RESUMEN
BACKGROUND: Elevated liver enzyme levels have been associated with metabolic syndrome in both obese and non-obese pediatric populations. This study aims to compare the serum liver enzyme levels in obese adolescents with and without insulin resistance (IR). METHODS: A cross-sectional analysis was conducted involving obese adolescents aged 10-18. We assessed somatometry, serum insulin levels, lipid profiles, and liver enzymes (aspartate aminotransferase [AST], alanine aminotransferase [ALT], and gamma-glutamyl transferase [GGT]). Statistical differences between groups were evaluated using Student's t-test or the Chi-squared test, with IR (wIR) status matched by propensity scores based on body mass index (BMI) z-scores. RESULTS: The study included 365 adolescents with obesity, 229 wIR, and 136 without (woIR). Before matching, the wIR group had a significantly higher BMI z-score (2.21 vs. 2.14, p = 0.032). After matching for BMI z-scores (n = 122 each group), the wIR group displayed significantly higher levels of AST (32.3 vs. 24.7, p < 0.001) and ALT (42.4 vs. 30.9, p < 0.001), but no significant differences were observed in GGT levels (37.4 vs. 32.5, p = 0.855). CONCLUSION: Obese adolescent's wIR exhibit higher serum ALT and AST levels, suggesting that altered AST is a potential risk factor for IR.
INTRODUCCIÓN: Se ha observado asociación entre niveles elevados de enzimas hepáticas y síndrome metabólico en población pediátrica con y sin obesidad. El objetivo del estudio fue comparar los niveles séricos de enzimas hepáticas entre adolescentes con obesidad con y sin resistencia a la insulina (RI). MÉTODOS: Se realizó un estudio transversal en adolescentes con obesidad entre 10 y 18 años. Se analizaron los datos somatometricos, insulina sérica, perfil lipídico y niveles de enzimas hepáticas (aspartato aminotransferasa [AST], alanina aminotransferasa [ALT] y gamma-glutamil transferasa [GGT]). Análisis estadístico: se utilizó t de Student o la prueba de Chi-cuadrado para evaluar diferencias entre grupos. Los pacientes con RI se emparejaron con pacientes sin RI utilizando puntuaciones de propensión basadas en la puntuación z del IMC. RESULTADOS: Se incluyeron un total de 365 adolescentes con obesidad (229 con RI y 136 sin RI). El grupo con RI tuvo un IMC mayor (con RI 2.21 vs sin RI 2.14 p = 0.032). Después de emparejar los grupos según el IMCz (n = 122 por grupo), el grupo con RI tuvo niveles de AST (24.7 vs., 32.3, p < 0.001) y ALT (30.9 vs., 42.4, p < 0.001) significativamente más altos en comparación al grupo sin RI. Sin embargo, no hubo diferencia en los niveles de GTT (37.4 vs 32.5, p = 0.855). CONCLUSIONES: Los niveles séricos de ALT y AST en adolescents con obesidad y RI fueron mayores. La AST alterada fue un factor de riesgo para presentar RI.
Asunto(s)
Alanina Transaminasa , Aspartato Aminotransferasas , Índice de Masa Corporal , Resistencia a la Insulina , Hígado , Obesidad Infantil , Puntaje de Propensión , gamma-Glutamiltransferasa , Humanos , Adolescente , Estudios Transversales , Femenino , Masculino , Alanina Transaminasa/sangre , Niño , Aspartato Aminotransferasas/sangre , gamma-Glutamiltransferasa/sangre , Hígado/enzimología , Síndrome Metabólico/sangre , Insulina/sangreRESUMEN
OBJECTIVE: Direct-acting antiviral (DAA) drugs have resulted in high rates of virological cure in chronic hepatitis C (CHC)-infected patients. We used noninvasive tests to assess fibrosis in subjects who had been cured with DAA. METHODS: Retrospective data collection (2014-2019) from the medical record of CHC patients at the hepatology clinic was performed. Subjects co-infected with HIV and hepatitis B, post-liver transplant, and lost to follow-up were excluded. We evaluated fibrosis at baseline and 1 year after completing therapy using vibration-controlled transient elastography (VCTE), fibrosis-4 (FIB-4), and aspartate aminotransferase-toplatelet ratio index (APRI) scores. RESULTS: With 210 medical records reviewed, 41 were included. The mean age was 62.8 years; 61% were men. Significant fibrosis regression was observed 1-year post-treatment using 3 noninvasive methods: VCTE, APRI, and FIB-4 score. Prior to treatment, 46% of the patients had advanced fibrosis compared to 25% 1 year after treatment. The VCTE scores of 4 subjects (with body mass indices [BMIs] > 30) indicated a worsening of fibrosis. We did not find a statistically significant association between BMI and VCTE, FIB-4, or APRI score. CONCLUSION: In most CHC patients, DAA therapy leads to liver fibrosis regression. Obesity may play an important role in the worsening of hepatic fibrosis or the absence of fibrosis regression.
