biobank cohort. Second, genome-wide gene-environment interaction study (GWGEIS) was conducted by PLINK 2.0, and FUMA platform was used to identify enriched pathway terms. RESULTS In UK Biobank cohort, we found that TP (P < 2.00 × 10-16), DBil (P = 1.72 × 10-3) and TBil (P = 3.38 × 10-5) were significantly associated with insomnia. GWGEIS of both DBil and TBil observed significant G × INSOMNIA effects between insomnia and UDP Glucuronosyltransferase Family 1 (rs6431558, P = 6.26 × 10-11) gene. GWGEIS of TP also detected several significant genes interacting with insomnia, such as KLF15, (rs70940816, P = 6.77 × 10-10) and DOK7, (rs2344205, P = 1.37 × 10-9). Multiple gene ontology (GO) terms were identified for bilirubin, such as GO_URONIC_ACID_METABOLIC_PROCESS (adjusted P = 4.15 × 10-26). CONCLUSION Our study results suggested negative associations between insomnia and DBil and TBil; and a positive association between insomnia and TP.
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Affiliation(s)
- Xiaomeng Chu
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Li Liu
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Jing Ye
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Ping Li
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Bolun Cheng
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Shiqiang Cheng
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Lu Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Xin Qi
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Mei Ma
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Chujun Liang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Om Prakash Kafle
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Cuiyan Wu
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Sen Wang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Xi Wang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Yujie Ning
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.
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16
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Huang X, Lu Z, Zhang K, Wang G, Cai B, Wu P, Yin J, Miao Y, Jiang K. Prognostic impact of the ratio of preoperative CA19-9 to liver enzyme levels in pancreatic cancer patients with jaundice (predictability of combined CA19-9/AST and CA19-9/γ-GGT for jaundiced PDAC patients). Pancreatology 2021; 21:S1424-3903(21)00470-1. [PMID: 34090807 DOI: 10.1016/j.pan.2021.05.300] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 05/02/2021] [Accepted: 05/17/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Carbohydrate antigen 19-9 (CA19-9) has been reported as the most significant survival predictor of patients with pancreatic ductal adenocarcinoma (PDAC). However, the elevation of CA19-9 could interfere with obstructive jaundice and the predictive value of CA19-9 in PDAC patients with jaundice remains to be analyzed and elucidated to find possible adjustments. OBJECTIVE To evaluate the predictability of preoperative CA19-9 and its adjustments for the overall survival (OS) of PDAC patients by analyzing the relationship between preoperative serum CA19-9 and total bilirubin (TBIL). METHODS A total of 563 consecutive patients who underwent surgery for primary pancreatic adenocarcinoma in our center between January 2015 and September 2018 were retrospectively reviewed. Clinicopathologic information was collected and preoperative parameters such as CA19-9, CEA, TBIL, γ-GGT, AST, ALT, and ALP were recorded as well as overall survival rates, which began from the date of operation to that of death or the last follow-up. Kaplan-Meier survival curves with log-rank test and Cox regression models were applied using SPSS and the survival and survminer packages in R software. RESULTS Using 39/390/1000 as the cut-off values for preoperative serum CA19-9, significant capability of OS stratification was found in the total cohort (p < 0.001, MST = 29.7/19.1/15.2/12.1 months) and patients with TBIL <102.6 μmol/L (p < 0.001, MST = 32.2/19.6/15.0/11.2 months). However, in the subgroup of TBIL≥102.6 μmol/L, this classification method was replaced by the combined scoring of CA19-9/AST and CA19-9/γ-GGT. CONCLUSIONS As an independent predictor of overall survival of PDAC patients, preoperative serum CA19-9 is defective in survival stratification when TBIL≥102.6 μmol/L but a positive survival prognosis could be achieved with the application of combined preoperative CA19-9/AST and CA19-9/γ-GGT.
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Affiliation(s)
- Xumin Huang
- Pancreas Center, First Affiliated Hospital of Nanjing Medical University, Nanjing, China; Pancreas Institute, Nanjing Medical University, Nanjing, China
| | - Zipeng Lu
- Pancreas Center, First Affiliated Hospital of Nanjing Medical University, Nanjing, China; Pancreas Institute, Nanjing Medical University, Nanjing, China
| | - Kai Zhang
- Pancreas Center, First Affiliated Hospital of Nanjing Medical University, Nanjing, China; Pancreas Institute, Nanjing Medical University, Nanjing, China
| | - Guangfu Wang
- Pancreas Center, First Affiliated Hospital of Nanjing Medical University, Nanjing, China; Pancreas Institute, Nanjing Medical University, Nanjing, China
| | - Baobao Cai
- Pancreas Center, First Affiliated Hospital of Nanjing Medical University, Nanjing, China; Pancreas Institute, Nanjing Medical University, Nanjing, China
| | - Pengfei Wu
- Pancreas Center, First Affiliated Hospital of Nanjing Medical University, Nanjing, China; Pancreas Institute, Nanjing Medical University, Nanjing, China
| | - Jie Yin
- Pancreas Center, First Affiliated Hospital of Nanjing Medical University, Nanjing, China; Pancreas Institute, Nanjing Medical University, Nanjing, China
| | - Yi Miao
- Pancreas Center, First Affiliated Hospital of Nanjing Medical University, Nanjing, China; Pancreas Institute, Nanjing Medical University, Nanjing, China.
| | - Kuirong Jiang
- Pancreas Center, First Affiliated Hospital of Nanjing Medical University, Nanjing, China; Pancreas Institute, Nanjing Medical University, Nanjing, China.
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17
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Bakirci EM, Degirmenci H, Hamur H, Cosgun MS, Coskun R, Gunduz T, Tan M, Dogan MO, Tanriseven HI, Cakir M, Buyuklu M. Predictors of left atrial remodeling in newly diagnosed hypertensive patients: a speckle-tracking echocardiographic study. Int J Cardiovasc Imaging 2021; 37:2881-2889. [PMID: 34002299 DOI: 10.1007/s10554-021-02259-3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/26/2021] [Indexed: 11/26/2022]
Abstract
Endothelial dysfunction, oxidative stress, and increased inflammatory activity are the main pathophysiological mechanisms responsible for cardiac remodeling secondary to hypertension. Bilirubin has anti-oxidant, anti-inflammatory, and anti-fibrotic functions. This report's objectives are to determine whether Query identifiers of left atrial (LA) remodeling, total atrial conduction time (TACT) and LA reservoir strain (LARS), are associated with serum total bilirubin levels, and to identify the possible predictors of LA remodeling in newly diagnosed hypertensive subjects. One hundred thirty-four subjects were enrolled in this study. TACT was evaluated by tissue Doppler imaging, and LARS was calculated by speckle-tracking echocardiography. Laboratory parameters were recorded. The subjects were classified into two separate groups according to the median value of TACT and LARS. In patients with supramedian TACT, LA volume index (LAVI) and epicardial adipose tissue (EAT) thickness were higher, while LARS and LVGLS were lower. In subjects with inframedian LARS, TACT was longer, LAVI and EAT thickness were higher, and LVGLS was lower. Patients with supramedian TACT and inframedian LARS were older and had lower total bilirubin. Total bilirubin, EAT thickness, and age were predictors of TACT and LARS. Serum bilirubin levels may have a protective effect on the LA remodeling process in newly diagnosed hypertensive subjects.
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Affiliation(s)
- Eftal Murat Bakirci
- Department of Cardiology, Faculty of Medicine, Erzincan Binali Yildirim University, 24000, Erzincan, Turkey.
| | - Husnu Degirmenci
- Department of Cardiology, Faculty of Medicine, Erzincan Binali Yildirim University, 24000, Erzincan, Turkey
| | - Hikmet Hamur
- Department of Cardiology, Faculty of Medicine, Erzincan Binali Yildirim University, 24000, Erzincan, Turkey
| | - Muharrem Said Cosgun
- Department of Cardiology, Faculty of Medicine, Erzincan Binali Yildirim University, 24000, Erzincan, Turkey
| | - Resit Coskun
- Department of Cardiology, Faculty of Medicine, Erzincan Binali Yildirim University, 24000, Erzincan, Turkey
| | - Tayfun Gunduz
- Department of Cardiology, Faculty of Medicine, Erzincan Binali Yildirim University, 24000, Erzincan, Turkey
| | - Mucahit Tan
- Department of Cardiology, Faculty of Medicine, Erzincan Binali Yildirim University, 24000, Erzincan, Turkey
| | - Mehmet Onur Dogan
- Department of Cardiology, Faculty of Medicine, Erzincan Binali Yildirim University, 24000, Erzincan, Turkey
| | - Halil Ibrahim Tanriseven
- Department of Cardiology, Faculty of Medicine, Erzincan Binali Yildirim University, 24000, Erzincan, Turkey
| | - Murat Cakir
- Department of Cardiology, Faculty of Medicine, Erzincan Binali Yildirim University, 24000, Erzincan, Turkey
| | - Mutlu Buyuklu
- Department of Cardiology, Faculty of Medicine, Erzincan Binali Yildirim University, 24000, Erzincan, Turkey
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Lyu S, Wang F, Ren Z, He Q. Correlation analysis of CA19-9/Glutamyltransferase ratio and long-term survival for patients with pancreatic head cancer under different bilirubin levels. Asian J Surg 2021; 44:765-6. [PMID: 33762143 DOI: 10.1016/j.asjsur.2021.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 02/07/2021] [Indexed: 11/22/2022] Open
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19
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Zhang C, Zhu L, Zhang J, Wang W, Zeng Y, You S, Qi W, Su R, He Z. An effective enzymatic assay for pH selectively measuring direct and total bilirubin concentration by using of CotA. Biochem Biophys Res Commun 2021; 547:192-7. [PMID: 33618226 DOI: 10.1016/j.bbrc.2021.01.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 01/27/2021] [Indexed: 11/23/2022]
Abstract
In this study, we aimed to develop B. subtilis spore coat protein A (CotA) for the enzymatic determination of bilirubin. Firstly, molecular docking and oxidation kinetic analysis confirmed the feasibility of CotA for oxidizing bilirubin. Secondly, CotA showed pH-preferable oxidization performance to direct bilirubin (DB) in acidic conditions and an alkaline-catalytic oxidation capacity to total bilirubin (TB). Mechanism analysis results confirm that the conformational changes of CotA, DB and UB caused by pH changes are responsible for the selective oxidation of DB and TB by CotA. Then, CotA exhibits better structural characteristics and enzymatic performance than M. verrucaria-derived bilirubin oxidase (Mv-BOD). Besides, the strong anti-interference ability helps CotA adapt to complex catalytic environment in the detection of DB and TB. Our results prove that CotA can be used as a promising candidate bio-enzymatic detection reagent for DB and TB.
