Serum Alanine Aminotransferase Values Research Articles

Diagnostic utility of alpha-fetoprotein and des-gamma-carboxyprothrombin in nigerians with hepatocellular carcinoma.

Alpha-fetoprotein (AFP) and Des-gamma-carboxyprothrombin (DCP) have been extensively studied as biomarkers for the diagnosis of and prognostication in hepatocellular carcinoma (HCC). However there are only few reports on the clinical characteristics of hepatocellular carcinoma in relation to the combination of the two tumor markers in hepatitis B virus-related HCC. The aim of this study was to investigate the clinical characteristics of HBV-related HCC in relation to different sets of AFP and DCP values. Sixty-two patients with untreated HCC were studied. The positive value of AFP was set at 20 1U/L while DCP positive value was set at 150 mAU/ml. Patients were divided into three groups: Group 1(n=36) with AFP ≥ 20 IU/L and DCP ≥ 150 mAU/ml. Group 2(n=24) with AFP <20 1U/L and DCP ≥ 150 mAU/ml. Group 3 (n=2) with AFP < 20 1U/L and DCP < 150 mAU/ml. There were no patients in group 4 meant for those with AFP ≥ 20 1U/L and DCP < 150 mAU/ml. Clinical and laboratory variables were compared among the groups. Clinical and laboratory variables were comparable among the groups with the exception of gender and values of serum alanine aminotransferase (ALT). Males were significantly more than females among the groups (p<0.03). ALT values were significantly different among the groups (p<0.006). Paired comparisons between the groups showed the mean values of serum ALT were significantly higher in group 2 than in group 1(p<0.003). The mean serum ALT values were also higher in group 2 than in group 3 (p <0.014). There was no significant difference between group 1 and group 3 (P = 0.124). HCC patients who are sero-positive for DCP and sero-negative for AFP have significantly higher levels of serum ALT; serum ALT levels may be of diagnostic importance in AFP-negative, HBV-related HCC patients.

Babao Dan attenuates hepatic fibrosis by inhibiting hepatic stellate cells activation and proliferation via TLR4 signaling pathway.

Babao Dan (BBD), a traditional Chinese medicine, has been widely used as a complementary and alternative medicine to treat chronic liver diseases. In this study, we aimed to observe the protective effect of BBD on rat hepatic fibrosis induced by diethylnitrosamine (DEN) and explore it possible mechanism. BBD was administrated while DEN was given. After eight weeks, values of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) indicated that BBD significantly protected liver from damaging by DEN and had no obvious side effect on normal rat livers. Meanwhile, BBD attenuated hepatic inflammation and fibrosis in DEN-induced rat livers through histopathological examination and hepatic hydroxyproline content. Furthermore, we found that BBD inhibited hepatic stellate cells activation and proliferation without altering the concentration of lipopolysaccharide (LPS) in portal vein. In vitro study, serum from BBD treated rats (BBD-serum) could also significantly suppress LPS-induced HSCs activation through TLR4/NF-κB pathway. In addition, BBD-serum also inhibited the proliferation of HSCs by regulating TLR4/ERK pathway. Our study demonstrated that BBD may provide a new therapy strategy of hepatic injury and hepatic fibrosis.

Naloxone pretreatment prevents kidney injury after liver ischemia reperfusion injury.

The aim of this study was to assess the effects of naloxone, an opioid receptor antagonist, on the renal injury as a remote organ after hepatic ischemia reperfusion (IR) in rats. Forty male Wistar rats were randomly allocated into four groups as follows: sham, sham+naloxone, IR and IR+naloxone. In anesthetized rats, hepatic ischemia was applied for 30min in IR and IR+naloxone groups. Sham+naloxone and IR+naloxone groups were given naloxone (3.0mg/kg, iv) 30min before ischemia. After 24h, blood and tissue samples were obtained for histopathological, tissue malondialdehyde (MDA) and biochemical analyses. Histopathological study of liver in IR group showed enlarged sinusoids, sinusoidal congestion, cellular degenerative changes and necrosis. The kidney of the rats with hepatic IR showed pathological changes in tubular cell swelling, tubular dilatation, moderate to severe necrosis, glomerular fibrosis and hemorrhage. Histological examination confirmed the extent of hepatic and renal changes in IR group was higher (P<0.05) than in other groups. Rats that underwent hepatic IR exhibited significant increase in serum concentrations of urea and creatinine levels (P<0.05). The serum alanine aminotransferase and aminotransferase values were significantly higher in IR group compared to the other groups (P<0.05). Liver IR produced a significant increase in hepatic and renal tissue MDA levels, while pretreatment with naloxone was associated with a significantly lower MDA levels (P<0.05). The results of this study showed that naloxone pretreatment protected the renal injury from hepatic IR.