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Antivirales , Diagnóstico por Imagen de Elasticidad , Hepatitis C Crónica , Cirrosis Hepática , Humanos , Persona de Mediana Edad , Masculino , Estudios Retrospectivos , Hepatitis C Crónica/tratamiento farmacológico , Hepatitis C Crónica/complicaciones , Antivirales/administración & dosificación , Femenino , Diagnóstico por Imagen de Elasticidad/métodos , Anciano , Puerto Rico , Aspartato Aminotransferasas/sangre , Estudios de CohortesRESUMEN
OBJECTIVE: Cisplatin, a widely used anticancer agent, induces hepatotoxicity alongside organ damage. Understanding Cisplatin's toxicity mechanism and developing preventive measures are crucial. Our study explores Myricetin, a flavonoid, for its protective effects against Cisplatin-induced hepatotoxicity. METHODS: In our study, a total of 32 Wistar albino male rats were utilized, which were categorized into four distinct groups: Control, Myricetin, Cisplatin, and Myricetin+Cisplatin. For the histological assessment of hepatic tissues, hematoxylin-eosin and periodic acid Schiff staining were employed, alongside immunohistochemical measurements of TNF-α, interleukin-17, and interleukin-6 immunoreactivity. Additionally, aspartate transaminase and alanine transaminase values were examined by biochemical analysis. RESULTS: In the histological evaluation of the tissues, a normal healthy cell structure and a strong periodic acid Schiff (+) reaction were observed in the hepatocyte cells in the tissues of the Control and Myricetin groups, while intense eosinophilia, minimal vacuolization, congestion, and sinusoidal expansions were observed in the hematoxylin-eosin stainings, and a decrease in the positive reaction in the periodic acid Schiff staining was observed in the Cisplatin group. Consistent with these histological findings, an increase in TNF-α, interleukin-17, and interleukin-6 expressions (p<0.0001) and a concomitant increase in aspartate transaminase and alanine transaminase values were observed in the Cisplatin group. In the group protected by Myricetin, a significant improvement was observed in all these histological and biochemical values. CONCLUSION: Cisplatin induces notable histopathological alterations in the liver. In this context, Myricetin exhibits the potential to alleviate Cisplatin-induced damage by modulating histological parameters and biochemical processes.
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Alanina Transaminasa , Antineoplásicos , Aspartato Aminotransferasas , Enfermedad Hepática Inducida por Sustancias y Drogas , Cisplatino , Flavonoides , Interleucina-6 , Ratas Wistar , Factor de Necrosis Tumoral alfa , Animales , Flavonoides/farmacología , Flavonoides/uso terapéutico , Cisplatino/toxicidad , Masculino , Enfermedad Hepática Inducida por Sustancias y Drogas/prevención & control , Enfermedad Hepática Inducida por Sustancias y Drogas/patología , Alanina Transaminasa/sangre , Aspartato Aminotransferasas/sangre , Antineoplásicos/efectos adversos , Antineoplásicos/toxicidad , Interleucina-6/análisis , Interleucina-6/metabolismo , Hígado/efectos de los fármacos , Hígado/patología , Ratas , Interleucina-17/metabolismo , InmunohistoquímicaRESUMEN
The daily variations of temperature are one of the main synchronizers of the circadian rhythms. In addition, water temperature influences the embryonic and larval development of fish and directly affects their metabolic processes. The application of thermocycles to fish larvae has been reported to improve growth and the maturation of the digestive system, but their effects on metabolism are poorly understood. The aim of the present study was to evaluate the effect of two different temperature regimes, cycling versus constant, on the daily rhythms of metabolic factors of Nile tilapia (Oreochromis niloticus) larvae. For this purpose, fertilized eggs were divided into two groups: one reared in a 31 °C:25 °C day:night thermocycle (TCY) and another group maintained in a constant 28 °C temperature (CTE). The photoperiod was set to a 12:12 h light/dark cycle. Samples were collected every 4 h during a 24-h cycle on days 4, 8 and 13 post fertilization (dpf). The expression levels of alanine aminotransferase (alt), aspartate aminotransferase (ast), malic enzyme, glucose-6-phosphate dehydrogenase (g6pd), phosphofructokinase (pfk) and pyruvate kinase (pk) were analyzed by qPCR. Results showed that, in 13 dpf animals, most of the genes analyzed (alt, ast, malic, g6pd and pfk) showed daily rhythms in TCY, but not in the group kept at constant temperature, with most acrophases detected during the feeding period. An increase in nutrient metabolism around feeding time can improve food utilization and thus increase larval performance. Therefore, the use of thermocycles is recommended for tilapia larviculture.