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20
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Cao Y, Deng S, Yan L, Gu J, Yang J, Yang M, Liu L, Cai K. A nomogram based on pretreatment levels of serum bilirubin and total bile acid levels predicts survival in colorectal cancer patients. BMC Cancer 2021; 21:85. [PMID: 33478423 PMCID: PMC7818769 DOI: 10.1186/s12885-021-07805-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 07/21/2020] [Accepted: 01/11/2021] [Indexed: 02/08/2023] Open
Abstract
Background Serum bilirubin and total bile acid (TBA) levels have been reported to be strongly associated with the risk and prognosis of certain cancers. Here, we aimed to investigate the effects of pretreatment levels of serum bilirubin and bile acids on the prognosis of patients with colorectal cancer (CRC). Methods A retrospective cohort of 1474 patients with CRC who underwent surgical resection between January 2015 and December 2017 was included in the study. Survival analysis was used to evaluate the predictive value of pretreatment levels of bilirubin and bile acids. X-Tile software was used to identify optimal cut-off values for total bilirubin (TBIL), direct bilirubin (DBIL) and TBA in terms of overall survival (OS) and disease-free survival (DFS). Results DBIL, TBIL, and TBA were validated as significant prognostic factors by univariate Cox regression analysis for both 3-year OS and DFS. Multivariate Cox regression analyses confirmed that high DBIL, TBIL and TBA levels were independent prognostic factors for both OS (HR: 0.435, 95% CI: 0.299–0.637, P < 0.001; HR: 0.436, 95% CI: 0.329–0.578, P < 0.001; HR: 0.206, 95% CI: 0.124–0.341, P < 0.001, respectively) and DFS (HR: 0.583, 95% CI: 0.391–0.871, P = 0.008; HR:0.437,95% CI: 0.292–0.655, P <0.001; HR: 0.634, 95% CI: 0.465–0.865, P = 0.004, respectively). In addition, nomograms for OS and DFS were established according to all significant factors, and the c-indexes were 0.819 (95% CI: 0.806–0.832) and 0.835 (95% CI: 0.822–0.849), respectively. Conclusions TBIL, DBIL and TBA levels are independent prognostic factors in colorectal cancer patients. The nomograms based on OS and DFS can be used as a practical model for evaluating the prognosis of CRC patients.
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Affiliation(s)
- Yinghao Cao
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, Hubei, China
| | - Shenghe Deng
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, Hubei, China
| | - Lizhao Yan
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, Hubei, China
| | - Junnan Gu
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, Hubei, China
| | - Jia Yang
- Department of Gastrointestinal Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ming Yang
- Department of Pathology, Union Hospital, Tongji Medical, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Li Liu
- Department of Epidemiology and Biostatistics, the Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China.
| | - Kailin Cai
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, Hubei, China.
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Okumura A, Ichimura S, Hayakawa M, Arai H, Maruo Y, Kusaka T, Kunikata T, Kumada S, Morioka I. Neonatal Jaundice in Preterm Infants with Bilirubin Encephalopathy. Neonatology 2021; 118:301-309. [PMID: 33744898 DOI: 10.1159/000513785] [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: 07/19/2020] [Accepted: 12/15/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of this study is to clarify bilirubin parameters and its treatment in preterm infants with bilirubin encephalopathy (pBE). METHODS We asked the responders to an earlier nationwide Japanese survey on pBE to provide additional information. pBE was diagnosed based on the criteria used in the nationwide survey. We collected data on serum total bilirubin (TB), direct bilirubin (DB), albumin, and unbound bilirubin (UB) levels during the first 8 weeks of life, and on phototherapy and exchange transfusion treatments. RESULTS We obtained clinical data from 75 patients with pBE from 58 hospitals (response rate of 59%), who were born between 2002 and 2016. The average peak TB level was 12.6 mg/dL (215 μmol/L), and the average age at peak attainment was 19.7 days after birth. Albumin level was <2.5 g/dL in 44 patients, and the peak DB level was ≥2 mg/dL (34.2 μmol/L) in 20 patients. The average peak bilirubin/albumin (B/A) (mg/g) ratio was 3.8 (molar ratio of 0.475), and the average age at peak attainment was 18.6 days. The average peak UB level was 0.67 μg/dL (11.5 nmol/L). The median duration of phototherapy was 6 days, and the median day of the last session was 12. The peak TB level occurred after the last day of phototherapy in 30 of the 61 patients available for comparison. CONCLUSIONS Most patients with pBE lacked marked elevations in serum TB levels and the B/A ratio, the peaks of which were sometimes delayed to >4 weeks after birth.
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Affiliation(s)
- Akihisa Okumura
- Department of Pediatrics, Aichi Medical University, Nagakute, Japan,
| | - Shintaro Ichimura
- Department of Perinatal and Neonatal Medicine, Aichi Medical University, Nagakute, Japan
| | - Masahiro Hayakawa
- Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan
| | - Hiroshi Arai
- Department of Pediatric Neurology, Bobath Memorial Hospital, Osaka, Japan
| | - Yoshihiro Maruo
- Department of Pediatrics, Shiga University of Medical Science, Otsu, Japan
| | - Takashi Kusaka
- Department of Pediatrics, Faculty of Medicine, Kagawa University, Takamatsu, Japan
| | - Tetsuya Kunikata
- Division of Neonatal Medicine, Department of Pediatrics, Saitama Medical University Hospital, Iruma-Gun, Saitama, Japan
| | - Satoko Kumada
- Department of Neuropediatrics, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Ichiro Morioka
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
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Arques S, Chelaifa H, Allari JB, Gelisse R, Roux E. [Does hypoalbuminemia contribute to the worsening of heart failure?]. Ann Cardiol Angeiol (Paris) 2020; 69:294-298. [PMID: 32800317 DOI: 10.1016/j.ancard.2020.07.009] [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: 07/09/2020] [Accepted: 07/21/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Hypoalbuminemia has now emerged as a powerful prognosticator in heart failure regardless of age, clinical presentation, left ventricular ejection fraction and usual prognostic markers. Growing evidence is that this prognostic value persists after adjusting for causative factors for hypoalbuminemia such as malnutrition, inflammation and liver dysfunction. OBJECTIVE To address the prognostic relevance of hypoalbuminemia in frail elderly patients with well-characterized cardiogenic pulmonary edema at high risk for adverse outcome, beyond causative factors for low serum albumin levels. Serum albumin was measured after clinical stabilization to avoid hypervolemia. RESULTS In all, 67 patients with a mean age of 86 years were included. Hospital mortality was 30%. Patients who died and who survived were similar in age, ejection fraction, BNP concentration, serum creatinine, serum hemoglobin, total bilirubin and prealbumin. Patients who died had lower serum albumin levels (P<0.001), higher blood urea nitrogen (P=0.03) and higher C-reactive protein (P=0.02). In multivariate analysis, serum albumin was the sole independent predictor of hospital death (P<0.01), after adjusting for malnutrition (prealbumin P=ns), inflammation (C-reactive protein P=ns) and liver dysfunction (total bilirubin P=ns). CONCLUSION Serum albumin is a powerful prognosticator in frail elderly patients with acute cardiogenic pulmonary edema even after adjusting for main causative factors. These results suggest that hypoalbuminemia may contribute to the worsening of heart failure given the physiological properties of serum albumin that includes antioxidant activity and plasma colloid osmotic pressure action. Further studies are critically needed to address the relevance of prevention and correction of hypoalbuminemia in heart failure.
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Affiliation(s)
- S Arques
- Structure de cardiologie, centre hospitalier Edmond-Garcin, avenue des Soeurs-Gastine, 13400 Aubagne, France.
| | - H Chelaifa
- Structure de cardiologie, centre hospitalier Edmond-Garcin, avenue des Soeurs-Gastine, 13400 Aubagne, France
| | - J B Allari
- Structure de cardiologie, centre hospitalier Edmond-Garcin, avenue des Soeurs-Gastine, 13400 Aubagne, France
| | - R Gelisse
- Structure de cardiologie, centre hospitalier Edmond-Garcin, avenue des Soeurs-Gastine, 13400 Aubagne, France
| | - E Roux
- Structure de cardiologie, centre hospitalier Edmond-Garcin, avenue des Soeurs-Gastine, 13400 Aubagne, France
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23
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Liu Y, Wang J, Zeng WZ, Lyu QS. Nonlinear relationship between serum total bilirubin levels and initial ischemic stroke in patients with non-valvular atrial fibrillation. J Int Med Res 2020; 48:300060520962347. [PMID: 33100092 PMCID: PMC7645432 DOI: 10.1177/0300060520962347] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Objective This study aimed to examine the relationship between total bilirubin levels and initial ischemic stroke in patients with non-valvular atrial fibrillation. Methods This was a retrospective study. Atrial fibrillation was diagnosed by 24-hour Holter electrocardiography and serum total bilirubin levels were divided into quintiles. Ischemic stroke was diagnosed by symptoms, signs, and a medical image examination. The multivariate Cox proportional hazards model and survival analysis were used to estimate the association of total bilirubin with initial ischemic stroke. Results We studied 316 patients with non-valvular atrial fibrillation. During follow-up, there were 42 (13.29%) first ischemic strokes. After multivariate adjustment, for each 1 µmol/L increase in total bilirubin, the risk of first ischemic stroke increased by 4% (95% confidence interval [CI]: 1.01, 1.07). When using the first quintile as the reference, from the second to fifth quintiles, the risks of first ischemic stroke were 0.52 (95% CI: 0.17, 1.65), 0.23 (95% CI: 0.06, 0.87), 0.92 (95% CI: 0.32, 2.67), and 1.33 (95% CI: 1.09, 4.41), respectively. The optimal cut-off point of total bilirubin for the lowest risk of ischemic stroke was 17.0 µmol/L. Conclusions Total bilirubin levels are nonlinearly associated with initial ischemic stroke in patients with non-valvular atrial fibrillation.
