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Abstract Background Nonalcoholic fatty liver disease (NAFLD) is a prevalent chronic liver disorder worldwide. According to several previous studies, the treatment of patients with NAFLD using medicinal and food-homologous substances has consistent effects on the levels of blood lipids and blood glucose and liver function. Objective This systematic review was conducted to investigate the impact of medicinal and food homologous substances on blood lipid and glucose levels as well as liver function in patients with NAFLD. Methods A thorough search was conducted in eight databases, including China Science and Technology Journal Database (VIP), Chinese National Knowledge Infrastructure(CNKI), China Biomedical Literature Database (SinoMed), Wanfang Database, PubMed, Cochrane Library, Web of Science and Embase, for articles published from database inception until June 24, 2023. The methodological quality of the included studies was evaluated utilizing Cochrane Randomized Trial Risk Bias Tool, Edition 2 and GRADE methodology for assessment. Results A total of 13 randomized controlled trials, involving 829 patients with NAFLD, were included in the analysis, these studies included a total of 9 medicinal and food homologous substances. In the 13 studies, hawthorn (2), sea buckthorn (1), ginger (2), turmeric (4) (1 with chicory seeds), cinnamon (1), cardamom (1), purslane (1) and saffron (1) were included. The results of the included studies showed that medicinal and food homologous substances could improve high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TGs), fasting blood glucose (FBG) and liver enzyme levels in patients with NAFLD to a certain extent, but the effect of turmeric on TC, liver enzyme levels is controversial. Conclusion In patients with NAFLD, dietary intervention using medicinal and food homologous substances can ameliorate blood lipid and blood glucose levels and liver enzymes to some extent. In clinical work, medicinal and food homologous substances can be used to provide patients with NAFLD with a safe and effective dietary plan to help prevent and treat disease onset and progression.

Background Azovudine is a widely used antiviral drug for COVID-19 in China, but published trials on its effect on hepaticand renal function are extremely scarce. Objective To explore the changes of in hepatic and renal function in patients with COVID-19 infection after using Azovudine, so as to provide a reference for thesafe use of Azovudine in patients with renal insufficiency. Methods Inpatients ina tertiary general hospitalwho used Azovudine for COVID-19 from December 26, 2022 to December 31, 2022 were consecutively included in the retrospective study and divided into the normal group, mild injury group, moderate injury group, severe injury group, and end-stage groupaccording to estimated glomerularrate (eGFR) levels. The changes of biochemical parametersof liver and kidney including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), albumin (ALB), total bilirubin (TB), serum creatinine (Scr), eGFR were observed in each group; the formula D_FR=D_NL×[1-F_k (1-K_f) ] was used to correct the maintenance dose of Azivudine in patients with eGFR0.05) ; because the patients with moderate and severe renal injury were dose-corrected with Azivudine, the safety of this population was not compared if the dose was not corrected. Conclusion The use of Azivudine is prone to cause the elevation of ALT level and the decrease of eGFR, but the injury with clinical significance is 2.6% and 3.7%, respectively; there was no aggravation of liver and kidney injury in patients with moderate and severe kidney injury after using the corrected dose of Azivudine, however, this conclusion needs to be confirmed in a multicenter randomized controlled study with a large sample.

Background & Aims: The coronavirus disease 2019 (COVID-19) outbreak has become a global public health pandemic, and many deaths occurred in a short period. It is possible for coronaviruses to cause hepatic injury, and the dying patient may complain about it. Aim of this study was to compare the liver function parameters, and demographic, clinical, and laboratory results between survivors and non-survivors of COVID-19. Materials & Methods: This was a retrospective-prospective cohort study conducted at Universal Hospital in Sudan. The Study included 80 cases of coronaviruse infected patients, of them 43 (53.7%) were female and 37 (46.3%) were male. A structured questionnaire was used to collect demographic, clinical, and results of liver function tests on the first day of admission. Patients were divided into survivors (treated and discharged) and non-survivors (died) groups, according to their outcomes. The analysis of the questionnaire was done using SPSS version 25. Results: Out of the 80 coronaviruse infected patients, 35 (43.8%) were survivors while the remaining 45 (56.2%) were non-survivors. The results revealed a significant increase in the mean levels of AST (p. value= 0.001), ALT (p. value= 0.047), and decreased levels of Albumin (p. value= 0.009) in the Non-survivor group compared to the survivors' group. The regression analysis demonstrated a significant correlation between AST (p value =0.04) and albumin (p value=0.02) with COVID-19 death. In the Receiver Operation Curve (ROC) analysis, the Area Under the Curve (AUC) value of the AST was 0.70 (p=0.002) with sensitivity and specificity of 73% and 66%, respectively. Conclusion: The Study concluded that baseline AST level was significantly correlated with the mortality of COVID-19 patients.

Abstract Background The benefits and harms of vitamin D supplementation in the treatment of COVID-19 have not yet been fully documented. In this study, we aimed to evaluate the effects of high-dose vitamin D supplementation on liver function tests in COVID-19. Method This double-blinded randomized clinical trial was conducted on 140 hospitalized patients aged > 30 years. Patients were randomly allocated to receive either intervention group (n = 70 receiving 50,000 IU of vitamin D capsules orally as a single dose and then 10,000 IU syrup daily from the second day of admission for 30 days) and the control group (n = 70 receiving 1000 IU vitamin D syrup orally per day). Liver function tests (LFT), including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and Lactate Dehydrogenase (LDH) were evaluated at baseline and at the end of the intervention. Decision tree analysis was performed to identify the predictors for change in liver enzymes. Results Among COVID-19 patients, a significant decrease was observed in serum level of ALP between intervention and placebo groups (p = 0.04). In addition, decision tree analysis revealed that GGT, temperature, serum magnesium level at baseline and gender were the most important predictors of ALT changes in COVID-19 patients. Conclusion High-dose vitamin D supplementation improved ALP markers among COVID-19 patients. More randomized controlled trials with longer follow-up times will be required.

Abstract Background Liver-to-spleen signal intensity ratio (LSR) is evaluated by magnetic resonance imaging (MRI) in the hepatobiliary phase and has been reported as a useful radiological assessment of regional liver function. However, LSR is a passive (non-time-associated) assessment of liver function, not a dynamic (time-associated) assessment. Moreover, LSR shows limitations such as a dose bias of contrast medium and a timing bias of imaging. Previous studies have reported the advantages of time-associated liver functional assessment as a precise assessment of liver function. For instance, the indocyanine green (ICG) disappearance rate, which is calculated from serum ICG concentrations at multiple time points, reflects a precise preoperative liver function for predicting post-hepatectomy liver failure without the dose bias of ICG or the timing bias of blood sampling. The aim of this study was to develop a novel time-associated radiological liver functional assessment and verify its correlation with traditional liver functional parameters. Methods A total of 279 pancreatic cancer patients were evaluated to clarify fundamental time-associated changes to LSR in normal liver. We defined the time-associated radiological assessment of liver function, calculated using information on LSR from four time points, as the “LSR increasing rate” (LSRi). We then investigated correlations between LSRi and previous liver functional parameters. Furthermore, we evaluated how timing bias and protocol bias affect LSRi. Results Significant correlations were observed between LSRi and previous liver functional parameters such as total bilirubin, Child-Pugh grade, and albumin-bilirubin grade (P 0.973 each), indicating that the timing bias of imaging was minimal. Conclusions This study propose a novel time-associated radiological assessment, and revealed that the LSRi correlated significantly with traditional liver functional parameters. Changes in LSR over time may provide a superior preoperative assessment of regional liver function that is better for predicting post-hepatectomy liver failure than LSR using the hepatobiliary phase alone.

