LIVER FUNCTION IN ALCOHOLISM.
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Alcoholism↗
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Effects of long-term use of testosterone enanthate. II. Effects on lipids, high and low density lipoprotein cholesterol and liver function parameters.
The present study was designed to evaluate the effects of long-term administration of testosterone enanthate (TE) on lipid and liver function parameters in rhesus monkeys (n = 9) maintained under controlled dietary conditions. Bimonthly administration of 50 mg of TE increased serum testosterone into the supraphysiological range one day after injection and peak levels were seen on day 3, followed by a decrease to above baseline values by day 14. High density lipoprotein cholesterol (HDL-C) levels decreased gradually; compared to baseline values, the decline was significant from the 19th month of injection until the first month of recovery. The increase in low density lipoprotein cholesterol (LDL-C) levels and the LDL-C/HDL-C ratio during the treatment period was not significant compared to baseline values; however, when compared to control animals, HDL-C and LDL-C levels and the LDL-C/HDL-C ratio were significantly elevated from the 12th month until the end of the treatment period. All lipid parameters recovered by the end of the treatment period. Control animals (n = 9) did not show significant changes in HDL-C and LDL-C levels and the LDL-C/HDL-C ratio during the study period. Total cholesterol levels decreased in control (n = 9) and treated animals from 6 to 15th months of the treatment period, coinciding with the feeding of sprouted grams to animals. TE injections did not change the levels of triglycerides, alkaline phosphatase or bilirubin in control and treated animals. However, transaminase (SGOT and SGPT) levels increased following TE injections and remained elevated until the end of injections followed by a return to baseline values or below during the recovery period. These effects could be due to the pharmacokinetic profile of TE in which testosterone levels were elevated to supraphysiological values after injections. The recovery of the TE-induced changes in lipid parameters and liver transminases is reassuring but the changes in these parameters during TE injections indicate the need for long-acting androgens with better pharmacokinetic properties.
Alanine Transaminase↗
The influence of diet upon liver function tests and serum lipids in healthy male volunteers resident in a Phase I unit.
AIM: To investigate the effect of diet upon liver function tests and serum lipids within the restricted environment of a Phase I unit. METHODS: An open randomized three-way crossover study was designed with subjects consuming three types of diet. The diets comprised, a balanced normal calorie diet, a high-carbohydrate high-calorie diet and a high-fat high-calorie diet. Each diet was consumed in a randomized sequence over 8 days with a recovery period of 14 days between periods. The blood concentrations of various laboratory parameters were measured at intervals throughout each dietary period and during the recovery periods. RESULTS: Blood transaminase activity and triglyceride concentrations increased significantly whilst subjects consumed a high-carbohydrate high-calorie diet but not when fed either a high-fat high-calorie diet or a balanced normal calorie diet. CONCLUSIONS: The rises in transaminases and triglycerides were caused by the carbohydrate content of the diet rather than its calorific value. Sucrose rather than starch was the carbohydrate which caused the rise in transaminases and triglycerides. The importance of controlling diet in Phase I studies is stressed.
Adult↗
Liver function and medroxyprogesterone acetate elimination in man.
Medroxyprogesterone acetate (MPA) elimination rate was investigated in 25 patients with primary biliary cirrhosis, alcoholic cirrhosis and fatty liver. The serum and urine concentrations of MPA were measured by RIA after a single oral administration of the drug. Biochemical liver tests and antipyrine kinetics were determined as indicators of the liver function. The antipyrine test, a reflector of the activity of hepatic drug-metabolizing enzyme system, was impaired only in alcoholics. The results demonstrate that the elimination rate of MPA is reduced in subjects with alcoholic cirrhosis, whereas the values of the patients with fatty liver and primary biliary cirrhosis are in the normal range. The findings show that the MPA elimination is impaired only in cases with far advanced liver disease.
Antipyrine↗
THE EFFECT OF INTRAVENOUS FAT EMULSIONS ON DISTURBANCES OF LIVER FUNCTION DURING OPERATION.
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Chemical and Drug Induced Liver Injury↗
Liver function tests in normal pregnancy: a prospective study of 103 pregnant women and 103 matched controls.