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Affiliation(s)
- Ying Liu
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Jie Wang
- Department of Cardiology, The Central Hospital of Yongzhou, Yongzhou, Hunan, China.,Jishou University, Jishou, Hunan, China
| | - Wen-Zhen Zeng
- Department of Cardiology, The Central Hospital of Yongzhou, Yongzhou, Hunan, China
| | - Qing-Shan Lyu
- Department of Cardiology, The Central Hospital of Yongzhou, Yongzhou, Hunan, China
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Xu X, Ai F, Huang M. Deceased serum bilirubin and albumin levels in the assessment of severity and mortality in patients with acute pancreatitis. Int J Med Sci 2020; 17:2685-2695. [PMID: 33162796 PMCID: PMC7645339 DOI: 10.7150/ijms.49606] [Citation(s) in RCA: 12] [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: 06/17/2020] [Accepted: 09/09/2020] [Indexed: 12/13/2022] Open
Abstract
Background: Our study investigated the diagnostic and prognostic role of serum antioxidant indexes in patients with acute pancreatitis (AP). Methods: This study included 708 AP patients from the Medical Information Mart for Intensive Care-III (MIMIC-III) database and 477 patients from the eICU Collaborative Research Database (eICU-CRD). X-tile software was applied to determine the best cutoff values for serum antioxidant indexes. Univariate and multivariate regression analyses were employed to select variables associated with severe AP (SAP) and in-hospital mortality. Finally, the nomograms were also externally validated in the eICU-CRD. Results: The best cutoff values for serum total bilirubin (TBIL) and albumin were 1.1 mg/dL and 2.1 g/dL in the training set, respectively. Multivariate logistical regression indicated that both TBIL (odds ratio [OR]=0.740, 95% confidence interval [CI]: 0.616-0.889, P=0.001) and albumin (OR=0.890, 95%CI: 0.819-0.967, P=0.006) were independent risk factors for SAP. Similarly, multivariate Cox analysis revealed that serum TBIL (hazard ratio [HR]=0.768, 95%CI:0.635-0.928, P=0.006) and albumin (HR=0.962, 95%CI:0.927-0.998, P=0.037) were independent risk factors for in-hospital mortality in AP patients. The diagnostic nomogram containing TBIL, albumin, Sequential Organ Failure Assessment (SOFA) score and urea nitrogen and prognostic nomogram combining TBIL, albumin, white blood count, SOFA score, and age obtained good discrimination, calibration and clinical utility in both the MIMIC-III and eICU-CRD. Conclusion: Serum TBIL and albumin were independent predictors for SAP and in-hospital mortality in AP patients. The nomograms combining serum TBIL and albumin with other significant features exerted favorable predictive performance for SAP and in-hospital mortality.
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Affiliation(s)
- Xiao Xu
- Department of Emergency, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Hubei, 430014, China
| | - Fen Ai
- Department of Emergency, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Hubei, 430014, China
| | - Min Huang
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College of Huazhong University of Science and Technology, Wuhan Hubei, 430014, China
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Wang M, Yan W, Qi W, Wu D, Zhu L, Li W, Wang X, Ma K, Ni M, Xu D, Wang H, Chen G, Yu H, Ding H, Xing M, Han M, Luo X, Chen T, Guo W, Xi D, Ning Q. Clinical characteristics and risk factors of liver injury in COVID-19: a retrospective cohort study from Wuhan, China. Hepatol Int 2020; 14:723-732. [PMID: 33026573 PMCID: PMC7539280 DOI: 10.1007/s12072-020-10075-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/11/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has rapidly become a major international public health concern. This study was designed to evaluate the clinical characteristics and risk factors of COVID-19-associated liver injury. METHODS A fraction of 657 COVID-19 patients were retrospectively analyzed. Clinical and laboratory data were derived from electronic medical records and compared between patients with or without liver injury. Multivariate logistic regression method was used to analyze the risk factors for liver injury. RESULTS Among 657 patients, 303 (46.1%) patients had liver injury with higher rate in severe/critically ill patients [148/257 (57.6%)] than those in moderate cases [155/400 (38.8%)]. The incidence of liver injury was much higher in male [192/303 (63.4%)] than female [111/303 (36.6%)], and in severe/critical patients [148/303 (48.8%)] with percutaneous oxygen saturation ≤ 93% [89/279 (31.9%)] or peak body temperature ≥ 38.5 °C [185/301 (61.5%)] on admission. Liver injury-related inflammations included increased white blood cells, neutrophils and decreased lymphocytes. More patients with liver injury than without had increased serum IL-2R, TNFα, ferritin, hsCRP, PCT, ESR, γ-GT, and LDH. Multivariate regression analysis revealed that increasing odds of liver injury were related to male, higher serum hsCRP (≥ 10 mg/L), and neutrophil-to-lymphocyte ratio (NLR) (≥ 5). Moreover, more deceased patients (14/82 (17%)) had significantly elevated serum TBIL than discharged patients [25/532 (4.7%)]. CONCLUSION Liver injury is a common complication in COVID-19 patients. The potential risk factors of liver injury include male, hsCRP and NLR score. A close monitor of liver function should be warned in COVID-19 patients, especially in severe/critical individuals.
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Affiliation(s)
- Ming Wang
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Weiming Yan
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Weipeng Qi
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Di Wu
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Lin Zhu
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Weina Li
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiaojing Wang
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ke Ma
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ming Ni
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Dong Xu
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hongwu Wang
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Guang Chen
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Haijing Yu
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hongfang Ding
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Mingyou Xing
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Meifang Han
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiaoping Luo
- Department of Paediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Chen
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wei Guo
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Dong Xi
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Qin Ning
- Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Shiomura R, Kobayashi N, Shirakabe A, Okazaki H, Shibata Y, Yasushi M, Noritake H, Asai K, Shimizu W. Systolic blood pressure and cardiac mortality related to serum total bilirubin levels at admission in patients with acute heart failure. Heart Vessels 2021; 36:69-75. [PMID: 32671462 DOI: 10.1007/s00380-020-01666-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 03/23/2020] [Accepted: 07/10/2020] [Indexed: 01/05/2023]
Abstract
The impact of elevated total bilirubin (Tbil) levels on adverse clinical outcomes in patients with acute heart failure (HF) has not been fully established, although liver damage is common among these patients. We therefore examined the associations between Tbil levels at admission and systolic blood pressure (SBP) in patients with acute HF in an emergency setting and to evaluate clinical outcomes related to elevated Tbil, particularly in patients with SBP < 100 mmHg. Clinical data and outcomes in acute HF patients (n = 877) were compared according to Tbil quartiles. SBP values < 100 mmHg were more prevalent among patients in the highest quartile (Tbil ≥ 1.0 mg/dL) vs. others (15.4% vs. 3.1%, p < 0.001). Tbil levels were inversely and significantly correlated with SBP at admission (Spearman's ρ, - 0.243; p < 0.001). Kaplan-Meier estimate survival curves showed that event-free survival was worse among patients in the highest Tbil quartile vs. others (78.5% vs. 90.4%, p < 0.001). When comparing survival rates among patients in SBP < 100 mmHg (n = 50), the difference of survival rate became larger for the patients in the highest quartile (n = 29) vs. others (n = 21) (41.4% vs. 77.7%, p < 0.001). Multivariate Cox proportional hazard analysis showed that Tbil ≥ 1.3 mg/dL, not SBP or B-type natriuretic peptide, independently and significantly predicted cardiac death within 180 days in acute HF patients with SBP < 100 mmHg (hazard ratio 3.74; 95% confidence interval 1.39-10.05; p < 0.001). In conclusion, Tbil levels were inversely correlated with SBP at admission in patients with acute HF. Tbil levels independently predicted the risk of 180-day cardiac mortality, especially in acute HF patients with SBP < 100 mmHg.
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Tan H, Liao S, Pan T, Zhang J, Chen J. Rapid and simultaneous analysis of direct and indirect bilirubin indicators in serum through reagent-free visible-near-infrared spectroscopy combined with chemometrics. Spectrochim Acta A Mol Biomol Spectrosc 2020; 233:118215. [PMID: 32151990 DOI: 10.1016/j.saa.2020.118215] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 02/20/2020] [Accepted: 03/01/2020] [Indexed: 06/10/2023]
Abstract
Indirect (IBil), direct (DBil) and total (TBil) bilirubin are important clinical indicators of hepatobiliary diseases, which require rapid detection in diagnosis and treatment. IBil and DBil have a structural relationship with several macromolecules in hepatobiliary metabolism. Here, the rapid analysis models for bilirubin indicators using serum visible-near-infrared (Vis-NIR) spectroscopy were established. Norris derivative filter with optimisation was used for spectral pretreatment; the optimal parameters (derivative order, number of smoothing points, number of differential gaps) were (2, 15, 9) for IBil; (2, 13, 9) for DBil, respectively. Equidistant combination-partial least squares (EC-PLS) was used for large-scale wavelength screening. Wavelength step-by-step phase-out PLS (WSP-PLS) was used for secondary wavelength optimisation. The wavelength models of the optimal EC-WSP-PLS for IBil and DBil included 11 and 18 wavelengths, respectively. In independent validation, the root-mean-square errors and correlation coefficient for prediction (SEP, RP), and ratio of performance-to-deviation (RPD) were 0.90 μmol L-1, 0.975, and 4.4 for IBil; 0.71 μmol L-1, 0.955, and 3.3 for DBil, respectively. TBil was subjected to spectral analysis, and the summation of the prediction values of IBil and DBil was compared. The latter was obviously better, and SEP, RP, RPD were 0.82 μmol L-1, 0.990, 7.1, respectively. The results for IBil, DBil and TBil indicated high correlation, low error and good overall prediction ability and confirmed the feasibility of the simultaneous analysis of bilirubin indicators through reagent-free serum Vis-NIR spectroscopy. The proposed method is crucial for the rapid screening of large populations and the treatment of hepatobiliary diseases.
