γ-glutamyl transpeptidase in men and alanine aminotransferase in women are the most suitable parameters among liver function tests for the prediction of metabolic syndrome in nonviral hepatitis and nonfatty liver in the elderly

A volunteer study suggested that taking paracetamol 4 g daily could result in elevated alanine aminotransferase plasma levels in a substantial proportion of healthy volunteers. The safety of this dose of paracetamol for acute postoperative pain remains controversial. This study aimed to examine the incidence of alanine aminotransferase elevations after short-term use of paracetamol 4 g daily, as part of the standard pain management protocol, for 93 consecutive patients after cardiothoracic surgery. Alanine aminotransferase levels and other liver function tests were measured preoperatively as baseline and once daily after surgery during the intensive care unit stay. Preoperative alanine aminotransferase levels of more than one time the upper limit of normal (ULN, >40 U/l) was observed in 11% (n=10) of the patients but none of these baseline alanine aminotransferase levels exceeded three times the ULN (>3×ULN). The average daily dose of paracetamol administered was 50 mg/kg (SD=16) after surgery. Postoperative alanine aminotransferase levels of >1×ULN was observed in 17% (n=16), and 4% (n=4) exceeded >3×ULN. The other liver function tests of the latter four patients, including aspartate aminotransferase (range 173 to 5590 U/l), γ-glutamyltransferase (range 56 to 103 U/l), lactate dehydrogenase (range 376 to 3518 U/l) and the International Normalised Ratio (range 2.0 to 6.6), were all abnormal. These four patients all had right ventricular failure or cardiogenic shock during the postoperative period which could explain the significant rises in alanine aminotransferase after surgery. In conclusion, the incidence of significant alanine aminotransferase elevations after using daily paracetamol as an analgesic agent for cardiac surgery, at a dose of 4 g per day, was low and mostly due to complications after surgery. Our results, albeit still very limited, provided some reassurance about the safety of paracetamol 4 g daily, as a supplementary analgesic agent for adult patients undergoing cardiac surgery.

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Liver function tests as indicators of metabolic syndrome

The Korean Journal of Hepatology ◽

10.3350/kjhep.2011.17.1.9 ◽

2011 ◽

Vol 17 (1) ◽

pp. 9 ◽

Cited By ~ 2

Author(s):

Han Chu Lee

Keyword(s):

Metabolic Syndrome ◽

Liver Function ◽

Liver Function Tests ◽

Function Tests

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Establishment of Reference Intervals For Serum Liver Function Tests Among Healthy Elderly Population In Northeast China: A Retrospective Study

10.21203/rs.3.rs-902529/v1 ◽

2021 ◽

Author(s):

Zeyu Sun ◽

Jiatong Chai ◽

Qi Zhou ◽

Jiancheng Xu

Keyword(s):

Liver Function ◽

Northeast China ◽

Elderly Population ◽

Parametric Method ◽

The Elderly ◽

Liver Function Tests ◽

Reference Intervals ◽

Healthy Elderly ◽

Function Tests ◽

Lms Method

Abstract Background: Liver function changes with age, however, there are few studies that are specific for the elderly. This study is aimed to establish reference intervals (RIs) of serum liver function tests among healthy elderly population aged between 60-89 in northeast China.Methods: Subjects were colleted from laboratory information system (LIS) in the First Hospital of Jilin University. The following parameters were collected: aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP), total protein (TP) albumin (ALB), total bilirubin (TBIL), and direct bilirubin (DBIL). Tukey method was used to eliminate outliers. The Harris and Boyd method and Mann-Whitney U-test were performed to evaluate significant differences between subgroups of sex and age. The lambda-mu-sigma (LMS) method was used to analyze the dynamic changes of analytes. RIs were established by the non-parametric method.Results: A total of 23597 healthy individuals, including 20048 subjects (18-59 years old) and 3549 subjects (60-89 years old) were enrolled in the study. AST, ALT, TP and ALB required no sex partition. Except for AST, ALP and TBIL, ALT, GGT, TP, ALB and DBIL required different levels of age partitions. Serum ALT and ALB levels decreased with age, ALB showed apparent decreases throughout the aging process. DBIL showed an increase trend over time. This study showed different results compared with RIs in other studies.Conclusions: The RIs for liver function tests among healthy elderly population were different from those of other young individuals. There were apparent sex or age differences in the RIs of liver function for the elderly. Therefore, it is necessary to establish sex- and age-specific RIs of serum liver function tests among elderly population.

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Abnormal Liver Function Tests and Metabolic Syndrome—Is Fatty Liver Related to Risks for Atherosclerosis beyond Obesity?

