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 ◽  
...  

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.

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 4
Author(s):  
Adi Lukas Kurniawan ◽  
Chien-Yeh Hsu ◽  
Jane C.-J. Chao ◽  
Rathi Paramastri ◽  
Hsiu-An Lee ◽  
...  

Background and objectives: Insulin resistance (IR) is frequently associated with chronic low-grade inflammation and has an important role as a mediator in the development of liver disease. Thus, this study aimed to explore the relationship between two indexes of IR and abnormal liver function parameters. Materials and Methods: This cross-sectional study obtained data of 41,510 men and 92,357 women aged ≥30 years from a private health screening institute in Taiwan. Two IR indexes namely triglyceride-glucose (TyG) index and triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio were used to examine their relationship to predict abnormal liver function parameters (aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP)). Results: Positive trend was shown for the association of TyG index in the highest quintile (Q5) and risk of high AST (OR = 1.45, 95% CI: 1.33–1.57), high ALT (OR = 1.85, 95% CI: 1.73–1.97), high GGT (OR = 2.04, 95% CI: 1.93–2.15), and high ALP (OR = 1.13, 95% CI: 1.07–1.19) compared with the median quintile (Q3) in the fully adjusted model. Similarly, participants in the Q5 of the TG/HDL-C ratio were associated with 1.38 (95% CI: 1.27–1.49), 1.71 (95% CI: 1.61–1.82), 1.75 (95% CI: 1.66–1.84), and 1.21 (1.16–1.27) odds for having high AST, ALT, GGT, and ALP respectively. The AUC (95% CI) value of the TyG index for predicting high AST, high ALT, and high GGT was 0.699 (0.692–0.705), 0.738 (0.734–0.742), and 0.752 (0.749–0.755), respectively. Meanwhile, the AUC (95% CI) of the TG/HDL-C ratio for predicting high AST, high ALT, and high GGT was 0.680 (0.673–0.686), 0.738 (0.734–0.742), 0.734 (0.731–0.738), respectively. Conclusions: Our study supported that the TyG index and TG/HDL-C ratio may be useful as non-invasive methods to predict the existence of impaired liver function in the early stage.


Author(s):  
Amit Kumar Meena ◽  
Sonali Sharma ◽  
Barkha Gupta ◽  
Asrar Ahmed

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.


Author(s):  
Do-won Kim ◽  
Jeongwon Ock ◽  
Kyong-Whan Moon ◽  
Choong-Hee Park

Background: Exposure to lead (Pb), cadmium (Cd), and mercury (Hg) has been reported to be associated with liver-related diseases. However, studies examining the association between heavy metal exposure and liver injury in a large population are scant and characterized by inconsistent results. This study aimed to evaluate the association between levels of heavy metal exposure and liver injury in the general population. Methods: Data for 2953 participants aged 19 years or more obtained from the Korean National Environmental Health Survey (KoNEHS) Cycle 3 (2015–2017) were used. The associations between levels of blood or urine heavy metals (Pb, Cd, and Hg) and liver function biomarkers [aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transferase (GGT)] were evaluated using multiple linear regression analysis. Results: Regarding the blood Pb (BPb), AST was higher in those of the 4th quartile, ALT was higher in those of the 2nd and 4th quartiles, and GGT was higher in those of the 3rd and 4th quartiles than in the 1st quartile. For urinary Cd (UCd), AST was higher in those of the 4th quartile; ALT was higher in those of the 2nd, 3rd, and 4th quartiles; and GGT was higher in the 4th quartile than in the 1st quartile. For the blood Hg (BHg), AST was higher in those of the 2nd and 4th quartile, ALT was higher in those of the 2nd, 3rd, and 4th quartiles; and GGT was higher in those of the 3rd and 4th quartiles than in the 1st quartile. There was no significant difference between urinary Hg (UHg) and liver function markers. Conclusion: Heavy metal exposure showed an association with liver injury among the general adult population in Korea. Further studies are required to clarify the relationship between heavy metals and liver injury.


