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liver function tests and metabolic-associated fatty liver disease:Changes in upper normal limits,does it really matter?

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World Journal of Hepatology 2021年第12期13卷 2104-2112页

作者： Roberta Forlano Benjamin H Mullish Ameet Dhar Robert D Goldin Mark Thursz Pinelopi Manousou liver Unit/Department of Metabolism Digestion and ReproductionFaculty of MedicineImperial College LondonLondon W21NYUnited Kingdom Centre for Pathology Department of MedicineImperial College LondonLondon W21NYUnited Kingdom

BACKGROUND Metabolic-associated fatty liver disease(MAFLD)is the commonest cause of abnormal liver function tests(LFTs).Current upper normal of limit(UNL)of LFTs was derived from a“healthy”population,where undiagnosed MAFLD and viral hepatitis might be *** To evaluated potential implications of changes in UNL of alanine aminotransferase(ALT)in *** We retrospectively assessed consecutive first referrals with a diagnosis of MAFLD from 2010 to *** conventional UNL of ALT was 45 IU/L for men and 34 IU/L for women,while a low UNL of ALT was 30 IU/L for men and 19 IU/L for *** UNL of aspartate aminotransferase(AST)was 40 IU/*** Total 436 patients were enrolled;of these,288 underwent liver *** a lower UNL reduced the percentage of those with significant disease despite normal ALT;specifically,patients with advanced fibrosis(F≥F3)or definite“metabolic-associated steato-hepatitis(MASH)”(NAS≥5)within normal ALT decreased from 10%to 1%and from 28%to 4%***,the proportion of those with elevated ALT and no evidence of advanced fibrosis or“definite MASH”increased from 39%to 47%and from 3%to 19%.Overall,LFTs performed poorly in distinguishing“definite MASH”from simple steatosis(receiver operating characteristic areas under the curves 0.59 for ALT and 0.55 for AST).CONCLUSION liver function tests might both under-and overestimate MASH-related liver *** the UNL might not be beneficial and imply an increase in healthcare *** stratification in MAFLD should rely on a combination of risk factors,not on LFTs alone.

关键词： Metabolic-associated fatty liver disease liver function tests Alanine aminotransferase Fibrosis Stiffness

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Establishment of age-and gender-specific pediatric reference intervals for liver function tests in healthy Han children

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World Journal of Pediatrics 2018年第2期14卷 151-159页

作者： Xin Li Di Wang Chun Yang Qi Zhou Suo-Lang Zhuoga Li-Qiang Wang Han-Xin Yao Qin Zhang Qing Ai Chen-Xi Yang Jian-Cheng Xu Department of Laboratory Medicine First Hospital of Jilin UniversityXinmin Street No.71Changchun 130021China Department of Pediatrics First Hospital of Jilin UniversityChangchunChina Centre for Heart&Lung Innovation University of British ColumbiaVancouverBCCanada

Background The development and growth of children influence values of liver function *** study aims to establish age-and gender-specific pediatric reference intervals of liver function among Han children in Changchun,*** A total of 1394 healthy Han children,aged 2-14 years,were recruited from communities and schools with informed parental consent in *** levels of serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),y-glutamyltransferase(GGT),alkaline phosphatase(ALP),total protein(TP),albumin(ALB),total bilirubin(TBIL)and direct bilirubin(DBIL)were measured on Hitachi 7600-210 automatic biochemical *** age-and gender-specific reference intervals were partitioned using Harris and Boyd's test and calculated using nonparametric rank *** pediatric reference intervals were validated in five representative hospitals located in different areas in *** All the analytes required some levels of age ***(TP,ALB)and bilirubins(TBIL,DBIL)required no gender *** contrast,considerable gender partitioning was required for serum ALT,AST,GGT,and ***,TBIL,and DBIL showed steady increases,and AST showed apparent decreases over time,whereas ALT,GGT,ALP,and ALB demonstrated complex trends of *** and GGT increased sharply in males from 11 to 14 years ***,ALP declined in females from 13 to 14 *** five laboratories passed the validation of reference *** There were apparent age or gender variations of the reference intervals for liver *** establishing pediatric reference intervals,partitioning according to age and gender is necessary.

