Alanine Aminotransferase Values Research Articles

Eichhornia crassipes Ameliorated Rheumatoid Arthritis by Modulating Inflammatory Cytokines and Metalloproteinase Enzymes in a Rat Model.

Background and Objectives: This study was planned to investigate the anti-arthritic property of flowers of E. crassipes in a Sprague-Dawley rat model by administering Freund's Complete Adjuvant (FCA). Materials and Methods: Arthritis was induced at day 0 in all rats except negative controls, while arthritic progress and paw edema were analyzed on specific days (8th, 13th, 18th, and 23rd) via the macroscopic arthritic scale and a digital Vernier caliper, respectively. Histopathological parameters were examined using a Hematoxylin and Eosin (H&E) staining method. Blood samples were withdrawn from rats to investigate the effects of the E. crassipes flower on the mRNA expression values of inflammatory markers, via a reverse transcription PCR technique. Serum samples were used to determine prostaglandin E2 (PGE2) levels using enzyme-linked immunosorbent assay (ELISA). Values of alanine transaminase (ALT), aspartate aminotransferase (AST), creatinine, and urea, besides hematological parameters, i.e., the hemoglobin (Hb) content and complete blood count (CBC), were investigated. Results: The data showed that E. crassipes inhibited the arthritic progress and ameliorated the paw edema. The amelioration of parameters assessed via the histopathological analysis of ankle joints, as well as via hematological analysis, confirmed the diminution of rheumatoid arthritis (RA) in the plant-treated groups. Treatment with E. crassipes inhibited the expression levels of tumor necrosis factor-α (TNF-α), interleukins (IL-1β and IL-6), nuclear factor KappaB (NF-κB), matrix metalloproteinase (MMP-2 and MMP-3), and vascular endothelial growth factor (VEGF). Serum PGE2 levels were also found to be reduced in treatment groups. A biochemical investigation revealed the improvements in hepatic markers in plant-treated groups. The data indicated that the plant has no hepatotoxic or nephrotoxic effects at the studied dose. GC-MS (Gas Chromatography-Mass Spectrometry) analysis displayed the presence of phytochemicals having known anti-inflammatory and antioxidant properties. Conclusions: Therefore, it may be concluded that E. crassipes possesses anti-arthritic characteristics that could be attributed to the modulation of pro-inflammatory cytokines, MMPs, and PGE2 levels.

Dietary green-synthesized curcumin-mediated zinc oxide nanoparticles promote growth performance, haemato-biochemical profile, antioxidant status, immunity, and carcass quality in Nile tilapia (Oreochromis niloticus)

This study evaluated the effect of dietary curcumin-assisted green synthesized zinc oxide nanoparticles (CUR-ZnONPs) on growth performance, haemato-biochemical profile, antioxidant capacity, immune response, carcass composition, and bioaccumulation of Zn in Nile tilapia. The fish (‎16.20 ± 1.02 g‎) were fed with diets enriched with 0 (CZP1), 5 (CZP2), 7.5 (CZP3), and 10 (CZP4) mg/kg CUR-ZnONPs for 56 days and then challenged with Aeromonas hydrophila. The highest growth performance (final weight, weight gain, and specific growth rate) and the lowest feed conversion ratio were recorded in CZP4 (P < 0.05). Feeding the fish with CZP4 resulted in a significant increase in the hematological indices, body crude protein content, ‎antioxidant capacity (superoxide dismutase and reduced glutathione), and humoral immunity (immunoglobulin M, lysozyme, and complement pathway activity) (P < 0.05). However, the levels of malondialdehyde, body crude lipid, cholesterol, and aspartate aminotransferase were significantly decreased in the fish fed with CZP4 compared to others (P < 0.05). There was no significant difference in the values of glucose, alanine aminotransferase, catalase, monocyte count, and muscle Zn accumulation between the treated fish and the control group (P > 0.05). The mortality rate of the fish infected with A. hydrophila was significantly lower in the group that received CZP4 compared to the other experimental groups (P < 0.05). The principal component analysis demonstrated that the fish fed with CUR-ZnONPs have significantly higher growth performance, immune responses, and antioxidant status than the fish fed with the control diet. Overall, it is suggested to use dietary CUR-ZnONPs, especially at 10 mg/kg, as a beneficial feed supplement to improve growth performance, antioxidant status, and immune parameters in Nile tilapia.

Evaluation of factors affecting treatment and mortality in patients over 65 years of age and without chronic disease, followed in the Intensive Care Unit due to COVID-19.

