乙肝免疫标志物与乙肝病毒核酸含量与肝功能的关系研究

目的:研究乙肝免疫标记物(HBV-M)与乙肝病毒脱氧核苷酸(HBV-DNA)载量与肝功能的关系。方法:检测104例乙肝患者HBs Ag、HBe Ag、HBc Ab、HBs Ab、HBe Ab5种HBV-M;用PCR法检测HBV-DNA含量;同时检测天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、胆碱酯酶(CHE)等肝功能指标,对三者关系采用Spearman相关性分析。结果:HBs Ag、HBc Ab、HBe Ag阳性组HBV-DNA阳性率及载量均大于其余组(P0.05);HBe Ag含量、ALT浓度与HBV-DNA载量均呈正相关(r=0.48,P0.05)、(r=0.36,P0.05);AST、CHE与HBV-DNA含量无明显相关性,但在无病毒载量与有病毒载量组之间AST比较有统计学意义(P0.05)。结论:HBV-M、HBV-DNA与肝功能之间有一定的相关性,但HBe Ag阴转不代表病毒复制停止,HBV-DNA也不能完全反应肝损害程度,临床应加大重视。     

Cytoplasmic enzyme activities involved in energy and amino acid metabolism in pathological human renal cortex

Enzyme levels of lactate dehydrogenase (LDH), alpha-hydroxybutyrate dehydrogenase (HBDH), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were measured in the cytosol of renal cortex samples from either normal and pathologic kidney tissue. The mean enzyme activity values, expressed in Units per gram of cytosolic protein decreased in the following order: normal cortex (LDH = 4,299 +/- 654; AST = 522 +/- 101; ALT = 197 +/- 44). chronic pyelonephritis (LDH = 2,360 +/- 876; AST = 297 +/- 117; ALT = 90 +/- 48), hydronephrosis (LDH = 2,208 +/- 1,264; AST = 279 +/- 165; ALT = 82 +/- 61), pyonephrosis (LDH = 1,410 +/- 596; AST = 158 +/- 69; ALT = 23.4 +/- 16.4) and renal tuberculosis (LDH = 1,149 +/- 481; AST = 93 +/- 34; ALT = 5.6 +/- 2.8). The decrease in the enzyme activities paralleled tissue damage and it was shown to affect cellular functionality in relation with energy and amino acid metabolism.     

慢性乙型肝炎患者血清白介素17A和胆碱酯酶的表达及临床意义

目的:检测慢性乙型肝炎(CHB)患者血清白介素17A(IL-17A)、胆碱酯酶(CHE)水平,并分析其临床意义。方法:选取2018年1月到2019年3月期间在重庆三峡中心医院接受治疗的CHB患者84例,根据病情严重程度将所有患者分为轻度组30例、中度组28例、重度组26例,另选取同期在重庆三峡中心医院进行体检的健康志愿者50例作为对照组。比较各组的凝血四项指标[纤维蛋白原(FIB)、凝血酶原时间(PT)、凝血活酶时间(APTT)、凝血酶时间(TT)]、肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)]、IL-17A、CHE水平,采用Pearson相关分析CHB患者血清IL-17A、CHE与凝血四项、ALT、AST的相关性。结果:重度组、中度组、轻度组、对照组的FIB、CHE水平逐渐升高,PT、APTT、TT、ALT、AST、IL-17A水平逐渐降低,两两比较均有统计学差异(P0.05),IL-17A与FIB、CHE呈负相关,与PT、APTT、TT、ALT、AST呈正相关(P0.05);CHE与FIB呈正相关,与PT、APTT、TT、ALT、AST呈负相关(P0.05)。结论:CHB患者血清中IL-17A、CHE水平与患者的肝功能和凝血功能密切相关,联合检测IL-17A和CHE有助于患者的病情评估以及预后判断。     