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Cíclidos , Ritmo Circadiano , Temperatura , Animales , Cíclidos/crecimiento & desarrollo , Cíclidos/metabolismo , Cíclidos/fisiología , Cíclidos/genética , Ritmo Circadiano/fisiología , Larva/crecimiento & desarrollo , Larva/metabolismo , Fotoperiodo , Glucosafosfato Deshidrogenasa/metabolismo , Glucosafosfato Deshidrogenasa/genética , Aspartato Aminotransferasas/metabolismo , Alanina Transaminasa/metabolismoRESUMEN
INTRODUCTION AND OBJECTIVES: Autoimmune hepatitis (AIH) is a rare disease with a complex and not fully understood pathogenesis. Prognostic factors that might influence treatment response, relapse rates, and transplant-free survival are not well established. This study investigates clinical and biochemical markers associated with response to immunosuppression in patients with AIH. MATERIALS AND METHODS: This retrospective cohort study included 102 patients with AIH treated with immunosuppressants and followed at the Federal University of Minas Gerais, Brazil, from 1990 to 2018. Pretreatment data such as clinical profiles, laboratory, and histological exams were analyzed regarding biochemical response at one year, histological remission, relapse, and death/transplantation rates. RESULTS: Cirrhosis was present in 59 % of cases at diagnosis. One-year biochemical remission was observed in 55.7 % of the patients and was found to be a protective factor for liver transplant. Overall survival was 89 %. Patients with ascites at disease onset showed a higher aspartate aminotransferase (AST)/ alanine aminotransferase (ALT) ratio and elevated Model of end-stage liver disease (MELD) score. The presence of ascites was significantly associated with a 20-fold increase in mortality rate. CONCLUSIONS: AIH has a severe clinical phenotype in Brazilians, with high rates of cirrhosis and low remission rates. Early diagnosis and treatment are essential for achieving remission and reducing complications. The presence of ascites is significantly associated with mortality, emphasizing the importance of monitoring and prompt intervention. This study also stresses the need for further research on AIH in Latin America.
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Hepatitis Autoinmune , Inmunosupresores , Humanos , Hepatitis Autoinmune/tratamiento farmacológico , Hepatitis Autoinmune/sangre , Hepatitis Autoinmune/mortalidad , Hepatitis Autoinmune/patología , Masculino , Femenino , Estudios Retrospectivos , Adulto , Persona de Mediana Edad , Inmunosupresores/uso terapéutico , Pronóstico , Brasil/epidemiología , Resultado del Tratamiento , Trasplante de Hígado , Cirrosis Hepática/mortalidad , Recurrencia , Aspartato Aminotransferasas/sangre , Alanina Transaminasa/sangre , Inducción de Remisión , Biomarcadores/sangre , Adulto Joven , Ascitis/etiología , AncianoRESUMEN
In reptile medicine, the enzymes aspartate aminotransferase (AST) and creatine kinase (CK) have been used in clinical diagnostics, where CK is considered an enzyme specific to muscle cell damage, while AST is a nonspecific enzyme that is mainly produced in the liver and muscle. When many native reptiles are sampled, it is evident that there are important differences between species and individuals belonging to the same species, making the AST and CK ranges very wide. The minimum and maximum values, variations and standard deviations were extracted for each enzyme from 17 wild reptile studies, revealing high variation and a wide range of variation for each species. AST and CK must be interpreted with caution in wild reptiles since there appears to be an important amount of individual and specific variation due to the muscular origin of these enzymes, and such variations tell us that there are considerable differences between individuals, physiological characteristics or sampling methods; thus, there is no apparent value derived from these kinds of studies on the utility of AST for evaluating liver damage, but the measurement of AST and CK can be useful for reptile health assessments or any manipulative study since they can eventually be used as indicators or potential biomarkers for restraint techniques or holding time.
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Creatina Quinasa , Músculos , Humanos , Animales , Aspartato Aminotransferasas , Biomarcadores , ReptilesRESUMEN
Bromodeoxyuridine (BrdU) is used in studies related to cell proliferation and neurogenesis. The multiple intraperitoneal injections of this molecule could favor liver function profile changes. In this study, we evaluate the systemic and hepatocellular impact of BrdU in male adult Wistar rats in 30 %-partial hepatectomy (PHx) model. The rats received BrdU 50 mg/Kg by intraperitoneal injection at 0.5, 1, 2, 3, 6, 9 and 16 days after 30 %-PH. The rats were distributed into four groups as follows, control, sham, PHx/BrdU(-) and PHx/BrdU(+). On day 16, we evaluated hepatocellular nuclei and analyzed histopathological features by haematoxylin-eosin stain and apoptotic profile was qualified by caspase-3 presence. The systemic effect was evaluated by liver markers such as alanine transferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), alkaline phosphatase (AP), bilirubin, total proteins and serum albumin content. The statistical analysis consisted of a student t-test and one-way ANOVA. BrdU did not induce apoptosis or hepatocellular damage in male rats. Multiple administrations of BrdU in male rats did not induce significant decrease body weight, but increased serum ALT and LDH levels were found. Our results show that the BrdU does not produce hepatocellular damage.
