Liver Enzymes In Patients Research Articles

Correlation of Liver Fibroscan Results with Liver Elastographyand Liver Enzymes in Patients with Fatty Liver

Background: Accurate diagnosis of fatty liver is crucial for prognosis and treatment planning. Objectives: This study aimed to correlate liver fibroscan results with shear wave elastography and liver enzyme levels in fatty liver patients. Methods: In a cross-sectional study, 80 fatty liver patients from Shahid Motahari Clinic in Shiraz was examined over six months. Diagnoses were made using fibroscan (Echosense 500) and CAP scores, while the Hepatorenal Index was measured with shear wave elastography (Sypersonic, Aixplorer elit). Previous sonography reports were collected for correlation. Results: Patients’ average age was 50.91 years so that 45% were men, and 55% were women. About 78.8% diagnosed with fatty liver by ultrasound were also diagnosed by elastography (true positive). A weak, non-significant positive correlation was observed between the Ratio and CAP score (r = 0.18, P = 0.87). ALT predicted fatty liver by elastography with 83.6% sensitivity and 64.7% specificity. Few studies in Iran have explored elastography and fibroscan correlation in fatty liver. Conclusions: Shear wave elastography is a valuable non-invasive technique for predicting fatty liver.

Role of liver enzymes in patients with blunt trauma to liver on conservative management

Background: When blunt abdominal trauma occurs, the liver is the organ most often affected. The liver enzymes are often elevated in blunt trauma to the liver. However, the variation of liver enzymes among various grades of liver injury is not clear. The aim of our investigation is to determine the variation of liver enzymes across various grades of liver injury as well as whether it affects any change in management including surgical intervention. Methods: Our research was a prospective observational study. Patients of blunt abdominal trauma having a liver damage which was detected on a contrast CT scan and managed conservatively were included. They were categorized as per the AAST (American Association for the Surgery of Trauma) system. Various biochemical markers including liver enzymes were compared between the groups. Any change in management or need for intervention was found out. Results: A total of 35 patients has been included. Ages between 31 and 40 accounted for the majority of cases (34.3%). Our study showed male preponderance (85.7%). Most patients presented to the hospital within 24 hours of trauma (82.9%). Most of our patients had blood transfusions during their hospital stay (71.4%). AAST grade III injury was predominant (48.6%). Subgroup analysis between minor and major liver injury patients was done. No significant distinction was seen among the two groups concerning the assessed biochemical parameters. No significant variation was observed regarding the necessity for intervention. Conclusions: Liver enzymes can not be used to differentiate among various grades of liver injury. Patients who are managed conservatively can be managed so with close monitoring and supportive treatment without the need for any intervention. However, larger and randomized studies are needed to validate the results.

The Impact of Probiotic Supplementation on Liver Enzymes in Patients with Non-Alcoholic Fatty Liver Disease Attending the Family Medicine Clinic at Ain Shams University Hospitals

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is a condition marked by the accumulation of fat (more than 5% of liver tissue) without the presence of alcohol abuse or other chronic liver ailments. NAFLD can lead to liver inflammation and advance to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and, in severe cases, may contribute to the development of hepatocellular carcinoma (HCC) Objective To assess the impact of probiotic supplementation, specifically lactobacillus, on liver enzymes (ALT & AST). Patients and Methods This study involved 50 participants (15 males and 35 females) with a body mass index equal to or greater than 25 and an age range of 18-60 years, all exhibiting evidence of bright fatty liver in ultrasonography. Exclusion criteria comprised any signs of other chronic liver diseases, including viral hepatitis (B and C), autoimmune hepatitis, a history of alcohol consumption, diabetes mellitus (DM), statin therapy for cardiovascular disease (CVD), recent surgery, gastroenteritis, or diarrhea in the last 2 weeks. The participants were divided into two groups: a probiotic group consisting of 25 patients who received daily probiotics for 12 weeks along with diet and lifestyle modifications, and a standard treatment group of 25 patients who underwent diet and lifestyle modifications only. The study involved clinical assessments, laboratory evaluations, and abdominal ultrasound for all participants. Results The average age of the entire study sample was 46.48. No statistically significant differences were observed between the standard treatment group and the probiotic- treated group with respect to smoking, weight, and BMI. The probiotic-treated group exhibited a significant reduction in ALT and AST (P values 0.014 and 0.004, respectively), while the standard treatment group showed a smaller decrease in AST only (P value 0.025). Conclusion The findings of the present study indicate that short-term treatment with the probiotic resulted in improvements in ALT and AST levels in the probiotic group