In this study, demographic, clinical, and laboratory data of patients aged 65 and over who are followed on mechanical ventilators due to COVID-19 in intensive care clinics will be useful in terms of strategies to be developed in the fight against COVID-19 and other infectious agents. Our study included 299 patients aged 65 years and older, who were not chronically ill, and who were followed up on mechanical ventilators due to COVID-19 in intensive care clinics in the period between 2020 and 2022. Our study was designed as a retrospective cross-sectional study. The demographic characteristics of the patients included in the study, their complaints during hospitalization, the time between the beginning of the complaint and the admission to the hospital, the vital signs at the time of admission to the hospital, the lung computed tomography findings during hospitalization, and the treatments given were examined. 55.9% of all patients were males, and the mean age was 75.45±7.47 years. While there was no significant difference in terms of mean age between the groups of patients with/without a higher risk of mortality, there was a significant difference in gender (p=0.025). There was a statistically significant difference between the COVID-19 intensive care (p=0.001) and renal failure (p=0.014) and mortality groups. The mean nutric score, Procalcitonin (PCT), Lactate Dehydrogenase (LDH), Blood Urea Nitrogen (BUN), Phosphorus, and lactate values, which are important parameters, were statistically higher in the group with a higher risk of mortality (p<0.001). In addition, there was a statistically significant difference in terms of sepsis, neuromuscular blocker (Nmb), vasopressor, and intubation between the groups of patients with/without a higher risk of mortality (p<0.001). In the group with high mortality, 34.2% (n=55) had plasmapheresis treatment, and 14.2% had hemodiafiltration treatment (p<0.001). According to the results of the multivariate logistic regression model in determining the factors associated with a higher risk of mortality, those who were males (p=0.001), those with kidney failure (p<0.001), those with organ failure (p=0.006), increased in alanine aminotransferase (ALT) values (p=0.019), those with sedation (p=0.001) and those with vasopressors (p<0.001) were found to have an increased risk of mortality. We think that our study is valuable in terms of determining the most appropriate treatment strategies by following the patients in terms of parameters that are significant in the findings during their follow-up period in the Intensive Care Unit.

Chronic Hepatitis B In Children: Case Series From A Tertiary Paediatric Hospital.

Chronic hepatitis B (CHB) remains an important global public health problem. Seroconversion is highly correlated with favourable long-term outcome. There is no consensus on the treatment method, onset time and duration for paediatric CHB patients. In this study, we aimed to evaluate the course of children with CHB, to determine the characteristics of the patients who developed spontaneous seroconversion and treatment indications, and to compare the effectiveness of different treatment modalities. Patients aged 1-18 years with a diagnosis of CHB were included in this study and evaluated for the development of spontaneous hepatitis B envelope antigen (HBeAg)/surface antigen (HBsAg) seroconversion and treatment modalities. The treated patients were divided into two groups according to their treatment regimen. Of the 114 patients, the median age at diagnosis was 8.4 years and median follow-up period was 5.2 years. Spontaneous HBeAg and HBsAg seroconversion developed in 18 (20.6%) of 87 HBeAg positive patients and two (1.8%) patients, respectively. Thirty-one patients were treated. The follow-up period was higher in the group with HBeAg seroconversion (p:0.005). There was no statistical difference between the patients in terms of seroconversion development and treatment status. The serum alanine aminotransferase (ALT) values at the time of diagnosis were statistically higher in treated patients. HBV infection and CHB continue to be an important problem for children in our country. Consensus on the appropriate ALT ULN is needed for the treatment of hepatitis in children.

Influence of dietary mannan-oligosaccharides supplementation on hematological characteristics, blood biochemical parameters, immune response and histological state of laying hens

This study aimed to determine the influence of dietary mannan-oligosaccharides (MOS) on the immune system, hematological traits, blood biochemical parameters, and histological state of laying hens. At 34 wk of age, The Mandarah chicken strain's 120 laying hens and 12 cocks were divided into 4 groups, each with 30 hens and 3 cocks. The first group performed as a control group, which nourished on a basal diet. The second, third, and fourth experimental groups received 0.1, 0.2, and 0.5 g/kg of MOS and a base diet, respectively. Birds obtained MOS at numerous doses significantly (P ˂ 0.05) raised serum levels of immunoglobulin Y (IgY), immunoglobulin M (IgM), and avian influenza (AI) antibodies compared to control birds. Furthermore, adding MOS at a level of 0.1 g/kg diet significantly improved the immune response of the control group. Additionally, compared to the control group, treated birds with MOS at various dosages did not significantly enhance hematological parameters such as red blood cells (RBCs), white blood cells (WBCs), hemoglobin, and hematocrit. Compared to control birds, birds fed MOS at all levels exhibited considerably lower serum cholesterol, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) values. Also, compared to other treated birds, MOS-treated birds displayed improved histological examination of the small intestine, isthmus, and testis compared to the control group, particularly in birds fed MOS at 0.1 and 0.2 g/kg diet. It could be concluded that using MOS at 0.1 or 2 g/kg diet can successfully improve the physiological performance and overall health of laying hens.

The Effect of Vitamin E Supplementation on Serum Aminotransferases in Non-Alcoholic Fatty Liver Disease (NAFLD): A Systematic Review and Meta-Analysis.