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Carcinoma Hepatocelular , Neoplasias Hepáticas , Ratas , Masculino , Animales , Ratas Wistar , Bromodesoxiuridina/farmacología , Carcinoma Hepatocelular/patología , Neoplasias Hepáticas/patología , Hígado/patología , Alanina Transaminasa/metabolismo , Alanina Transaminasa/farmacología , Aspartato Aminotransferasas/metabolismo , Aspartato Aminotransferasas/farmacologíaRESUMEN
Liver enzymes alterations (activity or quantity increase) have been recognized as biomarkers of obesity-related abnormal liver function. The intake of healthy foods can improve the activity of enzymes like aspartate and alanine aminotransferases (AST, ALT), γ-glutaminyl transferase (GGT), and alkaline phosphatase (ALP). Beans have a high concentration of several phytochemicals; however, Restriction Irrigation (RI) during plant development amends their synthesis. Using chemometric tools, we evaluated the capacity of RI-induced phytochemicals to ameliorate the high activity of liver enzymes in obese rats. The rats were induced with a high-fat diet for 4 months, subsequently fed with 20% cooked beans from well-watered plants (100/100), or from plants subjected to RI at the vegetative or reproduction stage (50/100, 100/50), or during the whole cycle (50/50) for 3 months. A partial least square discriminant analysis indicated that mostly flavonols have a significant association with serum AST and ALT activity, while isoflavones lowered GGT and ALP. For AST and ALT activity in the liver, saponins remained significant for hepatocellular protection and flavonoids remained significant as hepatobiliary protectants by lowering GGT and ALP. A principal component analysis demonstrated that several flavonoids differentiated 100/50 treatment from the rest, while some saponins were correlated to 50/100 and 50/50 treatments. The intake of beans cultivated under RI improves obesity-impaired liver alterations.
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Phaseolus , Saponinas , Ratas , Animales , Quimiometría , Aspartato Aminotransferasas , Obesidad/tratamiento farmacológico , Hígado , Fosfatasa Alcalina , Alanina Transaminasa , Semillas , Flavonoides/farmacología , Fitoquímicos/farmacologíaRESUMEN
PURPOSE: Early diagnosis of necrotic bowel segment resulting from incarcerated inguinal hernia (IIH) is crucial for reducing morbidity and mortality. The aim of this study was to investigate the efficacy of the De Ritis ratio (DRR), also known as the ratio of aspartate aminotransferase to alanine aminotransferase, as a biomarker for intestinal necrosis. METHODS: This retrospective study included 132 patients who underwent emergency surgery for IIH. Patients were divided into two groups: those who underwent bowel resection for necrosis (Group 1) and those who did not (Group 2). Patients' demographic and clinical data were recorded. Using laboratory test results, DRR, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and lymphocyte-to-CRP ratio (LCR) were calculated. RESULTS: The morbidity and mortality rates and the length of stay for Group 1 were statistically significantly different (p < 0.0001). The DRR, NLR, PLR, LMR, and LCR values of the same group were also significantly different (p < 0.05). CONCLUSION: DRR can be used as a biomarker for early diagnosis of bowel necrosis in patients with IIH.
ANTECEDENTES: El diagnóstico temprano del segmento intestinal necrótico resultante de una hernia inguinal incarcerada es crucial para reducir la morbilidad y la mortalidad. OBJETIVO: Investigar la eficacia del índice de De Ritis (IDR), también conocido como cociente de aspartato aminotransferasa a alanina aminotransferasa, como biomarcador de necrosis intestinal. MÉTODO: Estudio retrospectivo que incluyó a 132 pacientes que fueron intervenidos de urgencia por hernia inguinal incarcerada. Los pacientes se dividieron en dos grupos: los que se sometieron a resección intestinal por necrosis (grupo 1) y los que no (grupo 2). Se registraron los datos demográficos y clínicos de los pacientes. Usando los resultados de las pruebas de laboratorio, se calcularon el IDR, el índice neutrófilos-linfocitos (INL), el índice plaquetas-linfocitos (IPL), el índice linfocitos-monocitos (ILM) y el índice linfocitos-proteína C reactiva (ILPCR). RESULTADOS: Las tasas de morbilidad, mortalidad y duración de la estancia para el grupo 1 fueron estadísticamente significativas (p < 0.0001). Los valores de IDR, INL, IPL, ILM, ILPCR del mismo grupo también fueron significativamente diferentes (p < 0.05). CONCLUSIONES: El IDR puede utilizarse como biomarcador para el diagnóstico precoz de necrosis intestinal en pacientes con hernia inguinal incarcerada.
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Hernia Inguinal , Enfermedades Intestinales , Humanos , Alanina Transaminasa , Aspartato Aminotransferasas , Hernia Inguinal/complicaciones , Hernia Inguinal/cirugía , Estudios Retrospectivos , NecrosisRESUMEN
SUMMARY: The toxic effects of acetaminophen appear primarily in the liver and kidney. The protective effect of blue green alga Arthrospira platensis on hepato-renal toxicity caused by acetaminophen was evaluated in male rats. The obtained results showed that subcutaneous injection of acetaminophen at a dose 120 &240 սl acetaminophen/kg by weight resulted in an observed elevation in the enzyme activities of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and Alkaline phosphatase (ALP), serum total lipids, total cholesterol, creatinine, total bilirubin, urea, nitric oxide (NO), L- malondialdehyde (MDA) and interleukins (IL-2 &IL-6). However, there is a decrease in the serum total protein, albumin and loss in antioxidant enzyme activities in liver including; superoxide dismutase (SOD), catalase (CAT) and glutathione reductase (GSH). This effect was found to be dose and time dependent. In spite of, pre- oral administration of Arthrospira platensis 1000 mg/kg .b. wt. prior acetaminophen injection succeeded to modulate the effect of the observed abnormalities caused by acetaminophen. Moreover, there were no remarkable changes in serum biomarkers of rats received Arthrospira platensis only at a dose of 1000 mg/kg by weight (group 2). The histopathological findings confirm the biochemical results that indicates the safety use of Arthrospira platensis at the selected dose in this study. Therefore, the present results clarified the protective effect of blue green alga Arthrospira platensis on oxidative stress, hepatic and nephrotoxicity induced by acetaminophen in male Wister rats.