S1495 Elevation of Liver Enzymes In Patients With Inflammatory Bowel Disease Treated With Upadacitinib Is Associated With Metabolic Risk Factors

S1495 Elevation of Liver Enzymes In Patients With Inflammatory Bowel Disease Treated With Upadacitinib Is Associated With Metabolic Risk Factors

Iron overload and liver function in patients with beta thalassemia major: A cross sectional study.

In thalassemia major, repeated blood transfusions result in iron overload causing organ damage. The objective of this study was assessment of liver enzymes in patients with Thalassemia major and to observe their association with ferritin. A cross-sectional study was performed, at Islamabad Medical and Dental College and its affiliated Akbar Niazi Teaching Hospital from November 2021 till August 2022. Serum ferritin, AST, ALT, and total bilirubin levels were determined, in 135 patients of beta thalassemia major receiving transfusions. Data analysis was performed using SPSS Version 20. For categorical variables, calculation of frequencies and percentages was performed. Mean (± standard deviation) was determined for quantitative variables. ANOVA with post hoc Tukey's test was used for determining association between liver enzymes and serum ferritin. A p-value of <0.05 was considered significant. The correlation between ferritin and LFTs was determined by Pearson's correlation coefficient. Patients had an age range of 7-30 years, and males constituted 51% of sample. Mean level of ferritin was 6062.61 + 3641.79 ng/ml, with an insignificant difference between the genders (p =0.366). The levels of AST, ALT and bilirubin were perceived to show a significant increase in patients with ferritin levels >5000ng/ml, when compared with patients having ferritin levels < 2,500 ng/ml. A significant positive correlation of increasing serum ferritin levels was observed with ALT (r= 0.682), to a lesser extent with AST (r = 0.532), and only a weak correlation with serum bilirubin (r = 0.350). Liver damage was caused by increased iron deposition. LFTs should be performed regularly to detect and reduce liver damage by increasing chelation therapy, thereby reducing morbidity and mortality due to thalassemia.

Incidence of Elevated Liver Enzyme Levels in Patients Receiving Remdesivir and Its Effective Factors.

Emergency use of remdesivir was approved for COVID-19 in some countries. Based on the promising results of remdesivir, the most common side effects were nausea, worsening respiratory failure, increased alanine aminotransferase levels, and constipation. The aim of this study was to determine the incidence of elevated liver enzymes in patients with COVID-19 receiving remdesivir. In this retrospective study, information was collected from patients' files. The study population included patients with moderate to severe COVID-19 who were admitted to Rouhani Babol Hospital. For daily patient selection, the list of patients was extracted from the system, and based on the census, the patient file was selected. Data were analyzed using Stata 16. 620 patients suffering from moderate to severe COVID-19 were included in this study, 43% of whom were men. Of these patients, 120 were selected as the control group who did not receive remdesivir. The increase in liver enzymes in patients receiving remdesivir compared with the control, for alanine transaminase (ALT) and aspartate transaminase (AST), respectively, was 6.20 and 3.64 times, but it was not statistically significant for alkaline phosphatase (ALP). Also, the increase in bilirubin levels in patients receiving remdesivir was not statistically significant. The recipients of remdesivir had high liver enzymes, which is one of the possible side effects of this drug. The intensity of the enzymes was mild and moderate, and they were not dangerous to the health of any of the consumers. Deaths in patients with COVID-19 were not due to drug-induced liver complications but to other factors such as disease-related complications.