超声引导下经皮穿刺聚桂醇注射液与无水乙醇硬化治疗单纯性肝囊肿的疗效对比研究

目的:探讨并对比超声引导下经皮穿刺聚桂醇注射液与无水乙醇硬化治疗单纯性肝囊肿的疗效。方法:选择2014年5月至2016年9月我院收治的60例单纯性肝囊肿患者为研究对象,按随机数字表法分为两组。实验组30例在超声引导下给予聚桂醇注射液进行硬化治疗,对照组30例在超声引导下给予无水乙醇进行硬化治疗。比较两组患者临床有效率、不良反应发生率;于术前及术后24 h检测并对比两组患者血常规指标水平;于术前、术后1周及术后1月检测并对比两组患者总胆红素(TBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、胆碱酯酶(CHE)及白蛋白(ALB)。结果:实验组总有效率为93.33%,对照组总有效率为90.00%,两组总有效率比较,差异无统计学意义(P0.05)。术前、术后24 h两组各项血常规指标对比,差异均无统计学意义(P0.05)。与术前相比,术后1周实验组患者血清TBIL、ALT、AST、ALP、CHE及ALB均无明显变化(P0.05),对照组患者血清ALT和AST升高(P0.05)。与术后1周相比,术后1个月实验组患者血清ALT、ALP降低,CHE升高(P0.05),对照组ALT、AST及ALP降低,CHE升高(P0.05)。术后1周实验组患者血清ALT和AST水平明显低于对照组(P0.05),TBIL、ALP、CHE及ALB均无明显差异(P0.05);术后1月实验组患者血清ALT水平明显低于对照组,ALB水平明显高于对照组(P0.05),TBIL、AST、ALP及CHE均无明显差异(P0.05)。实验组不良反应发生率为16.67%,低于对照组的30.00%,差异具有统计学意义(P0.05)。结论:超声引导下经皮穿刺聚桂醇注射液与无水乙醇治疗单纯性肝囊肿均具有较好的疗效,但聚桂醇注射液作为硬化剂的不良反应率明显低于无水乙醇,对肝功能的损伤也较无水乙醇小。因此对于单纯性肝囊肿的硬化治疗,聚桂醇注射液是一种安全有效的硬化剂,值得在临床上推广。     

Epidemiology of serum aminotransferase activities in the elderly.

BACKGROUND: Our study used data collected in Chung-Hsing Village in May 1998 to explore the distribution of serum aminotransferase activities and the relationship between aminotransferase and its related factors in the elderly. METHODS: All individuals aged 65 and over were recruited as study subjects. A total of 1093 persons, out of 1774 registered residents, were contacted by face-to-face interview. The response rate was 61.6 percent. However, only 586 subjects had blood tests and completed questionnaires. Analysis in this study was based on these 586 subjects. In order to study the significant related factors of abnormal aminotransferase activities, the t-test, ANOVA, chi-square analysis, and multivariate logistic regression were used. RESULTS: There were 66 percent men and 34 percent women. The mean age was 73.1 +/- 5.3 years. The mean values of aspartate aminotransferase (AST) were 29.3 +/- 14.5 u/l in men and 27.8 +/- 10.7 u/l in women (p > .05). The mean values of alanine aminotransferase (ALT) were 30.9 +/- 25.2 u/l in men and 26.3 +/- 12.6 u/l in women (p < .01). The abnormality rates of AST (> or = 40 u/l) were 10.5 percent in men and 12.2 percent in women (p > .05). The abnormality rates of ALT (> or = 40 u/l) were 16.7 percent in men and 12.6 percent in women (p > .05). After controlling for the other covariates, the multivariate logistic regression analysis showed that the significant related factor of abnormal AST was retirement status (odds ratio 4.4; 95 percent confidence interval = 1.5-13.3; p < .01). The significant related factors of abnormal ALT were obesity (odds ratio = 2.2; 95 percent confidence interval = 1.1-4.2; p < .05) and hypertriglyceridemia (odds ratio = 2.7; 95 percent confidence interval = 1.5-4.9; p < .01). CONCLUSIONS: We raise the hypothesis that evidence of liver disease with abnormal ALT may co-vary with other indicators of chronic diseases. A large-scale investigation will be suggested in the future to demonstrate the causal-effect issue between abnormal ALT and obesity or hypertriglyceridemia.     

Effect of envenomation on enzymes of brain of albino rats

Effects of high doses of cobra venom, (150 micrograms/120 +/- 20 g body wt) and viper venom (300 micrograms/120 +/- 20 g body wt) on aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), acetylcholinesterase (ACh) and alkaline phosphatase (ALP) of brain of albino rats were studied. While AST, LDH, ACh and ALP activities increased in both viper and cobra venom treated rats, ALT decreased in both groups compared to control.     