Νon-alcoholic fatty liver disease (NAFLD) is a common cause of end-stage liver disease in developed countries. Oxidative stress plays a key role during the course of the disease and vitamin E supplementation has shown to be beneficial due to its antioxidative properties. We aim to investigate the effect of vitamin E supplementation on serum aminotransferase levels in patients with NAFLD. Three electronic databases (MEDLINE, CENTRAL, and Embase) were reviewed for randomized trials that tested vitamin E supplementation versus placebo or no intervention in patients with NAFLD, published until April 2023. A total of 794 patients from 12 randomized trials were included in this meta-analysis. Notwithstanding the studies' heterogeneity and moderate internal validity in certain cases, among studies testing vitamin E supplementation at 400 IU/day and above, the values of alanine aminotransferase (ALT) were reduced compared with placebo or no intervention [ALT Mean Difference (MD) = -6.99 IU/L, 95% CI (-9.63, -4.35), for studies conducted in Asian countries and MD = -9.57 IU/L, 95% CI (-12.20, -6.95) in non-Asian countries]. Regarding aspartate aminotransferase (AST), patients in the experimental group experienced a reduction in serum levels, though smaller in absolute values [AST MD = -4.65 IU/L, 95% CI (-7.44, -1.86) in studies conducted in Asian populations] and of lower precision in non-Asian studies [MD = -5.60 IU/L, 95% CI (-11.48, 0.28)].

Comparative Analysis of Hepatocellular Carcinoma Patients with and Without Type 2 Diabetes Mellitus

Purpose of the Study: To evaluate the clinical impact of Type 2 Diabetes Mellitus (T2DM) in patients with Hepatocellular Carcinoma (HCC) in comparison to those without T2DM. Methods: Retrospective study, HCC data obtained from public domain (kaggle.com). Summary of Results Obtained: Mean age in the diabetic and non-diabetic groups were 70.4 and 62.08 years respectively. There was a female preponderance seen in both groups. Mean aspartate aminotransferase and alanine aminotransferase (AST/ALT) values in diabetic group were 81.42/54.8 U/L and in non-diabetic group were 116.72/77.4 U/L (p=0.19). Mean International Normalized Ratio (INR) in diabetic and non-diabetic groups were 1.51 and 1.34 respectively (p=0.32). Mean total bilirubin values in diabetic and non-diabetic groups were 2.39 and 1.95 mg/dL respectively (p=0.63). Total number of patients with varices were 33 in the diabetic and 32 in the non-diabetic group (p=0.59). Total number of patients with portal hypertension were 33 in the diabetic and 34 in the non-diabetic group (p=0.32). Portal venous thrombosis was found in 9 patients in the diabetic and 12 patients in the non-diabetic group (p=0.67). Metastatic disease was seen in 10 patients in the diabetic and 12 patients in the non-diabetic group (p=0.74).

Stimulatory effect of dietary alpha-lipoic acid on growth performance, antioxidant capacity, liver enzymes, immunity and protection of African catfish, Clarias gariepinus (B.), Edwardsiella tarda infection.

Edwardsiella tarda is one of the most common causes of fish diseases that hinder aquaculture. Oxidative stress in farm animals can induce a number of pathological disorders, productionand general animal welfare. The use of exogenous dietary nonenzymatic antioxidants such as alpha-lipoic acid (ALA) can stop a pro-oxidant state and thus appears to have the potential to modulate the immune system and protect fish from bacterial infection. Thus, this study investigates the stimulatory effect of dietary ALA on growth performance, antioxidant capacity, liver enzymes, immunityand protection of African catfish, Clarias gariepinus (B.), against an infection with E. tarda. Five isonitrogenous and isocaloric diets (400 g/kg of crude protein) containing ALA at doses of 0.0 (control), 500, 1000, 1500or 2000 mg/kg diet were served to 300 juveniles of African catfish (mean weight = 8.2 ± 0.2 g) adequately thrice per day for 12 weeks. Thereafter, 0.1 mL of E. tarda (ATCC 15947; 1.0 × 108 CFU/mL) was intraperitoneally injected into 10 fish from each tank and was monitored for 14 days. The results showed that ALA-fortified diets significantly boosted the fish growth, feed consumption and utilizationand feed conversion ratio but no did not affect fish survival rate. The highest final fish weight (g), weight growth (g)and weight gain (%) were all considerably higher in fish fed with ALA-fortified diets (p < 0.05), especially from 1000 to 200 mg/kg ALA than the control group. Also, an enhanced hemato-biochemical, antioxidantand immune indices were noticed in African catfish-fed ALA-enriched diets. In a dose-dependent order, the levels of haematological indices such Ht, Hb, RBCs, WBCsand platelets were markedly increased (p < 0.05). Additionally, fish fed with ALA-based diets showed substantial (p < 0.05) declines in aspartate and alanine aminotransferase values, with the lowest values being found in the 2000 mg/kg diet while control group had highest values. Further, African catfish fed the feed fortified with 2000 mg ALA/kg diet showed the highest levels of lysozyme, respiratory burst, proteasesand esterase activities (p < 0.05). Following exposure of fish to E. tarda infection, a significant reduction in the mortality was obtained in African catfish fed with ALA-based diets, especially from 1500 to 2000 mg ALA/kg diet (3.3%); while fish fed with the control diet had highest mortality (86.7%). Therefore, diets supplemented with ALA evoked fish growth performance, antioxidantsand nonspecific immunity of African catfish. Also, resistance of African catfish to E. Tarda infection were raised when fed ALA-fortified diets at optimum inclusion rate of 1300 mg ALA/kg diet.