Abstract Purpose To evaluate the value of MRI T1 mapping with Gd-EOB-DTPA for assessing liver function. Methods Seventy-two patients who underwent Gd-EOB-DTPA-enhanced MRI for focal liver lesions at Beijing Friendship Hospital from August 2020 to March 2022 were prospectively enrolled, and variable-flip-angle T1 mapping was performed before and 20 min after enhancement. The Child–Pugh (C-P) score and albumin-bilirubin (ALBI) grade of liver function were assessed using the clinical data of the patients. Correlation analysis was used to evaluate the correlation between T1 mapping parameters and liver function grading and laboratory tests. Nonparametric tests were used to compare the differences among different liver function groups. The liver function classification efficiency of each image index was evaluated with receiver operating characteristic (ROC) curves. Results T1post was positively correlated with the C-P grade and the ALBI grade (r = 0.717 and r = 0.652). ΔT1 was negatively correlated with the C-P grade and the ALBI grade (r = -0.790 and r = -0.658). T1post and ΔT1 significantly differed among different liver function grades (p

Non-alcoholic fatty liver disease (NAFLD) and its progressive form (non-alcoholic steatohepatitis; NASH) are the main reason for chronic liver disease in the general population, characterized by fat accumulation in hepatocytes (steatosis) and anomalies in liver biochemical analyses. To date, no pharmacological agents have been approved for NAFLD or NASH treatment. However, silymarin, the active ingredient in milk thistle, has been used in the last decades for the treatment of several liver diseases. In this case report, treatment with silymarin 140 mg three-times daily highlighted moderate efficacy and a good safety profile in the management of NASH and liver function, as it decreased serum AST and ALT levels over the treatment period with no side-effects, supporting silymarin as a promising supplemental intervention that can normalize liver activity in NAFLD and NASH. This article is part of the Current clinical use of silymarin in the treatment of toxic liver diseases: a case series. Special Issue: https://www.drugsincontext.com/special_issues/current-clinical-use-of-silymarin-in-the-treatment-of-toxic-liver-diseases-a-case-series

This study examined the effects of radon on the endogenous antioxidants, biochemical, and hematological parameters of workers in Erbil, Iraqi Kurdistan. This was carried out to ascertain how radon affects the health of those who work in certain factories producing building materials. The case study group consisted of 70 workers, who were then divided into seven subgroups (gypsum, cement plant, lightweight block, marble, red brick 1, crushed stone, and concrete block 2), while the control group consisted of 20 healthy volunteers. The total antioxidant capacity (TAC), levels of carcinoembryonic antigen (CEA), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPX), the complete blood count (CBC), and liver function tests were evaluated. The statistical analysis revealed that the antioxidant activities and CEA levels between the case study group and the control group differed significantly. Also, antioxidant enzyme activities and indoor radon concentration, the annual effective dosage, were found to be highly significantly correlated by Pearson and Spearman analyses in the case study group. Additionally, the results demonstrated a substantial correlation in the data between the levels of CEA biomarkers and radon (r=0.478, p˂0.000). The present results showed that radon concentration increased alanine aminotransferase (ALT) activity in a radon concentration-dependent manner (r=0.263 and p ˂0.05). The aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin activities, on the other hand, were not significantly affected by radon. The most significantly influenced CBC parameter was the low white blood cells (WBC) in the case study group compared to the controls. Low platelet count (PLT) was the second-highest problematic metric. The other CBC values, however, did not significantly differ between the research group and the control group. This study offers a preliminary image of the endogenous antioxidant systems in employees, especially to show a connection between radon and the occurrence of cancer among workers in Iraq Kurdistan Region.

Background: Thromboelastogram (TEG) is an effective indicator that monitors the dynamic changes of blood coagulation in real-time. It still remains controversial about the performance and influence of coagulation at high altitude. The present study intends to describe comprehensively the clinical features of TEG in populations exposed to or transferring from high altitude. Methods: Two groups were recruited in the present study. Group A included young males who worked at high-altitude (4888 m or 5418 m) areas for some time, while Group B included young males who had recently returned from high-altitude (4888 m or 5418 m) areas. Medical examinations were performed using portable devices. Spearman's test was used to evaluate the correlations between thromboelastogram (TEG) variables and other variables. Logistic regression analysis was used to analyze the factors affecting various abnormal TEG variables. Results: A total of 51 adult males were included in the two groups. Significantly increased reaction time (R) and decreased maximum amplitude (MA) were found in group B (P

Per- and polyfluoroalkyl substances (PFAS) can disrupt liver homeostasis. Studies have shown that a single exposure to PFAS may provoke abnormal liver function; however, few studies have investigated the overall effect of PFAS mixtures. We aimed to investigate associations between exposure to PFAS mixtures and liver function indices and explore the relevant mechanisms. This study included 278 adult males from Guangzhou, China. Serum metabolite profiles were analyzed using untargeted metabolomics. We applied weighted quantile sum (WQS) regression as well as Bayesian kernel machine regression (BKMR) to analyze the association of nine PFAS mixtures with 14 liver function indices. PFAS mixtures were positively associated with apolipoprotein B (APOB) and gamma-glutamyltransferase (GGT) and negatively associated with direct bilirubin (DBIL) and total bilirubin (TBIL) in both the WQS and BKMR analyses. In addition, Spearman’s correlation test showed individual PFAS correlated with APOB, GGT, TBIL, and DBIL, while there’s little correlation between individual PFAS and other liver function indices. In linear regression analysis, PFHxS, PFOS, PFHpS, PFNA, PFDA, and PFUdA were associated with APOB; PFOA, PFDA, PFOS, PFNA, and PFUdA were associated with GGT. Subsequently, a metabolome-wide association study and mediation analysis were combined to explore metabolites that mediate these associations. The mechanisms linking PFAS to APOB and GGT are mainly related with amino acid and glycerophospholipid metabolism. High-dimensional mediation analysis showed that glycerophospholipids are the main markers of the association between PFAS and APOB, and that (R)-dihydromaleimide, Ile Leu, (R)-(+)-2-pyrrolidone-5-carboxylic acid, and L-glutamate are the main markers of the association between PFAS and GGT. In summary, overall associations between PFAS and specific indices of liver function were found using two statistical methods; the metabolic pathways and markers identified here may serve to prompt more detailed study in animal-based systems, as well as a similar detailed analysis in other populations.

Objective Our objective was to analyze the correlation between Golgi protein 73 (GP73), alpha-fetoprotein (AFP), liver function indicators, and traditional Chinese medicine (TCM) syndrome types of primary liver cancer (hereinafter referred to as “liver cancer”).

This systematic review and meta-analysis aimed to evaluate the overall effect of caper fruit on the modulation of glycemic, lipid profile, liver enzymes, and body mass. Google Scholar, PubMed, and Scopus were explored to collect relevant studies in the last 10 years. RCTs with caper fruit supplementation or consumption in different cohorts of subjects with non-alcoholic fatty liver disease (NAFLD), Type-2-Diabetes (T2D), metabolic syndrome, and hyperlipidemia were included in this systematic review with a mean intervention duration from 2 to 12 weeks. The outcomes measured in this meta-analysis were liver enzymes such as aspartate aminotransferase (AST) and alanine aminotransferase (ALT), the lipid profile represented by triglycerides, total cholesterol (TC) with LDL and HDL and also, weight, and fasting blood glucose. Five randomized controlled trials, which involved a total of 178 adults, were included. According to the results, caper fruit seems to decrease liver enzymes ALT −12.29 U/L [−24.47, −0.11], AST −2.20 U/L [−4.70, 0.31]. Furthermore, the lipid profile seems to improve with a decrease in triglycerides. −11.89 mg/dL [−33.73, 9.95], LDL −4.80 mg/dL [−16.34, 6.74], HDL 0.72 mg/dL [0.10, 1.34], total cholesterol −7.83 mg/dL [−20.04, 4.38], FPG −17.93 [−42.66, 6.79], weight −1.00 kg [−1.44, −0.56]. Significant modulations were found only for ALT, HDL, and weight. In conclusion, this systematic review and meta-analysis showed the paucity of data available on the topic while showing the potential role of caper fruit as a promising food for improving the liver-lipid profile axis in patients with metabolic syndrome and diabetes. Further studies are required to confirm these results.