An outbreak of acute fasciolosis in goats of Chhattisgarh

An outbreak of acute fasciolosis occurred at Goat Breeding Farm, Pakaria, Bilaspur, Chhattisgarh. Out of 416 goats, 36 goats (21 females and 15 males) exhibiting symptoms of dullness, weakness, anorexia and paleness of visible mucous membrane died within a time span of 16 days. The mortality rate in male goats was 16.55% compared to 6.50% in females. The post-mortem examination of dead animals revealed extensive haemorrhage and marked destruction of liver parenchyma. The mean haematological values of RBC, Hb and PCV were decreased in clinically infected goats. The mean values of total serum protein and albumin were also decreased in infected animals. In addition, the mean biochemical values of serum aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase in sick animals were higher. The histopathological changes in the livers of infected animals revealed excessive proliferation of fibrous tissue around the bile duct along with infiltration of numerous eosinophils admixed with lymphocytes. Sections of fluke remnants surrounded by clear spaces were found in the dilated and thickened bile ducts. The migratory tracts of the immature liver flukes were filled with necrosed hepatocytes and there was infiltration of eosinophils with lymphocytes along with haemorrhage and proliferation of fibrous tissue. The migrating flukes produced severe reaction in the host tissue and in the later stages they became surrounded by macrophages, eosinophils and granular tissue.

Hepatic Enzyme's Reference Intervals and Their Modulating Factors in Western Indian Population.

The reference intervals (RIs) of serum aminotransferases and Gamma-glutamyl transferase (GGT) have been established many years ago. Recent RIs are not available. The prospective study was conducted to re-evaluate the RIs of liver enzymes and the effect of demographic and anthropometric variables on them in western Indian population. A total of 1059 blood donors comprised the study population. Anthropometry and serum liver enzymes levels were measured. Subjects were categorized into normal weight and overweight by using body mass index (BMI) and waist circumference (WC). For RI determination, non-parametric methodology recommended by IFCC/CLSI was adopted. Mann-Whitney test and Spearman's rank correlation were used for statistical analysis. Upper limit of normal reference value of liver enzymes were lower in female compared to male. (ALT-23.55 F vs 36.00M, GGT-34.58 F vs 36.20M) When RI of liver enzymes were calculated according to body mass index, the upper limit of normal of ALT and GGT were higher in overweight group compared to normal weight group. (ALT-38.00 vs 27.00IU/L and GGT-37.59 vs 35.26IU/L). In both male and female, liver enzymes correlated significantly with age. WC and BMI were positively correlated with AST, ALT and GGT in both subgroups and the correlation was stronger in male. Demographic factors should be considered for making liver enzyme tests more clinically relevant. Gender based partitioning should be adopted for serum alanine aminotransferase (ALT) and GGT reference values for Western Indian population.

Traditional chinese medicine Xuebijing treatment is associated with decreased mortality risk of patients with moderate paraquat poisoning.

