Tests Alanine Aminotransferase Research Articles

Silent information regulator sirtuin 1 ameliorates acute liver failure via the p53/glutathione peroxidase 4/gasdermin D axis.

Acute liver failure (ALF) has a high mortality with widespread hepatocyte death involving ferroptosis and pyroptosis. The silent information regulator sirtuin 1 (SIRT1)-mediated deacetylation affects multiple biological processes, including cellular senescence, apoptosis, sugar and lipid metabolism, oxidative stress, and inflammation. To investigate the association between ferroptosis and pyroptosis and the upstream regulatory mechanisms. This study included 30 patients with ALF and 30 healthy individuals who underwent serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) testing. C57BL/6 mice were also intraperitoneally pretreated with SIRT1, p53, or glutathione peroxidase 4 (GPX4) inducers and inhibitors and injected with lipopolysaccharide (LPS)/D-galactosamine (D-GalN) to induce ALF. Gasdermin D (GSDMD)-/- mice were used as an experimental group. Histological changes in liver tissue were monitored by hematoxylin and eosin staining. ALT, AST, glutathione, reactive oxygen species, and iron levels were measured using commercial kits. Ferroptosis- and pyroptosis-related protein and mRNA expression was detected by western blot and quantitative real-time polymerase chain reaction. SIRT1, p53, and GSDMD were assessed by immunofluorescence analysis. Serum AST and ALT levels were elevated in patients with ALF. SIRT1, solute carrier family 7a member 11 (SLC7A11), and GPX4 protein expression was decreased and acetylated p5, p53, GSDMD, and acyl-CoA synthetase long-chain family member 4 (ACSL4) protein levels were elevated in human ALF liver tissue. In the p53 and ferroptosis inhibitor-treated and GSDMD-/- groups, serum interleukin (IL)-1β, tumour necrosis factor alpha, IL-6, IL-2 and C-C motif ligand 2 levels were decreased and hepatic impairment was mitigated. In mice with GSDMD knockout, p53 was reduced, GPX4 was increased, and ferroptotic events (depletion of SLC7A11, elevation of ACSL4, and iron accumulation) were detected. In vitro, knockdown of p53 and overexpression of GPX4 reduced AST and ALT levels, the cytostatic rate, and GSDMD expression, restoring SLC7A11 depletion. Moreover, SIRT1 agonist and overexpression of SIRT1 alleviated acute liver injury and decreased iron deposition compared with results in the model group, accompanied by reduced p53, GSDMD, and ACSL4, and increased SLC7A11 and GPX4. Inactivation of SIRT1 exacerbated ferroptotic and pyroptotic cell death and aggravated liver injury in LPS/D-GalN-induced in vitro and in vivo models. SIRT1 activation attenuates LPS/D-GalN-induced ferroptosis and pyroptosis by inhibiting the p53/GPX4/GSDMD signaling pathway in ALF.

B-088 Estimation of Antibodies to Hbsag and Liver Function Markers From a Large Laboratory Database in São Paulo, Brazil