The easy albumin–bilirubin (EZ–ALBI) score is derived using the following equation: total bilirubin (mg/dL) − 9 × albumin (g/dL). This study aimed to determine whether the EZ–ALBI score predicted mortality risk in adult trauma patients in an intensive care unit (ICU). Data from a hospital's trauma database were retrospectively evaluated for 1083 adult trauma ICU patients (139 deaths and 944 survivors) between 1 January 2016 and 31 December 2021. Patients were classified based on the ideal EZ–ALBI cut-off of −26.5, which was determined via receiver operating characteristic curve analysis. The deceased patients' EZ–ALBI scores were higher than those of the surviving patients (−26.8 ± 6.5 vs. −30.3 ± 5.9, p = 0.001). Multivariate logistic analysis revealed that, in addition to age, the presence of end-stage renal disease, Glasgow Coma Scale scores, and injury severity scores, the EZ–ALBI score is an independent risk factor for mortality (odds ratio (OR), 1.10; 95% confidence interval (CI): 1.06–1.14; p = 0.001)). Compared with patients with EZ–ALBI scores < −26.5, those with scores ≥ −26.5 had a 2.1-fold higher adjusted mortality rate (adjusted OR, 2.14; 95% CI: 1.43–3.19, p = 0.001). In conclusion, the EZ–ALBI score is a substantial and independent predictor of mortality and can be screened to stratify mortality risk in adult trauma ICU patients. [ABSTRACT FROM AUTHOR]

A total of 120 patients admitted to affiliated hospitals of the North Sichuan Medical College between September 2020 and June 2022 were recruited for this study and received percutaneous transhepatic cholangial drainage. Patients in the control group received parenteral nutrition support, whereas patients in the treatment group received parenteral and combined enteral nutrition support. Compared to the control group, the time of first exhaustion and defecation in the treatment group was faster, and the postoperative activity time and hospital stay were shorter. Serum albumin and prealbumin levels in both groups decreased on the 1st day after surgery and recovered on the 7th day, with the treatment group reaching higher levels. After surgery, the decline in alanine aminotransferase, aspartate aminotransferase, total bilirubin, and direct bilirubin levels was higher in the treatment group. CD4+, CD8+ levels, and CD4+/CD8+ ratios in both groups were elevated, with the treatment group showing higher levels. The occurrence of complications in the treatment group was lessened relative to the control group. In summary, enteral combined parenteral nutrition support for patients with malignant obstructive jaundice after surgery can promote faster recovery of gastrointestinal function, improve nutritional status, facilitate the recovery of liver function, and promote immune function. [ABSTRACT FROM AUTHOR]

We have examined the effect of added elemene on the clinical efficacy of combined treatment of advanced hepatocellular carcinoma with lenvatinib and tislelizumab chemotherapy. Patients with advanced hepatocellular carcinoma (n = 150) were divided into groups of equal size and treated with the multi-kinase inhibitor lenvatinib plus the PD-1 inhibitor tislelizumab alone (control) or along with elemene (treatment), a plant sesquiterpene with antiproliferative effects. The results of the study show a higher objective response rate and local control rate, superior post-treatment liver function, immune function, anti-angiogenesis capacity, and better quality of life, as reflected by higher functional assessment of cancer therapy scores (P < 0.05). Additionally, after treatment, albumin and prealbumin were elevated, and patient-generated subjective global assessment scores declined in both groups after treatment, but no difference was found between the two groups (P > 0.05). To sum up, elemene added to lenvatinib and tislelizumab chemotherapy is effective in treating advanced hepatocellular carcinoma patients and is recommended for clinical use. [ABSTRACT FROM AUTHOR]

Purpose: Our objective was to investigate the impact of albumin-bilirubin (ALBI) score at the time of post-hepatectomy hepatocellular carcinoma (HCC) recurrence on survival after recurrence (SAR). We further explored the perioperative factors associated with the ALBI score at recurrence. Methods: Patients who underwent primary hepatectomy for HCC between 2007 and 2018 and developed recurrence were included in the study. Cox regression models were used to assess the association between the ALBI score at recurrence and SAR. Linear regression models were used to explore factors associated with ALBI score at recurrence. Results: Of the 233 patients analyzed, 158 developed recurrence within the Milan criteria (RWM) and 76 developed recurrence beyond the Milan criteria (RBM). Multivariable cox regression analysis demonstrated that higher ALBI scores at recurrence were associated with poorer SAR in both RWM and RBM groups (hazard ratios 4.5, 5.0; 95% confidence intervals 2.3–8.8, 2.2–11.6, respectively). In addition, multivariable linear regression analysis revealed that higher ALBI scores at hepatectomy and post-hepatectomy liver failure (PHLF) ≥ grade B were associated with higher ALBI scores at recurrence (β = 0.21, 0.11; 95% confidence intervals 0.15–0.26, 0.06–0.17, respectively). Conclusions: The ALBI score at recurrence was a significant prognostic factor for SAR, and the ALBI scores at hepatectomy and PHLF ≥ Grade B were independently associated with the ALBI score at recurrence. Prevention of PHLF and consequent preservation of liver function at recurrence may be paramount to achieving better survival after HCC recurrence. [ABSTRACT FROM AUTHOR]

Background and aim: First, it has been demonstrated that endoscopic ultrasonography (EUS)-guided cyanoacrylate (CYA) injection (EUS-CYA) has greater efficacy than direct endoscopic injection of cyanoacrylate (DEI-CYA) for treating type 1-isolated gastric varices. However, it is necessary to conduct further studies to determine whether EUS has any advantage over the current guidelines for treating gastroesophageal varices type 1 (GOV1). Second, liver function is an important prognostic factor in patients with liver cirrhosis. Therefore, we evaluated the liver function of patients treated with EUS-CYA. Methods: In a single-center study, a prospective cohort from February 2021 to September 2022 involving 89 patients with cirrhosis with GOV1 were assigned to undergo EUS-CYA (n = 45) or DEI-CYA (n = 44). The success rate of CYA injection, the rate of overall rebleeding, the rate of reintervention, the complications during the follow-up period, and the liver function were compared. Results: In both groups, 100% of the operations were successful. The follow-up time of the two groups was 290 (153–398) days and 267 (177–416) days, respectively. In the EUS group, the perforating veins had an average diameter of 7.0 ± 2.7 mm, and they had a 100% occlusion rate. A statistically significant difference was found between the two groups regarding the number of sessions needed to eradicate GV (p = 0.005, pairwise comparisons were conducted using the Bonferroni correction method.), the late rebleeding rate after EUS-CYA [n = 3 (6.7%) vs n = 10 (22.7%); p = 0.032], and the incidence of postinjection ulcers [n = 4 (8.9%) vs n = 12 (27.3); p = 0.023)]. Following EUS or DEI-CYA treatment, the patient's liver function did not show any significant deterioration or decline. Conclusion: EUS-CYA has a higher eradication success rate and fewer complications, recurrences, and rebleeding episodes than DEI-CYA used for GOV1 treatment. In addition, EUS-CYA did not impair liver function. [ABSTRACT FROM AUTHOR]

Background and Aim: Microbiome‐targeted therapies (MTTs) are considered as promising interventions for cirrhosis, but the impact of gut microbiome modulation on liver function and disease severity has not been fully assessed. We comprehensively evaluated the efficacy of MTTs in patients with liver cirrhosis. Methods: Data from randomized controlled trials were collected through MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrial.gov from inception to February 20, 2023. Clinical outcomes were pooled and expressed in terms of risk ratios or mean differences (MD). Additional subgroup and sensitivity analyses were performed to validate the robustness of findings. A trial sequential analysis was applied to calculate the required information size and evaluate the credibility of the meta‐analysis results. Results: Twenty‐one studies with a total of 1699 cirrhotic patients were included for meta‐analysis. MTTs were associated with a significant reduction in aspartate aminotransferase (MD, −3.62; 95% CI, −6.59 to −0.65), the risk of hepatic encephalopathy (risk ratio = 0.56, 95% CI: 0.46 to 0.68), model for end‐stage liver disease score (MD, −0.90; 95% CI, −1.17 to −0.11), ammonia (MD, −11.86; 95% CI, −16.39 to −7.33), and endotoxin (MD, −0.14; 95% CI, −0.23 to −0.04). The trial sequential analysis yielded reliable results of these outcomes. No effects were observed on the changes of other hepatic function indicators. Conclusion: MTTs appeared to be associated with a slowed deterioration in liver cirrhosis, which could provide reference for clinicians in treatment of cirrhotic patients based on their conditions. [ABSTRACT FROM AUTHOR]

Aflatoxins are liver carcinogens and are common contaminants in unpackaged peanut (UPP) oil. However, the health risks associated with consuming aflatoxins in UPP oil remain unclear. In this study, aflatoxin contamination in 143 UPP oil samples from Guangdong Province were assessed via liquid chromatography–tandem mass spectrometry (LC-MS). We also recruited 168 human subjects, who consumed this oil, to measure their liver functions and lipid metabolism status. Aflatoxin B1 (AFB1) was detected in 79.72% of the UPP oil samples, with levels ranging from 0.02 to 174.13 μg/kg. The average daily human intake of AFB1 from UPP oil was 3.14 ng/kg·bw/day; therefore, the incidence of liver cancer, caused by intake of 1 ng/kg·bw/day AFB1, was estimated to be 5.32 cases out of every 100,000 persons per year. Meanwhile, Hepatitis B virus (HBV) infection and AFB1 exposure exerted a synergistic effect to cause liver dysfunction. In addition, the triglycerides (TG) abnormal rate was statistically significant when using AFB1 to estimate daily intake (EDI) quartile spacing grouping (p = 0.011). In conclusion, high aflatoxin exposure may exacerbate the harmful effects of HBV infection on liver function. Contamination of UPP oil with aflatoxins in Guangdong urgently requires more attention, and public health management of the consumer population is urgently required. [ABSTRACT FROM AUTHOR]