The Effect of Hospital-Based Liquid Diet and Commercial Formulas on Laboratory Parameters and Postoperative Complications in Patients with Head and Neck Cancer.

Background: Patients with head and neck cancer (HNC) are at high risk of malnutrition. The aim of this study was to compare the effect of polymeric formulas available commercially and a high-protein liquid diet prepared in the hospital on laboratory parameters and postoperative complications in patients undergoing surgery for HNC. Methods: This single-center retrospective study included 149 patients who underwent surgery for HNC between 2008 and 2017. The following data were collected: patient and tumor characteristics, postoperative complications, and laboratory parameters measured at baseline and after surgery, including creatinine, alanine transaminase (ALT), aspartate transaminase (AST), and blood glucose levels. Correlations between the duration of enteral nutrition and blood parameters were assessed. Results: After surgery, patients receiving commercial formulas had lower creatinine and blood glucose levels and higher ALT and ASP levels than those on the hospital-based diet. The longer duration of feeding with commercial formulas before surgery was associated with enhanced preoperative levels of ALT and ASP and with lower postoperative blood glucose. Patients on the hospital-based diet had a higher rate of postoperative complications than those receiving commercial formulas (16.1% vs. 3.3%). Conclusions: There were no clinically important differences in blood parameters among patients with HNC depending on the type of preparations used for enteral feeding. However, increased levels of liver enzymes in patients fed with commercial formulas were notable. The early initiation of enteral nutrition before surgery helped achieve normal blood glucose levels after surgery. The use of commercial preparations contributed to reducing the number and incidence of postoperative complications.

Effects of Resveratrol on Liver Function Tests in Patients with Non-Alcoholic Fatty Liver Disease: a Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background. Some studies have shown that resveratrol may prevent, delay, or treat liver damage. This study aimed to provide up-to-date evidence regarding the effect of resveratrol on the liver enzymes (ALT &amp; AST) in NAFLD patients. We conducted a systematic review and meta-analysis to evaluate the effect of resveratrol on liver enzymes in patients with NAFLD by searching various databases for published RCTs.Methods. A systematic search in PubMed, Scopus, and Web of Science was performed up to September 2023. This systematic review and meta-analysis included all the RCT studies assessing resveratrol supplements on serum AST and/or ALT in NAFLD patients. The effect was presented as a mean difference and 95 % confidence interval (CI) in a random-effects model.Results. Finally, six eligible randomized controlled trials consisting of 256 patients were found. Resveratrol had no significant effect on serum ALT (Mean diff = 3.30 IU/L; 95 % CI: –2.34, 8.94; p = 0.25) and AST (Mean diff = 0.07 IU/L; 95 % CI: –2.96, 3.10; p = 0.96) concentrations. Moreover, subgroup analysis revealed that neither resveratrol dose nor intervention duration had any significant effect on the serum ALT and AST levels.Conclusion. The current evidence shows that resveratrol supplementation did not affect liver enzymes in NAFLD patients.

Effect of statin use on liver enzymes and lipid profile in patients with non-alcoholic fatty liver disease (NAFLD)