Except for increased serum alkaline phosphatase (AP) levels, the changes in liver function test (LFT) values during normal pregnancy have not been clearly established, mainly because most studies do not include matched controls. We therefore measured the serum values of routine liver tests including 5'-nucleotidase and total bile acids in 103 healthy pregnant women (first trimester, n = 34; second trimester, n = 36; third trimester, n = 33) and in 103 age-matched controls not receiving oral contraception. Fasting blood samples were taken. Because of hemodilution, serum albumin levels were significantly lower during all trimesters. As expected, AP activity was significantly higher in the third trimester. Serum aspartate transaminase (AST) activity and total bile acid (TBA) concentrations did not differ between pregnant and nonpregnant women. Serum alanine transaminase (ALT) activity was slightly higher in the second-trimester pregnant women than in controls (6.8 +/- 4.5 vs. 8.2 +/- 5.8, P = .04), although all values remained within normal limits. In pregnant women, total and free bilirubin concentrations were significantly lower during all three trimesters, as was conjugated bilirubin during the second and third trimesters. Serum gamma-glutamyl transpeptidase (GGT) activity was significantly lower in the second and third trimesters. Serum 5'-nucleotidase activity was slightly but significantly higher in the second and third trimesters. The knowledge of these results is useful for the interpretation of LFT values and the management of liver diseases during pregnancy.
5'-Nucleotidase↗
[Effects of neuroleptics on liver function, the hematopoietic system, blood pressure and temperature regulation. Comparison of clozapine, perazine and haloperidol by evaluating medical records].
The frequency of disturbances of the liver function, of leucopoiesis, blood pressure and temperature regulation under clozapine in comparison with perazine and haloperidol in 478 patients (partly being treated repeatedly) was investigated by means of case histories of the Psychiatric Clinic of Tübingen from October 1974 up to June 1978. Within the time of the investigation no case of jaundice arose, however non-symptomatic increases of the liver values could be observed. The three drugs did not differ in this respect. Within the time of the investigation no case of agranulocytosis was observed. Only one leucopenia under clozapine, one under perazine, and six under haloperidol occurred. Concerning cardio-vascular effects of the neuroleptic medication, in 4.1% of the patients under clozapine therapy, 4.3% under haloperidol therapy and 10.3% under perazine therapy hypotension could be observed. Under clozapine 15.2% of the patients showed a rise of temperature, under perazine 3.2% and under haloperidol 2.8% of the patients. 83.3% of cases with elevated temperature under clozapine occurred during the first two weeks of treatment.
Adult↗
The liver function profile in PCR-RNA Egyptian HCV-patients and normal controls.
No doubt, Hepatitis C virus (HCV) is a real health problem worldwide. The liver function tests (S.ALT, S.AST, Albumin, Total Protein, Total Bilirubin and Direct Bilirubin) were evaluated in 20 PCR-RNA positive HCV-patients and 10 cross matched apparently healthy population. All the HCV-patients and controls were free from liver helminthes. The results showed that in the HCV-patients, there was elevation in the level of S.ALT (17/20 or 85%), S.AST (20/20 or 100%), Total Bilirubin (7/20 or 35%), and (4/20 or 20%). Besides, there was neither a correlation between sexes nor the degrees of viraemia and the elevation of these four parameters. However, serum levels of Albumin, and Total Protein were within the normal range. On the other hand, in the controls the levels of the six tests were within the normal range. Nevertheless, only one control subject who had positive HBs-Ag, showed elevated Total Bilirulin and Direct Bilirubin. Consequently, these tests are indicative as useful and dependable markers in the non-invasive diagnosis of the hepatitis C virus (HCV).
Adolescent↗
The quantitative liver function as measured by the galactose elimination capacity. I. Diagnostic value and relations to clinical, biochemical, and histological findings in patients with steatosis and patients with cirrhosis.
Quantitative liver function was estimated by determination of the galactose elimination capacity (GEC) in 29 patients with steatosis, 50 with cirrhosis and 42 control patients without clinical history or signs of liver disease. In patients with steatosis and cirrhosis, clinical signs of liver disease were recorded and the most common liver tests were carried out. The degree of histological changes was investigated in needle liver biopsies performed in a close relation to the GEC determinations. A positive correlation between GEC and body weight and body surface area was observed in all three patient groups. GEC (absolute value, per kg body weight and per m2 body surface area) was significantly different (p less than 0.001) between the three groups, but was without diagnostic value due to a broad scattering of results in each group. This may be due to methodological errors in the determination of GEC, but also to the large biological variation in normal man and the pathophysiological conditions in patients with liver disease. Neither in patients with steatosis nor in patients with cirrhosis could significant relations be found between GEC and clinical signs of liver disease or the degree of severity of histological changes assessed semiquantitatively. In patients with cirrhosis but not in patients with steatosis, GEC was significantly correlated with the majority of the most commonly utilized liver tests.