Background: Thalassemia major is a genetic disorder characterized by severe anemia and the need for lifelong blood transfusions. Aims and Objectives: The aim of this study was to investigate the clinical profile of transfusion-dependent thalassemia major children with reference to serum ferritin levels and liver function. Materials and Methods: A prospective observational study included 100 children aged 1–12 years with beta-thalassemia major, who were receiving blood transfusions. Clinical data, including growth parameters, serum ferritin levels, and liver function tests, were collected. Descriptive and inferential statistical analyses were performed. Results: The study population predominantly consisted of children aged 1–5 years (54%) and males (51%). Hindu children accounted for 85% of the participants. Most children were diagnosed with thalassemia major before the age of 1 year (84%) and were diagnosed through Hb electrophoresis (77%). The majority of children received blood transfusions every 15–30 days (49%). Pre-transfusion hemoglobin levels ranged from <5 g/dL to 8.0 g/dL, while post-transfusion levels ranged from 7.1 g/dL to 10.1 g/dL. Liver function tests indicated the mean values for total serum bilirubin (0.81±0.2), direct bilirubin (0.34±0.10), indirect bilirubin (0.49±0.10), aspartate transaminase (47.22±11.06), alanine transaminase (45.45±8.97), alkaline phosphatase (97.74±4.39), total proteins (6.28±0.29), and serum albumin (3.72±0.2). No significant changes were observed in growth parameters over the 18-month study period. Conclusion: This study provides insights into the clinical profile of children with transfusion-dependent thalassemia major, emphasizing the significance of early diagnosis, regular transfusions, and monitoring of serum ferritin levels and liver function. [ABSTRACT FROM AUTHOR]

Background: Portal veinous system thrombosis (PVST) is a common complication after laparoscopic splenectomy plus esophagogastric devascularization (LSED). Anticoagulation therapy was still in debate in LSED perioperation. This study aimed to determine the postoperative risk factors of PVST, the efficacy and safety of the anticoagulation therapy after LSED procedure, and the potential impact of anticoagulation on patients' liver function and overall survival (OS). Methods: Three hundred patients who underwent LSED were retrospectively enrolled and analyzed in the study. The characteristics of patients, perioperative parameters, risk of PVST, and long-term follow-up data were recorded and analyzed. Results: One hundred eighty six of 300 patients received perioperative anticoagulation therapy (p-AT) postoperation, while 114 patients did not receive p-AT (non-p-AT). The non-p-AT group had more intraoperative blood loss, PVST, longer abdominal drain days, and postoperative hospital stays separately compared with the p-AT group. No significant difference of postoperative complications was found between the two groups. In the 1-year follow-up postoperation, both groups had great improvement in hypersplenism and the portal vein hemodynamics. During the 10-year follow-up period, the incidence of PVST was significantly higher in the non-p-AT group than in the p-AT group. Anticoagulation therapy, sex, variceal hemorrhage history, portal vein diameter, and portal vein velocity were the independent prognostic factors determined by the Cox regression analysis for PVST. The thrombosis-free survival rate (P = .002), recurrent hemorrhage-free survival rate (P < .01), and the OS rate (P < .01) were significantly lower in the non-p-AT group than in the p-AT group. Conclusions: The initiate use of anticoagulation therapy in postoperation of LSED is effective and safe in cirrhotic patients. The anticoagulation therapy after LSED will help decrease portal vein thrombosis, the rebleeding rate, and extend the OS of the patients, especially among women, with variceal hemorrhage history, high portal vein diameter, and low portal vein velocity. [ABSTRACT FROM AUTHOR]

Purpose: Liver cirrhosis disrupts liver function and tissue perfusion, detectable by magnetic resonance imaging (MRI). Assessing liver function at the voxel level with 13‐b value intravoxel incoherent motion diffusion‐weighted imaging (IVIM‐DWI) could aid in radiation therapy liver‐sparing treatment for patients with early impairment. This study aimed to evaluate the feasibility of IVIM‐DWI for liver function assessment and correlate it with other multiparametric (mp) MRI methods at the voxel level. Method: This study investigates the variability of apparent diffusion coefficient (ADC) derived from 13‐b value IVIM‐DWI and B1‐corrected dual flip angle (DFA) T1 mapping. Experiments were conducted in‐vitro with QIBA and NIST phantoms and in 10 healthy volunteers for IVIM‐DWI. Additionally, 12 patients underwent an mp‐MRI examination. The imaging protocol included a 13‐b value IVIM‐DWI sequence for generating IVIM parametric maps. B1‐corrected DFA T1 pulse sequence was used for generating T1 maps, and Gadoxatate low temporal resolution dynamic contrast‐enhanced (LTR‐DCE) MRI was used for generating the Hepatic extraction fraction (HEF) map. The Mann‐Whitney U test was employed to compare IVIM‐DWI parameters (Pure Diffusion, Dslow; Pseudo diffusion, Dfast; and Perfusion Fraction, Fp) between the healthy volunteer and patient groups. Furthermore, in the patient group, statistical correlations were assessed at a voxel level between LTR‐DCE MRI‐derived HEF, T1 post‐Gadoxetate administration, ΔT1%, and various IVIM parameters using Pearson correlation. Results: For‐vitro measurements, the maximum coefficient of variation of the ADC and T1 parameters was 12.4% and 16.1%, respectively. The results also showed that Fp and Dfast were able to distinguish between healthy liver function and mild liver function impairment at the global level, with p = 0.002 for Fp and p < 0.001 for Dfast. Within the patient group, these parameters also exhibited a moderate correlation with HEF at the voxel level. Conclusion: Overall, the study highlighted the potential of Dfast and Fp for detecting liver function impairment at both global and pixel levels. [ABSTRACT FROM AUTHOR]

Background: Pemafibrate has been reported to ameliorate lipid profiles and liver dysfunction. However, which patients derive benefit from the hepatoprotective effects of pemafibrate is unclear. Methods: We conducted a sub-analysis of the PARM-T2D study where subjects with type 2 diabetes complicated by hypertriglyceridemia were prospectively treated with pemafibrate or conventional therapies for 52 weeks. From the original cohort, subjects who had metabolic-associated fatty liver disease without changing their treatment regimens for comorbidities were analyzed. Eligible subjects (n = 293) (average age 61.2 ± 11.7 years, 37.5% female) treated with pemafibrate (pemafibrate, n = 152) or controls who did not change their treatment regimens (controls, n = 141) were divided into three groups based on their alanine aminotransferase (ALT) levels: ALT ≤ upper normal limit (UNL) (pemafibrate, n = 65; controls, n = 50), UNL < ALT ≤ 2×UNL (pemafibrate, n = 58; controls, n = 54), and 2×UNL < ALT (pemafibrate, n = 29; controls, n = 27). Results: Pemafibrate treatment significantly ameliorated ALT levels (from 29 to 22 U/L, p < 0.001 by Wilcoxon's signed-rank test) in the total cohort and subjects with high ALT levels (2×ULN < ALT), and improved liver fibrosis as assessed by the Fibrosis-4 index (mean change − 0.05 (95% confidence interval: −0.22 to − 0.02), p < 0.05 versus baseline by the Mann-Whitney U-test and p < 0.05 versus the ALT ≤ UNL group by the Kruskal–Wallis test followed by Dunn's post-hoc analysis). Conclusions: The hepatoprotective effects of pemafibrate were dominant in subjects with type 2 diabetes complicated with liver dysfunction. Trial registration: This study was registered with the University Hospital Medical Information Network Center Clinical Trials Registry (UMIN000037385). [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to elucidate the effects of long-term day and night shifts on liver function and lipid metabolism in a group of nurses. Methods: This cross-sectional study in December 2019 was based on a group of nurses. A total of 1,253 physically healthy caregivers were included, including 1231 women and 22 men. A total of 886 nurses had long-term shift work (working in a rotating system for >1 year). The receiver operating characteristic (ROC) curve and logistic regression analyses were used to evaluate factors related to long-term shift work. Results: We observed differences in liver and kidney indicators between the nonnight and night shift groups. The ROC curve revealed that CHO (AUC: 62.4%), LDLC (AUC: 62%), and GLUO (AUC: 61.5%) were more related to the night shift. Logistic regression analysis showed that night shift work was associated significantly with CREA (log (OR) = -0.02, 95% CI: -0.04 to -0.01), CHO (log (OR) = -0.38, 95% CI: -0.67 to -0.09), and GLUO (log (OR) = -0.35, 95% CI: -0.56 to -0.17). This correlation was observed only for CHO and LDHC (CHO: log (OR) = -0.55, 95% CI: -0.98 to -0.12; LDLC: log (OR) = 0.83, 95% CI: 0.32, 1.4) after age standardization. After using propensity score matching, we did not find evidence to support that the indicators differed between night and nonnight shift groups. Conclusion: Our study observed an association of long-term night work with abnormal liver and kidney function and dyslipidemia, but the difference was not significant after strict age matching. Although these findings may support interventions for long-term night shift nurses, more detailed studies are needed to confirm. [ABSTRACT FROM AUTHOR]