2022 ◽  
Vol 8 (1) ◽  
pp. 117-123
Author(s):  
Vivek Ahuja ◽  
Raghav Singhal ◽  
Paraag Kumar

Background: Liver diseases are a cause of worldwide morbidity .The course is usually long and has no signs before the development of late stage disease. The only indicative markers are liver enzymes, such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma glutamyl transferase (GGT) during asymptomatic period. There is a paucity of data from our subcontinent regarding the prevalence, risk factors and etiology of asymptomatic chronically raised liver enzymes.The aim of the study was to determine the prevalence, risk factors and etiology associated with unexplained chronically raised liver transaminases in patients attending OPD in a tertiary care hospital.Methods:This was a prospective study conducted in the Department of Gastroenterology, MMIMSR, Mullana from July 2019-Dec 2020 in 50 patients who presented with chronically raised liver enzymes. Detailed comprehensive history, physical examination and investigation was done to identify etiology and risk factors associated with raised liver enzymes.Results:566 patients were screenedfor inclusion in the study. The prevalence of raised transaminases in asymptomatic patients was 9.4%. NAFLD was the most common etiology of raised liver transaminases, seen in 70 % of patients followed by Hepatitis C and Hepatitis B. Dyslipidemia was the most important risk factor associated with NAFLD.Conclusion:NAFLD should be kept in mind while dealing patients with unexplained transaminitis. Earlier detection could help halt the progression to chronic liver disease.


2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Tasha Salsabila ◽  
Bradley J. Waleleng ◽  
Karel Pandelaki

Abstract: The incidence and death rate of COVID-19 in North Sulawesi Province continues to increase and data regarding abnormal liver function in COVID-19 is not yet available. This study was aimed to obtain the liver function in COVID-19 patients. This was a literature review study using two databases, namely Pubmed and ClinicalKey. Keywords used were abnormal liver function AND COVID-19, elevated alanine aminotransferase AND COVID-19, elevated aspartate aminotransferase AND COVID-19, elevated gamma-glutamyl transferase AND COVID-19, elevated alkaline phosphatase AND COVID-19, elevated total bilirubin AND COVID-19. After being selected, 10 literatures were obtained based on inclusion and exclusion criteria. The results showed that increased liver function often occurred in cases of COVID-19, but the increase did not reach twice of the normal value. The most frequent increases were in GGT, followed by ALT and AST, total bilirubin, and the least was the increase in ALP. All literatures reported that increased liver function was more common in males, and in severe COVID-19 patients reported by eight literatures. Five literatures reported that elevated liver function increased mortality in COVID-19 cases. In conclusion, there are increases in ALT, AST, ALP, GGT, and total bilirubin levels in COVID-19 patients.Keywords: abnormal liver function, COVID-19 Abstrak: Angka kejadian dan angka kematian COVID-19 di Provinsi Sulawesi Utara terus bertambah sedangkan data mengenai gambaran gangguan fungsi hati pada COVID-19 belum tersedia. Penelitian ini bertujuan untuk mengetahui gambaran fungsi hati pada COVID-19. Jenis penelitian ialah literature review dengan pencarian data menggunakan dua database yaitu Pubmed dan ClinicalKey. Kata kunci yang digunakan yaitu abnormal liver function AND COVID-19, elevated alanine aminotransferase AND COVID-19, elevated aspartate aminotransferase AND COVID-19, elevated gamma-glutamyl transferase AND COVID-19, elevated alkaline phosphatase AND COVID-19, elevated total bilirubin AND COVID-19. Setelah diseleksi, didapatkan 10 literatur berdasarkan kriteria inklusi dan eksklusi. Penelitian ini mendapatkan bahwa peningkatan fungsi hati sering terjadi pada kasus COVID-19 namun peningkatannya tidak mencapai dua kali nilai normal. Peningkatan paling sering terjadi pada GGT, diikuti oleh ALT dan AST, bilirubin total, dan paling sedikit yaitu pada peningkatan ALP. Seluruh literatur melaporkan peningkatan fungsi hati lebih sering terjadi pada laki-laki dan pada kasus COVID-19 gejala berat dilaporkan oleh delapan literatur. Lima literatur melaporkan peningkatan fungsi hati meningkatkan mortalitas pada kasus COVID-19. Simpulan penelitian ini ialah, terdapat peningkatan kadar ALT, AST, ALP, GGT, dan bilirubin total pada penderita COVID-19.Kata kunci: gangguan fungsi Hati, COVID-19