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Affiliation(s)
- Hui Tan
- Department of Optoelectronic Engineering, Jinan University, Huangpu Road West 601, Tianhe District, Guangzhou 510632, China
| | - Sixia Liao
- Department of Biological Engineering, Jinan University, Huangpu Road West 601, Tianhe District, Guangzhou 510632, China
| | - Tao Pan
- Department of Optoelectronic Engineering, Jinan University, Huangpu Road West 601, Tianhe District, Guangzhou 510632, China.
| | - Jing Zhang
- Department of Optoelectronic Engineering, Jinan University, Huangpu Road West 601, Tianhe District, Guangzhou 510632, China
| | - Jiemei Chen
- Department of Biological Engineering, Jinan University, Huangpu Road West 601, Tianhe District, Guangzhou 510632, China.
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Lu Z, Wen T, Wang Y, Kan W, Xun G. Peripheral non-enzymatic antioxidants in patients with schizophrenia: a case-control study. BMC Psychiatry 2020; 20:241. [PMID: 32414343 DOI: 10.1186/s12888-020-02635-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 04/29/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Recent studies show that oxidative stress is associated with the pathogenesis of schizophrenia. There are two major types of antioxidant systems in vivo, namely enzymatic antioxidants and non-enzymatic antioxidants. This study investigated differences of non-enzymatic antioxidants between schizophrenia patients and healthy controls. METHODS Peripheral UA, ALB, and TBIL of 107 schizophrenic patients in the acute stage and 101 in the remission stage were measured respectively, so were 273 healthy controls. RESULTS The levels of UA (P = 0.020) and TBIL (P < 0.001) of schizophrenic patients in the acute stage were higher than those of healthy controls, while the level of ALB (P < 0.001) was lower. Similar results were detected form schizophrenic patients in the remission stage. Schizophrenic patients in the acute stage were divided into antipsychotics-use subgroup (n = 56) and antipsychotics-naïve/free subgroup (n = 51). The level of UA (P = 0.001) in the antipsychotics-use subgroup was higher than that in the antipsychotics-naïve/free subgroup, while the level of TBIL (P = 0.002) was lower than that in the antipsychotics-naïve/free subgroup. Seventy-seven schizophrenic patients in the acute stage were followed up, and there was no significant difference in the level of UA before and after treatment, but levels of ALB (P < 0.001) and TBIL (P < 0.001) decreased significantly after the treatment. CONCLUSION This study demonstrated that the dysfunction of the peripheral non-enzymatic anti-oxidation system might be involved in the pathogenesis of schizophrenia.
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Moradi Kelardeh B, Rahmati-Ahmadabad S, Farzanegi P, Helalizadeh M, Azarbayjani MA. Effects of non-linear resistance training and curcumin supplementation on the liver biochemical markers levels and structure in older women with non-alcoholic fatty liver disease. J Bodyw Mov Ther 2020; 24:154-160. [PMID: 32825982 DOI: 10.1016/j.jbmt.2020.02.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 01/30/2020] [Accepted: 02/17/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND With increasing age, non-alcoholic fatty liver disease is very common among women with low levels of physical activity. Nonlinear resistance training is one of the new methods to help patients who have low levels of physical activity. Curcumin is an herbal supplement that has anti-inflammatory effects. The present study aimed to examine the effects of nonlinear resistance training and curcumin supplementation on the liver structure and biochemical markers in obese older women with non-alcoholic fatty liver disease. METHODS Forty-five obese women with non-alcoholic fatty liver disease were randomly assigned into resistance training (RT), curcumin supplement (C), resistance training with curcumin supplement (RTC), and placebo (P) groups. The RT and RTC groups received 12-weeks of nonlinear resistance training while the C and P groups had a normal sedentary lifestyle. Daily, the C and RTC groups received a curcumin capsule while the P and RT groups were given a placebo capsule. Blood sampling and ultrasonography were taken before and after the protocol. RESULTS Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels significantly decreased in the RT and RTC groups (P ≤ 0.05) but not in the C and P groups (P > 0.05). Alkaline phosphatase (ALP), total bilirubin (TB) levels, platelet counts (PLT), and liver structure did not significantly change in all groups (P > 0.05). Resistance training alone and with curcumin supplementation could significantly improve liver function while taking curcumin alone did not have any significant effect on it. CONCLUSION 12-week non-linear resistance training has beneficial effects on non-alcoholic fatty liver disease in older obese women.
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Affiliation(s)
- Baharak Moradi Kelardeh
- Phd Exercise Physiology, Sama Technical and Vocational Training College, Islamic Azad University, Esfahan (Khorasgan) Branch, Esfahan, Iran
| | | | - Parvin Farzanegi
- Department of Exercise Physiology, Sari Branch, Islamic Azad University, Sari, Iran
| | - Masoumeh Helalizadeh
- Department of Exercise Physiology, Sport Medicine Research Center, Sport Sciences Research Institute, Tehran, Iran
| | - Mohammad-Ali Azarbayjani
- Department of Exercise Physiology, Central Tehran Branch, Islamic Azad University, Tehran, Iran.
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Katzman BM, Karon BS. Test Utilization Proposal for Reflex Bilirubin Testing: Why Order Two Tests When One Will Do? J Appl Lab Med 2020; 6:980-984. [PMID: 33454760 DOI: 10.1093/jalm/jfaa211] [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: 07/13/2020] [Accepted: 10/20/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Reflex testing algorithms are effective tools to reduce unnecessary laboratory testing. Direct (conjugated) bilirubin (DB) and total bilirubin (TB) are often ordered together at our institution. Therefore, the objective of our study was to evaluate the potential impact of performing reflex testing for DB when TB is elevated. METHODS We performed a retrospective review of test orders (patients ≥18 years of age) for DB, TB, or for both DB and TB on the same accession number received in our stat laboratory from January through April 2017. The orders were binned into 4 categories depending on the results from each individual test: (a) DB normal and TB normal, (b) DB normal and TB high, (c) DB high and TB normal, and (d) DB high and TB high. The percentage of orders and median (range) test result for each category was calculated. RESULTS During the months evaluated, a total of 4828 stat orders were placed for DB, TB, or both DB and TB. A total of 4296 stat orders (89%) were placed with both DB and TB on the same accession number for 4158 unique patients. Of those orders, the vast majority of tests (87.3%) contained normal results for both analytes; only 12.7% of orders contained ≥1 abnormal result. CONCLUSIONS The majority of all bilirubin tests ordered stat for emergency department and hospitalized patients have values within the reference interval. Consequently, if reflex testing were executed on elevated TB, a large number of DB tests could be avoided.
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Affiliation(s)
- Brooke M Katzman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Brad S Karon
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
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Kunutsor SK, Frysz M, Verweij N, Kieneker LM, Bakker SJL, Dullaart RPF. Circulating total bilirubin and risk of non-alcoholic fatty liver disease in the PREVEND study: observational findings and a Mendelian randomization study. Eur J Epidemiol 2020; 35:123-37. [PMID: 31773475 DOI: 10.1007/s10654-019-00589-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 11/20/2019] [Indexed: 01/14/2023]
Abstract
The relationship between circulating total bilirubin and incident non-alcoholic fatty liver disease (NAFLD) is uncertain. We aimed to assess the association of total bilirubin with the risk of new-onset NAFLD and investigate any causal relevance to the association using a Mendelian randomization (MR) study. Plasma total bilirubin levels were measured at baseline in the PREVEND prospective study of 3824 participants (aged 28–75 years) without pre-existing cardiovascular disease or NAFLD. Incident NAFLD was estimated using the biomarker-based algorithms, fatty liver index (FLI) and hepatic steatosis index (HSI). Odds ratios (ORs) (95% confidence intervals) for NAFLD were assessed. The genetic variant rs6742078 located in the UDP-glucuronosyltransferase (UGT1A1) locus was used as an instrumental variable. Participants were followed up for a mean duration of 4.2 years. The multivariable adjusted OR (95% CIs) for NAFLD as estimated by FLI (434 cases) was 0.82 (0.73–0.92; p = 0.001) per 1 standard deviation (SD) change in loge total bilirubin. The corresponding adjusted OR (95% CIs) for NAFLD as estimated by HSI (452 cases) was 0.87 (0.78–0.97; p = 0.012). The rs6742078 variant explained 20% of bilirubin variation. The ORs (95% CIs) for a 1 SD genetically elevated total bilirubin level was 0.98 (0.69–1.38; p = 0.900) for FLI and 1.14 (0.81–1.59; p = 0.451) for HSI. Elevated levels of total bilirubin were not causally associated with decreased risk of NAFLD based on MR analysis. The observational association may be driven by biases such as unmeasured confounding and/or reverse causation. However, due to low statistical power, larger-scale investigations are necessary to draw definitive conclusions.
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Yang M, Ni C, Chang B, Jiang Z, Zhu Y, Tang Y, Li Z, Li C, Li B. Association between serum total bilirubin levels and the risk of type 2 diabetes mellitus. Diabetes Res Clin Pract 2019; 152:23-28. [PMID: 31078667 DOI: 10.1016/j.diabres.2019.04.033] [Citation(s) in RCA: 15] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/11/2019] [Accepted: 04/30/2019] [Indexed: 01/19/2023]
Abstract
AIM To confirm whether serum bilirubin is an independent risk factor of type 2 diabetes mellitus (T2DM) onset in patients with impaired fasting glycemia (IFG) and impaired glucose tolerance (IGT). METHODS This was a prospective cohort study carried out at the Diabetic Identification Center of Tianjin Metabolic Diseases Hospital. Serum total bilirubin (TBIL) was measured at baseline and the patients were grouped according to baseline bilirubin quartiles. The outcome was the confirmation of T2DM by oral glucose tolerance test (OGTT) during the 3-year follow-up. Logistic regression was used to determine the risk factors for T2DM development and whether bilirubin levels are independently associated with T2DM development. RESULTS Finally, 523 patients were analyzed. After 3 years, 310 participants were diagnosed with diabetes based on OGTT. Baseline quartiles of total bilirubin were inversely associated with diabetes risk, even after multivariable adjustment. The adjusted ORs for diabetes were 1.0 (reference), 0.83 (95% CI 0.74-0.96), 0.78 (95% CI 0.68-0.90), 0.74 (95% CI 0.64-0.87) for the 1st, 2nd, 3rd, and 4th quartiles of baseline serum total bilirubin, respectively (P < 0.001). CONCLUSION In patients with IFG or IGT, low levels of serum total bilirubin were associated with a significantly increased risk of T2DM.