Simple Summary: Steroid-induced hepatopathy is the most important liver abnormality in dogs with hyperadrenocorticism (HAC). Serum activities of several liver enzymes increase in dogs with HAC. However, serum bile acids concentrations in dogs with HAC are poorly described. This study evaluated serum total bile acids concentrations and serum liver enzyme activities after trilostane treatment in dogs with HAC. Hyperadrenocorticism (HAC) often leads to vacuolar hepatopathy. The impact of trilostane treatment on serum total bile acids (SBAs) concentrations in dogs with HAC remains unknown. This study investigated SBAs concentrations in healthy dogs and those with HAC following trilostane therapy. Ten healthy dogs and fifteen dogs with HAC were prospectively enrolled. A biochemistry profile and pre- and post-prandial SBAs concentrations were determined in each dog. Dogs with HAC were reassessed at 1 and 3 months after the initiation of trilostane treatment. Dogs with HAC had significantly higher serum ALT, ALP, and GGT activities, and cholesterol, triglyceride, and pre-prandial SBAs concentrations compared to healthy dogs. After 3 months of trilostane treatment, polyuria/polydipsia and polyphagia were completely resolved in 42.8% and 35.7%, respectively. Significant improvements in serum ALT and ALP activities and cholesterol concentrations were observed within 1–3 months of trilostane treatment. However, pre- and post-prandial SBAs concentrations did not significantly decrease. These findings suggest that treatment with low-dose trilostane for 3 months appears to reduce serum liver enzyme activities, but not SBAs concentrations. Further investigation is warranted to explore the effects of low-dose trilostane treatment on SBAs concentrations for a longer duration or after achieving appropriate post-ACTH cortisol levels. [ABSTRACT FROM AUTHOR]

The liver is a key metabolic organ that maintains whole‐body nutrient homeostasis. Aging‐induced liver function alterations contribute to systemic susceptibility to aging‐related diseases. However, the molecular mechanisms of liver aging remain insufficiently understood. In this study, we performed bulk RNA‐Seq and single‐cell RNA‐Seq analyses to investigate the underlying mechanisms of the aging‐induced liver function changes. We found that liver inflammation, glucose intolerance, and liver fat deposition were aggravated in old mice. Aging significantly increased pro‐inflammation in hepatic macrophages. Furthermore, we found that Kupffer cells (KCs) were the major driver to induce pro‐inflammation in hepatic macrophages during aging. In KCs, aging significantly increased pro‐inflammatory levels; in monocyte‐derived macrophages (MDMs), aging had a limited effect on pro‐inflammation but led to a functional quiescence in antigen presentation and phagosome process. In addition, we identified an aging‐responsive KC‐specific (ARKC) gene set that potentially mediates aging‐induced pro‐inflammation in KCs. Interestingly, FOXO1 activity was significantly increased in the liver of old mice. FOXO1 inhibition by AS1842856 significantly alleviated glucose intolerance, hepatic steatosis, and systemic inflammation in old mice. FOXO1 inhibition significantly attenuated aging‐induced pro‐inflammation in KCs partially through downregulation of ARKC genes. However, FOXO1 inhibition had a limited effect on aging‐induced functional quiescence in MDMs. These results indicate that aging induces pro‐inflammation in liver mainly through targeting KCs and FOXO1 is a key player in aging‐induced pro‐inflammation in KCs. Thus, FOXO1 could be a potential therapeutic target for the treatment of age‐associated chronic diseases. [ABSTRACT FROM AUTHOR]

Introduction: Bariatric surgery is the best possible option for reducing weight when lifestyle changes and medication have not brought about lasting success and may reduce morbidity and mortality. Weight loss that may follow bariatric surgery in patients on calory restricted diet would result in reduced inflammation and therefore lowering inflammation-related organ damage, including that of the kidney and liver. The study aimed to observe the consequences of BMI change on Hepatic and Nephrological parameters in patients after One Anastomosis Gastric Bypass surgery. Method: This study was done at a bariatric center with 150 individuals (both male and female) aged 20 to 60 years with obesity grades II and III who were selected randomly. Hepatic and renal function tests were carried out at baseline visit, then 3 months and 6 months following surgically. Result: Bilirubin level significantly increased from baseline to visit 1; Serum glutamic-pyruvic transaminase (SGPT) levels significantly decreased at visits 1 and 2. The albumin to Globulin ratio was significantly increased at visit 2. Blood Urea level and serum creatinine level reduced considerably at visit 1 and decreased more at visit 2 from baseline. Conclusion: Bariatric surgery may be related to improvement in both hepatic and renal function. The improvement may be attributed to reduced inflammatory organ damage related to obesity. More such studies must be performed to highlight the possible health benefits of bariatric surgery for obese patients whose lifestyle modification and medication have not aided in weight loss. [ABSTRACT FROM AUTHOR]

Objective: To investigate diagnostic clinical significance of peripheral blood lymphocyte subsets in children with EB virus （EBV） infection. Methods: Forty-eight children with EBV infection were selected as observation group, another 23 children with acute bronchopneumonia and 48 children with mycoplasma pneumoniae（ MP） infection were selected as control group. Peripheral blood lymphocytes subsets were detected by flow cytometry, and clinical data of patients was collected. Changes of lymphocyte subsets between observation group and control group, as well as between children with infectious mononucleosis （IM） and non-IM, abnormal liver function and normal liver function in observation group were compared. Linear correlation analysis was used to analyze correlation between lymphocyte subsets and serum EBV-DNA load in observation group. Diagnostic efficacy of lymphocyte subsets was evaluated by receiver operating characteristic （ROC） curve. Results: Number of lymphocytes, number and proportion of T cells, number and proportion of CD8+T cells in infected peripheral blood of EBV children were increased （all P<0.05）. Proportion of CD4+T cells, B cells and CD4+/CD8+ were reduced （all P<0.05）. Changes of peripheral blood lymphocytes in children infected with EBV were correlated with EBV-DNA load. Number of lymphocytes （all P<0.001）, number （all P<0.001） and proportion of T cells （P<0.001;P=0.002）, number（ all P<0.001） and proportion of CD8+T cells（ all P<0.001） and number of NK cells（ P<0.001; P=0.001） in children with IM and abnormal liver function were more significant than those in children with non-IM and normal liver function. Number（ P<0.001; P= 0.049） and proportion （all P<0.001） of B cells and CD4+/CD8+ （P=0.001;P<0.001） were reduced more significantly. Diagnostic efficacy analysis of lymphocyte subsets showed that lymphocyte count, CD3+T cells count, CD3+CD8+T cells count, NK cells count, proportion of CD3+T cells and proportion of CD3+CD8+T cells in peripheral blood had better diagnostic efficacy for EBV infection （AUC were 0.750, 0.773, 0.826, 0.689, 0.718 and 0.779, all P<0.05）. Conclusion: Lymphocyte subsets can reflect immune status of body, with great significance for diagnosis of EBV infection and evaluation of disease progression and prognosis. [ABSTRACT FROM AUTHOR]