2016 ◽  
Vol 33 (S1) ◽  
pp. S158-S158
Author(s):  
P. Ifteni ◽  
A. Teodorescu

BackgroundMajor depressive disorder is one of the most prevalent psychiatric illnesses in the world affecting more than 12% of men and more than 21% of women in their lifetime. Selective serotonin reuptake inhibitors (SSRIs) are worldwide prescribed to treat depression. SSRIs drugs can cause drug-induced liver injury (DILI).AimsThe aim of the study was to evaluate the liver function in patients treated with SSRI in order to detect DILI.MethodsAll the patients with first major depressive episode treated with the same SSRI antidepressant for at least 3 months between September 2013 and September 2015 were entered into the study. The hepatic function panel included aminotransferases, total and direct bilirubin, albumin, total protein, gamma glutamyl transferase (GGT), LDH cholesterol, hepatitis B virus (HBV), and hepatitis C virus (HCV).ResultsOf 134 subjects with MDD according to The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) who met inclusion criteria, 98 patients entered into study. Seventy-seven (76.5%) were treated with SSRI for at least 3 months with mean age were 45.4 (SD = 6.3), 65 women (66.3%). Five patients (5.1%) were newly diagnosed with hepatitis, and 10 (10.2%) presented elevated values of ALT, AST. The mean duration of depressive symptoms was 9.2 months (SD = 6.9).ConclusionsThe treatment with SSRI seems to be effective and safe in our sample. A relative small number of patients with MDD were diagnosed with viral hepatitis during this cross-sectional study. Further randomized and controlled trials are needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.


Author(s):  
Дьякович ◽  
Olga Dyakovich ◽  
Кузнецова ◽  
Yuliya Kuznetsova

Diseases caused by disturbance of endogenous and exogenous pancreatic functions (endocrine function – diabetes mel-litus (DM) and exocrine function – chronic pancreatitis (CP)), are widely distributed in the world due to alcohol abuse, unhealthy lifestyle and negative influence of the environment. These pathologies often associate with abnormal liver functions. The goal of the study was to explore the features of the liver enzymes in 47 patients with a diagnosis of DM and CP. We revealed increase in the content of liver enzymes (aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transferase) in disturbance of pancreatic endocrine function. This dysfunction may be caused by hepatitis B and C, and fatty liver disease. Concentration of liver enzymes in the blood of individuals with hepatitis B and C was also increased. Levels of liver enzymes in patients with exocrine pathology ranged in the reference values. The reason could be the remission of CP in the examined patients. These studies require involvement of larger number of patients with the remission of the disease, and a new group of patients with CP exacerbation stage. Also additional functional and biochemical studies are necessary to identify the diagnosis of fatty liver.


2020 ◽  
Vol 8 (T1) ◽  
pp. 154-157
Author(s):  
Gontar Alamsyah Siregar ◽  
Ginanda Putra Siregar ◽  
Darmadi Darmadi ◽  
Riska Habriel Ruslie

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qing-Lei Zeng ◽  
Zu-Jiang Yu ◽  
Fanpu Ji ◽  
Guang-Ming Li ◽  
Guo-Fan Zhang ◽  
...  

Abstract Background Liver injuries have been reported in patients with coronavirus disease 2019 (COVID-19). This study aimed to investigate the clinical role played by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods In this multicentre, retrospective study, the parameters of liver function tests in COVID-19 inpatients were compared between various time-points in reference to SARS-CoV-2 shedding, and 3 to 7 days before the first detection of viral shedding was regarded as the reference baseline. Results In total, 70 COVID-19 inpatients were enrolled. Twenty-two (31.4%) patients had a self-medication history after illness. At baseline, 10 (14.3%), 7 (10%), 9 (12.9%), 2 (2.9%), 15 (21.4%), and 4 (5.7%) patients already had abnormal alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), albumin, and total bilirubin (TBIL) values, respectively. ALT and AST abnormal rates and levels did not show any significant dynamic changes during the full period of viral shedding (all p > 0.05). The GGT abnormal rate (p = 0.008) and level (p = 0.033) significantly increased on day 10 of viral shedding. Meanwhile, no simultaneous significant increases in abnormal ALP rates and levels were observed. TBIL abnormal rates and levels significantly increased on days 1 and 5 of viral shedding (all p < 0.05). Albumin abnormal decrease rates increased, and levels decreased consistently from baseline to SARS-CoV-2 clearance day (all p < 0.05). Thirteen (18.6%) patients had chronic liver disease, two of whom died. The ALT and AST abnormal rates and levels did not increase in patients with chronic liver disease during SARS-CoV-2 shedding. Conclusions SARS-CoV-2 does not directly lead to elevations in ALT and AST but may result in elevations in GGT and TBIL; albumin decreased extraordinarily even when SARS-CoV-2 shedding ended.


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