Paraquat poisoning causes multiple organ injury and high mortality due to severe toxicity and lack of effective treatment. Xuebijing (XBJ) injection, a traditional Chinese medicine preparation of five Chinese herbs (Radix Salviae Miltiorrhiae, Rhizoma Chuanxiong, Flos Carthami, Angelica Sinensis and Radix Paeoniae Rubra), has an anti-inflammatory effect and is widely used in the treatment of sepsis. This retrospective study was designed to evaluate the effects of XBJ combined with conventional therapy on mortality risk of patients with acute paraquat poisoning. Out of 68 patients, 27 were treated with conventional therapy (control group) and 41 were treated with intravenous administration of XBJ (100 ml, twice a day, up to 7 days) plus conventional therapy (XBJ group). Vital organ function, survival time within 28 days and adverse events during the treatment were reviewed. Results indicated that XBJ treatment significantly increased median survival time among patients ingesting 10-30 ml of paraquat (P=0.02) compared with the control group. After adjustment for covariates, XBJ treatment was associated significantly with a lower mortality risk (adjusted HR 0.242, 95% CI 0.113 to 0.516, P=0.001) compared with the control group. Additionally, compared with Day 1, on Day 3 the value of PaO2/FiO2 was significantly decreased, and the values of serum alanine aminotransferase, creatinine and troponin T were significantly increased in the control group (all P<0.05), but these values were significant improved in the XBJ group (all P<0.05). Only one patient had skin rash with itch within 30 minutes after injection and no severe adverse events were found in the XBJ group. In conclusion, XBJ treatment is associated with decreased mortality risk of patients with moderate paraquat poisoning, which may be attributed to improved function of vital organs with no severe adverse events.

Increased Accumulation of Protein-Bound Nε-(Carboxymethyl)lysine in Tissues of Healthy Rats after Chronic Oral Nε-(Carboxymethyl)lysine

In recent years, chronic diseases related to advanced glycation end products (AGEs) have attracted more attention. Because diet is an important exogenous source of AGEs, this study aimed to investigate the effects of chronic oral administration of pure N(ε)-(carboxymethyl)lysine (CML) (a major AGE) at 60 mg kg(-1) per day on healthy Sprague-Dawley rats. After administration for 12 weeks, the levels of protein-bound CML were increased to 202 ± 17, 167 ± 47, 217 ± 44, 107 ± 4, 144 ± 23, and 33 ± 7 μg/g dry matter in the kidneys, heart, liver, lungs, spleen, and pancreas, respectively, in comparison with control values of 98 ± 1, 90 ± 15, 140 ± 42, 76 ± 18, 115 ± 15, and 30 ± 4 μg/g dry matter. The difference was significant (p < 0.05) for the kidneys, heart, liver, and lungs, whereas no significant increase was seen in the spleen and pancreas. Furthermore, serum blood urea nitrogen (BUN), creatinine (CREA), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) values increased significantly (p < 0.05), as evidence of impaired kidney and liver function. Additionally, the rats' fasting blood glucose (FBG) levels remained within the normal range, indicating that chronic intake of CML does not promote a rise in blood glucose. These results clearly indicate that a CML-rich diet might be a potential health risk in humans, particularly with respect to kidney and liver function.

Determination of the upper cut-off values of serum alanine aminotransferase and aspartate aminotransferase in Chinese.

To determine the upper cut-off values of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in a Northern Chinese population. A total of 3769 subjects in Jilin Province Northeast China were stratified to determine the potential factors affecting serum ALT and AST levels. The upper cut-off values of serum ALT and AST in these subjects were determined using receiver operating characteristic analysis and their sensitivity and specificity were evaluated. Stratification analysis revealed that serum ALT and AST levels were associated with gender, alcohol consumption, serum cholesterol and triglyceride levels, and body mass index. The upper cut-off values of serum ALT and AST were 22.15 U/L and 25.35 U/L for healthy men and 22.40 U/L and 24.25 U/L for healthy women, respectively. The new cut-off values had a higher sensitivity, but a slightly lower specificity than the current standards. Our results indicate that the new upper cut-off values of serum ALT and AST are markedly lower than current standards and may be valuable for the evaluation of liver function.

A comparative study of serum aminotransferases in chronic kidney disease with and without end-stage renal disease: Need for new reference ranges.

Background:Hepatic diseases are common among chronic kidney disease patients and liver function tests particularly serum liver enzymes play an important role in diagnosing and monitoring these patients. Serum aminotransferase levels commonly fall near the lower end of the range of the normal values in patients of chronic kidney disease (CKD). High-levels of serum alkaline phosphatase (ALP) can occur in these patients due to renal osteodystrophy. Thus, the recognition of liver damage in these patients is challenging.Aim:To compare the levels of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and ALP among three groups - CKD patients without end stage renal disease (ESRD), patients with ESRD and healthy controls.Materials and Methods:A retrospective, hospital-based study was carried out from 100 patients’ records from each group and serum AST, ALT and ALP values were noted.Results:Our study showed that serum AST and ALT levels were significantly lower in CKD patients both without and with ESRD compared to controls. Further, these two enzyme levels were also significantly lower in CKD patients with ESRD compared to CKD patients without the condition. Serum ALP levels were significantly higher in patients with and without ESRD as compared to the controls. However, the values did not differ significantly between patients with and without ESRD.Conclusion:Levels of serum aminotransferases were low in CKD with and without ESRD and the levels become lower as the severity of CKD increases. Thus, the study established the need for separate reference ranges of serum aminotransferase in different stages of CKD.