Seasonal variation in serum testosterone, testicular volume, and semen characteristics in the coyote (Canis latrans)

The coyote is a seasonally breeding mammal, with most copulations occurring between December and April (depending on location). The objective of this study was to characterize seasonal changes in serum testosterone concentrations, testicular volume, and ejaculate quantity and quality in captive male coyotes. There were seasonal differences in testicular volume, with the greatest volume (20.2+/-5.4cm2), mean+/-S.E.M.) in February, corresponding with peak breeding season. Circulating serum testosterone concentrations peaked (3.31+/-0.9 ng/mL) during January and were positively correlated (P< or =0.001, r=0.413) with testicular volume. Ejaculate volume (1.67+/-0.4 mL) and sperm concentration (549.2 x 10(6)+/-297.7 spermatozoa/mL) both peaked during January and February, consistent with the height of the breeding season. Ejaculate volume and sperm concentrations were positively correlated with testicular size (r=0.679, P< or =0.001 and r=0.499, P< or =0.001, respectively) and with serum testosterone concentrations (r=0.368, P< or =0.01 and r=0.208, P< or =0.05). Progressively motile, viable, and morphologically normal spermatozoa fluctuated seasonally, peaked (90.4+/-4.5, 84.8+/-4.1, and 87.9+/-2.9%) during the breeding season, and then subsequently declined (period of aspermatogenesis). All three of these end points were positively correlated with testicular size (r=0.589, P< or =0.001; r=0.586, P< or =0.001; and r=0.469; P< or =0.001) and serum testosterone (r=0.167, P< or =0.05; r=0.190, P< or =0.05; and r=0.221, P< or =0.01). In conclusion, there were intricate relationships among testosterone concentrations, testicular volume, and the production of both functionally intact and morphologically normal spermatozoa.     

Protective effect of atorvastatin on oxidative stress in streptozotocin‐induced diabetic rats independently their lipid‐lowering effects

In the present study, we investigate the effects of atorvastatin on the lipid profile, oxidative stress, and liver enzyme markers, and its protective activity against diabetic complications, in streptozotocin (STZ)‐induced diabetic rats. Fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), and high‐density lipoprotein (HDL) levels, as well as alanine aminotransferase (ALT) and aspartate aminotransferase (AST) enzyme activities, were measured 7 weeks after the administration of STZ and atorvastatin. Thiobarbituric acid reactive substances (TBARS), non‐protein associated sulfhydryl (NP‐SH), total sulfhydryl (T‐SH), and nitric oxide (NO) levels were measured to evaluate oxidative stress. Atorvastatin was found to inhibit ALT and AST activities and to reduce FBG levels in rats with STZ‐induced diabetes. Moreover, atorvastatin treatment significantly reduced lipid peroxidation in kidney, heart, and eye tissues (P < 0.001, for all), and resulted in a significant increase in NP‐SH levels in brain tissues (P < 0.001). Total NO and nitrate levels increased significantly after atorvastatin treatment (P < 0.01). Our results revealed that atorvastatin has a protective effect against STZ‐induced oxidative damage by reducing TBARS levels and increasing NP‐SH levels, has a hepatoprotective effect by decreasing ALT and AST activities. It also shows the antihyperglycemic activity by lowering FBG levels.     

黄芪多糖对乙型肝炎小鼠肝脏脂肪变性的作用及机制

目的:探讨黄芪多糖对乙型肝炎相关的肝脏脂肪变性的治疗作用及机制。方法:选取5-6周龄的SPF雄性小鼠共20只作为研究对象,随机分为研究组和对照组,各10例,研究组小鼠进行黄芪多糖溶液灌胃,对照组小鼠采用同样剂量的生理盐水灌胃。分别于用药前后测量体重(BW)、甘油三酯(TG)、谷丙转氨酶(ALT)、谷草转氨酶(AST)。结果:研究组小鼠用药后BW和TG明显低于对照组,数据经统计学比较具有显著差异(P<0.05)。用药前两组小鼠ALT和AST比较无显著差异,用药后研究组ALT和AST明显下降,与对照组用药后比较具有显著差异(P<0.05)。结论:黄芪多糖可有效降低乙型肝炎小鼠BW和血脂TG,减少ALT和AST,促进肝脏的排毒与修复,从而改善肝脏脂肪变性,缓解和治疗HBV的毒性和侵害性,提高治疗效果。     