Los efectos tóxicos del paracetamol aparecen principalmente en el hígado y el riñón. Se evaluó en ratas macho Wistar el efecto protector del alga verde azulada Arthrospira platensis sobre la toxicidad hepatorrenal causada por paracetamol. Los resultados obtenidos mostraron que la inyección subcutánea de paracetamol a dosis de 120 y 240 µl de paracetamol/kg, resultó en una elevación en las actividades enzimáticas de la aspartato aminotransferasa (AST), alanina aminotransferasa (ALT) y fosfatasa alcalina (ALP), lípidos séricos totales, colesterol total, creatinina, bilirrubina total, urea, óxido nítrico (NO), L- malondialdehído (MDA) e interleucinas (IL-2 e IL-6). Sin embargo, hay una disminución en la proteína sérica total, albúmina y pérdida en las actividades de las enzimas antioxidantes en el hígado, incluyendo; superóxido dismutasa (SOD), catalasa (CAT) y glutatión reductasa (GSH). Se encontró que este efecto era dependiente de la dosis y el tiempo. A pesar de la administración preoral de Arthrospira platensis 1000 mg/kg, la inyección previa de acetaminofeno logró modular el efecto de las anormalidades observadas causadas por el acetaminofeno. Además, no hubo cambios notables en los biomarcadores séricos de ratas que recibieron Arthrospira platensis solo a una dosis de 1000 mg/kg (Grupo 2). Los hallazgos histopatológicos confirman los resultados bioquímicos que indican la seguridad del uso de Arthrospira platensis a la dosis seleccionada en este estudio. Por lo tanto, los presentes resultados aclararon el efecto protector del alga verde azulada Arthrospira platensis sobre el estrés oxidativo, la toxicidad hepática y la nefrotoxicidad inducida por paracetamol en ratas Wistar macho.
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Animales , Masculino , Ratas , Preparaciones de Plantas/administración & dosificación , Spirulina , Riñón/efectos de los fármacos , Hígado/efectos de los fármacos , Acetaminofén/toxicidad , Aspartato Aminotransferasas/análisis , Superóxido Dismutasa , Peroxidación de Lípido , Interleucinas , Ratas Wistar , Alanina Transaminasa/análisis , Fosfatasa Alcalina/análisisRESUMEN
The long-term laboratory aspects of the effects of coronavirus disease 2019 (COVID-19) on liver function are still not well understood. Therefore, this study aimed to evaluate the hepatic clinical laboratory profile of patients with up to 20 months of long-term COVID-19. A total of 243 patients of both sexes aged 18 years or older admitted during the acute phase of COVID-19 were included in this study. Liver function analysis was performed. Changes were identified in the mean levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), gamma-glutamyl transferase (GGT), and ferritin. A ferritin level of >300 U/L was observed in the group that presented more changes in liver function markers (ALT, AST, and GGT). Age ≥ 60 years, male sex, AST level > 25 U/L, and GGT level ≥ 50 or 32 U/L were associated with an ALT level > 29 U/L. A correlation was found between ALT and AST, LDH, GGT, and ferritin. Our findings suggest that ALT and AST levels may be elevated in patients with long-term COVID-19, especially in those hospitalised during the acute phase. In addition, an ALT level > 29 U/L was associated with changes in the levels of other markers of liver injury, such as LDH, GGT, and ferritin.
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COVID-19 , Femenino , Humanos , Masculino , COVID-19/epidemiología , Estudios Transversales , Hígado/metabolismo , Pruebas de Función Hepática , gamma-Glutamiltransferasa , Ferritinas , Alanina Transaminasa/metabolismo , Aspartato Aminotransferasas/metabolismoRESUMEN
INTRODUCTION AND OBJECTIVES: Fatty liver disease is an important public health problem. Early diagnosis is critical to lower its rate of progression to irreversible/terminal stages. This study aimed to evaluate the accuracy of non-invasive prediction scores for fatty liver disease (NAFLD and NASH) diagnosis in adults. MATERIALS AND METHODS: A search was conducted in 10 databases, a qualitative synthesis of 45 studies, and quantitative analysis of the six most common scores. There were 23 risk scores found for NAFLD diagnosis and 32 for NASH diagnosis. The most used were Fatty Liver Index (FLI), aspartate aminotransferase (AST) to Platelet Ratio Index, Fibrosis-4 Index (FIB-4), AST/alanine aminotransferase (ALT) ratio, BARD score, and NAFLD fibrosis score (NFS). RESULTS: The results from the meta-analysis for FLI: Area under the curve (AUC) of 0.76 (95% Confidence Interval [CI] 0.73, 0.80), sensitivity 0.67 (CI 95% 0.62, 0.72) and specificity 0.78 (CI 95% 0.74, 0.83). The AST to Platelet Ratio Index: AUC 0.83 (CI 95% 0.80, 0.86), sensitivity 0.45 (95% CI 0.29, 0.62), and specificity of 0.89 (95% CI 0.83, 0.92). The NFS: AUC of 0.82 (CI 95% 0.78, 0.85), sensitivity 0.30 (CI 95% 0.27, 0.33) and specificity 0.96 (CI 95% 0.95,0.96). CONCLUSIONS: The FLI for NAFLD and AST to Platelet Ratio Index for NASH were the risk scores with the highest prognostic value in the included studies. Further research is needed for the application of new diagnostic risk scores for NAFLD and NASH.
