Liver Function
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Biomedicines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1524
Paola Dongiovanni ◽  
Marica Meroni ◽  
Miriam Longo ◽  
Silvia Fargion ◽  
Anna Ludovica Fracanzani

Nonalcoholic fatty liver disease (NAFLD) is the leading contributor to the global burden of chronic liver diseases. The phenotypic umbrella of NAFLD spans from simple and reversible steatosis to nonalcoholic steatohepatitis (NASH), which may worsen into cirrhosis and hepatocellular carcinoma (HCC). Notwithstanding, HCC may develop also in the absence of advanced fibrosis, causing a delayed time in diagnosis as a consequence of the lack of HCC screening in these patients. The precise event cascade that may precipitate NASH into HCC is intricate and it entails diverse triggers, encompassing exaggerated immune response, endoplasmic reticulum (ER) and oxidative stress, organelle derangement and DNA aberrancies. All these events may be accelerated by both genetic and environmental factors. On one side, common and rare inherited variations that affect hepatic lipid remodeling, immune microenvironment and cell survival may boost the switching from steatohepatitis to liver cancer, on the other, diet-induced dysbiosis as well as nutritional and behavioral habits may furtherly precipitate tumor onset. Therefore, dietary and lifestyle interventions aimed to restore patients’ health contribute to counteract NASH progression towards HCC. Even more, the combination of therapeutic strategies with dietary advice may maximize benefits, with the pursuit to improve liver function and prolong survival.

2021 ◽  
Vol 10 (21) ◽  
pp. 4838
Hiroaki Takaya ◽  
Tadashi Namisaki ◽  
Soichi Takeda ◽  
Kosuke Kaji ◽  
Hiroyuki Ogawa ◽  

Mortality and recurrence rates of hepatocellular carcinoma (HCC) are high. Recent studies show that for patients with HCC beyond up-to-seven criteria, treatment with molecular-targeted agents (MTAs) is recommended because the treatment efficiency of transcatheter arterial chemoembolization (TACE) is poor; further, TACE increases decline in liver function. However, the relationship between TACE and liver function decline in patients with HCC within up-to-seven criteria has not been clarified. Hence, we aimed to investigate this relationship. This retrospective observational study included 189 HCC tumors within up-to-seven criteria in 114 Child–Pugh class A patients. Twenty-four (12.7%) tumors were changed from Child–Pugh class A to B after TACE, and 116 (61.4%) tumors exhibited recurrence within 6 months after TACE. Prothrombin time (PT) and albumin–bilirubin (ALBI) score before TACE were significantly associated with liver dysfunction from Child–Pugh class A to B. The combination of PT and ALBI score before TACE had high predictive ability for liver dysfunction from Child–Pugh class A to B after TACE (specificity = 100%, sensitivity = 91.7%). The combined use of pre-TACE PT and ALBI score has a high predictive ability for liver dysfunction after TACE for Child–Pugh class A patients with HCC within up-to-seven criteria.

2021 ◽  
pp. BJGP.2021.0282
Yin Zhou ◽  
Fiona M Walter ◽  
Luke Timothy Allan Mounce ◽  
Gary A Abel ◽  
Hardeep Singh ◽  

Background: Understanding pre-diagnostic test use could reveal diagnostic windows where more timely evaluation for cancer may be indicated. Aim: To examine pre-diagnostic patterns of results of abnormal blood tests in bladder and renal cancer patients. Design and setting: Retrospective cohort study using primary care and cancer registry data on bladder and renal cancer patients diagnosed between 2012-2015 in England. Method: We examined the rates of patients with a first abnormal result in the year before diagnosis, for “generic” (full blood count components, inflammatory markers, calcium) and “organ-specific” blood tests (creatinine, liver function test components) which may lead to subsequent detection of incidental cancers. We used Poisson regression, to detect the month during which the cohort’s rate of each abnormal test started to increase from baseline, and examined the proportion of patients with a test found in the first half of the window, as these ‘early’ tests might represent opportunities where further evaluation could be initiated. Results: Data from 4,533 bladder and renal cancer patients were analysed. The monthly rate of patients with a first abnormal test increased towards the time of cancer diagnosis. Abnormalities of both generic and organ-specific tests started to increase from 6-8 months pre-diagnosis, with 25-40% of these patients having an abnormal test in the “early half” of the diagnostic window. Conclusion: Population-level signals of bladder and renal cancer can be observed in abnormalities in commonly performed primary care blood tests up to 8 months before diagnosis, indicating the potential for earlier diagnosis in some patients.

2021 ◽  
Brian I. Carr ◽  
Harika Gozukara Bag ◽  
Volkan Ince ◽  
Sami Akbulut ◽  
Veysel Ersan ◽  

Abstract PurposeHCC patients typically present at an advanced tumor stage, in which surgical therapies cannot be used. Screening ultrasound exams can increase the numbers of patients diagnosed with small tumors, but are often not used in patients at risk for HCC. We evaluated clinically-available and cheap potential blood tests as biomarkers for screening patients at risk for HCC.MethodsA comparison was made of commonly used blood count and liver function parameters in a group of patients (n=101) with small HCCs (<3cm) or without HCC (n=275), who presented for liver transplantation in our institute. ResultsSignificant differences were found for blood lymphocytes and AST levels. This 2-parameter combination was found to be significantly different between patients with small HCCs versus no HCC. Using the combination of lymphocytes and AST levels to dichotomize the HCC patients, only blood levels of alpha-fetoprotein amongst the tumor characteristics, were found to be significantly different amongst the 2 HCC groups, as well as levels of blood total bilirubin, ALKP and PLR ratio. The results were confirmed using a separate smaller cohort of non-transplanted small size HCC patients.ConclusionThe combination of elevated blood levels of lymphocyte counts and AST levels holds promise for screening of patients with chronic liver disease who are at risk for HCC.