Caspase-1、OPN在慢加急性乙型肝炎肝衰竭患者血清中的表达及其临床意义

摘要 目的：探讨半胱氨酸蛋白酶-1 (Caspase-1)、骨桥蛋白（OPN）在慢加急性乙型肝炎肝衰竭（HBV-ACLF）患者血清中的表达及其临床意义。方法：选择2020年6月至2022年6月中国人民解放军联勤保障部队第九七Ο医院收治的86例HBV-ACLF患者（HBV-ACLF组）;另选取同时段接诊的58例慢性HBV感染患者（CHB组）;收集同时间段60例体检的健康志愿者（对照组）。检测所有受试者血清Caspase-1、OPN、肝功能指标水平,探讨HBV-ACLF患者血清Caspase-1、OPN水平与肝功能指标的相关性,单因素分析及Logistic多元逐步回归分析影响HBV-ACLF患者预后的危险因素。结果：三组血清Caspase-1、OPN、肝功能指标水平比较差异有统计学意义（P＜0.01）。HBV-ACLF组、CHB组血清Caspase-1、OPN、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、总胆红素（TBIL）水平高于对照组（P＜0.05）,白蛋白（Alb）、胆碱酯酶（CHE）水平低于对照组（P＜0.05）,HBV-ACLF组血清Caspase-1、OPN 、ALT 、AST 、TBIL水平高于CHB组（P＜0.05）,Alb、CHE水平低于CHB组（P＜0.05）。Pearson相关分析显示,HBV-ACLF患者血清Caspase-1、OPN水平均与ALT、AST、TBIL呈正相关（P＜0.05）,与Alb、CHE呈负相关（P＜0.05）。单因素分析显示,HBV-ACLF患者预后与肝硬化、肝性脑病、腹膜炎发生率、终末期肝病评分模型（MELD）评分、白细胞计数（WBC）、血小板计数（PLT）、肌酐（Cr）、国际标准化比值（INR）、TBIL、HBV-DNA载量（HBV-DNA）、Caspase-1、OPN有关（P＜0.05）;而与年龄、性别、血红蛋白（HGB）、BUN、ALT、AST、CHE、Alb无关（P>0.05）。Logistic多元逐步回归分析模型结果显示,HBV-DNA、MELD评分、Caspase-1、OPN是影响HBV-ACLF患者预后的危险因素（P＜0.05）。结论：HBV-ACLF患者血清Caspase-1、OPN水平呈异常高表达,且Caspase-1、OPN高表达水平与肝功能恶化和不良临床结局有关,可为HBV-ACLF患者病情进展及预后评估提供依据。     

Heparin and quercitin generate differential metabolic pathways that involve aminotransferases and LDH-X dehydrogenase in cryopreserved bovine spermatozoa

Heparin and quercetin induce capacitation in spermatozoa through membrane receptor binding and inhibition of Ca-ATPase of the plasma membrane, respectively. Although capacitation is energy intensive, ammonia from amino acid metabolism can inhibit respiration and Krebs cycle activity. The objective was to determine activities of key enzymes in bull spermatozoa that contribute to the redox state and supply energy for capacitation. Malate dehydrogenase (MDH-NAD(+)), alanine and aspartate aminotransferases (ALT, AST), and lactate dehydrogenase-X (LDH-X) were measured spectrophotometrically (340 nm); mean (+/-S.D.) activities in control spermatozoa were 7.65+/-1.67, 0.45+/-0.05 and 0.74+/-0.14x10(-2)U/10(8) spermatozoa for MDH-NAD(+), ALT and AST, respectively, and were 2.83+/-0.66U/10(8) spermatozoa for LDH-X. Heparin decreased (P<0.05) activities of MDH-NAD(+), ALT, AST and LDH-X (78, 53, 66 and 66% of control levels, respectively); we inferred that amino acid catabolism was decreased. Quercetin decreased (P<0.05) activities of MDH-NAD(+) and ALT (60 and 49% of control levels), but activities of AST and LDH-X were not significantly different from controls; apparently maintenance of LDH-X activity supplied pyruvate for cellular metabolism. The proportion of capacitated spermatozoa in controls (8.5+/-1.73%) was substantially increased (P<0.05) by treatment with either heparin (36.2+/-4.5%) or quercetin (32.8+/-4.7%), there was no significant difference among groups for acrosomal integrity and sperm viability. In conclusion, heparin- or quercetin-induced capacitation affected different metabolic pathways that modulated the redox state and oxidative metabolism in cryopreserved bovine spermatozoa.     