Abstract Background The Hepatitis B virus (HBV) infection can lead to chronic hepatitis B and severe hepatic disease. The Gamma Glutamyl Transferase (GGT), Aspartate Aminotransferase (AST), and Alanine Aminotransferase (ALT) tests are commonly used to assess liver function. Despite having an effective vaccine schedule, many people in Brazil are still susceptible to HBV. Vaccines use the surface protein (AgHBs) of the virus to induce immunity, and patients with antibody levels above 10 mUL/mL to this protein are considered to have vaccine-induced immunity. The study aims to analyze the pattern of hepatitis B markers and liver function in HBV-positive populations. Methods A retrospective analysis from 2020 to 2022 was conducted from a large laboratory database in São Paulo, Brazil selecting all individuals from whom the following serological diagnostic markers for Hepatitis B were requested: HBsAg, total Anti-HBc, IgM Anti-HBc, and Anti-HBs. HBV groups were classified based upon results for the following serological diagnostic markers: HBsAg, total Anti-HBc, IgM Anti-HBc, and Anti-HBs. The HBV susceptible group was identified as negative for all markers, the naturally immune group with Anti-HBc and Anti-HBs markers, and the vaccinated group with Anti-HBs only. Liver function was evaluated in two conditions: naturally immune and vaccinated, using liver cell injury markers: GGT, AST, and ALT. The Mann-Whitney U and Kruskal-Wallis tests were used for statistical analysis with P < 0.05 considered significant. Results Results from a total of 57 311 (32%) men and 121 404 (68%) women were evaluated. The study observed a lower frequency of individuals in the male vaccinated group (36%) compared to the susceptible group (56%). Conversely, the female group showed a higher frequency of individuals immunized by vaccination (51%) in relation to the susceptible group (45%). The rate of individuals exposed to natural infection was higher in the male group (9%) compared to the female group (4%). Regarding Anti-Hbs antibody levels, higher levels were observed in the population with natural infection markers compared to those immunized by HBV vaccination (527.5 ± 4.0 SEM vs 332.3 ± 1.1 mUI/mL, P < 0.001). Analyzing the age ranges with the greatest susceptibility (31–40 and 41–50 years), a gradual decrease in antibodies was observed over the years when compared: Naturally, P = 0.03, and immunized, P < 0.001). Indicator exams of liver function in both conditions showed average GGT levels above the reference value for the naturally infected groups: female 62.4 ± 5.34 SEM U/L; male 86.7 ± 5.4 SEM U/L, P < 0.001. No significant values of ALT and AST activity levels were seen. Conclusion The study results showed that this specific male population was more susceptible to HBV infection, while the female population has higher concentrations of Anti-HBs antibodies. Individuals who had a natural Hepatitis B infection exhibit GGT values above the standard.

Using Real-World Electronic Health Record Data to Assess Chronic Disease Screening in Children: A Case Study of Non-Alcoholic Fatty Liver Disease.

Background: Data sources for assessing pediatric chronic diseases and associated screening practices are rare. One example is non-alcoholic fatty liver disease (NAFLD), a common chronic liver disease prevalent among children with overweight and obesity. If undetected, NAFLD can cause liver damage. Guidelines recommend screening for NAFLD using alanine aminotransferase (ALT) tests in children ≥9 years with obesity or those with overweight and cardiometabolic risk factors. This study explores how real-world data from electronic health records (EHRs) can be used to study NAFLD screening and ALT elevation. Research Design: Using IQVIA's Ambulatory Electronic Medical Record database, we studied patients 2-19 years of age with body mass index ≥85th percentile. Using a 3-year observation period (January 1, 2019 to December 31, 2021), ALT results were extracted and assessed for elevation (≥1 ALT result ≥22.1 U/L for females and ≥25.8 U/L for males). Patients with liver disease (including NAFLD) or receiving hepatotoxic medications during 2017-2018 were excluded. Results: Among 919,203 patients 9-19 years of age, only 13% had ≥1 ALT result, including 14% of patients with obesity and 17% of patients with severe obesity. ALT results were identified for 5% of patients 2-8 years of age. Of patients with ALT results, 34% of patients 2-8 years of age and 38% of patients 9-19 years of age had ALT elevation. Males 9-19 years of age had a higher prevalence of ALT elevation than females (49% vs. 29%). Conclusions: EHR data offered novel insights into NAFLD screening: despite screening recommendations, ALT results among children with excess weight were infrequent. Among those with ALT results, ALT elevation was common, underscoring the importance of screening for early disease detection.

Analysis of efficacy and factors influencing sequential combination therapy with tenofovir alafenamide fumarate after treatment with entecavir in chronic hepatitis B patients with low-level viremia