Non-alcoholic fatty liver disease (NAFLD) is an independent risk factor for cardiovascular disease (CVD). Statins are recommended for treatment of dyslipidemia to reduce the overall cardiovascular risk in patients with NAFLD. However, statin treatment was underutilized and the effect of statins on liver enzymes remained unclear in this patient population. This study aimed to provide real-world evidence of the safety and effect of statin use in patients with NAFLD. We conducted a cross-sectional survey study of adults with NAFLD using pooled data from the US NHANES database 2009-2018. NAFLD was defined by Fatty Liver Index (FLI) ≥ 60 and United States Fatty Liver Index (USFLI) ≥ 30. Multivariate regression analyses adjusted for baseline clinical and demographic characteristics were performed to compare the liver enzymes and lipid profile between statin and non-statin users. The study included 2,533 adults with NAFLD, representing 22.6 million individuals in the US, with 27% receiving statin treatment between 2009 and 2018. The mean differences of liver enzymes for AST, ALT, ALP, and GGT between statin and non-statin users were -0.86 (p=0.539), -3.49 (p=0.042), -0.25 (p=0.913), and 0.57 (p=0.901), respectively. In individuals with NAFLD and dyslipidemia, total cholesterol and LDL levels were significantly lower in statin users compared to non-statin users (mean difference, -28.9; p<0.001 and -27.7; p<0.001). The use of statins was not associated with elevated liver enzymes in patients with NAFLD. Significantly lower levels of ALT, total cholesterol, and LDL were observed in statin users compared to non-statin users.

Levels of Liver Enzymes in Patients with Hydatid Disease

Levels of Liver Enzymes in Patients with Hydatid Disease

Liver enzymes as a predictor of mortality in patients with COVID-19? A cross-sectional study

Liver injury in patients with COVID-19 infection may directly result from viral infection of liver cells, immune-mediated inflammation such as cytokine storm, and hypoxia resulting from pneumonia. Additionally, liver injury may occur due to drug toxicity and may lead to liver failure in critically ill COVID-19 patients. Given the significance of the liver and its vulnerability in COVID-19 patients, this study aimed to investigate the correlation of serum liver enzymes with the prognosis of hospitalized COVID-19 patients at Imam Khomeini Hospital in Urmia. This descriptive-analytical study involved hospitalized COVID-19 patients at Imam Khomeini Hospital in Urmia. Patient data were extracted from medical records and recorded in checklists, including demographic characteristics (age and gender), serum levels of Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST), and patient outcomes (recovery and mortality). Subsequently, the serum levels of AST and ALT in recovered and discharged patients were compared with those of deceased patients. The mean AST level was higher in deceased patients compared to recovered and discharged patients, and this difference was statistically significant (P <0.033). Therefore, overall, higher AST levels in COVID-19 patients may indicate a worse prognosis. Similarly, the mean ALT level was higher in deceased patients compared to recovered and discharged patients, and this difference was statistically significant (P <0.015). Thus, higher ALT levels in COVID-19 patients may generally indicate a worse prognosis. Continuous monitoring of liver enzymes in patients with a poor prognosis can lead to early identification and, to the extent possible, prevention of complications and mortality through enhanced care.

Curcumin supplementation effect on liver enzymes in patients with nonalcoholic fatty liver disease: a GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials.

Clinical evidence from investigations of the effects of curcumin on liver enzymes in patients with nonalcoholic fatty liver disease (NAFLD) have led to inconsistent results. The aim of this systematic review and meta-analysis was to investigate the overall effects of curcumin and curcumin plus piperine supplementation on liver enzymes such as alanine aminotransferase (ALT), alkaline phosphatase (ALP), and aspartate aminotransferase (AST) in patients with NAFLD. The Scopus, Web of Science, PubMed, and Cochrane Library databases were searched from inception through July 2023, using search terms representing NAFLD and liver enzymes. Articles were screened independently by 2 researchers based on PICOS inclusion criteria. The following data were extracted: first author's name, study location, year of publication, mean age, study duration, study design, participants' sex, number of participants in each group, dose of curcumin supplementation, and ALT, ALP, and AST concentrations. Risk of bias was assessed using the Cochrane Collaboration's modified risk-of-bias tool. Fixed- or random-effects meta-analysis was performed to estimate the effects of curcumin on liver enzymes, considering heterogeneity across studies. The I2 and Cochran's Q tests were used to assess heterogeneity between studies. Overall, 15 randomized controlled trials comprising 905 participants were eligible for this meta-analysis. Curcumin supplementation significantly reduced ALT (weighted mean difference [WMD], -4.10, 95%CI, -7.16 to -1.04) and AST (WMD, -3.27; 95%CI, -5.16 to -1.39), but not ALP (WMD, -0.49; 95%CI, -1.79 to 0.82). Curcumin plus piperine supplementation had no significant effect on ALT (WMD, -3.79; 95%CI, -13.30 to 5.72), and AST (WMD, -1.1; 95%CI, -3.32 to 1.09). Curcumin supplementation improved AST and ALT levels compared with the control group. However, better-designed randomized controlled trials with larger sample sizes and of higher quality are needed to assess the effects of curcumin on ALP. PROSPERO registration no. CRD42023448231.