The impact of spontaneous portosystemic shunt (SPSS) on decompensated events and mortality for patients with hepatitis B-related cirrhosis remains poorly investigated. To evaluate the prevalence, clinical characteristics, and outcomes of SPSS among patients with hepatitis B-related cirrhosis. Patients who were diagnosed with hepatitis B-related cirrhosis were retrospectively recruited. All eligible patients were classified into SPSS and non-SPSS groups and their clinical characteristics and outcomes were compared and analyzed. Of the 1282 patients included in this study, SPSS was identified in 488 patients (38.1%). SPSS group had more severe liver function impairment, higher prevalence and severity of esophageal and gastric varices (EGV), and a higher prevalence of EGV bleeding (EGVB), portal vein thrombosis (PVT), hepatic encephalopathy (HE), ascites, and hepatocellular carcinoma (HCC, all P <0.05). During the follow-up period, SPSS group experienced a significantly higher incidence of EGVB, PVT, and HE (all P <0.05); however, there was no significant difference in the incidence of ascites, HCC, and mortality between the two groups (all P >0.05). With hepatitis B-related cirrhosis, SPSS was common and characterized by severe liver damage and a high prevalence of decompensated events. Moreover, patients with SPSS had higher risks of EGVB, PVT, and HE. [ABSTRACT FROM AUTHOR]

Chimeric antigen receptor (CAR)‐reprogrammed T cell therapy is a novel and powerful treatment against hematological malignancies. Cytokine release syndrome (CRS) and other potentially life‐threatening toxicities are known side effects which need appropriate management and supportive care. Coagulopathy is a common and severe CAR‐T‐related adverse event, while a comprehensive profile of coagulopathy in patients with multiple myeloma (MM) undergoing CAR‐T cell therapy has not been reported. Therefore, we performed a comprehensive analysis of coagulopathy in 51 patients with r/r MM given anti‐B cell maturation antigen CAR‐T cell therapy. We found that 49% of patients had coagulation disorders, and 29% of patients experienced disseminated intravascular coagulation (DIC). Severe CRS, abnormal liver function and higher tumor burden were risk factors for the CAR‐T‐related coagulopathy. We found that the serum IL‐6 level and alanine aminotransferase level were potential indicators for CAR‐T‐related DIC. Furthermore, we found that coagulation disorders occurred within 1 month after CAR‐T cell infusion, mainly between days 10 and 13, which was 2−5 days later than the beginning of CRS and simultaneous with the beginning of abnormal liver function and the peak of CRS. In addition, although patients with coagulation dysfunction had a trend for better outcomes and prognosis, no statistical significance was found. In conclusion, our research provided a comprehensive understanding of CAR‐T‐related coagulopathy in MM. Upon timely and standardized treatment, coagulopathy was manageable in most cases. [ABSTRACT FROM AUTHOR]

Obesity has emerged as one of the most prevalent chronic diseases worldwide. Our study was conducted to investigate the anti-obese potential of novel probiotic Bifidobacterium longum subsp. infantis FB3-14 (FB3-14) and the underlying molecular mechanisms in high-fat diet (HFD)-fed mice. The results demonstrated that an 8-week FB3-14 intervention significantly suppressed the HFD-induced body and fat weight gain and abnormal alterations of the serum lipid parameter, restoring the levels of cholesterol (4.29 mmol/L) and low-density lipoprotein cholesterol (3.42 mmol/L). FB3-14 treatment also attenuated adipocyte expansion, hepatic injury, and low-grade systemic inflammation and restored the expressions of lipid-metabolism-related genes, including Hsl, Leptin, and Adiponectin. Furthermore, FB3-14 was observed to reduce the Firmicutes/Bacteroidetes ratio in obese mice; increase the abundance of Akkermansia muciniphila, unclassified_Muribaculaceae, Lachnospiraceae_NK4A136_group, and Bifidobacterim; and upregulate G protein-coupled receptor41 associated with higher levels of butyric acid. These results indicate the protective effectiveness of FB3-14 in HFD-driven obesity and gut microbiota disorders, highlighting the promising potential of FB3-14 as a functional nutrition supplement. [ABSTRACT FROM AUTHOR]

Background: Cardiohepatic syndrome (CHS) has been identified as an important but underrecognized survival predictor in multiple cardiovascular disease entities. The objectives of this study were to evaluate the prevalence and prognostic value of CHS in patients undergoing TAVR for severe aortic stenosis (AS). Methods: The study included patients with available laboratory parameters of hepatic function who underwent TAVR from July 2013 until December 2019 at our center. CHS was defined as an elevation of at least two of three laboratory cholestasis parameters above the upper limit of normal (bilirubin, alkaline phosphatase, and gamma glutamyl transferase). Study endpoints were three-year survival, technical and device failure (VARC 3), as well as New York Heart Association (NYHA) functional class at follow-up. Results: Among a total of 953 analyzed patients (47.6% females, median age 80.0 [76.0–85.0] years) CHS was present in 212 patients (22.4%). In patients with vs. without CHS, rates of technical (6.1% vs. 8.4%, p = 0.29) and device failure (18.9% vs. 17.3%, p = 0.59) were comparable. NYHA functional class at baseline and follow-up was more severe in patients with CHS. Nevertheless, heart failure symptoms improved from baseline to follow-up irrespective of hepatic function. Three-year survival rates were significantly lower in patients with CHS (49.4 vs. 65.4%, p < 0.001). The predictive value of CHS persisted after adjustment in a multivariable analysis (hazard ratio 1.58, p < 0.01). Conclusion: In patients undergoing TAVR, CHS is prevalent in 22% of patients and is associated with increased postinterventional mortality. Thus, CHS should be included in the decision-making process within the TAVR heart team. Cardiohepatic syndrome (CHS) as defined by an elevation of at least two of three laboratory cholestasis parameters above the upper limit of normal was prevalent in 22% of patients undergoing TAVR for severe AS. The presence of CHS was associated with more severe heart failure symptoms and worse three-year survival. [ABSTRACT FROM AUTHOR]

The individual and combined associations of polycyclic aromatic hydrocarbons (PAHs) metabolites on liver function during pregnancy are still lacking. We aimed to explore the connection between urinary PAH metabolites and liver function in early pregnant women in southwest China based on the Zunyi birth cohort. Ten urinary PAH metabolites and five liver function parameters during early pregnancy were measured. The associations of single PAHs with parameters of liver function were assessed using multiple linear regression. A Bayesian kernel machine regression (BKMR) model was used to evaluate the joint associations of the PAH mixture with outcomes. We found that each 1% increment of urinary 2-hydroxyphenanthrene (2-OH-PHE) was associated with 3.36% (95% CI: 0.40%, 6.40%) higher alanine aminotransferase (ALT) and 2.22% (95% CI: 0.80%, 3.67%) higher aspartate aminotransferase (AST). Each 1% increment in 1-hydroxy-phenanthrene (1-OH-PHE) was significantly associated with 7.04% (95% CI: 1.61%, 12.75%) increased total bile acid (TBA). Additionally, there was a significant positive linear trend between 2-OH-PHE and AST and 1-OH-PHE and TBA. BKMR also showed a significant positive association of PAH mixture with AST. Our results indicate that PAH metabolites were associated with increased parameters of liver function among early pregnant women. Early pregnant women should pay more attention to the adverse relationships between PAHs and liver function parameters to prevent environment-related adverse perinatal outcomes. [ABSTRACT FROM AUTHOR]

To investigate the long-term effects of dietary zinc oxide nanoparticle (Nano-ZnO, 20–40 nm) on the relative organ weight, liver function, deposition, and absorption of trace minerals in intrauterine growth retardation (IUGR) pigs, piglets were allocated to NBW (6 normal birth weight piglets fed basal diets), IUGR (6 IUGR piglets fed basal diets) and IUGR+NZ (6 IUGR piglets fed basal diets + 600 mg Zn/kg from Nano-ZnO) groups at weaning (21 days of age), which were sampled at 163 days of age. There were no noteworthy changes in the relative weight of organs, hepatic histomorphology, serum alkaline phosphatase, glutamic pyruvic transaminase and glutamic oxalacetic transaminase activities, and Mn, Cu, and Fe concentrations in leg muscle, the liver, the tibia, and feces among the IUGR, NBW, and IUGR+NZ groups (P>0.05), and no intact Nano-ZnO in the jejunum, liver, and muscle was observed, while dietary Nano-ZnO increased the Zn concentrations in the tibia, the liver, serum, and feces (P<0.05) and mRNA expression of metallothionein (MT) 1A, MT2A, solute carrier family 39 member (ZIP) 4, ZIP14, ZIP8, divalent metal transporter 1, solute carrier family 30 member (ZnT) 1, ZnT4 and metal regulatory transcription factor 1, and ZIP8 protein expression in jejunal mucosa (P<0.05). Immunohistochemistry showed that dietary Nano-ZnO increased the relative optical density of ZIP8 (mainly expressed in cells of brush border) and MT2A (mainly expressed in villus lamina propria and gland/crypt) (P<0.05). In conclusion, long-term dietary Nano-ZnO showed no obvious side effects on the development of the major organs, liver function, and metabolism of Cu, Fe, and Mn in IUGR pigs, while it increased the Zn absorption and deposition via enhancing the expression of transporters (MT, ZIP, and ZnT families) in the jejunum, rather than via endocytosis as the form of intact nanoparticles. [ABSTRACT FROM AUTHOR]

