Hepatic Involvement in Aicardi-Goutières Syndrome

2021 ◽  
Author(s):  
Francesco Gavazzi ◽  
Zachary M. Cross ◽  
Sarah Woidill ◽  
Joseph M. McMann ◽  
Elizabeth B. Rand ◽  
...  
Keyword(s):  
Liver Enzymes ◽  
Fold Increase ◽  
Rank Test ◽  
Gamma Glutamyl Transferase ◽  
Type I ◽  
Hepatic Involvement ◽  
Markers Of Inflammation ◽  
Log Rank Test ◽  
Elevated Liver Enzymes ◽  
Glutamyl Transferase

AbstractAicardi-Goutières syndrome (AGS) is a monogenic type-I interferonopathy that results in neurologic injury. The systemic impact of sustained interferon activation is less well characterized. Liver inflammation is known to be associated with the neonatal form of AGS, but the incidence of AGS-related hepatitis across lifespan is unknown.We compared natural history data including liver enzyme levels with markers of inflammation, (liver-specific autoantibodies and interferon signaling gene expression[ISG] scores). Liver enzymes were classified as normal or elevated by the fold increase over the upper limit of normal (ULN). The highest increases were designated as hepatitis, defined as aspartate-aminotransferase or alanine-aminotransferase threefold ULN, or gamma-glutamyl transferase 2.5-fold ULN. A larger cohort was used to further characterize the longitudinal incidence of liver abnormalities and the association with age and genotype.Across the AGS cohort (n = 102), elevated liver enzymes were identified in 76 individuals (74.5%) with abnormalities at a level consistent with hepatitis in 29 individuals (28.4%). SAMHD1 mutations were less likely to be associated with hepatitis (log-rank test; p = 0.011). Hepatitis was associated with early-onset disease and microcephaly (log-rank test; microcephaly p = 0.0401, age onset p = 0.0355). While most subjects (n = 20/33) were found to have liver-specific autoantibodies, there was no association between the presence of autoantibodies or ISG scores with hepatitis-level enzyme elevations.In conclusion, all genotypes of AGS are associated with transient elevations of liver enzymes and the presence of liver-associated autoantibodies. This adds to our growing understanding of the systemic pathology AGS.

Blood mercury and liver enzymes: A pan-India retrospective correlation study

2020 ◽  
Vol 36 (12) ◽  
pp. 1019-1023
Author(s):  
Krishnakumar Sivapandi ◽  
Amruta Velumani ◽  
Kallathikumar Kallathiyan ◽  
Sandhya Iyer ◽  
Prachi Sinkar
Keyword(s):  
Inductively Coupled Plasma ◽  
Liver Enzymes ◽  
National Laboratory ◽  
Linear Regression Analysis ◽  
Correlation Study ◽  
Gamma Glutamyl Transferase ◽  
Toxic Heavy Metal ◽  
Elevated Liver Enzymes ◽  
The Difference ◽  
Glutamyl Transferase

Mercury (Hg) is a toxic heavy metal, and the reported effects of exposure on liver function continue to be inconsistent. The objective of our study was to identify correlations between high blood Hg levels and liver enzymes in a pan-India population including adults ≥19 years of age. This retrospective study analyzed the data from 95,398 individuals tested for blood Hg levels and liver enzymes in our national laboratory. Testing for blood Hg was done by inductively coupled plasma-mass spectrometry, while testing for liver enzymes—aspartate aminotransferase (AST/SGOT), alanine aminotransferase (ALT/SGPT), and gamma-glutamyl transferase—was done by automated photometry systems. Data from all the individuals inclusive of 52,497 males and 42,901 females were studied. The frequency of high blood Hg levels (>5 µg/L) was found to be 0.6%, and the difference between males and females was not found to be significant. Further correlation by linear regression analysis found no relationship between high blood Hg levels and liver enzymes among females. However, among males, there was a significant correlation between high blood Hg levels, and increased AST as well as ALT. Our report suggested that for males but not females, Hg exposure may be one of the differentials for elevated liver enzymes.

scholarly journals Elevated Liver Enzymes and Incident Type Two Diabetes Mellitus Risk in Yemeni Patients     

2021 ◽  
Author(s):  
Lotfi S. Bin Dahman ◽  
Mariam A. Humam ◽  
Nabil S. Musiaan ◽  
Ahmed M. Daakik ◽  
Mohammed A. Balfas
Keyword(s):  
Blood Glucose ◽  
Total Cholesterol ◽  
Liver Enzymes ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Predictive Biomarkers ◽  
Gamma Glutamyl Transferase ◽  
Incident Type ◽  
Elevated Liver Enzymes ◽  
Glutamyl Transferase