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Affiliation(s)
- Min Yang
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin 300070, China.
| | - Changlin Ni
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin 300070, China
| | - Baocheng Chang
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin 300070, China
| | - Zhenhuan Jiang
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin 300070, China
| | - Yanjuan Zhu
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin 300070, China
| | - Yunzhao Tang
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin 300070, China
| | - Zhu Li
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin 300070, China
| | - Chenguang Li
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin 300070, China
| | - Bin Li
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin 300070, China
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Ishitobi M, Hosaka T, Morita N, Kondo K, Murashima T, Kitahara A, Takahashi K, Sumitani Y, Tanaka T, Yokoyama T, Kondo T, Ishida H. Serum lactate levels are associated with serum alanine aminotransferase and total bilirubin levels in patients with type 2 diabetes mellitus: A cross-sectional study. Diabetes Res Clin Pract 2019; 149:1-8. [PMID: 30711436 DOI: 10.1016/j.diabres.2019.01.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 11/01/2018] [Revised: 12/28/2018] [Accepted: 01/24/2019] [Indexed: 12/15/2022]
Abstract
AIMS It was recently reported that lactate acts as a metabolic mediator and rises in the diabetic state, but the physiological effects are as yet poorly understood. The objective of the current study was to evaluate the significance of serum lactate elevation in type 2 diabetes mellitus (T2DM) patients. METHODS Fasting serum lactate levels, hematological and inflammatory serum markers and anthropometric parameters, obtained employing bioelectric impedance analysis, were measured in 103 patients with T2DM. RESULTS Statistically significant correlations of serum lactate levels with C-reactive peptide, insulin, aspartate aminotransferase, alanine aminotransferase (ALT), serum lipids, total bilirubin, adiponectin, homeostasis model assessment-insulin resistance, body weight, body mass index and body fat (weight or percentage of subcutaneous fat, visceral fat or total body fat), but neither fasting plasma glucose nor HbA1c, were detected. Stepwise regression analysis showed ALT to be independently positively associated with total bilirubin, while being negatively associated with serum lactate levels. Furthermore, serum lactate levels were significantly higher in patients with ALT-predominant liver dysfunction. CONCLUSION We found fasting serum lactate elevation in T2DM patients to be associated with the serum levels of ALT and total bilirubin independently of blood glucose control. TRIAL REGISTRATION UMIN clinical trials registry (UMIN000029178).
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Affiliation(s)
- Minori Ishitobi
- Third Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Kyorin University School of Medicine, Tokyo 181-8611, Japan
| | - Toshio Hosaka
- Graduate Program in Food and Nutritional Science, Graduate School of Integrated Pharmaceutical and Nutritional Science, The University of Shizuoka, Shizuoka 422-8526, Japan.
| | - Naru Morita
- Third Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Kyorin University School of Medicine, Tokyo 181-8611, Japan
| | - Ken Kondo
- Third Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Kyorin University School of Medicine, Tokyo 181-8611, Japan
| | - Toshitaka Murashima
- Third Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Kyorin University School of Medicine, Tokyo 181-8611, Japan
| | - Atsuko Kitahara
- Third Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Kyorin University School of Medicine, Tokyo 181-8611, Japan
| | - Kazuto Takahashi
- Third Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Kyorin University School of Medicine, Tokyo 181-8611, Japan
| | - Yoshikazu Sumitani
- Third Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Kyorin University School of Medicine, Tokyo 181-8611, Japan
| | - Toshiaki Tanaka
- Third Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Kyorin University School of Medicine, Tokyo 181-8611, Japan
| | | | - Takuma Kondo
- Third Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Kyorin University School of Medicine, Tokyo 181-8611, Japan
| | - Hitoshi Ishida
- Third Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Kyorin University School of Medicine, Tokyo 181-8611, Japan
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Yan P, Zhang Z, Miao Y, Xu Y, Zhu J, Wan Q. Physiological serum total bilirubin concentrations were inversely associated with diabetic peripheral neuropathy in Chinese patients with type 2 diabetes: a cross-sectional study. Diabetol Metab Syndr 2019; 11:100. [PMID: 31827625 PMCID: PMC6889527 DOI: 10.1186/s13098-019-0498-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 11/21/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Although bilirubin has been generally regarded as a waste with potential neurotoxicity at high levels, a few clinical studies suggest a potential protective role of physiological serum total bilirubin (TBIL) concentrations in diabetic peripheral neuropathy (DPN). However, the pathological mechanisms underlying the relationship remain poorly understood. The objective of this study was to explore the relationship between serum TBIL and DPN, and clinical and laboratory parameters. METHODS Serum TBIL was measured in 1342 patients with type 2 diabetes mellitus (T2DM). The relationship between TBIL and DPN and other parameters was analyzed. RESULTS Serum TBIL levels were significantly lower in T2DM patients with DPN, and were independently and negatively associated with vibration perception thresholds (VPT) (P < 0.01 or P < 0.05). Moreover, serum TBIL was negatively associated with neutrophil and white blood cell counts, fibrinogen, and the prevalence of hypertension, diabetic foot ulceration, peripheral arterial disease, diabetic nephropathy and diabetic retinopathy (P < 0.01 or P < 0.05). Additionally, serum TBIL was an independent decisive factor for the presence of DPN after multivariate adjustment. Compared to the highest quartile of TBIL, the lower quartiles were associated with a significantly increased risk of DPN (P < 0.01). Last but most importantly, the analysis of receiver operating characteristic curves revealed that the best cutoff value for serum TBIL to predict DPN was 10.75 μmol/L (sensitivity 54.6% and specificity 62.9%). CONCLUSIONS These findings suggest that lower physiological serum TBIL may be associated with the presence of DPN due to its decreased anti-inflammatory and vascular protective effects.
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Affiliation(s)
- Pijun Yan
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000 Sichuan China
| | - Zhihong Zhang
- Department of General Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000 Sichuan China
| | - Ying Miao
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000 Sichuan China
| | - Yong Xu
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000 Sichuan China
| | - Jianhua Zhu
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000 Sichuan China
| | - Qin Wan
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000 Sichuan China
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Nishimura T, Tanaka M, Saisho Y, Miyakoshi K, Tanaka M, Itoh H. Lower serum total bilirubin concentration is associated with higher prevalence of gestational diabetes mellitus in Japanese pregnant women. Endocr J 2018; 65:1199-1208. [PMID: 30305483 DOI: 10.1507/endocrj.ej17-0533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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] [Indexed: 11/23/2022] Open
Abstract
We aimed to clarify the pathophysiological significance of total bilirubin (TB) in gestational diabetes mellitus (GDM). This was a cross-sectional study that included 616 pregnant Japanese women (368 normal glucose tolerance [NGT] and 248 GDM). Serum TB concentration, homeostasis model assessment of insulin resistance (HOMA-IR), and other clinical parameters were compared in NGT and GDM women. TB concentration was also compared according to the number of abnormal OGTT values. Logistic regression analysis was used to evaluate the association between TB and GDM prevalence. A multiple linear regression model was used to evaluate the association between TB and HOMA-IR. TB concentrations were significantly lower in GDM women than in NGT women. This result did not change after adjustments for TB sampling timing were made. Out of 248 GDM women, the prevalences of 1- and 2/3- abnormal OGTT values (1- and 2/3-AV) GDM were 72.2% (n = 179) and 27.8% (n = 69), respectively. In the multiple comparisons, TB concentrations were significantly lower in women with 2/3-AV GDM than in women with NGT and 1-AV GDM. Multiple logistic regression analysis showed that TB was a significantly associated factor for 2/3-AV, but not for total GDM. HOMA-IR was significantly higher in GDM women than in NGT women. The univariate, but not multivariate, analysis showed that TB was a significantly associated factor for HOMA-IR. Our findings suggest that hypobilirubinemia may be involved in the pathogenesis of GDM.
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Affiliation(s)
- Takeshi Nishimura
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Masami Tanaka
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Yoshifumi Saisho
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kei Miyakoshi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Mamoru Tanaka
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Hiroshi Itoh
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
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Yang W, Xia J, Zhou G, Jiang D, Li Q, Wang S, Zheng X, Li X, Shen Y, Li X. Selective non-enzymatic total bilirubin detection in serum using europium complexes with different β-diketone-derived ligands as luminescence probes. Anal Bioanal Chem 2018; 410:6459-6468. [PMID: 30043114 DOI: 10.1007/s00216-018-1243-z] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/11/2018] [Accepted: 07/04/2018] [Indexed: 11/29/2022]
Abstract
Three europium(III) complexes, Eu(ectfd)3 (Hectfd = 1-(9-ethyl-9H-carbazol-7-yl)-4,4,4-trifluorobutane-1,3-dione), Eu(tta)3 (Htta = 4,4,4-trifluoro-1-(thiophen-2-yl)-butane-1,3-dione), and Eu(dbt)3 (Hdbt = 2-(4',4',4'-trifluoro-1',3'-dioxobutyl)dibenzothiophene), were synthesized and employed to detect total bilirubin (BR) in blood-serum samples. UV-visible absorption and fluorescence (FL) spectroscopies were used to evaluate the selectivity of each europium (III) fluorescence probe to BR, which was shown to remarkably reduce the luminescence intensities of the europium(III) complexes at a wavelength of 612 nm. The luminescence intensity of each complex is linearly related to BR concentration. Eu(tta)3 was shown to be the more-appropriate fluorescence probe for the sensitive and reliable detection of total BR in blood serum samples than either Eu(ectfd)3 or Eu(dbt)3. This observation can be ascribed to special σ-hole bonding between Htta and BR. In addition, the optimal pH test conditions for the detection of BR in human serum by the Eu(tta)3 probe were determined. Sensitivity was shown to be dramatically affected by the pH of the medium. The experimental results reveal that pH 7.5 is optimal for this probe, which coincides with the pH of human serum. Furthermore, BR detection using the Eu(tta)3 luminescence probe is simple, practical, and relatively free of interference from coexisting substances; it has a minimum detection limit (DL) of 68 nM and is a potential candidate for the routine assessment of total BR in serum samples. Graphical Abstract ᅟ.