Sea Buckthorn Seed Powder Provides Protection in the Oxidative Stress Produced by Thermally Oxidized Sunflower Oil in Rabbits

SBT seed powder was used against the oxidative stress produced by thermally oxidized sunflower oil. OSFO and SBT powder were orally administered to the rabbits. Blood biochemistry, hematology and liver pathology were investigated. The results show that OSFO produce changes in the blood biochemistry and hematology and alterations in the liver. However, the toxicity of OSFO was minimized when rabbits were fed with SBT seed powder. The SBT seed both in independent and in fortified forms significantly decreases the serum cholesterol, LDL-c, ALT (alanine aminotransferase) and TG values, whereas it increases serum glucose and HDL-c values. The seed powder normalizes all the hematological indices. Histopathological investigation of the liver reveals that OSFO intake causes severe adverse changes, whereas SBT seed powder was found to restore the normal condition. It was concluded that SBT seed powder has strong potential to reduce the toxicity of oxidized lipids in model animals. Practical Applications Thermally oxidized edible oils are one of the main concerns of the modern-day food chemists and technologists. The ingestion of these oxidized lipids results into the toxic effects on human beings. This study clearly showed for the first time that SBT seed powder reduces the degenerative and toxic changes in the liver produced by thermally oxidized lipids. It has been found that SBT seed powder supplementation has protective effects against the toxicity of OSFO by increasing the antioxidant potential.

Abnormality of autophagic function and cathepsin expression in the liver from patients with non‐alcoholic fatty liver disease

Recent evidences indicate that hepatic steatosis suppresses autophagic proteolysis. The present study evaluated the correlation between autophagic function and cathepsin expression in the liver from patients with non-alcoholic fatty liver disease (NAFLD). Liver biopsy specimens were obtained from patients with chronic liver diseases (chronic hepatitis C [CHC; n = 20], chronic hepatitis B [CHB; n = 16], primary biliary cirrhosis [PBC; n = 23], NAFLD [n = 22] and control [n = 14]). The number of autophagic vesicles in hepatocytes was counted by using transmission electron microscopy. Expression of cathepsin B, D, L and p62 in the liver section was analyzed by immunohistochemical staining. The histological severity of NAFLD is assessed by NAFLD activity score (NAS). The number of autophagic vesicles in hepatocytes was significantly increased in both CHC and NAFLD groups, but not CHB and PBC, more than control. Although hepatocytes with aggregation of p62 were observed in less than 15% of CHC, p62 aggregation was detected in approximately 65% of NAFLD. Cathepsin B, D and L expression was significantly suppressed in the liver from NAFLD patients. Suppression of cathepsin B, D and L expression was not observed in CHB, CHC and PBC. In NAFLD patients, p62 aggregation was correlated with serum alanine aminotransferase value and inflammatory activity by NAS. These results indicate that a decrease in hepatic cathepsin expression in NAFLD is associated with autophagic dysfunction. Hepatic inflammation correlates with autophagic dysfunction in NAFLD. These findings indicate that the suppression of autophagic proteolysis by hepatic steatosis is involved in the pathogenesis of NAFLD.

Large-scale analysis of factors influencing nonalcoholic fatty liver disease and its relationship with liver enzymes.