Objective: To observe the efficacy and factors influencing sequential or combined tenofovir alafenamide fumarate (TAF) after treatment with entecavir (ETV) in patients with chronic hepatitis B (CHB) with low-level viremia (LLV). Methods: 126 CHB cases treated with ETV antiviral therapy in the Department of Infectious Diseases of the First Affiliated Hospital of Nanchang University from January 2020-September 2022 were retrospectively collected. Patients were divided into a complete virologic response (CVR) group (n = 84) and a low-level viremia (LLV) group (n = 42) according to the HBV DNA level during treatment. Clinical characteristics and laboratory indicators of the two groups at baseline and 48 weeks were analyzed by univariate analysis. Patients in the LLV group were divided into three groups according to their continued antiviral treatment regimen until 96 weeks: continued use of ETV as a control group; replacement of TAF as a sequential group; and combination of ETV and TAF as a combined group. The data of the three groups of patients were analyzed by one-way analysis of variance for 48 weeks. HBV DNA negative conversion rate, HBeAg negative conversion rate, alanine aminotransferase (ALT), creatinine (Cr), and liver stiffness test (LSM) were compared among the three groups after 96 weeks of antiviral treatment. Multivariate logistic regression was used to analyze the independent factors influencing the occurrence of HBV DNA non-negative conversion in LLV patients at 96 weeks. Receiver operating characteristic curve (ROC) was used to evaluate the effectiveness of predicting the occurrence of HBV DNA non-negative conversion in LLV patients at 96 weeks. Kaplan-Meier was used to analyze the cumulative negative rate of DNA in LLV patients, and the Log-Rank test was used for comparison. HBV DNA and HBV DNA negative conversion rates during treatment were observed dynamically. Results: Univariate analysis showed statistically significant differences in age, BMI, HBeAg positivity rate, HBV DNA, HBsAg, ALT, AST, and LSM at baseline between the CVR group and the LLV group (P < 0.05). Univariate analysis of variance revealed no statistically significant difference among the three groups of LLV patients at 48 weeks (P > 0.05). HBV-DNA negative conversion rate in the sequential group and the combination group was significantly higher than that in the control group after 96 weeks of treatment (88.89% vs. 41.18%, 85.71% vs. 41.18%, χ (2) = 10.404, P = 0.006). HBeAg negative conversion rate was higher than that of the control group, with no statistically significant difference (P > 0.05).Compared with the control group, ALT, Cr, and LSM in the sequential group and the combined group were equally improved to varying degrees, with a statistically significant difference (P < 0.05). Subsequent use of ETV and HBV DNA at 48 weeks were independent risk factors for HBV DNA positivity at 96 weeks in LLV patients (P < 0.05). The AUC of HBV DNA at 48 weeks was 0.735 (95%CI: 0.578 ~ 0.891), the cut-off value was 2.63 log(10) IU/ml, and the sensitivity and specificity were 76.90% and 72.40%, respectively. DNA conversion rate was significantly lower in LLV patients receiving 48-week ETV and 48-week HBV DNA≥2.63 log10 IU/mL than in patients receiving sequential or combined TAF and 48-week HBV DNA < 2.63 log(10) IU/mL. HBV DNA negative conversion rates in the sequential group and combined group at 72 weeks, 84 weeks, and 96 weeks were higher than those in the control group during the period from 48 weeks to 96 weeks of continuous treatment, and the differences were statistically significant (P < 0.05). Conclusion: Sequential or combined TAF antiviral therapy could more effectively improve the 96-week CVR rate, as well as hepatic and renal function, and alleviate the degree of hepatic fibrosis in CHB patients with LLV following ETV treatment. Subsequent use of ETV and HBV DNA load at 48 weeks were independent predictors of HBV DNA positivity at 96 weeks in LLV patients.

Hepatitis E virus seroprevalence among employees in catering and public place industries in Nanjing, China.

This study aimed to assess the prevalence of anti-hepatitis E virus (HEV) immunoglobulin (Ig) M and elevated serum alanine aminotransferase (ALT) levels among employees in catering and public place industries. Blood samples were collected between January and December 2020 from 26,790 employees working in the Qinhuai district of Nanjing, China. Anti-HEV IgM in the serum samples was tested by the capture ELISA method and ALT was tested by the IFCC method. Samples positive for anti-HEV IgM or with ALT levels over 200U/L were subjected to PCR screening of HEV RNA. The overall seroprevalence of anti-HEV IgM was 0.41%, and the seroprevalence was slightly higher in males (0.47%) than in females (0.37%); however, the difference was not substantial (p=0.177). Seroprevalence of anti-HEV IgM increased with age, reaching its peak level after 48years of age. The prevalence of elevated ALT levels was 4.24%, and males exhibited a higher prevalence than females (6.78% vs 2.65%, p<0.001). Prevalence of elevated ALT levels differed in age groups and the 26-36-year-old group had the highest rate of elevated ALT levels. Employees with elevated ALT levels had a higher prevalence of positive anti-HEV IgM than those with normal ALT (0.57% vs 0.31%, p<0.001). Positive HEV RNA was detected in one anti-HEV IgM-negative employee with ALT higher than 200U/L. In our study, all the HEV RNA-positive and IgM-positive individuals are asymptomatic, and a combination of ALT tests, serological methods, and molecular methods is recommended to screen asymptomatic HEV carriers and reduce the risk of transmission.