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Enfermedad del Hígado Graso no Alcohólico , Adulto , Humanos , Enfermedad del Hígado Graso no Alcohólico/diagnóstico , Cirrosis Hepática/diagnóstico , Factores de Riesgo , Biomarcadores , Pruebas de Función Hepática , Biopsia , Aspartato AminotransferasasRESUMEN
PURPOSE: This study investigated the effects of oral administration of Clostridium butyricum (C. butyricum) on inflammation, oxidative stress, and gut flora in rats with hepatic ischemia reperfusion injury (HIRI). METHODS: The rats from C. butyricum group were given C. butyricum for 5 days. Then, hepatic ischemia for 30 min and reperfusion for 6 h were performed in all the rats. After the animals were sacrificed, alanine transaminase (ALT), aspartate aminotransferase (AST), lipopolysaccharide (LPS) in serum, short-chain fatty acids (SCFAs), and gut microbiota composition in feces, and malondialdehyde (MDA), glutathione (GSH), tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6), Toll-like receptor 4 (TLR4), nuclear factor-kappa Bp65 (NF-κBp65) and histological analysis in the liver were performed. RESULTS: The rats given C. butyricum showed decreased ALT, AST, LPS, and MDA; improved GSH and histological damage; changes in SCFAs; declined TNF-α, IL-6, TLR4, and pNF-κBp65/NF-κBp65; and changes in the gut microbial composition, which decreased the Firmicutes/Bacteroidetes ratio and increased the relative abundance (RA) of probiotics. CONCLUSIONS: C. butyricum supplementation protected against HIRI by regulating gut microbial composition, which contributed to the decreased LPS and attenuation of inflammation and oxidative stress. These indicate C. butyricum may be a potent clinical preoperative dietary supplement for HIRI.
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Clostridium butyricum , Probióticos , Daño por Reperfusión , Ratas , Animales , Clostridium butyricum/fisiología , Receptor Toll-Like 4 , Lipopolisacáridos , Factor de Necrosis Tumoral alfa , Interleucina-6 , Daño por Reperfusión/prevención & control , Daño por Reperfusión/patología , Hígado/patología , Aspartato Aminotransferasas , Alanina Transaminasa , Glutatión , Probióticos/farmacología , Inflamación/patologíaRESUMEN
The objective of this study was to establish hematological and plasma biochemical reference values in captive white-fronted Amazon parrots (Amazona albifrons), as well as to determine whether sex effects the reference values. To our knowledge, hematological and plasma biochemical data have not been reported in this species. Thirty-seven clinically healthy adult individuals (21 males, 16 females) from El Nido Bird Sanctuary, Ixtapaluca, Estado de México, were the subject birds for this study. Complete blood count and selected plasma biochemical parameters, including uric acid, glutamate dehydrogenase, aspartate aminotransferase, total protein, and albumin, were evaluated. Blood samples were collected in the winter (January), outside of the birds' breeding season. Many hematological and plasma biochemical analytes had large coefficients of variation, and there were no statistically significant sex differences identified.
