scholarly journals Lipoprotein A, combined with alanine aminotransferase and aspartate aminotransferase, contributes to predicting the occurrence of NASH: a cross-sectional study

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Yu Zhang ◽  
He He ◽  
Yu-Ping Zeng ◽  
Li-Dan Yang ◽  
Dan Jia ◽  
...  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Hirotaka Ochiai ◽  
Takako Shirasawa ◽  
Takahiko Yoshimoto ◽  
Satsue Nagahama ◽  
Akihiro Watanabe ◽  
...  

Abstract Background Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) to ALT ratio (AST/ALT ratio) have been shown to be related to non-alcoholic fatty liver disease or insulin resistance, which was associated with chronic kidney disease (CKD). However, it is unclear whether ALT and AST/ALT ratio are associated with CKD. In this study, we examined the relationship of ALT and AST/ALT ratio to CKD among middle-aged females in Japan. Methods The present study included 29,133 women aged 40 to 64 years who had an annual health checkup in Japan during April 2013 to March 2014. Venous blood samples were collected to measure ALT, AST, gamma-glutamyltransferase (GGT), and creatinine levels. In accordance with previous studies, ALT > 40 U/L and GGT > 50 U/L were determined as elevated, AST/ALT ratio < 1 was regarded as low, and CKD was defined as estimated glomerular filtration rate < 60 mL/min/1.73 m2 and/or proteinuria. Logistic regression model was used to calculate the odds ratio (OR) and 95% confidence interval (CI) for CKD. Results “Elevated ALT and elevated GGT” and “elevated ALT and non-elevated GGT” significantly increased the OR for CKD when compared with “non-elevated ALT and non-elevated GGT” (OR: 2.56, 95% CI: 2.10–3.12 and OR: 2.24, 95% CI: 1.81–2.77). Compared with “AST/ALT ratio ≥ 1 and non-elevated GGT”, “AST/ALT ratio < 1 and elevated GGT” and “AST/ALT ratio < 1 and non-elevated GGT” significantly increased the OR for CKD (OR: 2.73, 95% CI: 2.36–3.15 and OR: 1.68, 95% CI: 1.52–1.87). These findings still remained after adjustment for confounders. Conclusions Elevated ALT was associated with CKD regardless of GGT elevation. Moreover, low AST/ALT ratio was also associated with CKD independent of GGT elevation.


2020 ◽  
Author(s):  
Toshihiko Yanase ◽  
Ikumi Yanagita ◽  
Yuya Fujihara ◽  
Chikayo Iwaya ◽  
Yuichi Kitajima ◽  
...  

Abstract Background: Relatively low dehydroepiandrosterone sulfate (DHEA-S) and high cortisol/DHEA ratio have been suggested to be associated with frailty, evaluated using a physical scale. However, the significance of these two hormones for frailty in elderly patients with type 2 diabetes mellitus (T2DM) has not been assessed using a wider range of measures of frailty, including physical, mental, and social indices. Methods: We performed a cross-sectional study to investigate the significance of these two hormones for frailty in elderly T2DM patients (n=148; ≥65 years), using a broad assessment, the clinical frailty scale, and to reevaluate the risk factors for frailty in elderly T2DM patients. We compared parameters between the non-frail and frail groups using the unpaired t and Mann-Whitney U tests. The Jonckheere-Therpstra test was used to identify relationships with the severity of frailty and risk factors were identified using binary regression analysis. Results: Simple regression analysis identified a number of significant risk factors for frailty, including DHEAS <70 µg/dL and cortisol/DHEA-S ratio ≥0.2. Multiple regression analysis showed that low albumin (<4.0 g/dl) (odds ratio [OR]=5.79, p <0.001), low aspartate aminotransferase (AST) activity (<25 IU/L) (OR=4.34, p =0.009), and low body mass (BM) (<53 kg) (OR=3.85, p =0.012) were independent risk factors for frailty. A significant decrease in DHEA-S and a significant increase in the cortisol/DHEA-S ratio occurred alongside increases in the severity of frailty. DHEA-S concentration positively correlated with both serum albumin and BM. Conclusions: Hypoalbuminemia, low AST, and low BM are independent risk factors for frailty in elderly T2DM patients, strongly implying relative malnutrition in these frail patients. DHEA-S may be important for the maintenance of liver function and BM. A decrease in DHEA-S and an increase in the cortisol/DHEAS ratio may be involved in the mechanism of the effect of malnutrition in elderly T2DM patients.