Serum liver enzyme levels are often used effectively for the evaluation of nonalcoholic fatty liver disease (NAFLD). We aimed to investigate the associations between serum liver enzyme levels and risks for NAFLD in over 8000 cases in a large-scale analysis. A cross-sectional survey with multiple stages and random samplings was performed from May 2007 to May 2009 on 8102 workers at Tongji University. A questionnaire was given, assessments of physical measurements, plasma glucose, lipid profiles, and liver enzymes were made, and real-time liver ultrasounds conducted. The prevalence of NAFLD in Tongji University was 22.2%. It was higher in males than in females (P = 0.0023). The body mass index, waist-to-hip ratio, serum total triglycerides, serum total cholesterol, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) values were all higher in the NAFLD group than in the control group. For moderate and severe NAFLD patients, the ALT, AST and GGT values were significantly increased, high density lipoprotein cholesterol was decreased, and drinking much, heavy entertainment and less exercise were more prevalent (P < 0.001). There were strong correlations between serum liver enzyme levels and NAFLD (P < 0.001), with GGT being a more sensitive marker for NAFLD than ALT or AST. ALT and GGT were independent predictors for NAFLD, and GGT was a better predictor than ALT for NAFLD.

Early termination of immune tolerance state of hepatitis B virus infection explains liver damage.

To assess an early termination of immune tolerance state of chronic hepatitis B virus infection in Bangladesh and its clinical significance. From a series of 167 treatment-naive chronic hepatitis B patients aged between 12 to 20 years (mean ± SD; 17.5 ± 2.8 years), percutaneous liver biopsies of 89 patients who were all hepatitis B e antigen negative at presentation were done. Of them, 81 were included in the study. They had persistently normal or raised serum alanine aminotransferase (ALT) values. A precore mutation (PCM) study was accomplished in 8 patients who were randomly selected. Forty-four (53.7%) patients had significant necroinflammation (HAI-NI > 7), while significant fibrosis (HAI-F ≥ 3) was seen in 15 (18.5%) patients. Serum ALT (cut off 42 U/L) was raised in 29 (35.8%) patients, while low HBV DNA load (< 10(5) copies/mL) was observed in 57 (70.4%) patients. PCM was negative in all 8 patients. This study indicates that the current concept of age-related immune tolerance state of HBV infection deserves further analyses in different population groups.

Association of Chronic Hepatitis C and Diabetes: Is There a Gender Difference?

To the Editor: Montenegro et al. (1) recently reported in the Journal an association between chronic hepatitis C (HCV) infection and development of diabetes mellitus (DM) type 2 in a cohort of patients in a Southern Italian town. We have three comments on their excellent article. First, we similarly evaluated the association between HCV antibodies and DM in the United States, using the National Ambulatory Medical Care Survey (NAMCS), a large nationally representative cohort, which provides outpatient data from physician offices in the United States for 2000–2009. All patients with complete data on HCV and DM status were analyzed. Among 252,450 patients initially analyzed, 220 patients had HCV and 18 of them were diabetic. A multivariate logistic regression model was used to adjust for age, hypertension, obesity, and any lipid therapy. On multivariate analysis, HCV was independently associated with DM (odds ratio (OR)=1.97; 95% confidence interval (CI) 1.29–3.07, P=0.02). These data support the authors’ conclusions by showing a similar association between HCV and DM in a different population: United States outpatients. However, unlike the authors, we did not analyze the relation of serum ALT (alanine aminotransferase) values to DM, and did not separate DM type 1 from DM type 2. However, the latter difference is unlikely to affect the conclusions because DM type 2 represents the overwhelming majority of DM in America. Second, 13 of 18 patients with DM and HCV were male, and only 5 were female. This represents a quantitatively large, statistically significant effect (OR for being male=6.67; 95% CI 2.05–21.79). Montenegro et al. (1) report the same phenomenon, incidentally without commenting about its significance (OR for being female=0.44, 95% CI 0.31–0.63, P<0.001, Table 3). Our data in conjunction with the authors’ data suggest there may be a gender difference in the proposed association. This gender difference is not surprising because many toxins affect the liver according to gender, e.g., different minimum levels of alcohol consumption/day to develop alcoholic cirrhosis for males vs. females (2); and difference in mortality from hepatitis E infection between females in third trimester of pregnancy vs. other females or males (3). This large difference between genders might offer clues to the pathophysiology of association between HCV and DM. Third, the authors describe taking blood samples from each participant in 1985 (as well as 1992 and 2005) for anti-HCV antibodies, assessed by immunoenzymatic enzyme-linked immunosorbent assay (Methods (1)). The authors may want to clarify that this blood test was performed subsequently (retrospectively) on the bloods drawn in 1985 because hepatitis C was only discovered in 1988–1989 (4) and the assays for it first became commercially available in 1992 (5).