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Amazona , Femenino , Masculino , Animales , Valores de Referencia , México , Plasma , Aspartato AminotransferasasRESUMEN
We describe here hematological and biochemical findings in a cow with metastatic cholangiocarcinoma. On physical examination, apathy with congested mucous membranes, tachycardia and enlarged abdomen; hypoperistalsis in rumen, abomasum and intestines. In hematological examination, icteric plasma with leukocytosis by neutrophilia with regenerative left shift and inversion of the proportion between lymphocytes and segmented neutrophils, and hypofibrinemia. In serum biochemistry: hyperproteinemia, hypoalbuminemia, hyperglobulinemia, low albumin/globulin ratio and high levels of aspartate aminotransferase, gamma-glutamyltransferase. The cow died and in necropsy was observed a severe and diffuse increase in volume predominantly on the hepatic right lobe and moderate increase of volume in mesenteric lymph nodes. Which was diagnosed microscopically as a cholangiocarcinoma, characterized by arrangements in irregular and coalescent ducts. In conclusion, cholangiocarcinoma may cause important hematological and biochemical changes in cattle.(AU)
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Animales , Femenino , Neoplasias de los Conductos Biliares , Bovinos/fisiología , Colangiocarcinoma/diagnóstico , Aspartato Aminotransferasas , Albúmina Sérica , Hipoalbuminemia/veterinaria , gamma-GlutamiltransferasaRESUMEN
Naringin (Nar) has been reported to exert potential hepatoprotective effects against acetaminophen (APAP)-induced injury. Mitochondrial dysfunction plays an important role in APAP-induced liver injury. However, the protective mechanism of Nar against mitochondrial damage has not been elucidated. Therefore, the aim of this study was to investigate the hepatoprotective effects of Nar against APAP and the possible mechanisms of actions. Primary rat hepatocytes and HepG2 cells were utilized to establish an in vitro model of APAP-induced hepatotoxicity. The effect of APAP and Nar on cell viability was evaluated by a CCK8 assay and detection of the concentrations of alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase. The cellular concentrations of biomarkers of oxidative stress were measured by ELISA. The mRNA expression levels of APAP-related phase II enzymes were determined by real-time PCR. The protein levels of Nrf2, phospho (p)-AMPK/AMPK, and biomarkers of mitochondrial dynamics were determined by western blot analysis. The mitochondrial membrane potential (MMP) was measured by high-content analysis and confocal microscopy. JC-1 staining was performed to evaluate mitochondrial depolarization. Nar pretreatment notably prevented the marked APAP-induced hepatocyte injury, increases in oxidative stress marker expression, reductions in the expression of phase II enzymes, significant loss of MMP, mitochondrial depolarization, and mitochondrial fission in vitro. In conclusion, Nar alleviated APAP-induced hepatocyte and mitochondrial injury by activating the AMPK/Nrf2 pathway to reduce oxidative stress in vitro. Applying Nar for the treatment of APAP-induced liver injury might be promising.
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Enfermedad Hepática Crónica Inducida por Sustancias y Drogas , Enfermedad Hepática Inducida por Sustancias y Drogas , Animales , Ratas , Acetaminofén/toxicidad , Acetaminofén/metabolismo , Alanina/metabolismo , Alanina/farmacología , Alanina Transaminasa , Proteínas Quinasas Activadas por AMP/metabolismo , Aspartato Aminotransferasas , Enfermedad Hepática Inducida por Sustancias y Drogas/prevención & control , Enfermedad Hepática Crónica Inducida por Sustancias y Drogas/metabolismo , Lactato Deshidrogenasas/metabolismo , Hígado/metabolismo , Dinámicas Mitocondriales , Factor 2 Relacionado con NF-E2/metabolismo , Estrés Oxidativo , ARN Mensajero/metabolismo , Transducción de SeñalRESUMEN
BACKGROUND: Metabolic associated fatty liver disease (MAFLD) is associated with complications and mortality in patients with coronavirus disease 2019 (COVID-19). However, there are no prognostic scores aimed to evaluate the risk of severe disease specifically in patients with MAFLD, despite its high prevalence. Lactate dehydrogenase, aspartate aminotransferase and alanine aminotransferase have been used as markers of liver damage. Therefore, we propose an index based on lactate dehydrogenase, aspartate aminotransferase and alanine aminotransferase for the prediction of complications and mortality in patients with MAFLD and COVID-19. AIM: To evaluate the prognostic performance of an index based on lactate dehydrogenase and transaminases (aspartate aminotransferase/alanine aminotransferase) in patients with COVID-19 and MAFLD [liver fibrosis and nutrition (LNF)-COVID-19 index]. METHODS: In this retrospective cohort study, two cohorts from two different tertiary centers were included. The first was the derivation cohort to obtain the score cutoffs, and the second was the validation cohort. We included hospitalized patients with severe COVID-19 and MAFLD. Liver steatosis was evaluated by computed tomography scan. Area under the receiver operating characteristic (ROC) curve analysis and survival analysis were used. RESULTS: In the derivation cohort, 44.6% had MAFLD; ROC curve analysis yielded a LFN-COVID-19 index > 1.67 as the best cutoff, with a sensitivity of 78%, specificity of 63%, negative predictive value of 91% and an area under the ROC curve of 0.77. In the multivariate analysis, the LFN-COVID-19 index > 1.67 was independently associated with the development of acute kidney injury (odds ratio: 1.8, 95% confidence interval: 1.3-2.5, P < 0.001), orotracheal intubation (odds ratio: 1.9, 95% confidence interval: 1.4-2.4, P < 0.001), and death (odds ratio: 2.86, 95% confidence interval: 1.6-4.5, P < 0.001) in both cohorts. CONCLUSION: LFN-COVID-19 index has a good performance to predict prognosis in patients with MAFLD and COVID-19, which could be useful for the MAFLD population.