2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Jing Zhang ◽  
Zheng-Ying Wang ◽  
Jing-Ping Zhang ◽  
Hua Zhou ◽  
Zan Ding

Background. Serum alanine aminotransferase (ALT) activity was measured not only to detect liver disease, but also to monitor overall health. The purpose of this study was to obtain the prevalence of elevated ALT levels among adolescents. Methods. In a school-based cross-sectional study, a representative sample was analyzed from 9 middle and high schools in Shenzhen, China, during 2017 to 2018. Elevated ALT was defined as diagnostic criterion I (>30 U/L for boys and >19 U/L for girls) and diagnostic criterion II (>40 U/L). Results. From the adolescent population, a total of 7281 students (boys, 4014, and girls, 3267) aged from 10 to 17 years were collected. The prevalence of elevated ALT was 7.11% (6.88% for boys and 7.41% for girls) by criterion I and 2.72% (3.96% for boys and 1.19% for girls) by criterion II. Based on the Shenzhen census and Chinese national census population, the adjusted prevalence of elevated ALT was 7.65% (boys 7.19% and girls 8.21%) and 6.79% (boys 6.07% and girls 7.56%) by criterion I and 2.85% (boys 4.20% and girls 1.16%) and 2.43% (boys 3.49% and girls 1.29%) by criterion II. For age, the overall trends were increasing progressively, regardless of the use of diagnostic criteria for an elevated ALT activity. Conclusions. This study supplements the gap that the prevalence of elevated ALT levels differed in gender, age, and criteria among adolescents of Shenzhen. We should take the prevalence as a predictor and continue to play a warning and preventive role in preparation for further intervention.


2012 ◽  
Vol 1 (3) ◽  
pp. 1-9 ◽  
Author(s):  
Mary Seed ◽  
D John Betteridge ◽  
Jackie Cooper ◽  
Muriel Caslake ◽  
Paul N Durrington ◽  
...  

Objective To assess the relationship of levels of inflammatory risk markers to presence of clinical coronary artery disease (CAD) in patients with treated heterozygous familial hypercholesterolaemia. Design A cross-sectional study of patients on the Simon Broome Familial Hyperlipidaemia Register. Setting Six hospital outpatient clinics in the UK. Participants A total of 211 men and 199 women with heterozygous familial hypercholesterolaemia. Main outcome measures Analysis of conventional risk factors and concentrations of high-sensitivity C-reactive protein (hsCRP), lipoprotein (a), serum intercellular adhesion molecule (sICAM), interIeukin-6 (IL-6) and lipoprotein-associated phospholipase A2 (LpPLA2) mass. Results CAD was present in 104 men and in 55 women; the mean ages of onset were 43.1 and 46.5 years, respectively. On univariate analysis there was a positive relationship of CAD with age, male sex, smoking, IL-6 and sICAM, and an inverse relationship with low-density lipoprotein (LDL) and LpPLA2. On multivariate analysis, age, smoking, low LDL and low LpPLA2 were associated with CAD. When LpPLA2 values were adjusted for apoB and aspirin usage, there was no significant difference between those with and without CAD. Only age and smoking were independently associated with CAD in men, and IL-6 and lipoprotein(a) in women. Conclusions Although on univariate analysis inflammatory marker levels were associated with CAD in these patients, the majority of the associations, including that for hsCRP, disappeared when corrected for smoking and apoB. This may be because atherosclerotic plaques in these statin-treated patients were quiescent or an effect of aspirin usage. In this observational study newer risk markers were not usefully associated with the presence or absence of symptomatic CAD.


