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PubMed1989

Liver function of dairy cows in late pregnancy and early lactation.

The possibility that alterations in liver function may occur during late pregnancy as well as after calving has been investigated in healthy dairy cows and the results compared with those from non-pregnant non-lactating cows. There were significant alterations in plasma total bilirubin, glucose, total ketone body and urea concentrations, in bromsulphthalein clearance and in plasma aspartate aminotransferase and creatine kinase activities in periparturient cows compared with non-pregnant non-lactating cows. Of these, only the alterations in glucose, ketone bodies and urea concentrations and bromsulphthalein half-time and retention were markedly different before calving. The degree of fatty infiltration of the liver was significant two weeks before as well as two weeks after calving which differed from previous reports. It seems likely that the changes in the liver in dairy cows are functional and reversible and related to the metabolic demands of late pregnancy and early lactation. The results suggest that such changes in the liver occur well before calving.

Animals↗
PubMed2006

Investigation of the potential relationships between plasma voriconazole concentrations and visual adverse events or liver function test abnormalities.

This study investigated the relationship between plasma voriconazole concentrations (pVC) and risk of visual adverse events (VAEs) or liver function test (LFT) abnormalities using longitudinal logistic regression. Seven-day mean pVC were calculated from 2,925 plasma samples (1,053 patients); in each 7-day period, the presence or absence of VAEs/abnormal LFTs was analyzed as a binary outcome variable. There was a relationship between pVC and risk of VAE (P = .011) and a weaker, but statistically significant, association with risk of aspartate transaminase (AST), alkaline phosphatase (ALP), or bilirubin but not alanine transaminase (ALT) abnormalities. The odds ratios of LFT abnormalities per 1 mug/mL pVC increase ranged from 1.07 to 1.17. Maximum weekly occurrences were 10%, 8%, 5%, and 14% for AST, ALT, ALP, and bilirubin abnormalities, respectively. Receiver-operating characteristic curve analysis indicates that individual pVC cannot be used to predict subsequent LFT abnormalities.

Alanine Transaminase↗
PubMed1983

Plasma levels of apolipoproteins A-I, A-II and B in alcoholism. Relation to the degree of histological liver damage, and to liver function tests.

In 101 alcoholic patients, plasma apolipoproteins A-I, A-II and B, and lipids were studied in relation to liver function tests, albumin and bilirubin. As compared with controls, the entire population revealed a slight increase in triglycerides, transaminases and bilirubin, and a marked increase in gamma glutamyl transferase. The population was divided into 3 groups according to histological liver microscopy: no lesion, steatosis and cirrhosis. In group 1, apo A-I, A-II and HDL-C were significantly increased. In steatosis, apo A-I, apo A-II and HDL-C had almost normal levels. In cirrhosis, the 3 parameters were significantly decreased, but the apo A-I/apo A-II ratio was increased in relation to the predominant decrease in apo A-II. Liver enzymes were not discriminative, not even gamma GT, which was increased in all 3 groups. Apolipoprotein B, total cholesterol and LDL-cholesterol were insensitive to the degree of hepatic involvement, but a low apo A-I/B ratio might be indicative of a cardiovascular risk. It is suggested that apoproteins and their ratios be used as new markers for the degree of alcoholic intoxication and the risk of cardiovascular complications.

Adult↗
PubMed2003

The utility of the 13C-galactose breath test as a measure of liver function.

BACKGROUND: The 13C-galactose breath test has been reported to be an accurate, non-invasive method for the assessment of liver function. AIMS: To determine the optimal doses of labelled and unlabelled carrier galactose necessary to perform the 13C-galactose breath test, to assess the utility of the 13C-galactose breath test in distinguishing between normal subjects and those with liver cirrhosis and to determine whether the 13C-galactose breath test can stratify patients with cirrhosis based on their Child-Pugh score. METHODS: Twenty-three control subjects and 30 patients with liver cirrhosis received fixed doses of unlabelled carrier galactose and labelled 13C-galactose. Breath samples were collected just before and at 30-min intervals up to 4 h after the ingestion of unlabelled carrier galactose and labelled 13C-galactose. Each sample was analysed for its 13CO2 content. RESULTS: Doses of 25 g/m2 of unlabelled carrier galactose and 100 mg of 13C-galactose had the greatest sensitivity (93%; 95% confidence interval, 76-99%) and specificity (87%; 95% confidence interval, 65-97%) for distinguishing between normal subjects and cirrhotics when the test was performed 2 h after ingestion. The 13C-galactose breath test was also able to distinguish between class A and class B or C cirrhotics. CONCLUSION: The 13C-galactose breath test is a useful non-invasive tool for distinguishing between healthy subjects and patients with liver cirrhosis and between cirrhotics with well-compensated liver disease and those with decompensated liver disease.