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COVID-19 , Hígado Graso , Enfermedad del Hígado Graso no Alcohólico , Humanos , COVID-19/complicaciones , Alanina Transaminasa , Estudios Retrospectivos , Hígado Graso/complicaciones , Aspartato Aminotransferasas , Pronóstico , Lactato Deshidrogenasas , Oxidorreductasas , Enfermedad del Hígado Graso no Alcohólico/complicacionesRESUMEN
Objective: Describe the clinical profile of patients with biopsy-proven non-alcoholic fatty liver disease (NAFLD) and analyze the risk predictors of hepatic fibrosis in outpatient follow-up at a university hospital. Methods: Demographic, clinical and laboratory data of a cohort of 143 patients with biopsy-proven NAFLD were retrospectively analysed under univariate analyses. Diagnostic accuracy, determined by AUROC, was evaluated for variables that showed a significant difference in univariate comparison analysis and diagnostic performances were determined by sensitivity and specificity. Results: The mean age of studied patients were 48 years, 66.4% of them were women. Age, presence of diabetes mellitus, hypertension, metabolic syndrome and laboratory variables such as AST/ALT ratio, GGT, platelet count and fasting glucose were significantly associated with advanced fibrosis. FIB-4 and NAFLD fibrosis score (AUROC 0.82 and 0.89, respectively) outperformed APRI (AUROC 0.73) for advanced liver fibrosis and cirrhosis (P of 0.04). Conclusion: In our study, metabolic syndrome, diabetes, hypertension, AST/ALT ratio, GGT, platelet count and fasting glucose were associated with hepatic fibrosis in patients with NAFLD. The non-invasive tests FIB-4 and NAFLD fibrosis score showed the best accuracy to stratify disease severity.
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Diabetes Mellitus , Hipertensión , Síndrome Metabólico , Enfermedad del Hígado Graso no Alcohólico , Humanos , Femenino , Persona de Mediana Edad , Masculino , Enfermedad del Hígado Graso no Alcohólico/complicaciones , Aspartato Aminotransferasas , Alanina Transaminasa , Estudios Retrospectivos , Brasil , Síndrome Metabólico/complicaciones , Biomarcadores , Cirrosis Hepática/etiología , Biopsia , Fibrosis , Diabetes Mellitus/diagnóstico , Hipertensión/complicaciones , Glucosa , HospitalesRESUMEN
BACKGROUND: Tocilizumab (TCZ) is a new therapeutic alternative for severe cases of COVID-19 pneumonia. AIM: To evaluate the cumulative incidence (CI) of suspected adverse drug reactions (ADR) from TCZ in adult patients with COVID-19. MATERIAL AND METHODS: An active pharmacological surveillance protocol was carried out in patients older than 18 years old, who received at least one dose of TCZ between May and August 2020 at a clinical hospital. Non-infectious ADRs were categorized according to the Common Terminology Criteria for Adverse Events and the development of infection was classified as present or absent. Causality and preventability of ADRs were determined with the Naranjo Algorithm and the modified Schumock & Thornton criteria, respectively. RESULTS: The CI of ADRs caused by TCZ was 69.6% (95% confidence intervals (CI): 63.5-76.6). A rise in alanine and aspartate aminotransferases and the development of infections were the most frequent adverse events. Seventy-four percent were considered mild in severity. Sixty two percent of suspected non-infectious ADRs were classified as probable and all the infectious events as Possible. Of the ADRs observed, 33% were preventable. CONCLUSIONS: The occurrence of ADRs after the use of TCZ is frequent, of mild severity, and in one third of the cases, preventable. We suggest monitoring blood count, liver function tests and ruling out infection prior to TCZ administration.
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Tratamiento Farmacológico de COVID-19 , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Adolescente , Adulto , Alanina , Anticuerpos Monoclonales Humanizados , Aspartato Aminotransferasas , HumanosRESUMEN
BACKGROUND: Although most coronavirus disease 2019 (COVID-19) infections are mild, some patients have severe clinical conditions requiring hospitalization. Data on the severity of COVID-19 in Brazil are scarce and are limited to public databases. This study aimed to investigate the clinical and laboratory factors associated with the severity of COVID-19 in a cohort of hospitalized adults from two hospitals in Northeast Brazil. METHODS: Patients over 18 years of age who were hospitalized between August 2020 and July 2021 with a confirmed diagnosis of COVID-19 were included. The patients were classified into two groups: moderate and severe. Clinical, laboratory and imaging parameters were collected and compared between the groups. A multivariate logistic regression model was used to determine the predictors of COVID-19 severity. RESULTS: This study included 495 patients (253 moderate and 242 severe). A total of 372 patients (75.2%) were between 18 and 65 years of age, and the majority were male (60.6%; n = 300). Patients with severe disease had higher levels of leukocytes, neutrophils, platelets, neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, blood glucose, C-reactive protein, ferritin, D-dimer, aspartate aminotransferase, creatinine, and urea (p < 0.05). In multivariate logistic regression, the following variables were significant predictors of COVID-19 severity: leukocytes (odds ratio [OR] 3.27; 95% confidence interval [CI] 2.12-5.06), international normalized ratio (INR) (OR 0.22, 95% CI 0.14-0.33), and urea (OR 4.03; 95% CI 2.21-7.35). CONCLUSIONS: The present study identified the clinical and laboratory factors associated with the severity of COVID-19 in hospitalized Brazilian individuals.