Ideal cardiovascular health and liver enzyme levels in European adolescents; the HELENA study

There is an increasing interest for the role of liver enzymes as predictors of non-liver-related morbidity and mortality. The American Heart Association (AHA) described the ideal cardiovascular health concept as a score of seven cardiovascular health behaviors and factors that can be used to monitor and predict ideal cardiovascular health over time. This study aimed to examine the association of the ideal cardiovascular health (ICH), as defined by the AHA, with liver enzyme levels in European adolescents. A total of 637 adolescents (54.6% females), aged 14.6 ± 1.2 years from nine European countries participated in this cross-sectional study. Blood levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase were measured and the AST/ALT ratio calculated. Ideal cardiovascular health was defined as meeting ideal levels of the following components: four behaviors (smoking, body mass index, physical activity, and diet) and three factors (total cholesterol, blood pressure, and glucose). A higher number of ideal cardiovascular health behaviors, factors, and ideal cardiovascular health index were associated with lower ALT (P < 0.05, P < 0.001, and P < 0.001, respectively) and gamma-glutamyltransferase (P < 0.001, P < 0.01, and P < 0.001, respectively) levels. Similarly, a higher number of ideal cardiovascular health behaviors (P < 0.01), factors (P < 0.01), and ideal cardiovascular health index (P < 0.001) were associated with a higher aspartate aminotransferase to alanine aminotransferase ratio. These findings reinforce the usefulness of the ICH index as an instrument to identify target individuals and promote cardiovascular health in adolescents, and it also extends these observations to the liver manifestation of the metabolic syndrome.     

Biochemical stress indicators of greater wax moth exposure to organophosphorus insecticides

Although acetylcholinesterase (AChE) is the primary target of organophosphorus insecticides (OPs), increasing evidence regarding their secondary effects suggests that OPs disturb homeostasis of insects by generating free radical intermediates that trigger lipid peroxidation. We therefore investigated alterations in lipid peroxidation product, malondialdehyde (MDA) content, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities, in conjunction with AChE activity as biochemical stress indicators in greater wax moth, Galleria mellonella (L.) larvae for OPs methyl parathion (MP) and ethyl parathion (EP). The effects of MP and EP were first investigated by rearing the young larvae on an artificial diet containing 0.01, 0.1, 1, 10, and 100 ppm of each insecticide. Second, the mature larvae were injected with 0.05, 0.5, 5, 50, and 500 ng of insecticides for determining the changes in biochemical stress responses. The diet with lowest level of MP significantly decreased the activities of all measured enzymes, whereas it increased MDA content. However ALT and AST were significantly higher in the larvae reared with the diet with high levels of MP than in control larvae. All tested levels of MP resulted in a decrease in AChE activity. The lowest level of EP in diet (0.01 ppm) significantly increased ALT activity, whereas it reduced that of AChE. This insecticide at 0.1 ppm resulted in reduced AST activity, but 1 ppm in diet elevated AST activity and MDA content. EP at 0.1 ppm and higher levels in the diet reduced ALT activity. All dietary EP levels significantly decreased AChE activity. ALT, AST, and AChE were lower in larvae fed with the diet containing 100 ppm ethyl parathion compared with larvae on control diet. MP at 50 ng per larva increased ALT and AST activities from 35.42 +/- 0.74 and 26.34 +/- 0.83 to 203.57 +/- 1.09, and 122.90 +/- 1.21 U/g, respectively, when the mature larvae were injected. All injected doses of EP dramatically reduced both ALT and AST activities, but only the lowest and highest levels of this insecticide decreased AChE activity. The lowest level of this insecticide also significantly increased MDA content in larvae. High levels of both insecticides increased MDA content. We observed a significant higher increase in MDA content in the larvae reared with 10 ppm EP (102.16 +/- 1.57 nmol/g protein) than the control group (30.28 +/- 1.42 nmol/g protein). These results suggest that OPs caused the metabolic and synaptic dysfunctions in greater wax moth and alter its biochemical physiology in response to oxidative stress.     