Abstract This case-control study was aimed to assess the association between liver enzymes and incident T2D in Yemeni patients. The present study comprising 142 T2D patients and 142 healthy control subjects were recruited from the diabetic outpatient clinic of Ibn-Sina Hospital in Mukalla during the period from 1st January to 30th May 2020. Serum fasting blood glucose (FBG), total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) were analyzed using the Cobas Integra Plus 400 autoanalyzer. Anthropometric and blood pressure measurements were taken from each participant. T2D patients had significantly higher FBG (P= <0.0001), total cholesterol (P= <0.0001), LDL-C (P= <0.0001), and GGT (P= <0.0001) while, HDL-C was significantly lower in T2D patients (P= 0.021). Serum ALT and GGT levels were significantly associated with increased incident T2D risk (P= 0.006 for ALT and 0.022 for GGT), and the odds ratios at 95% CI comparing the highest versus lower tertiles of ALT and GGT were 2.75(2.01-3.48) and 1.17(1.83-6.42) respectively. In conclusion, higher levels of ALT and GGT are positively associated with increased blood glucose levels and are used as predictive biomarkers for developing a higher risk of diabetes. Thus, routine screening of ALT and GGT in T2D patients is recommended for the early detection of liver disorders.

scholarly journals Coronavirus Disease-19 and Liver Injury

2020 ◽  
Vol 8 (T1) ◽  
pp. 154-157
Author(s):  
Gontar Alamsyah Siregar ◽  
Ginanda Putra Siregar ◽  
Darmadi Darmadi ◽  
Riska Habriel Ruslie
Keyword(s):  
Liver Injury ◽  
Liver Enzymes ◽  
Gamma Glutamyl Transferase ◽  
Converting Enzyme ◽  
Drug Induced ◽  
Angiotensin Converting Enzyme 2 ◽  
Cytopathic Effects ◽  
Elevated Liver Enzymes ◽  
Apoptotic Activity ◽  
Glutamyl Transferase

Coronavirus Disease (COVID)-19 is a pandemic since March 11, 2020. The total case is more than a half million worldwide. Liver injury is quite common in COVID-19 patients. Direct viral infection is possible due to the presence of angiotensin converting enzyme 2 in cholangiocytes and hepatocytes. Other proposed mechanisms are virus-induced cytopathic effects, inflammation process, hypoxia and shock, increased apoptotic activity, increased positive end expiratory effect, and drug-induced. The manifestation of liver injury is mild and transient with elevated liver enzymes, bilirubin, and gamma-glutamyl transferase levels. Deterioration of liver function can occur in subjects with COVID-19 and underlying liver injury. The management is principally supportive. Hepatoprotective drugs may be administered in severe cases.

scholarly journals Elevated Liver Enzymes and Incident Type Two Diabetes Mellitus Risk in Yemeni Patients     

2021 ◽  
Author(s):  
Lotfi S. Bin Dahman ◽  
Omer M. Barahman ◽  
Mariam A. Humam ◽  
Nabil S. Musiaan ◽  
Ahmed M. Daakik
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Total Cholesterol ◽  
Liver Enzymes ◽  
Fasting Blood Glucose ◽  
Predictive Biomarkers ◽  
Gamma Glutamyl Transferase ◽  
Elevated Liver Enzymes ◽  
Glutamyl Transferase ◽  
Type Two Diabetes

Abstract Liver disease is a major cause of morbidity and mortality in patients with type two diabetes mellitus (T2DM). This case-control study was aimed to assess the association between liver enzymes and incident T2D in Yemeni patients. The present study comprising 142 T2D patients and 142 healthy control subjects were recruited from the diabetic outpatient clinic of Ibn-Sina hospital in Mukalla during the period from 1st January to 30th May 2020. Serum fasting blood glucose (FBG), total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) were analyzed using the Cobas Integra Plus 400 autoanalyzer. Also, anthropometric and blood pressure measurements were taken from each participant. T2D patients had significantly higher FBG (P= <0.0001), total cholesterol (P= <0.0001), LDL-C (P= <0.0001), and GGT (P= <0.0001) while, HDL-C was significantly lower in T2D patients (P= 0.021). In correlation analysis, serum GGT levels were positively associated with systolic BP (r= 0.134; P= 0.025), diastolic BP (r= 0.218; P= <0.001), FBG (r= 0.216; P= <0.0001), total cholesterol (r= 0.196; P= 0.0001), triglyceride (r= 0.123; P= 0.038), and LDL-C (r= 0.209; P= <0.0001). Also, serum ALT and GGT levels were significantly associated with increased incident T2D risk (P= 0.006 for ALT and 0.022 for GGT) and the odds ratio at 95% CI comparing highest versus lower tertiles of ALT and GGT were 2.75(2.01-3.48) and 1.17(1.83-6.42) respectively. In conclusion, higher levels of ALT and GGT are positively associated with increased blood glucose levels and may be used as the predictive biomarkers in developing higher risk of diabetes. Thus, routine screening of ALT and GGT in T2D patients is recommended for the early detection of liver disorders.