Significance of alanine aminotransferase testing in blood donor screening in Chongqing, China: a 7-year retrospective analysis

Significance of alanine aminotransferase testing in blood donor screening in Chongqing, China: a 7-year retrospective analysis

Prevalence of elevated alanine aminotransferase (ALT) in pregnancy: A cross-sectional labor and delivery-based assessment.

Since liver tests are not routinely checked in pregnancy, the prevalence of abnormal liver tests and liver-related abnormalities in pregnancy in a US-based population is not known. We sought to determine the prevalence of abnormal alanine aminotransferase (ALT) among pregnant Individuals who present to labor and delivery for evaluation and to evaluate prevalence of underlying diagnosed liver conditions. Prospective study evaluating liver tests in consecutive samples obtained on the labor and delivery unit. Patient characteristics were compared between those with and without abnormal ALT and those with and without abnormal ALT without a liver-related diagnosis made in clinical practice, using t tests for continuous measures and χ2 or Fisher’s exact tests as appropriate for categorical measures. Logistic regression was utilized to identify factors associated with abnormal ALT in this subcohort to determine predictors of abnormal ALT in those without a known liver-related diagnosis. We collected 1024 laboratory specimens from 996 patients. Of these patients, 131 of 996 (13.2%) had elevated ALT ≥25 IU/L; 20 (2%) had ALT ≥50, 6 (0.6%) had ALT ≥125 and 3 (0.3%) had ALT ≥250. 61/131 (46.6%) of patients with ALT ≥25 IU/L had not had LTs checked during routine pregnancy care. 20 (15%) of individuals with abnormal LT had preeclampsia; 5 (4%) had cholestasis of pregnancy; 1 (0.8%) had hepatitis C; there were no other chronic liver diseases diagnosed. There were no significant demographic or clinical differences between those with and without ALT ≥25, whether liver disease diagnosis was made or not. We identified an over 10% prevalence of abnormal LTs in consecutive pregnant individuals who presented to L&D, most of whom did not have a liver-related condition diagnosed in clinical practice. Among those with liver-related diagnoses, PE and ICP were the most common among individuals with ALT≥25 IU/mL, with chronic liver disease rarely diagnosed. Further evaluation of the role of ALT testing as part of routine prenatal care is needed, particularly in establishing a baseline prevalence of liver test abnormalities in pregnancy and independent association with pregnancy outcomes.

Liver blood marker testing in UK primary care: a UK wide cohort study, 2004–2016

ObjectiveWe aimed to determine (1) the temporal trends of liver enzyme testing in UK general practice and (2) how these vary among different subgroups at risk of chronic liver disease...

The Togo national proficiency test pilot programme for basic clinical chemistry tests.

BackgroundA national proficiency test (PT) programme is not currently implemented in most low-income countries. However, participation in such PT programmes assists improves test performance and result accuracy.ObjectiveThis study assessed how well 11 government hospital laboratories performed 18 basic clinical chemistry tests and identified areas needing improvement.MethodsA cross-sectional study was carried out by the Division of Laboratories of the Ministry of Health of Togo from 01 July 2016 to 31 December 2016. The test performance was evaluated using panels provided by One World Accuracy, Canada (Vancouver). The Clinical Laboratory Improvement Amendments criteria were used in evaluating the laboratories, and their success rates were compared with the World Health Organization Regional Office for Africa’s target of 80%.ResultsThe overall rate of acceptable results at the laboratories was over 80% for glucose, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase, alkaline phosphatase and triglycerides tests. The laboratories using fully automated spectrophotometers had an acceptable results rate of 89% (p = 0.001). The overall performance of the laboratories by cycles varied from 71% to 82%.ConclusionThis national PT programme identified the tests, which laboratories must improve their performance (urea, creatinine, uric acid, bilirubin, cholesterol, total protein, calcium, magnesium, phosphorus). It demonstrated the need for the use of routine appropriate internal quality control in all laboratories. The proficiency test programme should be extended to all clinical laboratories and target all biology disciplines.

Clinical practice gaps and challenges in non-alcoholic steatohepatitis care: An international physician needs assessment.

