A one-year retrospective review of vitamin D level, bone profile, liver function tests and body mass index in children with cystic fibrosis in a children’s university hospital

Abstract Purpose The diagnosis of vitamin D deficiency is based on the determination of total plasma 25-hydroxyvitamin D (25-OHD) concentrations, but the regulation of vitamin D 25-hydroxylation is not a major consideration and very little information is available on this activity. To check what factors could interfere with the activity of vitamin D-25-hydroxylase and thus alter the 25-OHD concentrations, we looked for potential correlations between 25-OHD and results of liver function tests in healthy adults. Methods This single-centre study was retrospective and consisted of evaluating the correlations between 25-OHD and the activities of aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and bone alkaline phosphatase (BALP) in 349 healthy subjects aged from 18 to 65 years. In particular, in Group 1 (n = 119), we looked for correlations between 25OHD and all liver function tests and in Group 2 (n = 230) the correlation between 25OHD and BALP. Results In Group 1, we found no correlation between 25OHD and AST (r = − 0.03; p = 0.8), ALT (r = − 0.02; p = 0.91), GGT (r = − 0.08; p = 0.68), direct bilirubin (r = − 0.02; p = 0.89), indirect bilirubin (r = − 0.24; p = 0.21), and total bilirubin (r = − 0.24; p = 0.21) but one between 25OHD and ALP (r = − 0.2; p = 0.007); in Group 2, we found a significant negative correlation between 25-OHD and BALP (r = − 0.2; p = 0.0008). Conclusions The correlations that we found suggest that ALP and BALP might be involved in the regulation of vitamin D-25-hydroxylase activity, but further studies are mandatory to confirm our assumptions.

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Vegan Diet Advice Might Benefit Liver Enzymes in Nonalcoholic Fatty Liver Disease: an Open Observational Pilot Study

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld-3064 ◽

2021 ◽

Author(s):

Giuseppe Chiarioni ◽

Stefan Lucian Popa ◽

Andrea Dalbeni ◽

Carlo Senore ◽

Daniel Corneliu Leucuta ◽

...

Keyword(s):

Body Mass Index ◽

Body Weight ◽

Liver Disease ◽

Liver Function ◽

Fatty Liver Disease ◽

Liver Enzymes ◽

Liver Function Tests ◽

Vegan Diet ◽

Nonalcoholic Fatty Liver ◽

Function Tests

Background and Aims: The Western diet is rich in saturated fats, refined sugars and meat consistent with a high-energy load and secondary risk of increased metabolic diseases including nonalcoholic fatty liver disease (NAFLD). However, no data are available on potential benefit of vegan diets in NAFLD and/or nonalcoholic steatohepatitis (NASH). We aimed to study prospectively the effect of a vegan diet, excluding all animal products on liver chemistry in a group of consecutive NAFLD patients. Methods: This was a prospective, pilot study run on 40 consecutive patients affected by NAFLD. Eight subjects refused to join the study for poor diet palatability, leaving 32 patients (19 males, mean age 50 years), with abnormal measures of liver function who agreed to adhere to a vegan diet for six months. The caloric intake was tailored by the dietitian to obtain a weight loss ≥5% of body weight in overweight patients [body-mass index (BMI) ≥25] and ranged from 1500 Kcal to 1800 Kcal. Patients were contacted monthly by phone to reinforce diet and lifestyle advice and were seen at the gastrointestinal clinic when doubtful about diet advice. Results: At six-month follow-up, 6 subjects did not attend the clinic leaving only 26 patients for data analysis. Initial anthropometric values were mean weight 78 kg (range 52-95), mean body mass index (BMI) 26.8 Kg/m2 (range 20.3-31.2). Liver function tests showed mean ALT value 99 U/L (SD±45), mean AST value 54 U/L (SD±44), mean GGT value 160 U/L (SD±122), pre-treatment. After six months mean body weight was 73 Kg (range 52-87), mean BMI was 25.2 Kg/m2 (range 20.3-29.7) (p<0.001 compared to baseline for both parameters). Liver enzymes improved to a mean of ALT value 36 U/L (SD±21), AST value 27 U/L (SD±10) and GGT value 55 U/L (SD±57), respectively (p<0.001 compared to baseline for all enzymes). Normalization of liver function tests as a whole was observed in 20/26 patients (76.9%). A loss of ≥ 5% of body weight was observed in 12 patients (46.1%), but it did not correlate with the normalization of liver function tests (p=0.5). Conclusions: Our data provide preliminary evidence of improved liver enzymes in NAFLD patients with a strict vegan diet and although our study sample is limited, decreased body weight did not seem critical to the outcome.

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Cystic fibrosis-related liver disease: a single-center experience

Pediatric Reports ◽

10.4081/pr.2011.e21 ◽

2011 ◽

Vol 3 (3) ◽

pp. 21 ◽

Cited By ~ 4

Author(s):

Paula Catarino Costa ◽

Celeste Canha Barreto ◽

Luisa Pereira ◽

Maria Luisa Lobo ◽

Maria Adília Costa ◽

...