The Effects of Lycopene on Modulating Oxidative Stress and Liver Enzymes Levels in Metabolic Syndrome Patients: A Randomised Clinical Trial.

The pathogenesis of metabolic syndrome (MetS) complications involves the excessive production of<br />reactive oxygen species, inflammation, and endothelial dysfunction. Due to Lycopene, a highly unstable structure and<br />its significant effects on modulating the metabolic system, there is a strong need for a formula that can increase its<br />stability. The aim of this study was to develop an approach for encapsulating Lycopene and investigate its effects on<br />inflammatory markers, oxidative stress, and liver enzymes in patients with MetS.<br />Materials and Methods: This study is a simple randomized, double-blind, objective-based clinical trial that involved<br />eighty subjects with MetS, who were equally and randomly assigned to two groups: one group received 20 mg of<br />Lycopene per day for 8 weeks, and the Placebo group followed the same protocol as the Lycopene group but received<br />a placebo instead of Lycopene. They were called Lycopene and placebo, respectively. During follow-up visits after 4<br />and 8 weeks, 20 ml of blood was collected for evaluation of liver enzymes and some inflammatory related markers.<br />Results: Prior to the assignment of volunteers to their respective groups, there were no notable differences in C-reactive<br />protein (CRP), serum liver enzymes, systolic and diastolic blood pressure, or pro-oxidant-antioxidant balance (PAB)<br />between the Lycopene and placebo groups. However, our subsequent analysis revealed a significant reduction in the<br />serum levels of CRP (P=0.001) and PAB (P=0.004) in the group that received Lycopene. Our encapsulated Lycopene<br />treatment was not associated with a significant difference in serum levels of alanine aminotransferase (ALT), aspartate<br />transferase (AST), or alkaline phosphatase (ALP) between our two groups.<br />Conclusion: This study investigated the impact of Lycopene on individuals with MetS, revealing a noteworthy<br />modulation effect on PAB and inflammation linked to MetS. However, no significant differences was demonstrated in<br />serum levels of ALT, AST and ALP between the studied group (registration number: IRCT20130507013263N3).

Evaluating of some heart and liver enzymes in patients with myocardial infarction in Wasit.

The aim of the study was to evaluate some heart and liver enzymes in patients with myocardial infarction in Wasit . Myocardial infarction (MI) is a major cause of death and disability worldwideA heart attack, also known as myocardial infarction, occurs when blood flow to a section of the heart is cut off, resulting in the death of heart cells. This usually happens when a coronary artery becomes blocked due to the rupture of a vulnerable plaque made up of cholesterol, fatty acids, and white blood cells. The study took place in the cardiac resuscitation unit at Al-Zahra Teaching Hospital and Al-Karama Teaching Hospital in Wasit Governorate from November 2022 to January 2023. Its objective was to examine the significance of physiological, immunological indicators, and inflammatory biomarkers for accurately diagnosing, assessing risk, and predicting the future outcomes of patients with acute myocardial infarction. The study included 100 patients with acute myocardial infarction, including 71 men aged30-70 years, and 29 women aged 33-75 years. And 50 samples from the control, 28 samples from men and 22 samples from women, and they were divided into three age groups. The first group is 30-45 years old, the second group is 46-60 years old, and the third group is 61-75 years old. Taking into account the risk factors for acute myocardial infarction, which include Sex, age, high blood pressure, diabetes, smoking, and dyslexia. Lipid lipids through a questionnaire. The results of our study with regard to the diagnostic signs of myocardial infarction revealed a significant increase in troponin, myoglobin, and H-FABP, and a significant decrease in Creatine kinase. This study also indicated, regarding the results of liver enzymes, a significant increase in both AST and ALT at p≤ 0.5. Conclusions: In patients with AMI, The plasma level of significant increase in troponin, myoglobin, and H-FABP, and a significant decrease in Creatine kinase AST and ALT at p≤ 0.5.