Background and aimsEven as several pharmacological treatments for non‐alcoholic steatohepatitis (NASH) are in development, the incidence of NASH is increasing on an international scale. We aim to assess clinical practice gaps and challenges of hepatologists and endocrinologists when managing patients with NASH in four countries (Germany/Italy/United Kingdom/United States) to inform educational interventions.MethodsA sequential mixed‐method design was used: qualitative semi‐structured interviews followed by quantitative online surveys. Participants were hepatologists and endocrinologists practising in one of the targeted countries. Interview data underwent thematic analysis and survey data were analysed with chi‐square and Kruskal‐Wallis tests.ResultsMost interviewees (n = 24) and surveyed participants (89% of n = 224) agreed that primary care must be involved in screening for NASH, yet many faced challenges involving and collaborating with them. Endocrinologists reported low knowledge of which blood markers to use when suspecting NASH (56%), when to order an MRI (65%) or ultrasound/FibroScan® (46%), and reported sub‐optimal skills interpreting alanine aminotransferase (ALT, 37%) and aspartate aminotransferase (AST, 38%) blood marker test results, causing difficulty during diagnosis. Participants believed that more evidence is needed for upcoming therapeutic agents; yet, they reported sub‐optimal knowledge of eligibility criteria for clinical trials. Knowledge and skill gaps when managing comorbidities, as well as skill gaps facilitating patient lifestyle changes were reported.ConclusionsEducational interventions are needed to address the knowledge and skill gaps identified and to develop strategies to optimize patient care, which include implementing relevant care pathways, encouraging referrals and testing, and multidisciplinary collaboration, as suggested by the recent Global Consensus statement on NAFLD.

The diagnostic value of laboratory tests in detecting solid organ injuries in pediatric patients with blunt abdominal trauma

BackgroundComputed tomography of the abdomen (CT) is used as the gold standard for detecting solid organ injuries (SOI) after blunt abdominal trauma (BAT). However, patient selection for CT is still controversial due to its potential risks. In this study, we aimed to investigate the usefulness of laboratory tests in the detection or exclusion of SOI in pediatric patients evaluated in the emergency department due to BAT. MethodsThe study was planned as a prospective, observational study and was conducted in the emergency department of a university hospital between February 2018 and February 2019. Patients under the age of 18 who were evaluated for BAT in the emergency department were included in the study. In the study, the diagnostic value of abnormal laboratory tests in detecting SOI was calculated by accepting CT results as the gold standard. ResultsOf the 323 patients included in the study, 118 (36%) were male. There were 283 patients who underwent CT. SOI was detected in 18 (6%) patients. Abnormal alanine aminotransferase, aspartate aminotransferase, amylase and lipase tests were found to be statistically significant in predicting SOI (p < 0.05). However, none of the tests were found to have sufficient sensitivity and specificity. Hemoglobin, hematocrit, lactate and base excess values were not found to be statistically significant in predicting SOI (p > 0.005). ConclusionsThe hematologic laboratory tests are insufficient to rule out solid organ injury in pediatric patient with BAT.

Utility of inflammatory makers, alanine aminotransferase, aspartate aminotransferase, and procalcitonin tests in COVID-19

Background and objective: Many tests are conducted for monitoring the progression and the severity of coronavirus disease (COVID-19) infection. However, the extent to which these tests are helpful in clinical practice and therapeutics of COVID-19 is still ambiguous. This study aimed to evaluate the feasibility of performing inflammatory marker tests, liver function tests, and procalcitonin test in the diagnosis and monitoring of COVID-19 infection. Methods: The current study compares the results of alanine aminotransferase, aspartate aminotransferase, ferritin, and procalcitonin tests in two different populations of 123 COVID-19 suspects and a control group of 110 healthy individuals in Erbil city of Kurdistan region of Iraq to search for possible significant differences in both groups. Results: The COVID-19 group had significantly higher ferritin and procalcitonin mean values than the control group (P = 0.001). The differences between alanine aminotransferase and aspartate aminotransferase were significant in some age and gender classes of both groups. However, the overall differences were not statistically significant (P = 0.339 and 0.286, respectively). Conclusion: The outcome of the current study suggests that among the group of tests conducted for the study population, the most useful tests are ferritin and procalcitonin to monitor the COVID-19 patients' health status.

Trends in indirect liver function marker testing in Wales from 2000 to 2017 and their association with age and sex: an observational study

ObjectiveIf non-invasive markers of liver fibrosis were recorded frequently enough in clinical practice, it might be feasible to use them for opportunistic community screening for liver disease. We aimed to...