Breath Tests↗
PubMed1997

Evaluation of liver function by co-administration methodology using 13C-labelled benzoic acid and hippuric acid coupled with nuclear magnetic resonance spectroscopy.

The amount of hippuric acid synthesized and excreted in the urine after benzoic acid loading (hippuric acid test) is a useful index of liver function. However, the hippuric acid test gives erroneous results in the event of failure of renal excretory function. A new stable isotope co-administration methodology using nuclear magnetic resonance (NMR) spectroscopy has been developed to overcome this defect. [7-(13)C]Benzoic acid and [glycine carbonyl-13C]hippuric acid ([gly-13C]hippuric acid), each 0.4-0.6 mmol kg(-1) were simultaneously administered intravenously as probes to normal or liver-injured rats and the urine was analysed by 100 MHz 13C NMR spectroscopy. Consequently, urinary excretion of [7-(13)C]hippuric acid formed from [7-(13)C]benzoic acid and [gly-13C]hippuric acid was successfully traced with very simple and convenient procedures. The urinary excretion of [7-(13)C]hippuric acid indicated the combined functions of hippuric acid synthesis and renal excretion, whereas that of [gly-13C]hippuric acid was indicative of renal excretion of hippuric acid only. The heights of resonances for C7 of [7-(13)C]hippuric acid and the glycine carbonyl carbon of [gly-13C]hippuric acid were used to calculate the concentrations of labelled hippuric acids. [7-(13)C]Hippuric acid was excreted more slowly than [gly-13C]hippuric acid by both normal and liver-injured rats. The liver-injured rats excreted the labelled hippuric acids more slowly than the normal rats. The kinetic parameters were computed for the individual rats on the basis of Michaelis-Menten elimination for benzoic acid and first-order elimination for hippuric acid. The maximum rates of metabolism (Vmax) (4.8-5.8 micromol min(-1) kg(-1)) and the renal elimination rate constants of hippuric acid (Kre) (0.010-0.021 min(-1)) in the liver-injured rats were lower than those (Vmax 6.7-11.8 micromol min(-1) kg(-1); Kre 0.026-0.045 min(-1)) in the normal rats. These results have demonstrated that liver function can be evaluated from the Vmax value even though the renal function of hippuric acid excretion (Kre) is impaired. Thus the co-administration methodology is feasible and can remove the defect of the previous hippuric acid test. These results could form the basis for a more convenient and reliable hippuric acid test in man.

Animals↗
PubMed2001

Human hepatocyte cell lines proliferating as cohesive spheroid colonies in alginate markedly upregulate both synthetic and detoxificatory liver function.

BACKGROUND/AIMS: Bio-artificial liver support systems for treatment of hepatic failure require maintained expression of hepatocyte function in vitro. We studied cultures of human hepatocyte cell-lines proliferating within alginate beads, investigating the hypothesis that 3-dimensional cohesive colonies of hepatocyte cell-lines would achieve polarity and cell-to-cell contact resulting in upregulation of function. METHODS: HepG2 and HHY41 human cell lines in alginate beads were cultured for >20 days. RESULTS: Proliferation was maintained for 20 days. Production of albumin, prothrombin, fibrinogen, alpha-1-acid glycoprotein and alpha-1-antitrypsin was maintained throughout, maximal at days 8-10, when upregulation was 300-1100% compared with monolayer cultures at similar cell number per unit volume. Detoxificatory functions: ethoxyresorufin deethylase activity, androstenedione metabolism, and urea synthesis from arginine was also increased several-fold. Function returned to pre-freezing levels within 18 h of thawing after cryopreservation of cells in alginate. Electron microscopy revealed spherical colonies of cells of cuboidal shape, with cell-to-cell contact via desmosomes and junctional complexes, abundant microvilli, and cytoplasmic appearances suggesting transcriptionally active hepatocytes. CONCLUSION: Hepatocyte cell-lines, proliferating in alginate express a range of liver-specific functions at levels approaching those found in vivo, relevant to their use in liver support systems.