The effects of curcumin on hepatic T2*MRI and liver enzymes in patients with β-thalassemia major: a double-blind randomized controlled clinical trial.

Background: Curcumin present in turmeric has been considered due to its cancer-preventive features, antioxidant and anti-inflammatory properties. This double-blind, randomized, controlled clinical trial with a reasonable sample size and longer intervention period was conducted to investigate how oral curcumin affected cardiac and hepatic T2*MRI and liver enzymes in patients with β-thalassemia major. Method: This clinical trial study was conducted on 171 patients over 5 years old. The subjects were randomly divided into a curcumin-treatment group and a placebo group to receive either curcumin capsules twice daily or placebo for 6 months. Patients were examined once a month for 6 months to receive capsules and measure the levels of alanine aminotransferase (ALT), aspartate transferase (AST), alkaline phosphatase (ALP), direct and total bilirubin, ferritin and cardiac and hepatic T2*MRI. Result: There was a significant decrease in levels of AST, ALT, ALP, and bilirubin (direct and total) in the curcumin group compared with the placebo group by the end of the study (p < 0.05). The levels of serum ferritin remained unchanged in both groups at the end of the follow-up period (p > 0.05). No significant differences were observed between the curcumin and placebo groups at baseline values or at the end of the study of cardiac and hepatic T2*MRI and serum magnesium. Conclusion: Administration of curcumin has some beneficial effects on liver function by reducing liver enzymes in patients with beta-thalassemia major.

Evaluation of renal markers and liver enzymes in patients infected with the Chikungunya virus.

Chikungunya virus (CHIKV) is an arbovirus (Togaviridae family, Alphavirus genus) that was first identified in 1953 in Tanzania. In 2014, the Asian and East/Central/South/African (ECSA) genotypes were identified in Brazil, although the genotype that spread the most in the following years across the Brazilian territory was the ECSA. The clinical symptoms associated with the infection caused by CHIKV include mainly fever, myalgia, headache, and arthralgia. In infections caused by other arboviruses (such as the ones caused by Dengue and West Nile viruses), changes in biochemical markers are often observed. This study aims to evaluate the biochemical markers profile of kidney and liver injury in acute patients infected with CHIKV. Two groups of correlations were found between the variables analyzed, namely, one between liver enzymes (r = 0.91), and another for kidney markers (r = 0.54-0.66). A significant elevation in the percentage of altered creatinine in CHIKV-infected patients was observed, followed by uric acid and AST. Altogether, in 8 different comparisons, it was possible to observe statistically significant differences between the levels of the markers when compared to the manifestation of symptoms (presence and absence). These noticeable changes in marker measurements could potentially be connected to the range of clinical symptoms seen in the disease.

Lymphocyte-related ratios, systemic immune-inflammatory and systemic inflammatory response index in alcohol use disorder

ABSTRACT Addictive disorders are associated with systemic and central nervous system inflammation, which may be important for the onset and development of these diseases. Although lymphocyte-related parameters have recently been studied in alcohol use disorder (AUD), systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) haven’t. Lymphocyte-related ratios, SII and SIRI levels were evaluated between AUD and healthy controls (HC) in this study. It was a retrospective and cross-sectional study. This study included 72 patients with AUD and 184 individuals in the HC group. Lymphocyte related ratios such as neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR) and platelet to lymphocyte ratio (PLR), SII and SIRI values were compared. Compared to HC group, NLR (p < 0.001), MLR (p < 0.001), and SIRI (p < 0.001) levels were significantly higher in AUD group. There was also a significant relationship between NLR and AST/ALT ratio in the AUD group (p = 0.022). The results of this study support that AUD is a chronic inflammatory psychiatric disorder. In addition, it may be useful to evaluate these markers in relation to liver enzymes in patients with AUD, as alcohol consumption causes liver damage. These markers may also be used in future studies to assess treatment response and disease severity.