Association between Asia–Pacific body mass index classification and serum liver enzymes: alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transferase in healthy individuals

BackgroundElevated levels of serum liver transaminases are good indicators of liver cell damage, and elevated serum gamma-glutamyl transferase (GGT) level is a good indicator of both bile duct and hepatocellular damage. At early stages, elevated serum levels of these liver enzymes can be mostly prevailed as an asymptomatic condition and therefore in an undiagnosed state. This may be resulted in a number of complications and may lead to chronic hepatic damage that will be more severe and difficult to care. Serum liver enzyme levels are affected by age, gender, body mass index (BMI), ethnicity, drugs and viruses. Obesity has been an epidemic in nearly every country in the world. BMI is the best parameter to assess the magnitude of obesity. Having this background, the present study was designed to investigate the correlation between the levels of serum liver enzymes alanine aminotransferase (ALT), aspartate aminotransferase (AST) and GGT and Asia–Pacific cut-off points of BMI in healthy individuals.MethodsA descriptive cross-sectional study was conducted using 120 Sinhala, Buddhist subjects which belonged to 18–32 years. BMI was calculated according to the standard protocol. The serum ALT and AST concentrations were measured by UV assay according to the IFCC method without pyridoxal phosphate activation, and the serum GGT concentration was measured by UV assay according to Szasz method, using the Mindray BS-240 Full Automatic Biochemistry Analyser.ResultsSerum levels of liver enzymes were significantly higher in males than females. In females, serum levels of ALT (r = 0.312, p < 0.001), AST (r = 0.138, p = 0.071) and GGT (r = 0.212, p = 0.047) positively correlated with BMI. In males too, serum levels of ALT (r = 0.431, p < 0.001), AST (r = 0.324, p = 0.013) and GGT (r = 0.314, p = 0.031) were positively correlated with BMI. The minimum values of serum ALT, AST and GGT levels were observed in underweight group, while the maximum values were observed in obese group in both genders.ConclusionsALT had the strongest correlation with BMI in both females and males. Therefore, ALT can be suggested as the best liver enzyme that can be used in screening purposes by concerning BMI.

Waist-to-height ratio associated cardiometabolic risk phenotype in children with overweight/obesity

BackgroundChildhood overweight/obesity has been associated with an elevated risk of insulin resistance and cardiometabolic disorders. Waist-to-height ratio (WHtR) may be a simple screening tool to quickly identify children at elevated risk for cardiometabolic disorders. The primary objective of the present study was to create sex-specific tertile cut points of WHtR and assess its association with Insulin resistance and elevated liver enzyme concentrations in children, factors using cross-sectional data from the randomized, controlled Family Weight Management Study.MethodsBaseline data from 360 children (7–12 years, mean Body Mass Index (BMI) ≥ 85th percentile for age and sex) were used to calculate WHtR tertiles by sex, male: ≤ 0.55 (T1), > 0.55- ≤ 0.59 (T2), > 0.59 (T3); female: ≤ 0.56 (T1), > 0.56- ≤ 0.6 (T2), > 0.6 (T3). The Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) was used to categorize participants as insulin-resistant (HOMA-IR ≥ 2.6) and insulin-sensitive (HOMA-IR < 2.6). Liver enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were categorized as normal vs. elevated (AST of < 36.0 µkat/L or ≥ 36.0 µkat/L; ALT of < 30.0 µkat/L or ≥ 30.0 µkat/L; ALT > 26 µkat/L males, > 22 µkat/L females). We examined differences in baseline cardiometabolic risk factors by WHtR tertiles and sex-specific multivariable logistic regression models to predict HOMA-IR and elevation of liver enzymes.ResultsStudy participants had a mean WHtR of 0.59 ([SD: 0.06]). Irrespective of sex, children in WHtR T3 had higher BMIz scores, blood pressure, triglycerides, 2-h glucose, fasting 2-h insulin, and lower high-density lipoprotein cholesterol (HDL-C) concentrations than those in T2 and T1. After adjusting for covariates, the odds of elevated HOMA-IR (> 2.6) were over five-fold higher among males in T3 versus T1 [OR, 95%CI: 5.83, 2.34–14.52] and T2 [OR, 95%CI: 4.81, 1.94–11.92] and females in T3 [OR, 95%CI: 5.06, 2.10–12.20] versus T1. The odds of elevated ALT values (≥ 30) were 2.9 [95%CI: 1.01–8.41] fold higher among females in T3 compared to T1.ConclusionIn public health settings, WHtR may be a practical screening tool in pediatric populations to identify children at risk of metabolic syndrome.