This study evaluated the effect of polyphenol-rich fraction of Parkia biglobosa leaves (PBF) in rats experimentally induced with diabetes. Thirty albino rats divided into five groups (n=6) were used for this study. Except for group one, the rats were first maintained on high high-calorie diet for eight weeks followed by streptozotocin injection (40 mg/kg). Groups 1 and 2 (normal and diabetic controls respectively) received 1 ml of distilled water throughout the experiment. Group 3 received 50 mg/kg of glibenclamide while groups 4 and 5 received 200 and 400 mg/kg of PBF respectively. After 4 weeks of treatment, after an overnight fast, blood was collected from the rats for haematological and biochemical analyses. Body weight and fasting blood glucose measurements were taken weekly. The in vitro antioxidant analysis revealed good ferric reducing power, and DPPH radical-quenching activity (IC50 = 0.47mg/ml). The PBF groups had markedly (p<0.05) reduced blood glucose and showed better glucose tolerance compared to the untreated group. The PBF groups also had marked (p<0.05) diminution of liver enzymes’ activities (ALP, ALT, AST) as well as markedly reduced bilirubin levels relative to the diabetic control. Urea, creatinine, and K+ levels were markedly (p<0.05) reduced in the PBF groups relative to the untreated, while the PBF groups had markedly high Na+ levels in comparison to the diabetic control. This result justifies the use of the leaves locally for disease management and could serve as a cheaper and low-toxicity alternative in the management of diabetes and associated complications. [ABSTRACT FROM AUTHOR]

Liver transplantation (LT) represents the best cure for several acute and chronic liver diseases. Several studies reported excellent mid-term survivals after LT. However, lesser evidence has been reported on very long (10- and 20-year) follow-up results. This study aims to analyze the monocentric LT experience of the Sapienza University of Rome to identify the pre-operatively available parameters limiting a 10-year post-transplant survival. A total of 491 patients transplanted between 1982 and 2012 were enrolled. The cohort was split into two groups, namely the Short Surviving Group (< 10 years; n = 228, 46.4%) and the Long Surviving Group (≥ 10 years; n = 263, 53.6%). Several differences were reported between the two groups regarding initial liver function, surgical techniques adopted, and immunosuppression. Four variables emerged as statistically relevant as independent risk factors for not reaching at least 10 years of follow-up: recipient age (OR = 1.02; P = 0.01), donor age (OR = 1.01; P = 0.03), being transplanted during the eighties (OR = 6.46; P < 0.0001) and nineties (OR = 2.63; P < 0.0001), and the UNOS status 1-2A (OR = 2.62; P < 0.0001). LT confirms to be an extraordinary therapy for several severe liver diseases, consenting to reach in half of the transplanted cases even more than 20 years of follow-up. The initial liver function and the donor and recipient ages are relevant in impacting long-term survival after transplantation. A broad commitment from many professional groups, including surgeons, hepatologists, and anesthesiologists, is necessary. The achievement of excellent results in terms of long-term survival is proof of the effectiveness of this multidisciplinary collaboration. [ABSTRACT FROM AUTHOR]

Context: The functional status of organs, such as the liver, involved in IGF-1 signaling pathways influences circulating levels of IGF-1 and hence its relationship to risk of chronic disease and mortality, yet this has received limited attention. Objective: To examine the relationship between IGF-1 and risk of morbidity and mortality from cancer, cardiovascular diseases (CVD), and all causes, accounting for liver function. Methods: This study was a case-cohort design nested within EPIC-Heidelberg. IGF-1 was measured in 7461 stored serum samples collected from 1994 to 1998. Median follow-up for incident mortality events was 17.5 years. The case-cohort included a subcohort of 1810 men and 1890 women, in addition to 1668 incident cases of cancer (623 breast, 577 prostate, 202 lung, and 268 colorectal), and 1428 cases of CVD (707 myocardial infarctions and 723 strokes) and 2441 cases of death. Results: Higher IGF-1 levels showed direct associations with risks of breast (1.25; 95% CI [1.06-1.47]) and prostate (1.31; [1.09-1.57]) cancers. Restricted cubic splines plots and models including IGF-1 as quintiles revealed a U-shaped relationship between the biomarker and mortality. Participants with the lowest and the highest levels of IGF-1 experienced higher hazards of mortality from cancer, CVD, and all causes. The U-shaped form of the relationship persisted but was attenuated in analyses including only participants without any indications of liver dysfunction. Conclusion: This large population-based prospective study showed that both individuals with lowest and highest levels of circulating IGF-1 were at increased risk of deaths from cancer, CVD, and all causes. For individuals with low IGF-1, the excess risks of death were more pronounced among individuals with liver cancer and cirrhosis but were also present among individuals without elevated liver enzymes. [ABSTRACT FROM AUTHOR]

Background: Sodium butyrate (SB) is a short-chain fatty acid and a safe antibiotic alternative. During 35 days, this study compared the impact of coated SB (Butirex C4) and lincomycin (Lincomix) on broiler growth, gut health, and litter hygiene in 1200 one-day-old Ross-308 broiler chicks that were randomly assigned into 5-dietary groups with 5-replications each. Groups divided as follows: T1: Basal diet (control), T2: Basal diet with buffered SB (1 kg/ton starter feed, 0.5 kg/ton grower-finisher feeds), T3: Basal diet with 100 g/ton lincomycin, T4: Basal diet with buffered SB (0.5 kg/ton starter feed, 0.25 kg/ton grower-finisher feeds) + 50 g/ton lincomycin, and T5: Basal diet with buffered SB (1 kg/ton starter feed, 0.5 kg/ton grower-finisher feeds) + 50 g/ton lincomycin. Birds were housed in a semi-closed deep litter house, where feed and water were available ad libitum. Results were statistically analyzed using ANOVA and Tukey's post hoc tests. Results: Combined dietary supplementation with SB and lincomycin (T4 and T5) significantly enhanced body weights, weight gains, feed conversion ratio, and profitability index. Also, carcasses in T4 and T5 exhibited the highest dressing, breast, thigh, and liver yields. T5 revealed the best blood biochemical indices, while T3 showed significantly elevated liver and kidney function indices. T4 and T5 exhibited the highest expression levels of IGF-1 and TLR4 genes, the greatest villi length of the intestinal mucosa, and the lowest levels of litter moisture and nitrogen. Clostridia perfringens type A alpha-toxin gene was confirmed in birds' caeca, with the lowest clostridial counts defined in T4. Conclusions: Replacing half the dose of lincomycin (50 g/ton) with 0.5 or 1 kg/ton coated SB as a dietary supplement mixture showed the most efficient privileges concerning birds' performance and health. [ABSTRACT FROM AUTHOR]

Background: Status epilepticus (SE) is a type of epileptic activity characterized by a failure of the inhibitory mechanisms that limit seizures, which are mainly regulated by the GABAergic system. This imbalance increases glutamatergic neurotransmission and consequently produces epileptic activity. It is also associated with oxidative stress due to an imbalance between reactive oxygen species (ROS) and antioxidant defences. Unfortunately, long-term treatment with anti-epileptic drugs (AEDs) may produce hepatotoxicity, nephrotoxicity, and haematological alterations. In this way, some secondary metabolites of plants have been used to ameliorate the deterioration of nervous system disorders through their antioxidant properties, in addition to their anticonvulsant effects. An example is Centella asiatica, a plant noted to have a reputed neuroprotective effect related to its antioxidant activity. However, similar to conventional drugs, natural molecules may produce side effects when consumed in high doses, which could occur with Centella asiatica. Therefore, we aimed to evaluate the effect of a standardized extract of Centella asiatica L. Urb with tested anticonvulsant activity on biochemical and haematological parameters in rats subjected to lithium/pilocarpine-induced seizures. Methods: Twenty-eight adult male Wistar rats were randomly divided into four groups (n = 7 each): vehicle (purified water), Centella asiatica (200 and 400 mg/kg), and carbamazepine (CBZ) (300 mg/kg) as a pharmacological control of anticonvulsant activity. Treatments were administered orally every 24 h for 35 consecutive days. On Day 36, SE was induced using the lithium/pilocarpine model (3 mEq/kg, i.p. and 30 mg/kg s.c., respectively), and the behavioural and biochemical effects were evaluated. Results: Centella asiatica 400 mg/kg increased the latency to the first generalized seizure and SE onset and significantly reduced the time to the first generalized seizure compared to values in the vehicle group. Biochemical parameters, i.e., haematic cytometry, blood chemistry, and liver function tests, showed no significant differences among the different treatments. Conclusion: The dose of Centella asiatica that produces anticonvulsant activity in the lithium/pilocarpine model devoid of hepatotoxicity, nephrotoxicity, and alterations in haematological parameters suggests that the standardized extract of this plant could be of utility in the development of new safe therapies for the treatment of convulsions associated with epilepsy. [ABSTRACT FROM AUTHOR]