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Affiliation(s)
- Wei Yang
- Department of Chemistry, East China Normal University, Shanghai, 200062, China
| | - Jinfeng Xia
- Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 200050, China
| | - Guohong Zhou
- Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 200050, China
| | - Danyu Jiang
- Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 200050, China
| | - Qiang Li
- Department of Chemistry, East China Normal University, Shanghai, 200062, China.
| | - Shiwei Wang
- Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 200050, China
| | - Xiaohong Zheng
- Department of Chemistry, East China Normal University, Shanghai, 200062, China
| | - Xi Li
- Department of Chemistry, East China Normal University, Shanghai, 200062, China
| | - Yibo Shen
- Department of Chemistry, East China Normal University, Shanghai, 200062, China
| | - Xin Li
- Department of Chemistry, East China Normal University, Shanghai, 200062, China
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Nishimura T, Tanaka M, Sekioka R, Itoh H. Serum total bilirubin concentration in patients with type 2 diabetes as a possible biomarker of polyvascular disease. Diabetol Int 2018; 9:129-135. [PMID: 30603360 PMCID: PMC6224939 DOI: 10.1007/s13340-017-0337-8] [Citation(s) in RCA: 3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 08/29/2017] [Indexed: 01/26/2023]
Abstract
AIMS The aim of this study was to investigate the association between serum total bilirubin concentration and complicated macrovascular diseases, such as cerebrovascular disease (CBVD), cardiovascular disease (CAD), and peripheral arterial disease (PAD), in patients with type 2 diabetes. METHODS We performed a retrospective cross-sectional study in 674 patients with type 2 diabetes. Serum total bilirubin concentration was compared between patients with and without CBVD, CAD, and PAD. Logistic regression analyses were performed to identify risk factors for CBVD, CAD, and PAD. Associations between total bilirubin concentration and the number of complicated macrovascular diseases were analyzed. RESULTS Patients with CBVD and PAD showed significantly lower serum total bilirubin concentrations than did those patients without those diseases. However, the bilirubin concentration did not differ between patients with and without CAD. Total bilirubin concentration was an independent predictor of CBVD, but not of CAD or PAD. There was a statistically significant trend for a decrease in bilirubin concentration in the presence of an increasing number of macrovascular diseases. CONCLUSION The presence of more than one macrovascular disease, called polyvascular disease, carries a high risk for cardiovascular mortality. Serum total bilirubin concentration may be useful as a clinical biomarker of polyvascular disease.
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Affiliation(s)
- Takeshi Nishimura
- Division of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Masami Tanaka
- Division of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Risa Sekioka
- Division of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
- Department of Internal Medicine, Jujo Takeda Rehabilitation Hospital, 32 Kisshoinhatsutandacho, Kyoto Minami-ku, Kyoto, 601-8325 Japan
| | - Hiroshi Itoh
- Division of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
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Choi YH, Lee CH, Ko MS, Han HJ, Kim SG. Lamivudine Therapy Exacerbates Bilirubinemia in Patients Underlying Severely Advanced Hepatitis. Toxicol Res 2017; 33:343-350. [PMID: 29071019 PMCID: PMC5654198 DOI: 10.5487/tr.2017.33.4.343] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 09/21/2017] [Accepted: 09/25/2017] [Indexed: 11/20/2022] Open
Abstract
Lamivudine belongs to the set of antiviral agents effective against hepatitis B virus infection. Given case reports on liver injuries after certain antiviral agent treatments, this study examined the effects of lamivudine on alanine aminotransferase (ALT) and total bilirubin (TB) using a medical system database. A total of 1,321 patients taking lamivudine alone or with others were evaluated using laboratory hits in an electronic medical system at Seoul National University Hospital from 2005 through 2011. The patients were grouped according to prior ALT results: G#1, ALT < 40 IU/L; G#2, 40 IU/L ≤ ALT < 120 IU/L; G#3, 120 IU/L ≤ ALT < 240 IU/L; and G#4, ALT ≥ 240 IU/L. In G#1 and G#2 patients, lamivudine or adefovir treatment decreased ALT and TB compared to prior values. In G#3 and G#4 patients with three times the upper limit of normal (ULN) ≤ ALT < 15 times the ULN, both ALT and TB were decreased after treatment with lamivudine alone, or adefovir following lamivudine therapy, indicating that lamivudine therapy ameliorated liver functions. However, in G#4 patients who experienced severely advanced hepatitis (ALT ≥ 15 times the ULN, or ≥ 600 IU/L), lamivudine augmented TBmax (6.3→13.3 mg/dL) despite a slight improvement in ALT (839→783 IU/L), indicative of exacerbation of bilirubinemia. Patients who used adefovir after lamivudine also showed a high incidence of hyperbilirubinemia when they experienced severely advanced hepatitis. Treatment with adefovir alone did not show the effect. In conclusion, lamivudine may increase the risk of hyperbilirubinemia in patients with severely advanced hepatitis, implying that caution should be exercised when using lamivudine therapy in certain patient populations.
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Affiliation(s)
- Young Hee Choi
- College of Pharmacy, Dongguk University_Seoul, Seoul,
Korea
| | - Chang Ho Lee
- Department of Pharmacology, College of Medicine, Hanyang University, Seoul,
Korea
| | - Myong Suk Ko
- Korea Intellectual Property Strategy Agency, Business Cooperation Team, Seoul,
Korea
| | - Hyun Joo Han
- Department of Pharmacy, Seoul National University Hospital, Seoul,
Korea
| | - Sang Geon Kim
- Department of Pharmacy, Seoul National University Hospital, Seoul,
Korea
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul,
Korea
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Kawamoto R, Ninomiya D, Senzaki K, Kasai Y, Kusunoki T, Ohtsuka N, Kumagi T. Interactive association of serum uric acid and total bilirubin with renal dysfunction among community-dwelling subjects. Int Urol Nephrol 2017; 49:1439-1446. [PMID: 28573490 DOI: 10.1007/s11255-017-1633-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 04/19/2017] [Accepted: 05/26/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Chronic kidney disease is a major public health concern. Serum uric acid (SUA) at high levels was oxidative stress agents, and total bilirubin (T-BiL) at mildly increased levels was potent antioxidants, but whether SUA and T-BiL produce an additive interaction for the risk of renal dysfunction remains unclear. METHODS The subjects comprised 567 men aged 71 ± 8 (mean ± standard deviation) years and 853 women aged 70 ± 8 years from a rural village. We examined the relationship between SUA and T-BiL, and renal function was evaluated by estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease Study Group equation. RESULTS Stepwise multiple regression analysis using eGFR as an objective variable, adjusted for risk factors as explanatory variables, showed that SUA (β = -0.358, p < 0.001) as well as age (β = -0.534, p < 0.001), drinking status (β = 0.119, p < 0.001), and the presence of antihypertensive medication (β = -0.058, p = 0.005) were significantly and independently associated with eGFR, but T-BiL was not associated with eGFR. While in the group with the highest tertile of SUA, T-BiL (β = 0.081, p = 0.032) was significantly and independently associated with eGFR, and in the group with the lowest to middle tertile of SUA, T-BiL was not associated with eGFR. In addition, interaction between SUA and T-BiL (F = 8.512, p = 0.004) as well as age, drinking status, the presence of antihypertensive medication, SUA, and T-BiL was a significant and independent determinant for eGFR. CONCLUSIONS Our data demonstrated that low T-BiL could be important as a potential risk factor for renal dysfunction in those with high SUA.
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Affiliation(s)
- Ryuichi Kawamoto
- Department of Community Medicine, Ehime University Graduate School of Medicine, Toon-city, 791-0295, Japan. .,Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, 797-1212, Japan.
| | - Daisuke Ninomiya
- Department of Community Medicine, Ehime University Graduate School of Medicine, Toon-city, 791-0295, Japan.,Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, 797-1212, Japan
| | - Kensuke Senzaki
- Department of Community Medicine, Ehime University Graduate School of Medicine, Toon-city, 791-0295, Japan.,Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, 797-1212, Japan
| | - Yoshihisa Kasai
- Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, 797-1212, Japan
| | - Tomo Kusunoki
- Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, 797-1212, Japan
| | - Nobuyuki Ohtsuka
- Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, 797-1212, Japan
| | - Teru Kumagi
- Department of Community Medicine, Ehime University Graduate School of Medicine, Toon-city, 791-0295, Japan
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Liu C, Zhong C, Zhou X, Chen R, Wu J, Wang W, Li X, Ding H, Guo Y, Gao Q, Hu X, Xiong G, Yang X, Hao L, Xiao M, Yang N. Higher direct bilirubin levels during mid-pregnancy are associated with lower risk of gestational diabetes mellitus. Endocrine 2017; 55:165-172. [PMID: 27726090 DOI: 10.1007/s12020-016-1103-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 07/13/2016] [Accepted: 08/24/2016] [Indexed: 12/16/2022]
Abstract
Bilirubin concentrations have been recently reported to be negatively associated with type 2 diabetes mellitus. We examined the association between bilirubin concentrations and gestational diabetes mellitus. In a prospective cohort study, 2969 pregnant women were recruited prior to 16 weeks of gestation and were followed up until delivery. The value of bilirubin was tested and oral glucose tolerance test was conducted to screen gestational diabetes mellitus. The relationship between serum bilirubin concentration and gestational weeks was studied by two-piecewise linear regression. A subsample of 1135 participants with serum bilirubin test during 16-18 weeks gestation was conducted to research the association between serum bilirubin levels and risk of gestational diabetes mellitus by logistic regression. Gestational diabetes mellitus developed in 8.5 % of the participants (223 of 2969). Two-piecewise linear regression analyses demonstrated that the levels of bilirubin decreased with gestational week up to the turning point 23 and after that point, levels of bilirubin were increased slightly. In multiple logistic regression analysis, the relative risk of developing gestational diabetes mellitus was lower in the highest tertile of direct bilirubin than that in the lowest tertile (RR 0.60; 95 % CI, 0.35-0.89). The results suggested that women with higher serum direct bilirubin levels during the second trimester of pregnancy have lower risk for development of gestational diabetes mellitus.