慢性乙型肝炎患者血清IL-17A、GP73水平与肝功能指标及病情严重程度的关系分析

摘要 目的：探讨慢性乙型肝炎(CHB)患者血清白细胞介素-17A (IL-17A)、高尔基体蛋白73(GP73)水平与肝功能指标及病情严重程度的关系。方法：选取2018年10月至2019年10月于青海大学附属医院就诊的CHB患者93例作为研究对象（CHB组）,另选取同时期于我院体检的健康志愿者33例作为对照组。比较不同病情严重程度、不同乙型肝炎e抗原（HbeAg）表达的CHB患者IL-17A、GP73水平及肝功能相关指标[丙氨酸氨基转移酶（ALT）、门冬氨酸氨基转移酶（AST）、白蛋白、总胆红素（TBiL）]的差异,并分析IL-17A、GP73水平与患者病情严重程度及肝功能相关指标的相关性。结果：CHB组中轻度、中度、重度患者血清IL-17A、GP73、ALT、AST及TBiL水平均高于对照组,白蛋白水平低于对照组（P<0.05）,并且随着CHB患者病情严重程度的加重其血清中IL-17A、GP73、ALT、AST及TBiL水平逐渐升高,白蛋白水平逐渐降低（P<0.05）。CHB组HbeAg阴性患者血清中的IL-17A、GP73、ALT及AST水平均明显高于HbeAg阳性患者（P<0.05）,而白蛋白和TBiL水平无明显差异（P>0.05）。CHB患者血清IL-17A、GP73均与ALT、AST及TBiL呈正相关,与白蛋白呈负相关,与患者病情严重程度呈正相关（P<0.05）。结论：CHB患者血清中IL-17A、GP73水平明显升高,且与患者病情严重程度及肝功能相关指标呈明显相关性,临床中可联合检测用于患者病情评估及预后监测。     

Hepatoprotective effects of phosphatidylserine liposomes on carbon tetrachloride-induced hepatotoxicity in rats

It has been proposed carbon tetrachloride (CCl₄) intoxication due to the production of free radicals and serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) overload results hepatotoxicity. Phosphatidylserine (PS) has shown antioxidant activity in numerous studies. Therefore, this study was aimed to investigate the effects of PS liposomes treatment against the CCl₄-induced hepatotoxicity in a rat model. Male Wistar rats were treated with PS (10 mg/kg, oral) or phosphatidylcholine liposomes (PC) (10 mg/kg, oral) for 3 days before CCl₄ (2 ml/kg; ip once on the third day) injection. The serum level of ALT, AST, and ALP were measured. Also, antioxidant assays were performed. Administration of PS with CCl₄ significantly inhibited alterations in the serum levels of AST, ALP (^**P < 0.01), and ALT (^***P < 0.001) compared with control group. Furthermore, measurement of malondialdehyde (MDA), catalase (CAT), and superoxide dismutase (SOD) levels indicated that PS significantly reduced reactive oxygen species. The results of the present study showed the hepatoprotective effects of PS against CCl₄-induced hepatotoxicity in rats.     

Individual differences in plasma ALT, AST and GGT: contributions of genetic and environmental factors, including alcohol consumption

The causes of individuality of the plasma enzymes alanine aminotransferase (ALT; EC 2.6.1.2), aspartate aminotransferase (AST; EC 2.6.1.1) and gamma-glutamyl transferase (GGT; EC 2.3.2.2) were investigated in a study of 206 pairs of twins. Between-person variance was greater in men than women, while within-person variation was similar in both sexes. Plasma ALT and AST levels were affected by genetic factors, while GGT was affected by some environmental factor shared by co-twins. In the men, alcohol intake had a significant but small effect on all three enzyme levels, and since alcohol consumption was highly heritable, this appeared as a genetic influence on enzyme activities. The major factors involved in the observed correlations between these enzymes were a non-shared environmental factor other than alcohol affecting ALT, AST and GGT, and a genetic factor affecting only ALT and AST.     