Predictive factors to estimate the severity of nonalcoholic fatty liver disease in candidates for Roux-en-Y gastric bypass

ObjectivesNon-alcoholic fatty liver disease (NAFLD) is related to obesity, insulin resistance, dyslipidemia, and metabolic syndrome. The increasing prevalence of NAFLD results in a significant number of patients manifesting chronic liver disease over time. The aim of this study was to analyze the predictive factors to estimate NAFLD severity in patients who are candidates for Roux-en-Y gastric bypass. MethodsThis descriptive observational study was conducted with 136 obese patients who were candidates for Roux-en-Y gastric bypass and had mild, moderate, or severe NAFLD. ResultsSevere NAFLD was more prevalent among the men (P = 0.007), and mild NAFLD was more prevalent among the women (P = 0.007). Hyperferritinemia was observed in the group with severe NAFLD (P = 0.01). Neck circumference and waist-to-height ratio were associated with an increased risk when comparing the groups with mild and severe NAFLD and those with moderate and severe NAFLD (P = 0.023 and P = 0.001, respectively); the alanine aminotransferase (ALT) and aspartate aminotransferase ratio values were >1 (P = 0.002) in the same comparisons. The regression analyses showed that an increase of 1 ng/mL in vitamin D reduced the chances of severe steatosis by 10% (P = 0.043), and an increase of 1 U/L ALT increased the chances of severe steatosis by 13% (P = 0.002). ConclusionHigh neck circumference and low waist-to-height ratio values, male sex, hyperferritinemia, increased serum ALT values, and decreased vitamin D levels were related to the risk for severe NAFLD.

Influence of substituting fishmeal with Vespa orientalis meal in the Nile tilapia (Oreochromis niloticus) diets on growth and feed utilisation

Abstract The impact on growth performance, feed efficiency, and health status of substituting 0, 25, 50, 75, and 100% of fishmeal (FM) with Vespa orientalis meal (WM) in the Nile tilapia diets was examined. Fifteen hapas of randomly selected fingerlings (with a mean weight of 1.1 g ± 0.02) were fed the test meals for 84 days. The findings indicated that the fish development rate was not noticeably affected when FM was partially replaced by up to 50% of WM. The feed conversion ratios of WM25 and WM50 were considerably greater () than those of all other diets. The substitution of FM by WM up to 100% did not significantly alter the values of total protein, globulin, albumin, urea, creatinine, alanine aminotransferase and aspartate aminotransferase (). These results suggest that the Nile tilapia is unaffected by the integration of WM up to 50% instead of FM without adverse effects on growth and nutrient utilisation.

Food Insecurity Is Associated With Chronic Liver Disease Among US Adults.

Food insecurity is associated with many poor health outcomes. Most contemporary liver disease is metabolic and impacted by nutritional status. Data regarding the association between food insecurity and chronic liver disease are limited. We evaluated the linkage between food insecurity and liver stiffness measurements (LSMs), a key measure of liver health. A cross-sectional analysis of 3502 subjects aged 20 years and older from the 2017 to 2018 National Health and Nutrition Examination Survey. Food security was measured using the US Department of Agriculture's Core Food Security Module. Models were adjusted using age, sex, race/ethnicity, education, poverty-income ratio, smoking, physical activity, alcohol intake, sugary beverage intake, Healthy Eating Index-2015 score. All subjects underwent vibration-controlled transient elastography, which provides LSMs (kPa) and a measure of hepatic steatosis (controlled attenuation parameter, dB/m). LSM was stratified: <7, 7 to 9.49, 9.5 to 12.49 (advanced fibrosis), and ≥12.5 (cirrhosis) in the whole-study population and stratified by age (20 to 49y and 50y and older). There were no significant differences in mean controlled attenuation parameter, alanine aminotransferase, or aspartate aminotransferase values by food security status. However, food insecurity was associated with a higher mean LSM (6.89±0.40 kPa vs. 5.77±0.14 kPa, P =0.02) for adults 50 years and older. After multivariate adjustment, food insecurity was associated with higher LSMs across all risk stratifications for adults 50 years and older: LSM≥7 kPa [odds ratio (OR): 2.06, 95% CI, 1.06 to 4.02]; LSM≥9.5 kPa (OR: 2.50, 95% CI, 1.11 to 5.64); LSM≥12.5 kPa (OR: 3.07, 95% CI, 1.21 to 7.80). Food insecurity is associated with liver fibrosis and an increased risk of advanced fibrosis and cirrhosis in older adults.

Hydroxychloroquine Toxicity in the Vital Organs of the Body: In Vivo Study.