Laboratory monitoring and antiviral treatment for chronic hepatitis B among routine care patients in the United States.

We investigated factors associated with rates of recommended monitoring of chronic hepatitis B (HBV) patients for viral DNA and alanine aminotransferase (ALT), and initiation of antiviral treatment among eligible patients, in a US cohort of patients under routine care. Patients were categorised by treatment indication: definite, equivocal or ineligible. Baseline covariates included demographics, clinical characteristics and specialist care status. 'Recommended monitoring' was defined ≥1 ALT or HBV DNA test per year. Logit models, univariate then multivariable, were used to evaluate factors associated with monitoring and treatment. Among 3,830 patients, treatment was received by 67.5% (788/1168 patients) in the 'definite' category, and 34.1% (208/610 patients) in the 'equivocal' category, of whom 109moved up to 'definite' status at some point during follow-up. Sex, age and specialist care were independently associated with receipt of treatment in 'definite' patients. Routine monitoring rates were high prior to treatment in 'definite/ treated' patients (ALT: 77%; DNA: 85%) but declined afterwards (ALT 63%; DNA 36%). Rates of monitoring were lower in 'definite/ untreated' patients (ALT: 48%; DNA: 32%). Among 'equivocal/ treated' patients, lower age and comorbidity scores were associated with receipt of treatment; ALT monitoring rates were similar before and after treatment initiation (41% and 46%, respectively), while rates of DNA monitoring declined (55% and 29%). Monitoring among 'treatment ineligible' patients was similar to those in the 'equivocal' and untreated 'definite' groups. A large proportion of US HBV patients under routine care did not receive recommended annual laboratory monitoring, especially after initiation of antiviral treatment, and nearly one-third of patients with 'definite' indications for antiviral therapy remained untreated.

Effect of Substituting Fish Oil with Camelina Oil on Growth Performance, Fatty Acid Profile, Digestibility, Liver Histology, and Antioxidative Status of Red Seabream (Pagrus major)

Simple SummaryThe shortage of natural resources, prices, and high demand for fish oil has encouraged the use of non-traditional ingredients in aquafeed. The search for an alternative lipid source in aquafeeds has seen terrestrial vegetable oils at the epicenter of various flagship aqua-feed research. Herein, we investigated the effects of substituting fish oil (FO) with camelina oil (CO) on growth performance, fatty acid profile, digestibility, liver histology, and antioxidative status of red seabream (Pagrus major). After 56 days of the feeding trial, the results suggested that FO can be replaced with CO in the feeds of farmed red seabream without compromising growth, blood chemistry, digestibility, and overall health status.A 56-day feeding trial to evaluate the responses of red seabream (initial weight: 1.8 ± 0.02 g) to the substitution of fish oil (FO) with camelina oil (CO) at different ratios was conducted. The control diet formulated at 46% CP (6F0C) contained only FO without CO; from the second to the fifth diet, the FO was substituted with CO at rates of 5:1 (5F1C), 4:2 (4F2C), 3:3 (3F3C), 2:4 (2F4C), and 0:6 (0F6C). The results of the present study showed that up to full substitution of FO with CO showed no significant effect on growth variables BW = 26.2 g–28.3 g), body weight gain (BWG = 1275.5–1365.3%), specific growth rate (SGR = 4.6–4.7), feed intake (FI = 25.6–27.8), feed conversion ratio (FCR = 1.0–1.1), biometric indices condition factor (CF = 2.2–2.4), hepatosomatic index (HSI = 0.9–1.1), viscerasomatic index (VSI = 7.5–9.5), and survival rates (SR = 82.2–100) with different FO substitution levels with CO. Similarly, there were no significant differences (p < 0.05) found in the whole-body composition except for the crude lipid content, and the highest value was observed in the control group (291 g/kg) compared to the other groups FO5CO1 (232 k/kg), FO4CO2 (212 g/kg), FO2CO4 (232 g/kg) and FO0CO6 (244 g/kg). Blood chemistry levels were not influenced in response to test diets: hematocrit (36–33%), glucose (Glu = 78.3–71.3 mg/dL), total protein (T-pro = 3.1–3.8 g/dL), total cholesterol (T-Chol = 196.0–241 mg/dL), blood urea nitrogen (BUN = 9.0–14.6 mg/dL), total bilirubin (T-Bil = 0.4–0.5 mg/dL), triglyceride (TG = 393.3–497.6 mg/dL), alanine aminotransferase test (ALT = 50–65.5 UL/L), aspartate aminotransferase test (AST = 38–69.3 UL/L). A remarkable modulation was observed in catalase (CAT) and superoxide dismutase (SOD) activities in the liver, as CAT and SOD values were lower with the complete FO substitution with CO (0F6C), and the highest values were observed in the control and (4F2C). This study indicates that red seabream may have the ability to maintain LC-PUFAs between tissues and diets, and CO substitution of FO could improve both lipid metabolism and oxidation resistance as well as maintain digestibility. In conclusion, dietary FO can be replaced up to 100% or 95% by CO in the diets of red seabream as long as n-3 HUFA, EPA, and DHA are incorporated at the recommended level.