Internal Medicine ◽

10.2169/internalmedicine.48.2517 ◽

2009 ◽

Vol 48 (18) ◽

pp. 1573-1574 ◽

Cited By ~ 2

Author(s):

Masaru Sakurai ◽

Toshinari Takamura ◽

Katsuyuki Miura ◽

Shuichi Kaneko ◽

Hideaki Nakagawa

Keyword(s):

Metabolic Syndrome ◽

Liver Function ◽

Fatty Liver ◽

Liver Function Tests ◽

Abnormal Liver Function ◽

Function Tests

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Should liver function tests be included in definitions of metabolic syndrome? Evidence from the association between liver function tests, components of metabolic syndrome and prevalent cardiovascular disease

Diabetic Medicine ◽

10.1111/j.1464-5491.2008.02408.x ◽

2008 ◽

Vol 25 (5) ◽

pp. 523-529 ◽

Cited By ~ 28

Author(s):

M. C. Devers ◽

S. Campbell ◽

J Shaw ◽

P. Zimmet ◽

D. Simmons

Keyword(s):

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Liver Function ◽

Liver Function Tests ◽

Function Tests

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Dietary restriction of energy and sugar results in a reduction in human cytochrome P450 2E1 activity

British Journal Of Nutrition ◽

10.1017/s0007114599001452 ◽

1999 ◽

Vol 82 (4) ◽

pp. 257-262 ◽

Cited By ~ 11

Author(s):

Isabelle Leclercq ◽

Yves Horsmans ◽

Jean-Pierre Desager ◽

Stanislas Pauwels ◽

André P. Geubel

Keyword(s):

Cytochrome P450 ◽

Liver Function ◽

Dietary Intake ◽

Fatty Liver ◽

Alanine Aminotransferase ◽

Liver Volume ◽

Liver Function Tests ◽

Function Tests ◽

Dietary Sugar ◽

Cyp2e1 Activity

Dietary habits are often considered as a pathogenic factor for fatty liver. The impact of dietary intake and steatosis on drug metabolism remains poorly investigated. Our aim was to assess the effect of dietary intake on in vivo cytochrome P450 (CYP) activities in eleven patients with abnormal liver function tests potentially due to fatty liver and associated with a high-sugar diet. Liver function tests, liver volume, aminopyrine breath test (ABT) and chlorzoxazone (CZ) pharmacokinetics (area under the curve, AUC) which are known to reflect CYP2E1 activity were evaluated before and after 2 months restriction of dietary sugar intake. Features at inclusion were an increased BMI (30·3 (sd 3·2) kg/m2), high hepatic volume (1·96 (sd 0·48) litres), hyperechogenic liver parenchyma, elevated liver enzyme activities (alanine aminotransferase (EC 2.6.1.2) 58·6 (sd 17·4) IU/l with alanine aminotransferase : aspartate aminotransferase (EC 2.6.1.1) ratio > 1), together with a normal ABT value (0·68 (sd 0·21) % specific activity of administered dose of [14C]aminopyrine in breath after 1 h) and a high CYP2E1 activity (CZ AUC 20·3 (sd 7·1) μg/ml per h). A dietary sugar restriction was prescribed. On the basis of repeated interviews by the same dietitian, unaware of any clinical and biochemical data, six patients remained compliant to the diet and exhibited reductions in BMI (P < 0·001), serum alanine aminotransferase (P = 0·008), liver volume (P = 0·002) and CYP2E1 activity (P = 0·007), a significant increase in ABT (P < 0·001) together with the disappearance of liver hyperechogenicity at ultrasound. In contrast, the five non-compliant patients did not show any significant change in any of these variables. In conclusion, CYP2E1 activity is induced in patients with perturbations of liver function tests potentially due to fatty liver. In these patients, effective dietary sugar restriction is associated with a reduction in liver volume, a reduction in CYP2E1 activity and an increased aminopyrine metabolism rate.

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Jaundice in adult patients above 50 years of age: a comparative study of liver function tests

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20201935 ◽

2020 ◽

Vol 8 (5) ◽

pp. 1823

Author(s):

Suneel Chauhan ◽

Vijay Kumar Barwal ◽

Gopal A. Sharma ◽

Ajay Vaid ◽

Nikhil Sood ◽

...

Keyword(s):

Liver Function ◽

Abdominal Distension ◽

The Elderly ◽

Liver Function Tests ◽

Older Age ◽

Common Symptom ◽

Age Group ◽

Function Tests ◽

Younger Age ◽

The Difference

Background: Diagnosis of jaundice involves a range of tests. The liver function tests are done in all to arrive at a diagnosis and then manage the case appropriately. With advancing age, the incidence of liver disease increases. Understanding these changes is important for the management of liver diseases in the elderly. We conducted this study to find the difference in mean levels of Liver enzymes in younger and older age group of patients suffering with jaundice.Methods: It was a prospective observational study. All patients admitted with jaundice in the medicine ward satisfying inclusion/exclusion criteria were enrolled. The results of liver function tests in younger age and older age participants were then compared.Results: Total 100 participants were enrolled during the study period. 53 were enrolled in group one and the rest in group two. Anorexia (90%) was the most common symptom followed by abdominal distension (54%). The total bilirubin (8.8±4.7) as well as conjugated bilirubin (3.4±2.8) were higher in group one though they were not significant statistically (p=0.10 and 0.25 respectively). Mean AST and ALT levels were much higher in group 1 and statistically significant (p values <0.004 and 0.002 respectively). Conversely the mean PT values were higher in group two (p=0.02).Conclusions: Although the symptom severity may be more in elderly, the LFTs are not deranged proportionately. So there is a need to devise separate cut offs and these have to be lower for the older age group patients with jaundice. More studies with larger sample size are required to confirm the results.

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