Background: In this study, by analyzing the correlation between various components of health-related physical fitness (HPF) and liver function indicators, the indicators of physical fitness that were highly correlated with liver function and could be monitored at home were screened to prevent more serious liver disease in the future, and to provide experimental basis for prescribing personalized exercise. Methods: A total of 330 faculties (female = 198) of a university were recruited. The indicators of HPF and liver function were measured. Spearman correlation analysis, multivariate linear regression, and cross-lagged panel model was used to data statistics. Results: In males, body fat (BF) was positively correlated with alanine aminotransferase (ALT); vital capacity and the vital capacity index were positively correlated with albumin; and vertical jump was positively correlated with globulin and negatively correlated with the albumin-globulin ratio (P < 0.05). However, there was no significant correlation among all indicators controlled confounding factors. In females, BF was negatively correlated with direct bilirubin; VO2max was positively correlated with indirect bilirubin; and vertical jump was positively correlated with the albumin-globulin ratio and significantly negatively correlated with globulin (P < 0.05). Controlled confounding factors, body fat percentage was positively correlated with globulin (β = 0.174) and negatively correlated with direct bilirubin (β = –0.431), and VO2max was positively correlated with indirect bilirubin (β = 0.238, P < 0.05). Cross-lagged panel analysis showed that BF percentage can negatively predict direct bilirubin levels with great significance (β = -0.055, P < 0.05). Conclusions: HPF may play a crucial role in liver function screening, particularly for female faculty members. For males, BF, vertical jump, vital capacity and vital capacity index could be associated with liver function but are susceptible to complex factors such as age, smoking, diabetes, and hypertension. In females, BF percentage is an important predictor of abnormal liver function in addition to VO2max and vertical jump, which are not affected by complex factors. [ABSTRACT FROM AUTHOR]

Intrahepatic cholestasis of pregnancy (ICP) is characterized by unexplained distressing pruritus in the mother and poses significant risk to the fetus of perinatal mortality. Occurring in the second and third trimester, the serum bile acid and aminotransferase are usually elevated in ICP patients. Ursodeoxycholic acid (UDCA) is the first line drug for ICP but the effectiveness for hepatoprotection is to a certain extent. In ICP patients with severe liver damage, combination use of hepatoprotective agents with UDCA is not uncommon. Herein, we reviewed the current clinical evidence on application of hepatoprotective agents in ICP patients. The underlying physiological mechanisms and their therapeutic effect in clinical practice are summarized. The basic pharmacologic functions of these hepatoprotective medications include detoxification, anti-inflammation, antioxidation and hepatocyte membrane protection. These hepatoprotective agents have versatile therapeutic effects including anti-inflammation, antioxidative stress, elimination of free radicals, anti-steatohepatitis, antifibrosis and anti-cirrhosis. They are widely used in hepatitis, non-alcoholic fatty liver disease, drug induced liver injury and cholestasis. Evidence from limited clinical data in ICP patients demonstrate reliable effectiveness and safety of these medications. Currently there is still no consensus on the application of hepatoprotective agents in ICP pregnancies. Dynamic monitoring of liver biochemical parameters and fetal condition is still the key recommendation in the management of ICP pregnancies. [ABSTRACT FROM AUTHOR]

Objective To investigate the correlation between the serum level of 25-hydroxyvitamin D (25 (OH) D) and liver function in children with infectious mononucleosis (IM) . Methods Ninety children with acute IM were enrolled into the IM group, and 40 healthy children who underwent physical examination during the same period were allocated into the control group. Serum level of 25 (OH) D was determined by electrochemiluminescence and the viral load of Epstein-Barr virus DNA (EBVDNA) in plasma was determined by quantitative fluorescent RT-PCR. Clinical data and serum 25 (OH) D levels were compared between two groups. The correlation between 25 (OH) D level and atypical lymphocytes, liver function parameters and plasma EBVDNA in children with IM was analyzed. Results Serum 25 (OH) D level in the IM group was significantly lower, whereas the 25 (OH) D inadequacy rate was significantly higher than those in the control group (both P < 0.05) . Serum 25 (OH) D level was negatively correlated with atypical lymphocytes in the IM group (P < 0.05) . The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamyl transpeptidase (GGT), and adenosine deaminase (ADA) in IM children with serum 25 (OH) D inadequacy were higher than those in their counterparts with adequate serum 25 (OH) D (all P < 0.05) . No significant differences were found in total bilirubin (TBIL), direct bilirubin (DBIL) and plasma EBV-DNA load between the adequate and inadequate subgroups (all P > 0.05) . In the IM group, serum 2 (5 OH) D level was negatively correlated with ALT, GGT, and ADA (all P < 0.05), whereas positively correlated with CHE (P < 0.05) and had no correlation with AST, TBIL or DBIL (all P > 0.05) . Conclusions Serum vitamin D insufficiency occurs in children with IM. Vitamin D may be involved in the incidence and development of the course of IM, which is probably associated with liver function impairment. [ABSTRACT FROM AUTHOR]

Background: Non-alcoholic steatohepatitis (NASH) is a clinical condition with a global prevalence of 25.24%. Peroxisome proliferator-activated receptors (PPAR) have been significantly associated with the pathogenesis of NASH. Aim: To evaluate the efficacy of saroglitazar in an animal model of NASH by evaluating the magnitude of changes in liver function tests (LFT) and histopathology. Materials and Methods: The baseline parameters of 14 male Sprague–Dawley rats were recorded and then grouped into four groups: treatment groups (high high-dose saroglitazar [HDSG] and low low-dose saroglitazar [LDSG] doses of saroglitazar), normal control, and disease control. Initially, except for the normal control, the other three groups were fed a fructose diet for 5 weeks and then all four groups were fed a standard chow diet for the next 2 weeks during which the two treatment groups were orally gavaged with saroglitazar. Changes in LFT, body weight (BW), lipid profile, oxidative stress, and histopathology were evaluated at different time points. Results: A statistically significant reduction was found in the mean serum glutamic-oxaloacetic transaminase (SGOT) (p = 0.0267) and serum glutamate-pyruvate transaminase (SGPT) (p = 0.0059) between the groups at the end of treatment. As with BW changes (p < 0.001), a significant difference was observed between the time points in HDSG and LDSG with respect to all parameters of the lipid profile assessed (p < 0.05). Amelioration of hepatocellular ballooning and lobular inflammation in histopathology was evident in both treatment groups. Immunohistochemistry revealed loss of cytokeratin CK8/18 in disease control while it was preserved in LDSG and HDSG. Conclusion: The study has explicitly illustrated the improvement in the biochemical and pathological changes in the rat model of NASH induced by a high fructose diet. [ABSTRACT FROM AUTHOR]

Background: Possible health benefits of fish balls tsumire consumption on human health have been deduced based on the results of our earlier study investigating tsumire consumption by young (6-weeks-old) Sprague-Dawley rats. Aim: The objectives of this study were to evaluate the effect of tsumire intake on aged rats by feeding them a diet containing 5% dried tsumire. Methods: Biomarker levels and organ weight of 80-weeks-old Sprague-Dawley rats that were fed with tsumire were examined for potential health benefits. Results: Following 84 days of administering tsumire-containing diet, we found a decrease in some liver function parameters, such as the levels of AST, ALT, ALP and LAP, in the tsumire-fed rats compared to control rats provided with normal diet. In particular, significantly reduced LDH levels were observed in the experimental group. Conclusions: The results can be extrapolated to possible beneficial effects of consumption of tsumire on human health. [ABSTRACT FROM AUTHOR]

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