EQA/PT scheme to improve the equivalence of enzymatic results between mutual recognition laboratories in Beijing.

BackgroundTo utilize the external quality assessment (EQA)/proficiency testing (PT) scheme to evaluate the equivalence of different clinical enzymatic measuring systems in Beijing.MethodsThe Beijing Center for Clinical Laboratory (BCCL) distributed three investigation samples to mutual recognition clinical laboratories in Beijing including alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ‐glutamyltransferase (GGT), creatine kinase (CK), and lactate dehydrogenase (LDH). These samples were derived from serum pools with values assigned by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) enzymatic reference measurement procedures (RMPs). Each laboratory performed duplicate tests of the samples. Then, the samples at level 1 were used to recalibrate individual measuring systems for repeating the tests. BCCL collected data for evaluation of their analytical quality.ResultsBefore recalibration, the biases of ALT and AST tests were not traceable to the IFCC RMPs, and the bias pass rates of GGT, CK, and LDH tests were only 51.2%, 55.7%, and 48.6% respectively. After recalibration, the pass rates of ALT, AST, GGT, CK, and LDH increased to 95.1%, 82.9%, 95.1%, 97.1%, and 70.0% respectively. The EQA/PT also showed that after recalibration, more than 95% of laboratories met the optimum level specifications of the biological variation for ALT, AST, GGT, and CK tests and the desirable for LDH tests.ConclusionThe enzymatic tests in Beijing need to be further standardized by category 1 or 2 EQA/PT scheme for mutual recognition between clinical laboratories. The criteria of biological variation are more relevant for determining the equivalence of clinical enzymatic tests.

Initial Evaluation, Long-Term Monitoring, and Hepatocellular Carcinoma Surveillance of Chronic Hepatitis B in Routine Practice: A Nationwide US Study.

Previous studies, mostly small and single center, have shown gaps in the evaluation and monitoring of patients with chronic hepatitis B (CHB) virus infection. We aimed to examine the rates and predictors of adherence to guidelines for CHB care in a large nationwide cohort. We identified adult patients with CHB infection from the Truven MarketScan databases of commercially insured and Medicare patients with private insurance supplement (2007-2014) using International Classification of Diseases, Ninth Revision, Clinical Modification codes. The initial evaluation cohort had at least 6 months follow-up, whereas at least 12 months was required for the long-term monitoring cohort. We analyzed 55,317 eligible patients with CHB infection: mean age 46 ± 12 years, 58% men, and 14.8% with cirrhosis. Over a mean follow-up of 3.2 ± 2.3 years, 55.8% had specialist (gastroenterology or infectious diseases) visits. For initial evaluation, 59% of patients received both alanine aminotransferase (ALT) and hepatitis B virus (HBV) DNA tests, whereas only 33% had ALT, HBV DNA, and hepatitis B e antigen tests, with higher frequencies among patients with specialist visits. For long-term monitoring, only 25% had both ALT and HBV DNA tests performed annually. Among patients at higher risk of developing hepatocellular carcinoma (patients with cirrhosis, male patients without cirrhosis older than 40 years, and female patients without cirrhosis older than 50), less than 40% underwent annual hepatocellular carcinoma surveillance, with 25% never receiving surveillance during the study period. Predictors of optimal initial evaluation and long-term monitoring were compensated cirrhosis (odds ratio: 1.60 and 1.47, respectively) and specialist visits (odds ratio: 1.86 and 1.31, respectively) (both P < 0.001). In this large cohort of patients with CHB infection with private insurance or Medicare with private insurance supplement, we observed poor adherence to the recommended initial evaluation and long-term monitoring. Among the predictors of adherence were specialist visits. Further efforts are needed to identify barriers and improve access to care.