Practical approach to abnormal liver enzymes in patients with inflammatory bowel disease

Inflammatory Bowel Diseases (IBD) are chronic inflammatory conditions that can impact organ systems beyond the gastrointestinal tract. Extraintestinal manifestations (EIMs) of IBDs are common and can occur at any stage of the disease. While EIMS most commonly involve the musculoskeletal system, up to 35% of individuals with IBD exhibit hepatobiliary involvement at some point during the course of their disease, often independently of disease activity. Chronic hepatobiliary diseases are noted in 5% of patients with IBD. These diseases manifest with indicative symptoms, abnormal liver biochemistry tests, or radiological abnormalities. This review provides a comprehensive outline and approach to abnormal liver enzymes in individuals with IBD.

The impact of gut microbiome-targeted therapy on liver enzymes in patients with nonalcoholic fatty liver disease: an umbrella meta-analysis.

Nonalcoholic fatty liver disease (NAFLD) is considered the leading cause of chronic liver disease worldwide. To date, no confirmed medication is available for the treatment of NAFLD. Previous studies showed the promising effects of gut microbiome-targeted therapies; however, the results were controversial and the strength of the evidence and their clinical significance remained unclear. This umbrella study summarizes the results of meta-analyses investigating the effects of probiotics, prebiotics, and synbiotics on liver enzymes in the NAFLD population. A comprehensive search of the PubMed, Scopus, Web of Science, and Cochrane Library databases was done up to December 20, 2022, to find meta-analyses on randomized control trials reporting the effects of gut microbial therapy on patients with NAFLD. Two independent investigators extracted data on the characteristics of meta-analyses, and any discrepancies were resolved by a third researcher. The AMSTAR2 checklist was used for evaluating the quality of studies. A final total of 15 studies were included in the analysis. Results showed that microbiome-targeted therapies could significantly reduce levels of alanine aminotransferase (ALT; effect size [ES], -10.21; 95% confidence interval [CI], -13.29, -7.14; P < 0.001), aspartate aminotransferase (AST; ES, -8.86; 95%CI, -11.39, -6.32; P < 0.001), and γ-glutamyltransferase (ES, -5.56; 95%CI, -7.92, -3.31; P < 0.001) in patients with NAFLD. Results of subgroup analysis based on intervention showed probiotics could significantly reduce levels of AST (ES, -8.69; 95%CI, -11.01, -6.37; P < 0.001) and ALT (ES, -9.82; 95%CI, -11.59, -8.05; P < 0.001). Synbiotics could significantly reduce levels of AST (ES, -11.40; 95%CI, -13.91, -8.88; P < 0.001) and ALT (ES, -11.87; 95%CI, -13.80, -9.95; P < 0.001). Prebiotics had no significant effects on AST and ALT levels (ES, -2.96; 95%CI, -8.12, 2.18, P = 0.259; and ES, -4.69; 95%CI, -13.53, 4.15, P = 0.299, respectively). Gut microbiome-targeted therapies could be a promising therapeutic approach in the improvement of hepatic damage in patients with NAFLD. However, more studies are needed to better determine the best bacterial strains, duration of treatment, and optimum dosage of gut microbiome-targeted therapies in the treatment of the NAFLD population. PROSPERO registration no. CRD42022346998.

Factors associated with elevated liver enzymes in patients with uncontrolled hyperthyroidism

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