scholarly journals Correlation of Gamma Glutamyl Transferase with Traditional Risk Markers of Cardiovascular Disease in Different Obesity Phenotypes

2021 ◽  
Author(s):  
Amit Kumar Meena ◽  
Sonali Sharma ◽  
Barkha Gupta ◽  
Asrar Ahmed
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Lipid Profile ◽  
Liver Enzymes ◽  
Tertiary Care ◽  
Gamma Glutamyl Transferase ◽  
Strong Positive Correlation ◽  
Positive Correlation ◽  
Gamma Glutamyl ◽  
Glutamyl Transferase

Introduction: The increased prevalence of overweight, obesity, and metabolic syndrome has revealed that liver enzymes have a potential role as determinants of metabolic conditions such as, hyperlipidemia, and Cardiovascular Disease (CVD). Aim: The study aimed to investigate the correlation between liver enzymes with anthropometric indices of obesity and lipid profile in different obese phenotypes at a tertiary care. Materials and Methods: The present observational study was conducted on a total of 180 obese participants of either gender in the age group 18-59 years from December 2018 to May 2019. These were further divided into two phenotypic groups viz., Metabolically Healthy Obese (MHO group; n=90) and Metabolically Unhealthy Obese (MUHO group; n=90) according to NCEP ATP III criteria.Traditional cardiovascular risk factors were evaluated in the study participants through anthropometric viz., Body Mass Index (BMI), Waist Circumference (WC), Hip Circumference (HC), waist–hip ratio (WHR), blood pressure and biochemical investigations i.e., serum glucose, lipid profile and liver enzymes. Data was analysed by using Microsoft excel software. Results: Among 180 obese participants, 76 were males and 104 females with mean age 40.42±10.84 years. In MUHO phenotype, Gamma Glutamyl Transferase (GGT) showed a strong positive correlation with BMI (r=0.413, p=0.00001), lipid parameters viz., LDL-C (r=0.3785, p=0.0001), TC (r=0.2953, p=0.0023), TG (r=0.2623, p=0.006) and negative correlation with HDL-C (-r=0.3167, p=0.001). No significant correlation was found in MHO phenotype between liver enzymes, BMI and lipid profile parameters. Conclusion: The results of this study indicated that GGT shows a strong positive correlation with traditional risk factors in MUHO participants. Thus, raised GGT may be considered as a risk marker of CVD in MUHO phenotype.

Abstract P027: Gamma-Glutamyl Transferase is More Strongly Associated with Diabetes Risk Than Alanine and Aspartate Aminotransferase: Results from the Atherosclerosis Risk in Communities (ARIC) StudyStudy

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Andrea L Christman ◽  
Mariana Lazo ◽  
Chiadi E Ndumele ◽  
James Pankow ◽  
Josef Coresh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Aspartate Aminotransferase ◽  
Liver Enzymes ◽  
Gamma Glutamyl Transferase ◽  
Community Based ◽  
Gamma Glutamyl ◽  
Spline Models ◽  
Glutamyl Transferase ◽  
Diagnosed Diabetes

Introduction: Liver disease and diabetes often co-occur and have shared risk factors. We undertook this study to investigate which liver enzyme (alanine aminotransferase (ALT), aspartate aminotransferase (AST), or gamma-glutamyl transferase (GGT)) would be most strongly associated with incident diabetes in a large, community-based population. Hypothesis: We hypothesized that ALT, AST, and GGT would be independently associated with diabetes and that ALT would be most strongly associated with diabetes due to its liver specificity. Methods: We conducted a prospective analysis of 9,524 participants in the ARIC Study without diagnosed diabetes or a history of high alcohol consumption (>14 [women] and >21 [men] drinks/week). Enzymes were measured from stored plasma samples. We examined the association of sex-specific quartiles of liver enzymes with incident diagnosed diabetes using Cox proportional hazards models adjusted for demographic, lifestyle, and behavioral risk factors. Restricted cubic spline models were fit to model the continuous associations. Results: Median ALT, AST, and GGT were 13, 18, and 22 U/L, respectively. During a median follow-up of 11 years, there were 1,905 self-reported cases of diabetes. All three liver enzymes were significantly associated with diabetes, even after adjustment for all covariates (HRs (95% CIs): ALT, 1.63 (1.44, 1.85); AST, 1.23 (1.09, 1.40); GGT, 1.99 (1.71, 2.30) comparing Q4 versus Q1). The restricted cubic spline models show similar patterns (Figure). After simultaneously adjustment for the other liver enzymes, only ALT and GGT remained significantly associated with diabetes. In analyses further restricted to participants who reported never consuming alcohol only GGT remained significant. Conclusion: In this community-based population, GGT was more strongly associated with diabetes risk than ALT and AST. Although ALT and AST are considered to be more specific markers of liver disease, higher levels of GGT may be a more important risk factor for diabetes.