Adult↗
[Liver function in biliary tract dyskinesia].
The authors analyze data obtained in a complex clinico-instrumental study of the functional activity of the liver, portal and hepatic blood flow in 77 patients with different forms of dyskinesias of the biliary tract. Obtained data evidence in these patients development (against the background of cholestasis) functional insufficiency of the liver and involvement of its parenchyma associated with a moderate pressure increase in the portal vein, reduction of the hepatic blood flow intensity, increase of its lability that may be a proof of development (in patients with functional bile secretion disorders) of chronic diffuse inflammatory process in the liver with subsequent appearance of clinically clear portal hypertension.
Adolescent↗
Caffeine elimination: a test of liver function.
Fasting plasma caffeine concentration and various parameters of caffeine elimination from plasma obtained after a standardized oral dose of 140 mg caffeine have been compared in nine patients with liver cirrhosis, eight patients with non-cirrhotic liver disease and ten healthy volunteers with regard to their ability to discriminate between the different groups. Fasting plasma caffeine concentrations were significantly higher in cirrhotics (11.1 +/- 10.5 mumol/l) than in healthy volunteers (1.5 +/- 0.8 mumol/l). The respective values measured in patients with non-cirrhotic liver disease (3.1 +/- 3.1 mumol/l) did not differ significantly from the controls. Plasma disappearance rate and clearance of caffeine were significantly decreased in cirrhotics (0.11 +/- 0.02 h-1; 1.0 +/- 0.3 ml/min per kg) and in patients with non-cirrhotic liver disease (0.18 +/- 0.04 h-1; 2.2 +/- 0.7 ml/min per kg) as compared to healthy volunteers (0.23 +/- 0.04 h-1; 3.1 +/- 0.9 ml/min per kg). Plasma caffeine concentration determined 12 h after administration of the test dosage discriminated best between patients with cirrhosis (5.4 +/- 1.6 mumol/l), patients with non-cirrhotic liver disease (2.0 +/- 1.4 mumol/l) and healthy volunteers (0.8 +/- 0.2 mumol/l). These results, the safety of the test compound and the simplicity of a single caffeine determination in plasma 12 h after a standardized dose of caffeine make this test attractive for evaluation of liver function.
Adult↗
[Effects of the administration of protein anabolic steroids on some liver function tests].
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Anatomy↗
A simple bedside test for liver function.
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Humans↗
Long term results (greater than 5 years) in patients with peritoneovenous shunting for intractable ascites: liver function and cancer mortality.
This report is based on twenty-eight (26%) of 107 patients included in a protocol for prospective evaluation of elective peritoneo-venous shunting for intractable ascites in cirrhosis. These patients had no other procedures and survived more than 5 years after the operation. All patients were free of ascites except one in whom it was mild. One patient refused follow-up. Shunt patency was assessed in 23 patients In 14 patients (60.9%), the shunt was obstructed and the superior vena cava was occluded in 5 of them. In 9 patients (39.1%), the shunt was still functioning. No clinical or biological parameters differentiated these two groups of patients. Of the 24 patients who were alcoholics, 2 abstained completely and 20 significantly reduced their drinking habits. In 25 patients, the Pugh's score improved and was A at the time of the study. Seven patients (25.9%) developed a malignant tumor of the oro-pharynx or digestive tract, all other patients were alive and in good health. This study suggests that patients with intractable ascites treated by a peritoneo-venous shunt may survive for a long period. In patients abstaining from heavy drinking, it may function as a therapeutic bridge permitting spontaneous improvement of liver function. The risk of supervening neoplasms suggests that a continuous follow-up of these patients is warranted.
Adult↗
Evaluation of [14C]aminopyrine breath test, peripheral clearance of [99mTc]EHIDA, and serum bile acid levels in liver function and disease.