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Affiliation(s)
- Chaoqun Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Chunrong Zhong
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Xuezhen Zhou
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Renjuan Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Jiangyue Wu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Weiye Wang
- Departments of Epidemiology and Health Statistic, Wuhan, China
| | - Xiating Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Huisi Ding
- Departments of Epidemiology and Health Statistic, Wuhan, China
| | - Yanfang Guo
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Qin Gao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Xingwen Hu
- Hubei Maternal and Child Health Hospital, Wuhan, 430070, Hubei, China
| | - Guoping Xiong
- The Central Hospital of Wuhan, Wuhan, 430014, Hubei, China
| | - Xuefeng Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Liping Hao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Mei Xiao
- Hubei Maternal and Child Health Hospital, Wuhan, 430070, Hubei, China
| | - Nianhong Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.
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Kim KS, Moon A, Kang HJ, Shin HY, Choi YH, Kim HS, Kim SG. Higher plasma bilirubin predicts veno-occlusive disease in early childhood undergoing hematopoietic stem cell transplantation with cyclosporine. World J Transplant 2016; 6:403-410. [PMID: 27358786 PMCID: PMC4919745 DOI: 10.5500/wjt.v6.i2.403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 02/15/2016] [Accepted: 03/18/2016] [Indexed: 02/05/2023] Open
Abstract
AIM: To analyze the association between plasma bilirubin levels and veno-occlusive disease (VOD) in non-adult patients undergoing hematopoietic stem cell transplantation (HSCT) during cyclosporine therapy.
METHODS: A total of 123 patients taking cyclosporine were evaluated using an electronic medical system at the Seoul National University Children’s Hospital from the years 2004 through 2011. Patients were grouped by age and analyzed for incidence and type of adverse drug reactions (ADRs) including VOD.
RESULTS: The HSCT patients were divided into three age groups: G#1 ≥ 18; 9 ≤ G#2 ≤ 17; and G#3 ≤ 8 years of age). The majority of transplant donor types were cord blood transplantations. Most prevalent ADRs represented acute graft-vs-host disease (aGVHD) and VOD. Although the incidences of aGVHD did not vary among the groups, the higher frequency ratios of VOD in G#3 suggested that an age of 8 or younger is a risk factor for developing VOD in HSCT patients. After cyclosporine therapy, the trough plasma concentrations of cyclosporine were lower in G#3 than in G#1, indicative of its increased clearance. Moreover, in G#3 only, a maximal total bilirubin level (BILmax) of ≥ 1.4 mg/dL correlated with VOD incidence after cyclosporine therapy.
CONCLUSION: HSCT patients 8 years of age or younger are more at risk for developing VOD, diagnosed as hyperbilirubinemia, tender hepatomegaly, and ascites/weight gain after cyclosporine therapy, which may be represented by a criterion of plasma BILmax being ≥ 1.4 mg/dL, suggestive of more sensitive VOD indication in this age group.
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Ou Yang Q, Zhang S, Cheng QB, Li B, Feng FL, Yu Y, Luo XJ, Lin ZF, Jiang XQ. Dynamic Change of Total Bilirubin after Portal Vein Embolization is Predictive of Major Complications and Posthepatectomy Mortality in Patients with Hilar Cholangiocarcinoma. J Gastrointest Surg 2016; 20:960-9. [PMID: 26831059 DOI: 10.1007/s11605-016-3086-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/14/2015] [Accepted: 01/14/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This study aims to evaluate the role of dynamic change in total bilirubin after portal vein embolization (PVE) in predicting major complications and 30-day mortality in patients with hilar cholangiocarcinoma (HCCA). METHODS Retrospective analysis of prospectively maintained data of 64 HCCA patients who underwent PVE before hepatectomy in our institution was used. Total bilirubin and other parameters were measured daily in peri-PVE period. The difference between them and the baseline value from days 0-5 to day -1 (∆D1) and days 5-14 to day -1 (∆D2) were calculated. The relationship between ∆D1 and ∆D2 of total bilirubin and major complications as well as 30-day mortality was analyzed. RESULTS Out of 64 patients, 10 developed major complications (15.6 %) and 6 patients (9.3 %) had died within 30 days after surgery. The ∆D2 of total bilirubin after PVE was most significantly associated with major complications (P < 0.001) and 30-day mortality (P = 0.002). In addition, it was found to be an independent predictor of major complications after PVE (odds ratio (OR) = 1.050; 95 % CI 1.017-1.084). ASA >3 (OR = 12.048; 95 % CI 1.019-143.321), ∆D2 of total bilirubin (OR = 1.058; 95 % CI 1.007-1.112), and ∆D2 of prealbumin (OR = 0.975; 95 % CI 0.952-0.999) were associated with higher risk of 30-day mortality after PVE. Receiver operating characteristic curves showed that ∆D2 of total bilirubin were better predictors than ∆D1 for major complications (AUC (∆D2) 0.817; P = 0.002 vs. AUC (∆D1) 0.769; P = 0.007) and 30-day mortality (ACU(∆D2) 0.868; P = 0.003 vs. AUC(∆D1) 0.721;P = 0.076). CONCLUSION Patients with increased total bilirubin in 5-14 days after PVE may indicate a higher risk of major complications and 30-day mortality if the major hepatectomy were performed.
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Lo SY, Saifee NH, Mason BO, Greene DN. Filling in the gaps with non-standard body fluids. Pract Lab Med 2016; 5:24-31. [PMID: 28856201 PMCID: PMC5574517 DOI: 10.1016/j.plabm.2016.03.003] [Citation(s) in RCA: 8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 03/05/2016] [Accepted: 03/15/2016] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES Body fluid specimens other than serum, plasma or urine are generally not validated by manufacturers, but analysis of these non-standard fluids can be important for clinical diagnosis and management. Laboratories, therefore, rely on the published literature to better understand the validation and implementation of such tests. This study utilized a data-driven approach to determine the clinical reportable range for 11 analytes, evaluated a total bilirubin assay, and assessed interferences from hemolysis, icterus, and lipemia in non-standard fluids. DESIGN AND METHODS Historical measurements in non-standard body fluids run on a Beckman Coulter DxC800 were used to optimize population-specific clinical reportable ranges for albumin, amylase, creatinine, glucose, lactate dehydrogenase, lipase, total bilirubin, total cholesterol, total protein, triglyceride and urea nitrogen run on the Beckman Coulter AU680. For these 11 analytes, interference studies were performed by spiking hemolysate, bilirubin, or Intralipid® into abnormal serous fluids. Precision, accuracy, linearity, and stability of total bilirubin in non-standard fluids was evaluated on the Beckman Coulter AU680 analyzer. RESULTS The historical non-standard fluid results indicated that in order to report a numeric result, 4 assays required no dilution, 5 assays required onboard dilutions and 2 assays required both onboard and manual dilutions. The AU680 total bilirubin assay is suitable for clinical testing of non-standard fluids. Interference studies revealed that of the 11 total AU680 analyte measurements on non-standard fluids, lipemia affected 1, icterus affected 3, and hemolysis affected 5. CONCLUSIONS Chemistry analytes measured on the AU680 demonstrate acceptable analytical performance for non-standard fluids. Common endogenous interference from lipemia, icterus, and hemolysis (LIH) are observed and flagging rules based on LIH indices were developed to help improve the clinical interpretation of results.
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Affiliation(s)
- Sheng-Ying Lo
- Department of Laboratory Medicine, Chemistry Division, University of Washington, Seattle, WA, USA
| | - Nabiha H Saifee
- Department of Laboratory Medicine, Chemistry Division, University of Washington, Seattle, WA, USA
| | - Brook O Mason
- Department of Laboratory Medicine, Chemistry Division, University of Washington, Seattle, WA, USA
| | - Dina N Greene
- Department of Laboratory Medicine, Chemistry Division, University of Washington, Seattle, WA, USA
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Nishimura T, Tanaka M, Sekioka R, Itoh H. Serum bilirubin concentration is associated with eGFR and urinary albumin excretion in patients with type 1 diabetes mellitus. J Diabetes Complications 2015; 29:1223-7. [PMID: 26234498 DOI: 10.1016/j.jdiacomp.2015.07.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [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: 04/30/2015] [Revised: 07/01/2015] [Accepted: 07/01/2015] [Indexed: 11/15/2022]
Abstract
AIMS Although relationships of serum bilirubin concentration with estimated glomerular filtration rate (eGFR) and urinary albumin excretion (UAE) in patients with type 2 diabetes have been reported, whether such relationships exist in patients with type 1 diabetes is unknown. METHODS A total of 123 patients with type 1 diabetes were investigated in this cross-sectional study. The relationship between bilirubin (total and indirect) concentrations and log(UAE) as well as eGFR was examined by Pearson's correlation analyses. Multivariate regression analyses were used to assess the association of bilirubin (total and indirect) with eGFR as well as log(UAE). RESULTS A positive correlation was found between serum bilirubin concentration and eGFR; total bilirubin (r=0.223, p=0.013), indirect bilirubin (r=0.244, p=0.007). A negative correlation was found between serum bilirubin concentration and log(UAE); total bilirubin (r=-0.258, p=0.005), indirect bilirubin (r=-0.271, p=0.003). Multivariate regression analyses showed that indirect bilirubin concentration was an independent determinant of eGFR and log(UAE). CONCLUSIONS Bilirubin concentration is associated with both eGFR and log(UAE) in patients with type 1 diabetes. Bilirubin might have a protective role in the progression of type 1 diabetic nephropathy.