Anticancer Effects of Tacrolimus on Induced Hepatocellular Carcinoma in Mice

2021 ◽  
Vol 14 ◽  
Author(s):  
Shireen Sami Mahmoud ◽  
Samia Hussein ◽  
Hayam Rashed ◽  
Eman M. A. Abdelghany ◽  
Alaa I. Ali
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cyclin D1 ◽  
Liver Enzymes ◽  
Combined Treatment ◽  
Treated Group ◽  
Nuclear Antigen ◽  
Enzyme Linked Immunosorbent Assay ◽  
Gamma Glutamyl Transferase ◽  
Anticancer Effects ◽  
Glutamyl Transferase

Background: Tacrolimus is a calcineurin inhibitor widely used for immunological disorders. However, there is a significant controversy regarding its effect on the liver. The present study was conducted to evaluate the anticancer effects of tacrolimus on an induced murine hepatocellular carcinoma (HCC) model and its possible hepatotoxicity at standard therapeutic doses. Methods: Fifty-four male mice were divided into five groups: a control healthy group, control HCC group, tacrolimus-treated group, doxorubicin (DOXO)-treated group, and combined tacrolimus- and DOXO-treated group. The activity of liver enzymes, including alkaline phosphatase, gamma-glutamyl transferase, lactate dehydrogenase, alanine transaminase, and aspartate transaminase, was determined. Serum vascular endothelial growth factor (VEGF) was measured using an enzyme-linked immunosorbent assay. A quantitative real-time polymerase chain reaction (qRT-PCR) was conducted to measure the expression of proliferating cell nuclear antigen (PCNA), Bax, and p53 mRNA. Immunohistochemical staining for cyclin D1 and VEGF was performed. Results: Mice that received combined treatment with tacrolimus and DOXO exhibited the best improvement in all parameters when compared with the groups that received DOXO or tacrolimus alone (p < 0.001). Conclusion: The combination of DOXO and tacrolimus was more effective in the management of HCC compared with either agent alone. This improvement was detected by the reduction of liver enzymes and the improvement of the histopathological picture. The involved mechanisms included significant apoptosis induction demonstrated by upregulation of bax along with a reduction in angiogenesis demonstrated by downregulation of VEGF. This was accompanied by inhibition of cell cycle progression mediated by upregulated p53 and downregulated PCNA and cyclin D1.

scholarly journals COVID-19 associated variations in liver function parameters: a retrospective study

2020 ◽  
pp. postgradmedj-2020-138930
Author(s):  
Ram Krishan Saini ◽  
Neha Saini ◽  
Sant Ram ◽  
Shiv Lal Soni ◽  
Vikas Suri ◽  
...  
Keyword(s):  
Liver Injury ◽  
Liver Function ◽  
Liver Enzyme ◽  
Inflammatory Markers ◽  
Liver Enzymes ◽  
Tertiary Care ◽  
Abnormal Liver Function ◽  
Gamma Glutamyl Transferase ◽  
Number Of Patients ◽  
Glutamyl Transferase