Keyword(s):

Cystic Fibrosis ◽

Liver Disease ◽

Liver Function ◽

Pediatric Patients ◽

Liver Function Tests ◽

Liver Involvement ◽

Clinical Expression ◽

Function Tests ◽

Related Liver Disease

Prospective studies concerning liver disease in pediatric cystic fibrosis patients are scarce. The present study aimed to describe the prevalence and clinical expression of cystic fibrosis - related liver disease, in a cohort of 62 pediatric patients. Descriptive study, resulting from the prospective evaluation, between 1994 and 2009, of 62 pediatric patients (age <18 years) with cystic fibrosis. The follow-up protocol included a clinical assessment every 2 months, liver function tests every 6 months and annual liver ultrasonography. The cumulative prevalence of liver disease was 11.2% (7/62 cases). All patients had ΔF508 mutation and pancreatic insufficiency, none had meconium ileus. The liver involvement became clinically evident at a mean age of 8 years (3-15 years), revealed by hepatomegaly or hepatosplenomegaly (3 cases) and/ or abnormalities of liver function tests (3 cases) changes of liver ultrasound (7 cases) with evidence of portal hypertension (2 cases). Four patients were submitted to liver biopsy; biliary fibrosis was documented in one case, focal biliary cirrhosis in 2 cases and multilobular cirrhosis in another case. Within a median 11.6 years follow-up period (all patients under UDCA therapy after liver disease diagnosis), progression of liver disease was observed in 2 patients; one patient developed refractory variceal bleeding and progressive hepatic failure, requiring liver transplant. The results of the present study agree with those of previous pediatric studies, further documenting clinical expression of liver disease in CF patients, which is usually detected in the first decade of life and emphasize the contribution of ultrasound to early diagnosis of liver involvement. Moreover, although advanced liver disease is a relatively rare event, early isolated liver transplantation may have to be considered at this age group.

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BODY MASS INDEX AND ALBUMIN LEVELS ARE ASSOCIATED WITH PULMONARY FUNCTION PARAMETERS IN PEDIATRIC SUBJECTS WITH CYSTIC FIBROSIS

Revista Paulista de Pediatria ◽

10.1590/1984-0462/;2019;37;4;00016 ◽

2019 ◽

Vol 37 (4) ◽

pp. 414-418

Author(s):

Miriam Isabel Souza dos Santos Simon ◽

Gabriele Carra Forte ◽

Paulo José Cauduro Marostica

Keyword(s):

Body Mass Index ◽

Cystic Fibrosis ◽

Pulmonary Function ◽

Body Mass ◽

Univariate Analysis ◽

Cross Sectional Study ◽

Forced Expiratory Volume ◽

Tertiary Referral Hospital ◽

Cross Sectional ◽

One Year

ABSTRACT Objective: To evaluate the association of body mass index (BMI) and albumin with pulmonary function in cystic fibrosis (CF) pediatric subjects. Methods: This is a cross-sectional study with clinically stable CF’s subjects. Clinical (pulmonary function) and nutritional evaluation (body mass index and albumin) were performed. Univariate analysis was performed using simple linear correlations. Regression analysis was performed using an exit level of p<0.05. Results: Seventy-eight CF’s subjects (mean age 12.8±3.8 years) with mean albumin 4.2±0.4 mg/dL, predicted forced expiratory volume in 1 second (FEV1%) 80.8±22.6 and BMI median percentile 51.2 (1.3-97.7). In the multiple regression models, albumin, age and BMI percentile were associated with pulmonary function. Subjects with lower than 25 BMI percentile had 12.2% lower FEV1%. An albumin increase of 0.1 mg was associated with 2.7% increase in predicted FEV1%, and one year increase in age was associated with reduction in 1.2% of predicted FEV1%. Conclusions: BMI percentile, albumin and age were independently associated with predicted FEV1% in a tertiary referral hospital.

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Incidence and clinical significance of elevated liver function tests in cystic fibrosis clinical trials

Contemporary Clinical Trials ◽

10.1016/j.cct.2012.11.005 ◽

2013 ◽

Vol 34 (2) ◽

pp. 232-238 ◽

Cited By ~ 11

Author(s):

Nicole Mayer-Hamblett ◽

Margaret Kloster ◽

Bonnie W. Ramsey ◽

Michael R. Narkewicz ◽

Lisa Saiman ◽

...

Keyword(s):

Cystic Fibrosis ◽

Clinical Trials ◽

Liver Function ◽

Clinical Significance ◽

Liver Function Tests ◽

Function Tests ◽

Elevated Liver Function Tests

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Liver function tests and one year risperidone treatment in children and adolescents

European Psychiatry ◽

10.1016/s0924-9338(11)71990-3 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 280-280

Author(s):

A. Erdogan ◽

N. Yurteri ◽

A.E. Tufan ◽

H. Ankarali ◽

E. Demirci

Keyword(s):

Liver Function ◽

Children And Adolescents ◽

Liver Enzymes ◽

Antipsychotic Agent ◽

Liver Function Tests ◽

Function Tests ◽

The Mean ◽

One Year ◽

Risperidone Treatment

ObjectiveRisperidone is an atypical antipsychotic agent, despite its many advantages and widespread use, there is increasing attention to the adverse effects associated with long-term exposure to this drug.We aimed to investigate the changes in the liver function tests (LFTs) associated with one year risperidone treatment in children and adolescents.MethodsOne hundred youths who treated with risperidone more than one year were included in the study. For this study, patients’ baseline and follow-up weight and hepatobiliary function tests including alanine aminotransferases(ALT) and aspartat aminotransferases (AST), gamma gluatamyl transerase (GGT), alkaline phosphatase (ALP) and serum bilirubin levels were measured baseline, after the treatment period of six months and one year.ResultsAsymptomatic liver function test abnormalities mostly ALP elevation was found in subjects treated with risperidone. The mean levels of liver enzymes and billuribin of the patients were significantly higher after one year of treatment than the baseline. Also the mean levels of liver enzymes and billuribin of the patients were significantly higher after one year of treatment than the six months. There was significant association between changes in weight, risperidone dose and liver enzymes and billuribin levels.ConclusionsThese findings suggest that risperidone treatment in the long term commonly leads to liver function changes however it rarely may induce a serious hepatic toxicity at therapeutic doses in children and adolescents.

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