Impact of Aspartate Aminotransferase–to–platelet Ratio Index Based Score to Assess Posthepatectomy Liver Failure in Patients With Hepatocellular Carcninoma

Background: Posthepatectomy liver failure (PHLF) is a life-threatening complication following hepatic resection. The aspartate aminotransferase-to-platelet ratio index (APRI) is a noninvasive model for assessing the liver functional reserve in patients with hepatocellular carcinoma (HCC). This study aimed to establish a scoring model to stratify patients with HCC at risk for PHLF.Methods: This single-center retrospective study included 451 patients who underwent hepatic resection for HCC between 2004 and 2017. Preoperative factors, including noninvasive liver fibrosis markers and intraoperative factors, were evaluated. The predictive impact for PHLF was evaluated using receiver operating characteristic (ROC) curves of these factors.Results: Of 451 patients, 30 (6.7%) developed severe PHLF (grade B/C). Multivariate logistic analysis indicated that APRI, model for end-stage liver disease (MELD) score, operating time, and intraoperative blood loss were significantly associated with severe PHLF. A scoring model (over 0–4 points) was calculated using these optimal cutoff values. The area under the ROC curve of the established score for severe PHLF was 0.88, which greatly improved the predictive accuracy compared with these factors alone (p < 0.05 for all). Conclusions: The scoring model-based APRI, MELD score, operating time, and intraoperative blood loss can predict severe PHLF in patients with HCC.

Effects Of High Dosage of Codeine - Containing Cough Syrup Administration on Some Biochemical Parameters of Liver in Albino Rats

The study aimed to determine the effect of a high dosage of codeine-containing cough syrup administration on some biochemical parameters of the liver in albino rats. Codeine at 80 mg/kg/day, 160 mg/kg/day, 240 mg/kg/day, 320 mg/kg/day cough syrup were administered orally to albino rats for 21 days, biochemical parameters were analyzed for the activities of Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Alkaline phosphatase (ALP), Bilirubin, Total protein and Albumin. Results obtained revealed that a high dosage of codeine administration significantly increased plasma levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin and albumin while it reduced total protein level when compared with the control rats. The study confirmed the risk of increased hepatotoxicity due to a high dosage of codeine administration. Although codeine is reported to be effective in pain management, its toxicity should be kept in mind.

Effect of Xanthohumol Added to Diet on Blood Biochemistry in Japanese Quails

In this paper, we monitored to effect of xanthohumol added to diet on blood biochemistry in Japanese quails. Forty Japanese quails breeds lines Pharaoh were included in the experiment. The quails were randomly divided into two groups: one control and one experimental group with supplementation by xanthohumol in feed. In the evaluation of biochemical parameters, we focused on total protein, albumin, globulin, glucose, cholesterol and enzyme activity of AST (Aspartate aminotransferase), ALT (Alanine aminotransferase) and ɤ-GT (ɤ-Glutamyltransferase). Statistical comparisons were made between group with supplementation by xanthohumol in feed and the control group. Total protein and albumin levels were significantly differed between groups (P <0.05). A significant decrease in AST activity (P <0.05) was observed in supplementation group relative to control group.

Direct comparison of the effects of liraglutide and dulaglutide on the dynamics of scales and markers of hepatic fibrosis

Objective. Comparison of the effects of liraglutide and dulaglutide on the dynamics of scales and markers of hepatic fibrosis.Materials and methods. 35 patients with NAFLD were included in the study and received liraglutide 1.8 mg or dulaglutide 1.5 mg once daily for 6 months.Results. Body weight and glycated hemoglobin (HbA1C) decreased significantly and comparable after 6 months of treatment in both groups. Serum aspartate aminotransferase (AST) levels decreased only in the dulaglutide group. The decrease in the AST level in the dulaglutide group was from 31.9 ± 26.8 to 30.8 ± 10.6 U / L (p = 0.04). The dynamics of the risk of fibrosis reached statistical significance only when assessed on the FIB-4 scale in the liraglutide group when comparing the baseline values and values after 6 months of treatment — 1.18 ± 0.51 and 0.97 ± 0.40, respectively (p = 0.022). In the dulaglutide group, there was also an insignificant positive dynamics of 1.31 ± 0.53 and 1.11 ± 0.23 (p = 0.865), which can be explained by the minimal severity of changes at baseline.Conclusions. The study demonstrated comparable effects of liraglutide and dulaglutide on metabolic parameters and, at the same time, the advantage of liraglutide in influencing the dynamics of the risk of fibrosis, assessed on the FIB-4 scale. To unequivocally confirm the benefits of liraglutide in the treatment of patients with NAFLD, randomized prospective comparative studies of various aGPP1 on large samples of patients with different stages of NAFLD are needed.

FIB-4, APRI, and AST/ALT ratio compared to FibroScan for the assessment of hepatic fibrosis in patients with non-alcoholic fatty liver disease in Bandar Abbas, Iran

Background Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. Researchers have tried to develop indices to assess liver fibrosis in NAFLD patients to avoid liver biopsy. In this study we aimed to compare fibrosis-4 (FIB-4), aspartate aminotransferase (AST) to platelet ratio index (APRI), and aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio with FibroScan for the assessment of hepatic fibrosis in patients with NAFLD. Methods This cross-sectional study included patients with NAFLD or non-alcoholic steatohepatitis (NASH) referred to the Gastroenterology Clinic of Shahid Mohammadi Hospital, Bandar Abbas, Iran, in 2019. Demographic features of the participants including age and gender were recorded. All participants underwent FibroScan and had their AST, ALT, and platelet count measured in a random blood sample, taken within 1 month of the FibroScan. Results Of the 205 NAFLD patients included in this study with a mean age of 42.95 ± 10.97 years, 144 (70.2%) were male. Fibroscan results revealed that 94 patients (45.9%) had F1, 67 (32.7%) F2, 29 (14.1%) F3, and 15 (7.3%) F4 liver fibrosis. A significant correlation was found between FibroScan score and FIB-4 (r = 0.572), APRI (r = 0.667), and AST/ALT (r = 0.251) (P < 0.001). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of APRI at the 0.702 cut-off for the differentiation of F3 and F4 from F2 and F1 were 84.1, 88.2, 66.1, 95.3, and 87.3%, FIB-4 at the 1.19 cut-off 97.7, 72.7, 49.4, 99.2 and 78%, and AST/ALT at the 0.94 cut-off 61.4, 77, 42.2, 87.9, and 73.7% respectively. Moreover, the area under the receiver operating curve of APRI, FIB-4, and AST/ALT for the differentiation of F3 and F4 from F2 and F1 was 0.923, 0.913, and 0.720, respectively. Conclusions Based on these results, APRI appears to be the most appropriate substitute of FibroScan for the detection of significant fibrosis in NAFLD patients. FIB-4 was the second best, suggesting that in case of FibroScan unavailability, APRI and FIB-4 are the best indices to assess liver fibrosis in NAFLD patients.