Hydroxychloroquine (HCQ) toxicity can adversely affect vital organs, cause pathologic ocular damage, and can have direct cardiovascular effects. This study aims to identify the biochemical, hematological, and histological alterations of the vital organs associated with the effects of HCQ. Male albino rats were exposed to the equivalent of HCQ therapeutic doses given to human patients being affected by malaria, lupus erythematosus, and COVID-19. The animal blood samples were subjected to hematological analysis, biochemical analysis, liver function tests, kidney function tests, and cardiac biomarkers. Liver, kidney, heart, spleen, and testis biopsies were subjected to histological examination. HCQ significantly lowered the values of erythrocytes, hemoglobin, hematocrit, platelets, leucocytes, and lymphocytes but significantly increased the values of aspartate aminotransferase (AST), alanine aminotransferase (ALT), amylase, alkaline phosphatase, lactate dehydrogenase, cholesterol, and chlorine ions. The renal tissues of HCQ-treated animals demonstrated glomerular fragmentation, partial atrophy degeneration, renal tubules hydropic degeneration, hyaline cast formation, and interstitial edema formation. Additionally, the heart exhibited myofiber necrosis, myolysis, wavy appearance, disorganization, and disarray. The testicular tissues also demonstrated spermatocyte degeneration, spermatogenic cell sloughing, testicular interstitial edema, and occasional spermatogenic arrest. Additionally, the spleen showed a decrease in the number and size of the white pulp follicles, a decrease in the number of apoptotic activity, and a decline in the number of T-rich cells. However, the red pulp demonstrated a diffuse decline in B rich-lymphocytes and macrophages. The liver was also the least affected but showed Kupffer cell hyperplasia and occasional hepatocyte dysplasia. The results indicate that chronic exposure to HCQ could alter the structures and functions of the vital organs.

Incidence of hypoxic hepatitis in patients with cardiogenic shock and association with mortality.

Shock of any cause leads to end-organ damage due to ischaemia, especially in perfusion-sensitive organs such as the liver. In septic shock, hypoxic hepatitis (S-HH) is defined as the 20-fold increase of the upper normal limit of aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT) and is associated with a mortality of up to 60%. However, as pathophysiology, dynamics, and treatment differ between septic and cardiogenic shock (CS), the S-HH definition may not be suitable for CS. Therefore, we aim to evaluate if the S-HH definition is applicable in CS patients. This analysis was based on a registry of all-comer CS patients treated between 2009 and 2019 at a tertiary care centre with exclusion of minors and patients without all necessary ASAT and ALAT values. N = 698. During in-hospital follow-up, 386 (55.3%) patients died. The S-HH was not significantly associated with in-hospital mortality in CS patients. To define HH among patients with CS (C-HH), optimal cut-off values were found to be ≥1.34-fold increase for ASAT and ≥1.51-fold increase for ALAT in serial measurements. The incidence of C-HH was 254/698 patients (36%) and C-HH showed a strong association with in-hospital mortality (odds ratio 2.36, 95% confidence interval: 1.61, 3.49). The C-HH is a frequent and relevant comorbidity in patients with CS, although its definition varies from the established definition of HH in patients with septic shock. As C-HH contributed to excess mortality risk, these findings emphasize the need for further investigation of therapies reducing the occurrence of C-HH and also improving the associated outcome.

Evaluation of the effects of radiation doses from computed tomography on the biochemical parameters of the hepatorenal organs of albino rats