2021 ◽  
Zeyu Sun ◽  
Jiatong Chai ◽  
Qi Zhou ◽  
Jiancheng Xu

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.

2021 ◽  
pp. 88-94
A. O. Bueverov ◽  
P. O. Bogomolov ◽  
O. A. Nechayeva ◽  
A. V. Zilov

Thyroid gland (TG) and the liver are in a complex relationship in both physiological and pathological conditions. Thyroid hormones accelerate metabolic processes, intensify the synthesis of proteins and vitamins, play an important role in the development and differentiation of all cells, including hepatocytes. In addition to the central role in the deiodination of thyroid hormones with the formation of their more active and inactivated forms, the liver also carries out their transport. Dysfunction of TG can lead to changes in liver function, and in liver diseases, abnormalities in the metabolism of thyroid hormones can occur. Most often, liver pathology in diseases of TG is manifested by an increase in the serum activity of enzymes of cytolysis and/or cholestasis. Changes in liver function tests are often observed in patients with thyrotoxicosis. They are based on oxidative stress or cholestasis. The increased activity of osteoblasts in hyperthyroidism leads to an increase in the bone fraction of alkaline phosphatase, which must be taken into account in the differential diagnosis. Hepatotoxicity of thyreostatic drugs is relatively common, ranging from minimal hepatocellular damage to fulminant liver failure. In the case of hypothyroidism, the pathophysiological mechanisms are mainly represented by lipid metabolism disorders leading to fatty degeneration. It should be remembered that severe hypothyroidism can be manifested by hyperammonemia and edematous-ascitic syndrome, requiring differential diagnosis with liver failure. Treatment of liver pathology in TG diseases includes normalization of thyroid status, and in cases of drug hepatitis – temporary withdrawal of a potentially hepatotoxic drug. The data on the association of hypothyroidism and non-alcoholic fatty liver disease in the aspect of developing new therapies are very interesting.

2021 ◽  
Vol 11 (11) ◽  
pp. 2153-2161
Wenxiang Li ◽  
Yajing Sun ◽  
Zaixing Wang

Aim: To discuss effects and mechanisms of allicin in hepatic fibrosis by vivo study. Materials and methods: Dividing 45 rats into 5 groups. Evaluating pathology and fibrosis by HE and Masson staining, measuring α-SMA, Collage III, Notch 1, p-AKT and p-mTOR protein expression by IHC assay and WB assay; LC 3B protein expression were evaluated by Immunofluorescence. Liver function were measured by Elisa assay. Results: With Allicin supplement, rats’ liver function, pathological and Collagen volume fraction were significantly improved with doses-dependent in liver tissues (P < 0.05, respectively); α-SMA, Collage III, Notch 1, p-AKT and p-mTOR protein expression were significantly suppressed with doses-dependent (P < 0.05, respectively); LC 3B protein expression was significantly increased with doses-dependent (P < 0.05, respectively). Conclusion: Allicin improved hepatic fibrosis by authophagy up regulation via regulation Notrch1/AKT/mTOR pathway by vivo study.

2021 ◽  
Vol 12 ◽  
Zhong Zheng ◽  
Chengqi Liu ◽  
Ying Shen ◽  
Liang Xia ◽  
Lili Xiao ◽  

Objectives: As a common otology emergency, sudden sensorineural hearing loss (SSNHL) has a great impact on quality of life. The diagnosis and treatment of SSNHL remain challenging. This study aims to identify and investigate the association of liver functions with SSNHL.Methods: A total of 135 SSNHL patients and 135 sex- and age-matched controls were prospectively enrolled. The baseline and clinical characteristics, along with liver function levels of participators, were collected. Linear correlation, logistic regression, and receiving operator characteristic curve analysis tests were applied to examine the association between liver function levels and SSNHL.Results: There were no differences in baseline characteristics between SSNHL and control groups. The albumin (ALB) level of the SSNHL group was significantly lower than that in the control group (p &lt; 0.001). The logistic regression showed that the low ALB level may be a predictive factor of SSNHL with an adjusted OR of 0.809 (95% CI, 0.742–0.882, p &lt; 0.001). By comparing the indicators of different prognosis groups, we found that the effective group had a significantly lower hearing impair onset and higher ALB (p = 0.001) and AGR (p = 0.003) levels than the ineffective group. Logistic regression revealed that the hearing level onset (OR, 0.976; 95% CI, 0.956–0.997; p = 0.026) and ALB level (OR, 1.181; 95% CI, 1.071–1.301; p = 0.001) showed strong associations with treatment outcome.Conclusions: Lower ALB levels, within the normal ranges, were associated with the occurrence and unfavorable outcome of SSNHL. However, further research on the underlying mechanisms needs to be conducted.

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