Electron Therapy Attenuated Elevated Alanine Aminotransferase and Oxidative Stress Values in Type 2 Diabetes-Induced Nonalcoholic Steatohepatitis of Rats.

Chronic oxidative stress plays a key role in the progression of nonalcoholic steatohepatitis (NASH). We examined the efficacy of antioxidative electron treatment on type 2 diabetes-induced NASH in a rat model. We established NASH model rats, induced by neonatal administration of streptozotocin and a high-fat diet, which exhibited pathologically high values of alanine aminotransferase (ALT), glucose, and malondialdehyde (MDA). The rats were exposed to electron discharge at very low energy for 4 weeks; this dose results in the reduction of Fe(3+) and glutathione disulfide in vitro. Serum ALT values were increased from baseline (8 weeks) to 125.0 ± 13 U/L at 10 weeks in the control group. In contrast, the values in the treated group did not show any increase at 10 weeks [87 ± 10 U/L (p = 0.0391)]. Hepatic MDA levels were also significantly decreased at 12 weeks (p < 0.05), but 8-hydroxy-2'-deoxyguanosine values were not statistically significant (p = 0.076). A gradual but steadily decreasing trend from initially high glucose levels was observed, though the values were not significant in 12-week-old animals (p = 0.074). However, the serum values of MDA, ALT, and glucose were well correlated. The progression of fibrosis as measured by increased serum levels of hyaluronic acid and histological examinations were not affected by the treatment in this model. Antioxidative electron treatment at very low energy attenuated the pathogenically elevated liver inflammation and oxidative stress, together with presumably impaired glucose metabolism in NASH rat model.

Impact of coffee on liver diseases: a systematic review

Coffee is one of the most commonly consumed beverages in the world. Its health benefits including improved overall survival have been demonstrated in a variety of disease states. To examine the association of coffee consumption with liver disease, a systematic review of studies on the effects of coffee on liver associated laboratory tests, viral hepatitis, nonalcoholic fatty liver disease (NAFLD), cirrhosis and hepatocellular carcinoma (HCC) was performed. Coffee consumption was associated with improved serum gamma glutamyltransferase, aspartate aminotransferase and alanine aminotransferase values in a dose dependent manner in individuals at risk for liver disease. In chronic liver disease patients who consume coffee, a decreased risk of progression to cirrhosis, a lowered mortality rate in cirrhosis patients, and a lowered rate of HCC development were observed. In chronic hepatitis C patients, coffee was associated with improved virologic responses to antiviral therapy. Moreover, coffee consumption was inversely related to the severity of steatohepatitis in patients with non-alcoholic fatty liver disease. Therefore, in patients with chronic liver disease, daily coffee consumption should be encouraged.

Therapeutic Potential of Myrrh and Ivermectin against Experimental Trichinella spiralis Infection in Mice

Trichinosis is a parasitic zoonosis caused by the nematode Trichinella spiralis. Anthelmintics are used to eliminate intestinal adults as well as tissue-migrating and encysted larvae. This study aimed to investigate the effects of ivermectin and myrrh obtained from the aloe-gum resin of Commiphora molmol on experimental trichinosis. Ninety albino mice were orally infected with 300 T. spiralis larvae. Drugs were tested against adult worms at day 0 and day 5 and against encysted larvae on day 15 and day 35 post-infection (PI). Mature worms and encysted larvae were counted in addition to histopathological examination of muscle specimens. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), total protein, albumin, globulin, urea, and creatinine values were estimated. Significant reductions in mean worm numbers were detected in ivermectin treated mice at day 0 and day 5 PI achieving efficacies of 98.5% and 80.0%, while efficacies of myrrh in treated mice were 80.7% and 51.5%, respectively. At days 15 and 35 post-infection, ivermectin induced significant reduction in encysted larval counts achieving efficacies of 76.5% and 54.0%, respectively, while myrrh efficacies were 76.6% and 35.0%, respectively. AST, ALT, urea, and creatinine levels were reduced, while total proteins were increased in response to both treatments compared to their values in the infected non-treated mice. Ivermectin use for controlling T. spiralis could be continued. Myrrh was effective and could be a promising drug against the Egyptian strains of T. spiralis with results nearly comparable to ivermectin.