关键词： Age Gender liver function tests Pediatric Reference intervals

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Abnormal liver function tests associated with severe rhabdomyolysis

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World Journal of Gastroenterology 2020年第10期26卷 1020-1028页

作者： Andy KH Lim Department of General Medicine Monash Health Department of Medicine School of Clinical Sciences Monash University

Rhabdomyolysis is a syndrome of skeletal muscle injury with release of cellular constituents such as potassium,phosphate,urate and intracellular proteins such as myoglobin into the circulation,which may cause complications including acute kidney injury,electrolyte disturbance and cardiac *** liver function tests are frequently observed in cases of severe ***,there is an increase in serum aminotransferases,namely aspartate aminotransferase and alanine *** raises the question of liver injury and often triggers a pathway of investigation which may lead to a liver ***,muscle can also be a source of the increased aminotransferase *** review discusses the dilemma of finding abnormal liver function tests in the setting of muscle injury and the potential implications of such an *** delves into some of the clinical and experimental evidence for correlating muscle injury to raised aminotransferases,and discusses pathophysiological mechanisms such as oxidative stress which may cause actual liver *** aminotransferases lack tissue specificity to allow clinicians to distinguish primary liver injury from muscle *** review also explores potential approaches to improve the accuracy of our diagnostic tools,so that excessive or unnecessary liver investigations can be avoided.

关键词： Rhabdomyolysis Muscle Creatine kinase liver function tests Alanine aminotransferase Aspartate aminotransferase Aminotransferases

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Could quantitative liver function tests gain wide acceptance among hepatologists?

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World Journal of Gastroenterology 2009年第28期15卷 3457-3461页

作者： Giovanni Tarantino Department of Clinical and Experimental Medicine Federico II University Medical School of Naples

It has been emphasized that the assessment of residual liver function is of paramount importance to determine the following： severity of acute or chronic liver diseases independent of etiology; long-term prognosis; step-bystep disease progression; surgical risk; and efficacy of antiviral treatment. The most frequently used tools are the galactose elimination capacity to asses hepatocyte cytosol activity, plasma clearance of indocyanine green to assess excretory function, and antipyrine clearance to estimate microsomal activity. However, a widely accepted liver test （not necessarily a laboratory one） to assess quantitative functional hepatic reserve still needs to be established, although there have been various proposals. Furthermore, who are the operators that should order these tests？ Advances in analytic methods are expected to allow quantitative liver function tests to be used in clinical practice.

关键词： Chronic diseases Fatty liver Hepatitis,viral liver cirrhosis liver function tests Prognosis

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Evaluation of liver function tests （AST ＆ ALT） in Patients with Hepatitis B and C in Tabriz-lran （2013）

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Journal of Pharmacy and Pharmacology 2015年第1期3卷 27-32页

作者： Navid Sarakhs Asbaghi Kazem Ghahreman Zadeh Taher Faraj Zadeh Javid Lotfi Attari Zahra Javan Masoomi Rana Faraj Zadeh Mohammad Reza Tarmohammadi Alireza Bakhtarai Behzad Bahrain Zadeh Babak Morshed Zadeh Faculty of Basic Sciences Department of Genetics lslamic Azad University Tabriz 51589 Iran Clinical Central Lab of Province Tabriz 51589 Iran

Viral hepatitis is among the infections that primarily affect the liver and is one of the main causes of death in the world. Every year, more than one million people worldwide die of viral hepatitis. In recent decades, the number of people with hepatitis B and C has declined in Iran. The purpose of this study was to investigate normal and abnormal liver enzymes （AST, ALT） in patients with chronic hepatitis B and C in a number of public and private laboratories in Tabriz. In the study conducted in 2013, of those who had referred to clinical laboratories for various reasons or who had been reported by centers of infectious or dialysis therapy, a sample of 1,000 patients were identified with hepatitis B and C; 693 people had hepatitis B and 307 people had hepatitis C. On a sample of patients, liver enzymes were evaluated using standard methods. The percentage of women and men in this study were inconsistent with global statistics. However this inconsistency could be justified by the alcohol consumption and an increase in the number of addicted people in society as well as women＇s fear due to some social issues.

关键词： Hepatitis B & C liver function tests AST & ALT Tabriz.