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Affiliation(s)
- Takeshi Nishimura
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Masami Tanaka
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Risa Sekioka
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hiroshi Itoh
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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Hamamoto S, Kaneto H, Kamei S, Shimoda M, Tawaramoto K, Kanda-Kimura Y, Kawasaki F, Hashiramoto M, Matsuki M, Mune T, Kaku K. Low bilirubin levels are an independent risk factor for diabetic retinopathy and nephropathy in Japanese patients with type 2 diabetes. Diabetes Metab 2015; 41:429-31. [PMID: 26054296 DOI: 10.1016/j.diabet.2015.05.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 05/07/2015] [Accepted: 05/10/2015] [Indexed: 11/17/2022]
Affiliation(s)
- S Hamamoto
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
| | - H Kaneto
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan.
| | - S Kamei
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
| | - M Shimoda
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
| | - K Tawaramoto
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
| | - Y Kanda-Kimura
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
| | - F Kawasaki
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
| | - M Hashiramoto
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
| | - M Matsuki
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
| | - T Mune
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
| | - K Kaku
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
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Nirmala M, Girija K, Lakshman K, Divya T. Hepatoprotective activity of Musa paradisiaca on experimental animal models. Asian Pac J Trop Biomed 2012; 2:11-5. [PMID: 23569826 DOI: 10.1016/S2221-1691(11)60181-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Revised: 06/07/2011] [Accepted: 06/21/2011] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To investigate the hepatoprotective activity of stem of Musa paradisiaca (M. paradisiaca) in CCl4 and paracetamol induced hepatotoxicity models in rats. METHODS Hepatoprotective activity of alcoholic and aqueous extracts of stem of M. paradisiaca was demonstrated by using two experimentally induced hepatotoxicity models. RESULTS Administration of hepatotoxins (CCl4 and paracetamol) showed significant biochemical and histological deteriorations in the liver of experimental animals. Pretreatment with alcoholic extract (500 mg/kg), more significantly and to a lesser extent the alcoholic extract (250 mg/kg) and aqueous extract (500 mg/kg), reduced the elevated levels of the serum enzymes like serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), alkaline phosphatase (ALP) and bilirubin levels and alcoholic and aqueous extracts reversed the hepatic damage towards the normal, which further evidenced the hepatoprotective activity of stem of M. paradisiaca. CONCLUSIONS The alcoholic extract at doses of 250 and 500 mg/kg, p.o. and aqueous extract at a dose of 500 mg/kg, p.o. of stem of M. paradisiaca have significant effect on the liver of CCl4 and paracetamol induced hepatotoxicity animal models.
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Sekioka R, Tanaka M, Nishimura T, Itoh H. Serum total bilirubin concentration is negatively associated with increasing severity of retinopathy in patients with type 2 diabetes mellitus. J Diabetes Complications 2015; 29:218-21. [PMID: 25536865 DOI: 10.1016/j.jdiacomp.2014.12.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [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: 10/21/2014] [Revised: 11/25/2014] [Accepted: 12/01/2014] [Indexed: 11/19/2022]
Abstract
AIMS Serum bilirubin concentration is associated with diabetic retinopathy in patients with type 2 diabetes. This study investigated the relationships between serum bilirubin concentration and the severity of diabetic retinopathy. In addition, the importance of bilirubin was compared with factors that were previously shown to be associated with the incidence of diabetic retinopathy. METHODS A total of 674 patients with type 2 diabetes were investigated in this cross-sectional study. Serum total bilirubin concentration was compared between patients with and without diabetic retinopathy, and according to the severity of retinopathy. Univariate and multivariate analyses were performed to evaluate the association of retinopathy with total bilirubin concentration, duration of diabetes, body mass index, systolic blood pressure, and haemoglobin A1c. RESULTS Serum total bilirubin concentration was significantly lower in patients with retinopathy than in those without. Patients with severer retinopathy showed lower total bilirubin concentration, longer diabetes duration, and higher systolic blood pressure. These three parameters were independent explanatory factors for diabetic retinopathy. CONCLUSIONS Total bilirubin concentration is lower in patients with type 2 diabetes complicated with severer retinopathy. Thus, bilirubin might protect against retinopathy in patients with type 2 diabetes.
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Affiliation(s)
- Risa Sekioka
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Masami Tanaka
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Takeshi Nishimura
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Hiroshi Itoh
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
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Su ZJ, Yu XP, Guo RY, Ming DS, Huang LY, Su ML, Deng Y, Lin ZZ. Changes in the balance between Treg and Th17 cells in patients with chronic hepatitis B. Diagn Microbiol Infect Dis 2013; 76:437-44. [PMID: 23747030 DOI: 10.1016/j.diagmicrobio.2013.04.026] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [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: 10/17/2012] [Revised: 04/12/2013] [Accepted: 04/26/2013] [Indexed: 12/21/2022]
Abstract
The purpose of this study was to explore the role of Treg cells, Th17 cells and cytokines associated with Treg/Th17 differentiation in the occurrence, development and outcome of chronic hepatitis B (CHB). To do so, we detected populations of Treg and Th17 cells and their associated cytokines in the peripheral blood of CHB patients. The populations of Treg cells (CD4(+)CD25(high)CD127(low) T cells) and Th17 cells (CD3(+)CD8(-)IL-17(+) T cells) were analyzed in 46 patients with low to moderate chronic hepatitis B (CHB-LM), 24 patients with severe chronic hepatitis B (CHB-S) and 20 healthy controls (HC) using flow cytometry. The levels of cytokines associated with Treg/Th17 differentiation, including IL-10, TGF-β1, IL-17 and IL-23, were measured by enzyme-linked immunosorbent assay (ELISA). Our study showed that the imbalance of Treg and Th17 cells might play an important role in the occurrence, development and outcome of CHB.
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Affiliation(s)
- Zhi-Jun Su
- Department of Infectious Diseases, First Hospital of Quanzhou, Fujian Medical University, Quanzhou 362000, China.
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Park HM, Lee DW, Hyun MC, Lee SB. Predictors of nonresponse to intravenous immunoglobulin therapy in Kawasaki disease. Korean J Pediatr 2013; 56:75-9. [PMID: 23482814 PMCID: PMC3589594 DOI: 10.3345/kjp.2013.56.2.75] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [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: 07/07/2012] [Revised: 09/11/2012] [Accepted: 10/24/2012] [Indexed: 12/12/2022]
Abstract
Purpose It has been reported that 10% to 20% of children with Kawasaki disease (KD) will not respond to intravenous immunoglobulin (IVIG) treatment. In this study, we aimed to identify useful predictors of therapeutic failure in children with KD. Methods We examined 309 children diagnosed with KD at the Kyungpook National University Hospital and the Inje University Busan Paik Hospital between January 2005 and June 2011. We retrospectively reviewed their medical records and analyzed multiple parameters in responders and nonresponders to IVIG. Results Among the 309 children, 30 (9.7%) did not respond to IVIG. They had significantly higher proportion of neutrophils, and higher levels of aspartate aminotransferase, alanine aminotransferase (ALT), total bilirubin, and N-terminal fragment of B-type natriuretic peptide than did responders. IVIG-nonresponders had a significantly longer duration of hospitalization, and more frequently experienced coronary artery lesion, and sterile pyuria. No differences in the duration of fever at initial treatment or, clinical features were noted. Conclusion Two independent predictors (ALT≥84 IU/L, total bilirubin≥0.9 mg/dL) for nonresponse were confirmed through multivariate logistic regression analysis. Thus elevated ALT and total bilirubin levels might be useful in predicting nonresponse to IVIG therapy in children with KD.
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Affiliation(s)
- Hyo Min Park
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
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Cheng XL, Shi KW, Xu J, Li W. Variation of NF-κB and its effect on immune response in rats with obstructive jaundice. Shijie Huaren Xiaohua Zazhi 2009; 17:662-666. [DOI: 10.11569/wcjd.v17.i7.662] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the variation of NF-κB and its effect on immune response in rats with obstructive jaundice (OJ).
METHODS: Sixty male Wistar rats were randomized into 3 groups, that is, sham operation group, common bile duct ligation (CBDL) group, and CBDL+PDCT group. Liver histopathology, levels of serum TB, ALT and LPS, liver IL-1β, IL-6, IL-10 and NF-κB were detected at 7 d and 14 d after operation respectively in each group (n = 10).
RESULTS: In CBDL group, all rats were injured with the liver histological damage, in which the level of serum TB, ALT, LPS were all increased as compared with those in SHAM group 7 d and 14 d post-operation (7 d: 140.14 ± 10.17 vs 7.309 ± 1.04, 134.479 ± 10.20 vs 35.79 ± 3.76, 189.33 ± 11.05 vs 2.816 ± 0.58; 14 d: 194.608 ± 12.73 vs 36.142 ± 3.51, 217.797 ± 12.37 vs 7.321 ± 1.03, 292.816 ± 14.53 vs 2.664 ± 0.53, all P < 0.01), besides, expressions of IL-1β, IL-6, IL-10 and NF-κB in liver were increased at day 7 (P < 0.01) and even more significant at day 14 (P < 0.01). After PDTC administration, compared with those in CBDL group, the level of serum TB, ALT as well as the expressions of IL-1β, IL-6 and NF-κB in liver were all significantly decreased at 7 d (P < 0.01), while at 14 d there was no significant difference. However, after PDTC administration, compared with those in CBDL group, there was no significant difference for the level of LPS and IL-10 at both 7 d or 14 d.
CONCLUSION: In the early days (7 d), PDTC does play a protective role in OJ by down-regulating the activation of NF-κB and down-regulating IL-1β and IL-6, so as to alleviate the injuries of liver tissues. While in the late days (14 d), PDTC has no significant effect, which may be caused by LPS, IL-10 and other functional channels.
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