Associations of liver dysfunction with incident dementia,cognition, and brain structure: A prospective cohort study of 431 699 adults

The relationship between liver dysfunction and dementia has been researched extensively but remains poorly understood. In this study, we investigate the longitudinal and cross-sectional associations between liver function and liver diseases and risk of incident dementia, impaired cognition, and brain structure abnormalities using Cox proportion hazard model and linear regression model. 431 699 participants with a mean of 8.65 (standard deviation [SD] 2.61) years of follow-up were included from the UK Biobank; 5542 all-cause dementia (ACD), 2427 Alzheimer's disease (AD), and 1282 vascular dementia (VaD) cases were documented. We observed that per SD decreases in alanine transaminase (ALT; hazard ratio [HR], 0.917; P_FDR <0.001) and per SD increases in aspartate aminotransferase (AST; HR, 1.048; P_FDR = 0.010), AST to ALT ratio (HR, 1.195; P_FDR <0.001), gamma-glutamyl transpeptidase (GGT; HR, 1.066; P_FDR <0.001), alcoholic liver disease (ALD; HR, 2.872; P_FDR <0.001), and fibrosis and cirrhosis of liver (HR, 2.285; P_FDR = 0.002), being significantly associated with a higher risk of incident ACD. Restricted cubic spline models identified a strong U-shaped association between Alb and AST and incident ACD (P_nonlinear <0.05). Worse cognition was positively correlated with AST, AST to ALT ratio, direct bilirubin (DBil), and GGT; negatively correlated with ALT, Alb, and total bilirubin (TBil); and ALD and fibrosis and cirrhosis of liver (P_FDR <0.05). Moreover, changes in ALT, GGT, AST to ALT ratio, and ALD were significantly associated with altered cortical and subcortical regions, including hippocampus, amygdala, thalamus, pallidum, and fusiform (P_FDR <0.05). In sensitivity analysis, metabolic dysfunction-associated steatotic liver disease (MASLD) was associated with the risk of ACD and brain subcortical changes. Our findings provide substantial evidence that liver dysfunction may be an important factor for incident dementia. Early intervention in the unhealthy liver may help prevent cognitive impairment and dementia incidence.     

Association of α-fetoprotein levels with liver stiffness measurement in outpatients with chronic hepatitis B

The association between α-fetoprotein (AFP) levels with the assessment of liver stiffness (LS) in chronic hepatitis B (CHB) patients were explored. A total of 283 outpatients with CHB were enrolled. Patient age, alanine aminotransferase (ALT), aspartate aminotransferase (AST), AFP, platelet (PLT), total bilirubin (TB), direct bilirubin (DB), alkaline phosphatase (ALP), albumin (ALB), globulin, and albumin/globulin (A/G) levels were associated with LS values in the univariate model (P<0.05). Significant associations between AFP and PLT levels with LS values were observed when both variables were included in the multivariate analysis models. Receiver operation characteristic (ROC) analysis indicated that the combination of AFP and PLT levels could enhance the predictive performance of liver fibrosis (area under the curve (AUC) = 0.819, P<0.001) and that PLT levels (PLT < 100 × 10⁹/l) combined with high AFP levels (AFP > 8 ng/ml) significantly increased the prediction of liver fibrosis (OR = 11.216). More importantly, LS values associated with higher AFP levels (AFP > 8 ng/ml), independently of higher ALT or AST values, were significantly higher than those of low AFP level groups. In conclusion, in Chinese outpatients with CHB, AFP outperformed ALT and/or AST levels in terms of their association with LS. AFP and PLT levels were independently associated with LS, and their combined assessment could enhance the diagnostic and predictive performance of liver fibrosis among CHB patients.     

Serum alanine aminotransferase to aspartate aminotransferase ratio and degree of fatty liver in morbidly obese patients

We evaluated the change in serum alanine aminotransferase (ALT; EC 2.6.1.2) to serum aspartate aminotransferase (AST; EC 2.6.1.; ALT/AST) ratio with the degree of fatty liver in morbidly obese patients. A total of 31 patients were included in the study. Fatty liver was graded as 0 to 4+. The mean and SD of AST and ALT were not significantly different between groups of patients with various grades of fatty liver. There was, however, a significant correlation between the ALT/AST ratio and the degree of fatty infiltration of the liver. This, we believe, implies damage mainly to the plasma membrane allowing loss of cytoplasmic enzymes rather than loss of mitochondrial enzymes.