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Effect of Ascorbic Acid Supplementation on liver function tests in Hepatitis C Patients

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Open Journal of Internal Medicine 2020年第3期10卷 263-279页

作者： Iffat Nayila University of Lahore Lahore Pakistan

An isolated liver function test is of little role in selection of liver disease because many harmful liver diseases may be correlated with normal levels of LFT’s. The outline of enzyme abnormalities in the perspective of patient’s commonly observed symptoms and laboratory data might be helpful in directing the subsequent diagnosis of liver diseases. liver function tests (LFTs) are most generally used screening blood tests for assessment of different liver diseases and these tests provide a lot of evidence for disease processes whether for the purpose of investigation of supposed liver disease or help in observing the progress of disease action or simply by blood investigation. The evaluation of different liver enzymes simply gives diagnostic information on basic level whether patient’s principal disorder is actually hepatitis or cholestasis in source. However, it is necessary in various cases to evaluate LFTs with knowledge of liver functioning enzyme fractions. The objective of this study was to explore the effects of ascorbic acid supplementation on serum liver function tests in Hepatitis C patients. A total of 100 hepatitis C patients were selected randomly. 50 were given ascorbic acid supplementation for one month along with anti HCV treatment. The other 50 HCV patients took their normal anti HCV treatment without intake of ascorbic acid supplementation, and serum ascorbic acid level and liver function test parameters were observed before and after intake of ascorbic acid in both groups. The liver function parameters determined were aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), serum total bilirubin, direct bilirubin, indirect bilirubin and serum protein (total protein, albumin, globulin and A/G ratio). These parameters along with serum ascorbic acid were measured before and 30 days after vitamin C supplementation. Various abnormally elevated LFTs were also improved more rapidly when compared to other group which w

关键词： Supplementation Ascorbic Acid liver function tests Alanine Aminotransferase Aspartate Aminotransferase Significant Diagnoses Alkaline Phosphatase

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96-Week Treatment of Tenofovir Amibufenamide and Tenofovir Disoproxil Fumarate in Chronic Hepatitis B Patients

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Journal of Clinical and Translational Hepatology 2023年第3期11卷 649-660页

作者： Zhihong Liu Qinglong Jin Yuexin Zhang Guozhong Gong Guicheng Wu Lvfeng Yao Xiaofeng Wen Zhiliang Gao Yan Huang Daokun Yang Enqiang Chen Qing Mao Shide Lin Jia Shang Huanyu Gong Lihua Zhong Huafa Yin Fengmei Wang Peng Hu Qiong Wu Chao Pan Wen Jia Chuan Li Chang’an Sun Junqi Niu Jinlin Hou TMF Study Group Department of Infectious Diseases and Hepatology Unit Institutes of Liver Diseases Research of Guangdong ProvinceNan-fang HospitalSouthern Medical UniversityGuangzhouGuangdongChina The First Hospital of Jilin University Chang-chunJilinChina The First Affiliated Hospital of Xinjiang Medical University UrumqiXinjiangChina The Second Xiangya Hospital of Central South University ChangshaHunanChina Chongqing University Three Gorges Hospital ChongqingChina Mengchao Hepatobiliary Hospital of Fujian Medical University FuzhouFujianChina Liuzhou People’s Hospital LiuzhouGuangxiChina The Third Affiliated Hospital of Zhongshan University GuangzhouGuangdongChina Xiangya Hospital of Central South University ChangshaHunanChina The First Affiliated Hospital of Xinxiang Medical University XinxiangHenanChina West China Hospital of Sichuan University ChengduSichuanChina The Southwest Hospi-tal of AMU ChongqingChina Affiliated Hospital of Zunyi Medical University ZunyiGuizhouChina Henan Provincial People’s Hospital ZhengzhouHenanChina The Third Xiangya Hospital of Central South University ChangshaHunanChina The Fourth Affiliated Hospital of Harbin Medical University HarbinHeilongjiangChina The First Affiliated Hospi-tal of Anhui Medical University HefeiAnhuiChina Tianjin Third Central Hospital TianjinChina The Second Affiliated Hospital of Chongqing Medical University ChongqingChina Jiangsu Hansoh Pharmaceutical Group Co. LtdLianyungangJiangsuChina Members listed in the Supplementary File 1