Background Aims: Computed tomography (CT) uses X-rays which are ionizing radiation. Interaction of ionizing radiation with the body may result in harmful effects on the organism depending on the radiation dose. This study aimed to evaluate the impact of different doses of CT radiation on the hepatorenal organs of male albino rats using biochemical parameters as the pathological response of the organs to radiation. Materials and Methods: Thirty healthy male Wistar albino rats weighing 180–200 g were assigned into five groups of six rats each. Rats in groups B, C, D, and E underwent noncontrast helical total body CT irradiation and received varying doses of CT radiation while group A received sham irradiation and served as control. At 72 h postirradiation, blood was collected using conventional methods, and serum was harvested for the determination of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total bilirubin (TB), total protein (TP), albumin (Alb), urea, uric acid, and creatinine. Results: The mean serum levels of TP in the control (group A) and in the irradiated groups B, C, D, and E were 8.21 ± 0.34, 6.08 ± 0.30, 5.86 ± 0.42, 5.22 ± 0.30, and 4.72 ± 0.16, respectively. The mean values of TP in the irradiated groups decreased significantly in a dose-dependent manner compared to the control. The mean serum levels of ALP in the group A and in the irradiated groups B, C, D, and E were 75.20 ± 3.14, 111.60 ± 1.60, 117.60 ± 1.12, 124.40 ± 2.48, and 133.60 ± 2.46, respectively. The mean serum levels of AST in the group A and in the irradiated groups B, C, D, and E were 33.80 ± 0.58, 54.40 ± 2.29, 52.60 ± 1.78, 58.60 ± 2.64, and 63.60 ± 0.81, respectively. The mean serum levels of ALT in the group A and in the irradiated groups B, C, D, and E were 21.20 ± 0.86, 36.00 ± 0.84, 40.40 ± 1.17, 37.40 ± 0.93, and 41.60 ± 1.03, respectively. The mean serum levels of TB in the group A and in the irradiated groups B, C, D, and E were 2.78 ± 0.28, 3.70 ± 0.18, 4.77 ± 0.40, 5.88 ± 0.11, and 6.34 ± 0.04, respectively. The mean serum levels of Alb in the group A and in the irradiated groups B, C, D, and E were 3.68 ± 0.16, 5.96 ± 0.21, 6.65 ± 0.26, 8.15 ± 0.23, and 8.91 ± 0.17, respectively. The mean serum levels of urea in the group A and in the irradiated groups B, C, D, and E were 42.40 ± 0.17, 54.40 ± 1.33, 56.00 ± 1.76, 54.60 ± 1.72, and 57.80 ± 1.39, respectively. The mean serum levels of uric acid in the group A and in the irradiated groups B, C, D, and E were 5.65 ± 0.36, 8.32 ± 0.46, 8.87 ± 1.11, 9.13 ± 0.29, and 9.91 ± 0.29, respectively. The mean serum levels of creatinine in the group A and in the irradiated groups B, C, D, and E were 2.05 ± 0.13, 4.44 ± 0.32, 5.81 ± 1.17, 6.31 ± 0.03, and 6.63 ± 0.40, respectively. The mean values of ALP, AST, ALT, TB, Alb, urea, uric acid, and creatinine increased significantly in the irradiated groups compared to the control group. Conclusion: From the lowest to the highest doses of CT irradiation in the study, alterations in the biochemical parameters were evident and significant. Moreover, this suggests a possible deleterious biological effect of CT radiation on the hepatorenal organs probably due to the effects of radiation-induced free radicals which adversely affected the hepatorenal organs.

1113-P: Alanine Aminotransferase Elevation in Youth-Onset Type 2 Diabetes—Prevalence and Risk Factors

Purpose: Fatty liver and Type 2 Diabetes (T2D) are components of insulin resistance, but the prevalence of fatty liver disease at diagnosis of youth onset T2D is unknown. Fatty liver disease is typically identified initially by elevated alanine aminotransferase (ALT). We aim to describe the prevalence of ALT elevation in youth onset T2D at diagnosis and associated risk factors. Methods: We conducted a single center retrospective review of patients (age≤21) diagnosed with T2D (5/1/2015-12/31/21). Chi-squared and two sample t-tests were used to compare those with ALT values in the highest and lowest quartiles at diagnosis for categorical and linear variables. Results: Analysis included 455 patients. ALT was elevated at diagnosis and varied widely (mean=70.4 IU/L, standard deviation=76.0 IU/L). At diagnosis 48% of patients had ALT ≥45 IU/L and 14% had ALT ≥135 IU/L. Compared to those with ALT values in the lowest quartile, those in the highest quartile were more likely to be male (p=0.0001), Hispanic (p&amp;lt;0.00001), have a lower HgbA1C (8.9% vs 9.8%, p=0.001), and not identify as Black (p&amp;lt;0.00001). There was no difference in BMI Z-score. A follow-up ALT (6-18 months later) was available in 49% of patients: 37% had ALT≥45 IU/L and 7% had ALT≥135 IU/L (Figure 1). Conclusions: Elevation of ALT is common at diagnosis of youth onset T2D, but often improves. Those with elevated ALT tend to have a lower HgbA1C and a similar BMI. Disclosure S.E.Delacey: None. S.Feng: None. A.Ranganna: None. M.Fishbein: None. M.E.Bianco: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (T32DK007169)

1342-P: Are Plasma Aminotransferases of Value in Screening Patients with T2DM for NAFLD or Fibrosis?