Bicyclol for the treatment of drug-induced liver injury: a propensity score matching analysis using a nationwide inpatient database.

ObjectiveTo evaluate the efficacy and safety of bicyclol in patients with drug-induced liver injury (DILI) using a nationwide database.MethodsWe retrospectively analyzed the clinical data of DILI patients in the DILI-R database. Propensity score matching was performed to balance the bicyclol and control groups, and alanine aminotransferase (ALT) recovery was compared between the two groups. Factors associated with ALT recovery and safety were identified.ResultsThe analysis included the data of 25,927 patients. Eighty-seven cases were included in the bicyclol group, with 932 cases in the control group. One-to-one propensity score matching created 86 matched pairs. The ALT normalization rate in the bicyclol group was significantly higher than that in the control group (50.00% vs. 24.42%), and statistical significance was found in the superiority test. After adjustment of baseline ALT levels, baseline total bilirubin levels, sex, age, acute or chronic liver diseases, and suspected drugs in the multivariate logic regression analysis, the major influencing factors for ALT recovery included the time interval between ALT tests (days) and the group factor (bicyclol treatment). There were no differences in the proportion of renal function impairment or blood abnormalities between the two groups.ConclusionsBicyclol is a potential candidate for DILI.

The Effect of Colistin Administration as Medicated Feed on Alanine Aminotransferase and Creatinine Level in Broiler Infected with Escherichia coli

Colistin is a decapeptide antibiotic with narrow spectrum activity, mainly used as treatment for Gram negative bacteria. This study aims to scientifically determine the effect of colistin administration as medicated feed on alanine aminotransferase (ALT) and creatinine level in broiler infected with Escherichia coli. KTOP group as positive control, KTON group as negative control, while I, II, and III groups were infected with Escherichia coli 1 x 108 CFU/ml 0.1 ml via intratracheal route. Group I, II, and III were given colistin treatment dosage of 0.3 g/kg food, 0.6 g/kg food, and 1.2 g/kg food. Blood samples were taken through brachial veins for ALT and creatinine examination with a Caretium NB-201 semi-auto chemistry analyzer. Data were examined statistically using IBM SPSS Statistics 24 software and graphically using Microsoft Excel 365. Conclusion of the research by statistical analysis with Kruskal-Wallis test obtained ALT test results P = 0.147 and creatinine test results P = 0.815. Based on the results of this study, the administration of colistin medicated feed did not cause a significant effect on ALT and creatinine level in broiler infected with Escherichia coli, indicating that colistin has low potential toxicity while given as medicated feed.

Study of specimen stability for biochemical parameters

Introduction: The blood sample is collected and transported to the laboratory for analysis, during this time the samples bares many extra-analytical factors prior to analysis. Contact time of plasma or serum with the blood cells is one of these factors because of ongoing cell metabolism as well as active and passive movement of analytes in cellular compartments. Aim and Objective: The aim of our study is to determine the stability of different seventeen biochemical parameters in primary collection (without separation of serum/plasma) and Secondary collection (with separation of serum/plasma) tube. Materials and Methods: Hundred patients’ venous blood sample were collected in plain vacutainer and fluoride vacutainer (primary tube), set of the seventeen biochemical analytes like sodium, potassium, ionized calcium, chloride, glucose, creatinine, urea, uric acid, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, total protein, albumin, bilirubin, triglyceride, total cholesterol and HDL-cholesterol tests were analysed. Once the tests were carried out from primary tube, approximately half serum was separated into two aliquots (secondary collection tube). All tubes were stored at 2 to 8° C. After 24 hr and 48 hr again same sate of tests were performed on the same equipment. Statistical analysis was done after that. Results: Out of seventeen analytes most analytes remained stable in both primary and secondary tubes up to 48 hr at 2 to 8° C, these includes chloride, creatinine, urea, uric acid, total bilirubin, total protein, albumin. alkaline phosphatase (ALP), aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Plasma glucose decreased in both primary and secondary collection tube but concentration is within significant change limit (SCL). While serum potassium is increase 28.84% at 24 hr and 75.58% at 48 hr; concentration is also out of SCL range in primary collection tube even though samples stored at 2 - 8⁰ C. Conclu