2019 ◽  
Vol 12 (3) ◽  
pp. 521
Author(s):  
Paulo Borini ◽  
Romeu Cardoso Guimarães ◽  
Zamir Calamita

The medical bibliography is deficient in research involving structural and laboratory abnormalities of the liver in asymptomatic and oligosymptomatic male alcoholics. The present study describes the alterations in tests that evaluate liver aggression, lesion and dysfunction, also correlating these with the changes in the consistency and sensitivity of the liver in aged and non-aged alcoholics. Cross-sectional study involving 100 alcoholic men, 50 aged and 50 non-aged. Of the aged and non-aged, respectively, the liver was palpable in 68% and 80%, the spleen was percutable in 72% and 74% and palpable in 12% and 22%, non-painful soft hepatomegaly was observed in 14% and 8%, painful hepatomegaly in 0% and 2%, firm hepatomegaly (painful and non-painful) in 54% and 70%, hepatomegaly and splenomegaly (percutable and palpable spleen) in 84% and 84%, and portal hypertension in 10 % and 14%. Elevated levels of aspartate aminotransferase were observed in 66% and 84%, alanine aminotransferase in 24% and 60%, gamma glutamyl transferase in 46% and 82% and alkaline phosphatase in 0% and 16% of the aged and non-aged, respectively. Elevation of aspartate aminotransferase greater than twice the reference value and the ratio aspartate aminotransferase to alanine aminotransferase greater than 2 were observed in 18% and 42% and 18% and 10% of the aged and non-aged, respectively. Hypoalbuminemia and hyperbilirubinemia were observed in 70% and 24% of the aged and 40% and 44% of the non-aged, respectively. The clinical and laboratory alterations observed are compatible with acute liver disease in 18% and 42%; chronic liver disease in 54% and 70%; portal hypertension in 10% and 14% of aged and non-aged patients, respectively.


2020 ◽  
Author(s):  
Toshihiko Yanase ◽  
Ikumi Yanagita ◽  
Yuya Fujihara ◽  
Chikayo Iwaya ◽  
Yuichi Kitajima ◽  
...  

Abstract Background: Relatively low dehydroepiandrosterone sulfate (DHEA-S) and high cortisol/DHEA ratio have been suggested to be associated with frailty as evaluated using a physical scale. However, the significance of these two hormones for frailty in elderly patients with type 2 diabetes mellitus (T2DM) has not been assessed using a wider range of measures of frailty, including physical, mental, and social indices.Methods: We performed a cross-sectional study to investigate the significance of these two hormones for frailty in elderly T2DM patients (n=148; ≥65 years), using a broad assessment, the clinical frailty scale, and to reevaluate the risk factors for frailty in elderly T2DM patients. We compared parameters between the non-frail and frail groups using the unpaired t and Mann-Whitney U tests. The Jonckheere-Therpstra test was used to identify relationships with the severity of frailty and risk factors were identified using binary regression analysis.Results: Simple regression analysis identified a number of significant risk factors for frailty, including DHEAS <70 µg/dL and cortisol/DHEA-S ratio ≥0.2. Multiple regression analysis showed that low albumin (<4.0 g/dl) (odds ratio [OR]=5.79, p<0.001), low aspartate aminotransferase (AST) activity (<25 IU/L) (OR=4.34, p=0.009), and low body mass (BM) (<53 kg) (OR=3.85, p=0.012) were independent risk factors for frailty. A significant decrease in DHEA-S and a significant increase in the cortisol/DHEA-S ratio occurred alongside increases in the severity of frailty. DHEA-S concentration positively correlated with both serum albumin and BM.Conclusions: Hypoalbuminemia, low AST, and low BM are independent risk factors for frailty in elderly T2DM patients, strongly implying relative malnutrition in these frail patients. DHEA-S may be important for the maintenance of liver function and BM. A decrease in DHEA-S and an increase in the cortisol/DHEAS ratio may be involved in the mechanism of the effect of malnutrition in elderly T2DM patients. trial registration number: UMIN (number 000031357)


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