BackgroundCharacteristics of laboratory findings of COVID-19 patients are of great significance for diagnosis and treatment. Studies that have analysed the variations in hepatic profile in correlation with the inflammatory markers in SARS-CoV-2 are limited.MethodsWe retrospectively analysed liver function tests and inflammatory markers of 170 admitted patients with confirmed COVID-19 in the tertiary care centre, Post Graduate Institute of Medical Education and Research (PGIMER), India, using Roche Cobas Autoanalyzer.ResultsNumber of patients with normal liver enzyme levels were 63 (41.5%), while with raised levels of any of the liver enzymes were 89 (58.5%), out of which 43 (48.31%) had liver injury which manifested as increased severity in terms of intensive care unit (ICU) requirement (p=0.0005). Significantly raised levels of liver enzymes and liver injury were observed with age (p<0.0001) and in males (p=0.004). Significantly decreased levels of albumin and total proteins and increased levels of total bilirubin (p<0.0001) were seen in patients with abnormal liver enzyme levels and liver injury as compared to patients with normal levels. Significant increase in the levels of alanine transaminase and gamma-glutamyl transferase was seen on the 7th day, CRP and ferritin (p<0.0001) peaks were observed on 2nd and 3rd day respectively. A significant positive correlation was found between the levels of these inflammatory markers and liver function parameters.ConclusionsMore than half of patients admitted to the hospital with SARS-CoV-2 infection had an abnormal liver function which was found to be associated with raised levels of inflammatory markers. Significantly higher proportions of patients with abnormal liver function were elderly and males and were at higher risk of progressing to severe disease.

scholarly journals Seroepidemiology of human fascioliasis and its relationship with anti-Fasciola IgG and liver enzymes as biomarkers of pathogenicity

2020 ◽  
Vol 20 (1) ◽  
pp. 208-218
Author(s):  
Kiran Afshan ◽  
Saman Kabeer ◽  
Sabika Firasat ◽  
Sarwat Jahan ◽  
Mazhar Qayyum
Keyword(s):  
Risk Factors ◽  
Liver Enzymes ◽  
Multiple Logistic Regression Analysis ◽  
Health Concern ◽  
Enzyme Linked Immunosorbent Assay ◽  
Gamma Glutamyl Transferase ◽  
Socioeconomic Condition ◽  
Human Fascioliasis ◽  
Associated Risk Factors ◽  
Glutamyl Transferase

Background: Fascioliasis has never been considered a public health concern in Pakistan, although the increasing numbers of human cases reported in south Asia need a re-consideration in the country. The current study aimed to find the seroprevalence of human fascioliasis, associated risk factors and its relationship with liver enzymes as biomarkers of pathogenicity. Methods: The cross-sectional study was conducted in different districts of Punjab region from May 2014 to August 2016. A total of 546 respondents were screened by using enzyme-linked immunosorbent assay (ELISA) and serum biochemical tests. Results: Higher seroprevalence was recorded in Muzaffargarh (6.2%) and Bhara kahu (5.9%), while low infection rate in Gu- jranwala (1.1%) and Islamabad (1.5%). The results of multiple logistic regression analysis showed rural inhabitants (OR=7.9, 95%CI: 2.5-24.8), females (OR=3.5, 95%CI: 1.7-7.1), family size 3-7 (OR=1.7, 95%CI: 1.0-2.9) and socioeconomic condition (OR=3.9, 95%CI: 1.5-10.4) were the significantly (p<0.005) associated risk factors with disease. The results of liver enzymes i.e. aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, gamma-glutamyl transferase and cholesterol levels were significantly (p=0.001) elevated and associated with fascioliasis pathogenicity. Conclusion: The higher prevalence recorded may explain with Fasciola IgG antibodies for both active and past infections and cross reactivity of the assay with other helminthes. Keywords: Human fascioliasis; immunodiagnosis; liver enzymes; Pakistan. 

scholarly journals EBV Infection Unmasking a Choledochal Cyst in an Infant

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Hassan El Khatib ◽  
Batoul Kawtharany ◽  
Diyaa Mohammad ◽  
Mohammad Siblini ◽  
Nahida El-Rifai
Keyword(s):  
Choledochal Cyst ◽  
Stone Formation ◽  
Liver Function Tests ◽  
Gamma Glutamyl Transferase ◽  
Barr Virus ◽  
Ebv Infection ◽  
Hepatic Involvement ◽  
Epstein Barr ◽  
Glutamyl Transferase

Hepatic involvement is common in acute Epstein–Barr virus (EBV) infection in children. It usually manifests as a transitory elevation of transaminases in up to 80% to 90% of patients, and they normalize by 2 to 6 weeks. A cholestatic pattern with elevated gamma-glutamyl transferase (γGT) and alkaline phosphatase (ALP) is common, in up to 60% in young adults. However, jaundice is very rare occurring in only 5% of pediatric patients. We report here an 8-month-old female with EBV infection who developed obstructive jaundice 2 weeks after the initial infection. Radiologic investigations were compatible with choledochal cyst type IVa complicated by stone formation in the common bile duct. In case of clinical exacerbation or nonamelioration of liver function tests in EVB infection, another diagnosis should be addressed. This highlights the importance of close follow-up in these patients in order not to miss a serious underlying condition such as choledochal malformation.

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