Alginates↗
PubMed1996

Liver function tests in recurrent P. vivax malaria.

Blood samples were collected from 61 P. vivax infected fresh and recurrent malaria patients and liver function parameters studied. Plasma albumin, A/G ratio were found decreased significantly (p < 0.001) when compared to controls. Among the group of recurrent malaria patients with more than five attacks lowest values were found and the decrease was directly correlated with the number of attacks. The enzyme activities of plasma LDH, SGPT and thymol turbidity were found increased significantly with the increase in the number of attacks (p < 0.001). The increase was more pronounced in more than 5 attack (R3) group. The levels of total, conjugated and free bilirubin and the enzyme activities of SGOT, alkaline phosphatase were also found increased significantly in all the recurrent malarial groups, when compared to controls, without any correlation between the number of attacks. The isoenzyme pattern of plasma LDH was not altered in either fresh or recurrent malarial attack groups when compared to controls.

Adolescent↗
PubMed1989

Serum 5'nucleotidase and alkaline phosphatase--highly predictive liver function tests for the diagnosis of graft-versus-host disease in bone marrow transplant recipients.

The diagnostic efficacy of five serum liver function tests (aspartate and alanine aminotransferase, alkaline phosphatase, 5' nucleotidase, and bilirubin) was investigated in 95 bone marrow transplant recipients in whom acute graft-vs-host disease was graded by the Seattle criteria. The patient population included a control group of 22 autologous transplant recipients (group I), 33 patients with no GVHD (group II), 21 patients with grades 1 and 2 GVHD (group III), 12 patients with grade 3 GVHD (group IV), and 7 patients with grade 4 GVHD (group V). Student t test analysis of the analytes among the five groups of patients showed that 5' nucleotidase and alkaline phosphatase were the best discriminants among all the possible combinations of group pairs. Peak levels of 5' nucleotidase within each group of patients correlated well with those of alkaline phosphatase in all the allogeneic transplant groups (II-V; r = 0.59), but the correlation of these with bilirubin was less frequent. Also, 5' nucleotidase and alkaline phosphatase showed significant discrimination (P less than 0.05) even between groups I and II, suggesting that they are more sensitive than the Seattle criteria in the diagnosis of GVHD. They also showed the best overall discriminatory ability by one-factor analysis of variance (ANOVA; P = 0.0001 as compared with 0.002, 0.009, and 0.04 for aspartate aminotransferase, alanine aminotransferase, and bilirubin, respectively). Receiver-operating curves of the five analytes again revealed that 5' nucleotidase and alkaline phosphatase were by far the best discriminators among the five groups of patients. Bilirubin was relatively insensitive because it was a good discriminator only between the control group and groups IV and V. The hepatocellular enzymes, alanine and aspartate aminotransferase, correlated well (r = 0.80) but discriminated poorly among the four groups of allogeneic transplant recipients (II-V), suggesting that all four groups had some measure of hepatocellular damage that was independent of the severity of GVHD.

5'-Nucleotidase↗
PubMed2003

Aqueous kava extracts do not affect liver function tests in rats.

Kava ( Piper methysticum Forst. f., Piperaceae), prepared as the traditional aqueous infusion, was tested in the rat for possible effects on liver function tests. Extracts were administered in daily dosages of 200 or 500 mg of the active kavalactones/kg for two or four weeks. Sera were assayed for four enzymes that are markers of liver toxicity and liver homogenates for malondialdehyde formation that indicates changes in lipid peroxidation. The data showed that none of the enzymes, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and lactate dehydrogenase, nor malondialdehyde were elevated, in fact in some cases they were significantly reduced, suggesting the lack of a toxic effect by kava on the liver.

Alanine Transaminase↗
PubMedDate not supplied

Functional and non-functional liver blood flow in patients with liver cirrhosis measured by indocyanine green.