Background and Aims:Tenofovir amibufenamide(TMF)is a novel phosphoramidated prodrug of tenofovir with nonin-ferior efficacy and better bone and renal safety to tenofovir disoproxil fumarate(TDF)in 48 weeks of ***,we update 96-week comparison ***:Patients with chronic hepatitis B were assigned(2:1)to receive either 25 mg TMF or 300 mg TDF with matching placebo for 96 *** virological suppression was defined as HBV DNA levels<20 IU/mL at week *** was evaluated thoroughly with focusing on bone,renal,and metabolic ***:Virological suppression rates at week 96 were similar between TMF and TDF group in both HBeAg-positive and HBeAg-negative *** efficacy was maintained in the pooled population,while it was first achieved in patients with HBV DNA≥7 or 8 log10 IU/mL at ***-indexed estimated glomerular filtration rate for renal safety assessment was adopted,while a smaller decline of which was seen in the TMF group than in the TDF group(p=0.01).For bone mineral density,patients receiv-ing TMF displayed significantly lower reduction levels in the densities of spine,hip,and femur neck at week 96 than those receiving *** addition,the lipid parameters were stable after week 48 in all groups while weight change still showed the opposite ***:TMF maintained similar efficacy at week 96 compared with TDF with continued superior bone and renal safety profiles(NCT03903796).

关键词： Hepatitis B liver function tests Viral hepatitis liver Osteoporosis

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liver function Derangement in Patients with Severe Fever and Thrombocytopenia Syndrome

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Journal of Clinical and Translational Hepatology 2022年第5期10卷 825-834页

作者： Sihong Lu Ling Xu Boyun Liang Hua Wang Tong Wang Tiandan Xiang Sumeng Li Lei Fan Junyuan Li Cheng Peng Xin Zheng Department of Infectious Diseases Union HospitalTongji Medical CollegeJoint International Laboratory of Infection and ImmunityHuazhong University of Science and TechnologyWuhanHubeiChina

Background and Aims:Patients with severe fever with thrombocytopenia syndrome(SFTS)commonly show liver function *** study aimed to characterize the liver function indices in SFTS patients and investigate their association with ***:Clinical information and laboratory results of 459 laboratory-confirmed SFTS patients,including 78 deceased and 381 surviving patients,were retrospectively *** explore the infectivity of SFTS caused by novel Bunyavirus(SFTSV)in hepatocytes,Huh7 human hepatoma cells were infected with various concentrations of SFTSV in ***:The proportion of SFTS patients developing liver injury during hospitalization was 73.2%(336/459);the hepatocellular injury was the predominant *** median time to occurrence of liver injury from disease onset was 8 *** injury in the deceased group occurred earlier than that in the surviving *** aminotransferase(ALT)level between 2–5 times upper limit of normal(ULN)at 4–6 d and between 5–15 ULN at 7–12 d of disease course were independent predictors of *** phosphatase(ALP)>2 ULN at 7–9 d and elevated ALP at 10–12 days after disease onset were risk factors for *** and aspartate transaminase(AST)levels were correlated with lymphocyte count and platelet-to-lymphocyte ratio(PLR).Total bilirubin(TB),ALT,AST levels showed positive correlation with viral *** the in vitro experiment,SFTSV infected and replicated inside Huh7 ***:liver injury is common in SFTS *** and ALP were independent predictors of SFTS-related *** monitoring and evaluation of liver function indices are needed for SFTS patients.

关键词： Severe Fever with Thrombocytopenia Syndrome liver function tests Mortality Risk Factors

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Clinical indicators for progression of nonalcoholic steatohepatitis to cirrhosis

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World Journal of Gastroenterology 2021年第23期27卷 3238-3248页

作者： Tasur Kumar Seen Muntazir Sayed Muhammad Bilal Jonathan Vincent Reyes Priyanka Bhandari Vennis Lourdusamy Ahmed Al-khazraji Umer Syed Yasar Sattar Raghav Bansal Division of Internal Medicine Icahn School of MedicineElmhurst Hospital and Mount Sinai HospitalElmhurstNY 11375United States Division of Internal Medicine R.C.S.M.Government CollegeMahrashta 416013India Division of Gastroenterology Hepatology and EndoscopyPakistan Institute of Medical SciencesIslamabad 45710Pakistan Division of Gastroenterology Icahn School of MedicineElmhurst Hospital and Mount Sinai HospitalElmhurstNY 11375United States Division of Gastroenterology Icahn School of MedicineElmhurst HospitalElmhurstNY 11375United States