The ADA recommends to screen for NASH and liver fibrosis individuals with type 2 diabetes (T2DM), obesity (OB) and/or elevated alanine aminotransferase (ALT). However, recent studies have questioned the clinical value of measuring ALT and AST for the detection of patients at risk of nonalcoholic fatty liver disease (NAFLD) or advanced liver fibrosis or cirrhosis. The aim of this study was to assess the clinical value of ALT and AST ≥40 IU/L, or their lower cut-offs ≥30 IU/L as recommended by recent AACE guidelines, to screen populations at risk. To this end, we recruited 714 participants (age: 56 ± 11 years, male: 42%; BMI: 30.8 ± 6.5 kg/m2; T2DM: 35%; A1c: 6.0 ± 1.2%) from primary care or endocrinology clinics, unaware of having NAFLD/fibrosis. Screening for NAFLD included laboratory tests and imaging with elastography (steatosis by controlled attenuation parameter [CAP]; fibrosis by liver stiffness measurement [LSM]). Elevated transaminases were more common in patients with vs. without T2DM, with ALT ≥40 IU/L occurring in 13% vs. 8% and AST in 9% vs. 3% of patients (both p&amp;lt;0.05). If using a cutoff of ≥30 IU/L: 25% vs. 18% and 20% vs. 13%; respectively (both p&amp;lt;0.05). Elevated ALT ≥30 IU/L was the highest in patients with T2DM and OB (n=164) vs. controls (without T2DM or OB; n=269; 27% vs 15%; p=0.02). The sensitivity for diagnosing steatosis by ALT or AST was very low, with ALT and AST ≥40 IU/L present in only 16% and 9%, respectively. However, steatosis by imaging (CAP) was often present if ALT or AST were high (81 and 90%, respectively). An ALT ≥40 IU/L was also not useful for diagnosing patients with fibrosis of any stage (LSM ≥7.0), missing the diagnosis in 63% of patients, and this did not improve when examining only those with more advanced fibrosis (≥F3) being elevated in only 40%. Conclusions: Plasma aminotransferases are of limited diagnostic value when screening patients with T2DM for NAFLD or fibrosis. This supports the ADA recent guidelines for using FIB-4 and additional noninvasive testing for screening. Disclosure A. Ortiz Rocha: None. E. Godinez Leiva: None. S. Kalavalapalli: None. R. Lomonaco: None. S.S. Shetty: None. S.A. Marangi: None. E. Valdez Saenz: None. S. Shrestha: None. M.A. Gonzalez: None. X. Chi: None. M.J. Gurka: None. D. Barb: None. K. Cusi: Research Support; Echosens, Inventiva. Consultant; Poxel SA. Research Support; LabCorp, Zydus. Consultant; Altimmune, Arrowhead Pharmaceuticals, Inc., AstraZeneca, 89bio, Inc., Bristol-Myers Squibb Company, Lilly, Madrigal Pharmaceuticals, Inc., Merck &amp; Co., Inc., Medscape, Myovant, Novo Nordisk, ProSciento, Quest Diagnostics, Sagimet, Sonic Incytes, Terns. Funding National Institutes of Health (R01120331-01A1)

Epstein Barr Virus Hepatitis-A Mild Clinical Symptom or a Threat?

The present study aimed to characterize pediatric patients diagnosed with hepatitis associated with primary Epstein-Barr Virus (EBV) infection. We described the changes in liver aminotransferases activity during the disease, and we analyzed the results of abdominal ultrasonography. A retrospective study was performed by analyzing the medical records of 166 immunocompetent children diagnosed with primary EBV hepatitis hospitalized at the Department of Children's Infectious Diseases, Medical University of Warsaw, Regional Hospital of Infectious Diseases in Warsaw, between August 2017 and March 2023. Elevated alanine aminotransferase (ALT) activity was noted in the first three weeks of the disease. In 46.3% of patients, ALT values exceeded five times the upper limit of the laboratory norm in the first week of illness. Aspartate aminotransferase activity increased from the first to fourth week from the onset of symptoms and showed two peaks in the first and third weeks. The changes over time of mean AST activity demonstrated significance. Transient cholestatic liver disease was the predominant type of hepatic involvement in 10.8% of children; 66.6% of them were older than 15 years. Clinical and ultrasound criteria of acute acalculous cholecystitis (AAC) were met in three female patients over 16 years of age. Hepatitis associated with primary EBV infection is usually a mild and self-limiting condition. Significantly elevated values of liver enzymes with features of cholestatic liver disease may occur in patients with a more severe course of the infection.

Parenteral Nutrition, Sepsis, Acute Heart Failure and Hepatotoxic Drugs Are Related to Liver Test Disturbances in Critically Ill Patients.

Parenteral nutrition (PN) is often associated with liver dysfunction in the ICU, although other factors such as sepsis, acute heart failure (AHF), and hepatotoxic drugs can be equally present. The relative impact of PN on liver dysfunction in critically ill patients is largely unknown. We recorded the presence of pre-existing liver disturbances, AHF, sepsis, daily PN volume, and commonly used hepatotoxic drugs in adult ICU patients, together with daily aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), alkalic phosphatase (AP), total bilirubin (TB), and INR values in patients with three or more PN treatment days. A linear mixed-effects model was used to assess the relative contribution of each liver parameter. Nutritional adequacy was defined as intake/needs. We included 224 ICU patients with PN treatment lasting more than 3 days between 1 January 2017 and 31 December 2019. For AST, pre-existing liver disturbances (+180% ± 11%) and the presence of AHF (+75% ± 14%) were the main predictors of deterioration, whereas PN volume caused only a limited increase of 14% ± 1%/L. Similar results were observed for ALT. GGT, INR, and TB are mainly influenced by the presence of sepsis/septic shock and pre-existing liver disturbances, with no impact of PN or hepatotoxic drugs. Carbohydrate intake exceeded recommendations, and protein and lipid intake were insufficient in this study cohort. Liver test disturbances in ICU patients on PN are multifactorial, with sepsis and AHF having the highest influence, with only limited impact from PN and hepatotoxic drugs. Feeding adequacy can be improved.