What is the normal serum alanine aminotransferase (ALT)value for Thai subjects with the low riskof liver diseases?

What is the normal serum alanine aminotransferase (ALT)value for Thai subjects with the low riskof liver diseases?

Tu1052 Prognostic Value of Contrast-Enhanced Ultrasonography in Patients With Small Hepatocellular Carcinoma

Introduction: Epidemiological studies have shown that nonalcoholic fatty liver disease (NAFLD) not only is a possible precursor of cirrhosis, but also has been associated with metabolic syndrome, diabetes and cardiovascular disease. There is a need to find a biomarker which proves to be reliable, non-invasive, and easy to perform in clinical practice. Our aim was to know whether serum alanine aminotransferase (ALT) value is a reliable biomarker of liver fat content in subjects with NAFLD in the general population, and to determine if the current threshold of normality for ALT is appropriate to assess the presence of liver fat in these subjects. Methods: This is a cross-sectional, randomized, prospective, populationbased study. We studied 120 healthy subjects attending health screening centers, alcohol consumption less than 50 g/week. Subjects underwent blood tests including aminotransferases. Viral hepatitis, autoimmune, drugs and others causes of liver disease were excluded. Measurements: quantification of liver fat content by spectroscopy 1H MR with magnetic field strength of 3 tesla. We used a cut off value .5% of liver fat content as the upper limit of normal for the diagnosis of hepatic steatosis (1). Serum ALT levels by commercially available kits. Results: There was an excellent positive correlation between liver fat content and serum levels of ALT (r = 0.73, p ,0.0001). All subjects with ALT values .37 U/L had hepatic steatosis (PPV: 100%) and none of the subjects with ALT ,20 U/L had steatosis (NPV: 100%). ROC curves were created, obtaining that the cutoff value that represents the normal threshold for the diagnosis of NAFLD was ALT: 23 U / L (sensitivity: 94.67%, specificity 73.91%, PPV: 85.84%, NPV: 89.47%). Conclusion: This study shows that serum ALT levels could be a reliable biomarker of NAFLD if the upper limit of normal for ALT is set at 23 U/L.

Tu1051 Noninvasive Assessment of Liver Fibrosis by Measurement of Lf Index in Patients With Chronic Viral Hepatitis

Introduction: Epidemiological studies have shown that nonalcoholic fatty liver disease (NAFLD) not only is a possible precursor of cirrhosis, but also has been associated with metabolic syndrome, diabetes and cardiovascular disease. There is a need to find a biomarker which proves to be reliable, non-invasive, and easy to perform in clinical practice. Our aim was to know whether serum alanine aminotransferase (ALT) value is a reliable biomarker of liver fat content in subjects with NAFLD in the general population, and to determine if the current threshold of normality for ALT is appropriate to assess the presence of liver fat in these subjects. Methods: This is a cross-sectional, randomized, prospective, populationbased study. We studied 120 healthy subjects attending health screening centers, alcohol consumption less than 50 g/week. Subjects underwent blood tests including aminotransferases. Viral hepatitis, autoimmune, drugs and others causes of liver disease were excluded. Measurements: quantification of liver fat content by spectroscopy 1H MR with magnetic field strength of 3 tesla. We used a cut off value .5% of liver fat content as the upper limit of normal for the diagnosis of hepatic steatosis (1). Serum ALT levels by commercially available kits. Results: There was an excellent positive correlation between liver fat content and serum levels of ALT (r = 0.73, p ,0.0001). All subjects with ALT values .37 U/L had hepatic steatosis (PPV: 100%) and none of the subjects with ALT ,20 U/L had steatosis (NPV: 100%). ROC curves were created, obtaining that the cutoff value that represents the normal threshold for the diagnosis of NAFLD was ALT: 23 U / L (sensitivity: 94.67%, specificity 73.91%, PPV: 85.84%, NPV: 89.47%). Conclusion: This study shows that serum ALT levels could be a reliable biomarker of NAFLD if the upper limit of normal for ALT is set at 23 U/L.