Indocyanine green administration was used in a group of ten patients with liver cirrhosis with portal hypertension to estimate hepatic extraction, liver blood flow and the degree of blood shunting. Extraction coefficients obtained by the hepatic catheterization were well correlated with the pharmacokinetic method. Values of the total liver blood flow measured by the classical method based on Fick's principle were always higher than those evaluated by the pharmacokinetic analysis estimating the functional liver blood flow only. Estimates of the degree of shunting varied between 32.0-78.9% of the total liver blood flow. A statistically significant correlation (r = 0.79) was found between the percentage of the functional fraction of the total liver blood flow and albuminemia. It is suggested that in liver cirrhosis with portal hypertension the reduction of the functional fraction of total liver blood flow is combined with partial impairment of hepatic cell metabolism in the remaining functional areas of the liver. In such a case neither the "intact" nor the "sick hepatocyte" hypotheses are appropriate in their strict sense for the interpretation of the findings.

Humans↗
PubMed2000

[Liver function of the most elderly patients].

To determine the decision level of liver function in the most elderly patients, we compared serum albumin, aspartate aminotransferase(AST), alanine aminotransferase(ALT) and alkaline phosphatase(ALP) values of the most elderly patients > 85 years with those of healthy young adults. Two hundred fifty five elderly people, aged 88-106 years and average 96.6 years(171 women, 84 men), were included in this study. Elderly people were divided into four groups according to their activities of daily living(ADL), 114 Rank-J: free living, 62 Rank-A: unable to go outside without help, 39 Rank-B: bedridden but able to sit up in bed and 40 Rank-C: completely bedridden. Serum albumin values for the most elderly patients in Rank-J were 4.2 +/- 0.3 g/dl for women and 4.0 +/- 0.3 g/dl for men, showing marked decrease from those of young healthy adults aged 19-59 years(p < 0.0001). In 22.2% of elderly women and 44.2% of elderly men, albumin values deviated from the reference interval of young adults. ALT value for the most elderly patients also showed a decrease in both sexes and AST and ALP values for the most elderly patients showed an increase in women compared with young adults. However, these were minor deviations from the reference interval for young adults. In ADL-stratified groups of the most elderly patients, serum albumin values showed marked decrease with decline in ADL, whereas AST, ALT and ALP values remained constant in both sexes regardless of ADL.

Activities of Daily Living↗
PubMed1997

Early assessment of transplanted liver function: lignocaine clearance test (MEGX).

The purpose of this study was to assess the value of lignocaine biotransformation into monoethylglycinexylidide (MEGX) and conventional liver function tests in the early post-operative period as an indicator of graft function and as a diagnostic tool for complications after hepatic transplantation. Monoethylglycinexylidide formation, plasma bilirubin, aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), factor V index (FVI) and prothrombin time index (PTI) were measured in 71 patients undergoing 80 liver transplantations respectively at 12 (T1), 24 (T2), 48 (T3) and 72 h (T4) after liver graft revascularization. Patients were divided into two group according to the post-operative outcome. Patients with favourable outcome (n = 59) had significantly higher monoethylglycinexylidide synthesis, higher factor V index and prothrombin time index plasma concentrations, lower bilirubin, ASAT and ALAT plasma concentration (P < 0.0001 at T2 and T3) than those with complicated time course (n = 21). Monoethylglycinexylidide synthesis was the best discriminant of a favourable outcome, whereas bilirubin and ALAT concentrations were associated with complications (bilirubin for primary non function [PNF], ALAT for acute rejection). Thus, the combination of parameters at T2 was a very efficient predictor of primary non function, acute rejection and an uncomplicated time course.

Anesthetics, Local↗
PubMed1999

Current status of liver function tests in Japan.

Inter-laboratory variations in data obtained from surveillance in Japan were studied. The items evaluated were related to liver function and were as follows: total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (gamma-GT), cholinesterase (CHE), lactate dehydrogenase (LD), alkaline phosphatase (ALP) and hepatitis markers. Inter-laboratory coefficients of variations for bilirubin, AST and ALT were acceptable, being less than 10%. but higher variations were found for thle other enzyme assays. Detection of hepatitis markers was acceptable. However. even for parameters with lower inter-laboratory variation, differences in obtained values among different reagents or methods still existed. Thus, standardization will be needed for laboratory data in Japan, and this will contribute to international standardization in laboratory medicine in the future.

Biomarkers↗