Non-alcoholic fatty liver disease(NAFLD),is a disease spectrum characterized by fat accumulation in hepatocytes presenting as hepatic steatosis to advance disease with active hepatic inflammation,known as nonalcoholic *** steatohepatitis will lead to progressive hepatic fibrosis causing cirrhosis and increased risk for developing hepatocellular carcinoma(HCC).Fatty liver disease prevalence has increased at alarming rates alongside obesity,diabetes and metabolic syndrome to become the second most common cause of cirrhosis after alcohol related liver disease *** this rise in prevalence,it is becoming increasingly more important to find non-invasive methods to diagnose disease early and stage hepatic *** clinicians with the tools to diagnose and treat the full spectrum of NAFLD will help prevent known complications such as cirrhosis and HCC and improve quality of life for the patients suffering from this *** article discusses the utility of current noninvasive liver function testing in the clinical progression of fatty liver disease along with the imaging modalities that are ***,we summarize available treatment options including targeted medical therapy through four different pathways,surgical or endoscopic intervention.

关键词： Nonalcoholic fatty liver disease Steatosis Hepatitis Cirrhosis Hepatocellular carcinoma liver function tests Imaging Histopathology

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Ursodeoxycholic acid as a means of preventing atherosclerosis,steatosis and liver fibrosis in patients with nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2021年第10期27卷 959-975页

作者： Maria Nadinskaia Marina Maevskaya Vladimir Ivashkin Khava Kodzoeva Irina Pirogova Evgeny Chesnokov Alexander Nersesov Jamilya Kaibullayeva Akzhan Konysbekova Aigul Raissova Feruza Khamrabaeva Elena Zueva Department of Propaedeutics of Internal Diseases Gastroenterology and HepatologySechenov First Moscow State Medical University(Sechenov University)Moscow 119991Russia Vasilenko Clinic of Internal Diseases Propedeutics Gastroenterology and HepatologyUniversity Clinical Hospital№2Sechenov First Moscow State Medical University(Sechenov University)Moscow 119991Russia LLC MC“Lotus” Center for Gastroenterology and HepatologyChelyabinsk 454092Russia Department of Hospital Therapy with the Course of Endocrinology and Clinical Pharmacology Tyumen State Medical UniversityTyumen 625003Russia Department of Gastroenterology S.Asfendiyarov Kazakh National Medical UniversityAlmaty 050000Kazakhstan functional and Ultrasound Diagnostics Scientific and Research Institute of Cardiology and Internal DiseasesAlmaty 050000Kazakhstan Department of Internal Diseases Scientific and Research Institute of Cardiology and Internal DiseasesAlmaty 050000Kazakhstan Faculty of Therapy Tashkent Institute of Advanced Medical StudiesTashkent 100007Uzbekistan Department of Therapy№1 with Training General Practitioners Tashkent Medical AcademyTashkent 100109Uzbekistan

BACKGROUND Atherosclerotic cardiovascular disease(ASCVD)is the leading cause of mortality in patients with nonalcoholic fatty liver disease(NAFLD).Weight loss is a key factor for successful NAFLD and CVD *** acid(UDCA),which is one of the first-line therapeutic agents for treatment of NAFLD,is reported to have a beneficial effect on dyslipidemia and ASCVD risk because of antioxidant *** To evaluate the effects of 6 mo of UDCA treatment on hepatic function tests,lipid profile,hepatic steatosis and fibrosis,atherogenesis,and ASCVD risk in men and women with NAFLD,as well as to assess the impact of>5%weight reduction on these *** An open-label,multicenter,international noncomparative trial was carried out at primary health care settings and included 174 patients with ultrasound-diagnosed NAFLD who received 15 mg/kg/d UDCA for 6 mo and were prescribed lifestyle modification with diet and *** efficacy criteria were liver enzymes,lipid profile,fatty liver index(FLI),noninvasive liver fibrosis tests(nonalcoholic fatty liver disease fibrosis score and liver fibrosis index),carotid intima-media thickness(CIMT),and ASCVD risk *** test statistical hypotheses,the Wilcoxon test,paired t-test,Fisher’s exact test,and Pearson's chi-squared test were *** The alanine aminotransferase(ALT)level changed by-14.1 U/L(-31.0;-5.3)from baseline to 3 mo and by-6.5 U/L(-14.0;0.1)from 3 to 6 *** magnitude of ALT,aspartate transaminase,and glutamyltransferase decrease was greater during the first 3 mo of treatment compared to the subsequent 3 mo(Pliver disease

关键词： Ursodeoxycholic acid Nonalcoholic fatty liver disease liver function tests Fatty liver index Carotid intima-media thickness Atherosclerotic cardiovascular disease

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