The purpose of this study is to evaluate the diagnostic value of the following tests in the assessment of patients with chronic liver disease (CLD) and cholestatic syndrome (CS): (1) aminopyrine breath test, measuring 14CO2 excretion in the expired air, (2) peripheral clearance of [99mTc]EHIDA, and (3) postprandial levels of glycocholic acid (GCA) and glycochenodeoxycholic acid (GCDCA). The results indicate that: (1) 14CO2 2-hr excretion rate is a specific and sensitive marker of liver function, with good correlation with postprandial bile acid levels, [99mTc]EHIDA retention, and the conventional tests of serum albumin and prothrombin time. (2) Peripheral clearance and retention of [99mTc]EHIDA increased in both groups of CLD and CS vs controls, but it does not discriminate between the two. (3) Postprandial bile acids were elevated in CLD, particularly those of GCDCA, whereas GCA levels were significantly elevated in CS compared with CLD. This may be due to increased synthesis and entry into the blood. (4) The combination of [14C]aminopyrine breath test and postprandial levels of GCDCA enhance the diagnostic value, specificity, and sensitivity in the assessment of patients with CLD.
Adult↗
A pediatric amino acid solution for total parenteral nutrition does not affect liver function test results in neonates.
PURPOSE: We studied the effects of an amino acid mixture used for total parenteral nutrition (TPN) in pediatrics, on the liver function test results (LFTs) of neonates. METHODS: Thirty neonatal surgical patients were randomly divided into three groups according to the dose of amino acids given: group H ( n = 12, 3.45 +/- 0.07 g/kg per day), group M ( n = 8, 2.59 +/- 0.07 g/kg per day), and group L ( n = 10, 1.72 +/- 0.06 g/kg per day). All patients received the same amount of dextrose (average 21.5 g/kg per day) and no lipid. RESULTS: There were no significant differences in LFTs, namely, direct bilirubin, glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, alkaline phosphatase, gamma-glutamyl transpeptidase, and total bile acids, among the three groups on the tenth day of TPN. CONCLUSION: These findings indicate that this amino acid solution for pediatrics has no significant effect on LFTs in neonates, even when high doses of amino acids (3.5 g/kg per day) are infused.
Amino Acids↗
13C-methacetin breath test as liver function test in patients with chronic hepatitis C virus infection.
BACKGROUND: The 13C-methacetin breath test enables the quantitative evaluation of the cytochrome P450-dependent liver function. AIM: To find out whether this breath test is sensitive in noncirrhotic patients also with chronic hepatitis C in early stages of fibrosis. METHODS: Sixty-one healthy controls and 81 patients with chronic hepatitis C underwent a 13C-methacetin breath test. In all patients, a liver biopsy was performed. The liver histology was classified according to the histology activity index-Knodell score. RESULTS: Delta over baseline values of the patients at 15 min significantly differed from controls (19.2 +/- 9.2 per thousand vs. 24.1 +/- 5.7 per thousand; P < 0.003). The cumulative recovery after 30 min in patients was 11.4 +/- 4.8% and in healthy controls 13.8 +/- 2.8% (P < 0.002). However, patients with early fibrosis (histology activity index IVB) did not differ in delta over baseline values of the patients at 15 min (23.2 +/- 7.9 per thousand vs. 22.6 +/- 7.2 per thousand; P = 0.61) or cumulative recovery (13.6 +/- 3.7% vs. 13.2 +/- 3.8%; P = 0.45) from patients with more advanced fibrosis (histology activity index IVC). Patients with clinically nonsymptomatic cirrhosis (histology activity index IVD; Child A) metabolized 13C-methacetin to a significantly lesser extent (delta over baseline values of the patients at 15 min: 8.3 +/- 4.9 per thousand; P < 0.005 and cumulative recovery after 30 min: 5.6 +/- 3.2%; P < 0.003). The 13C-methacetin breath test identified cirrhotic patients with 95.0% sensitivity and 96.7% specificity. CONCLUSION: The non-invasive 13C-methacetin breath test reliably distinguishes between early cirrhotic (Child A) and noncirrhotic patients, but fails to detect early stages of fibrosis in patients with chronic hepatitis C.
Acetamides↗
[Effect of preoperative liver function on serum lidocaine level during continuous epidural block].
To determine whether the blood lidocaine level during the continuous epidural block correlates with the preoperative liver function, i.e. serum albumin level, serum cholinesterase (ChE) activity, glutamic pyruvic transaminase (GPT) and indocyanine green retention rate (ICG R15), we measured the arterial serum lidocaine level in 45 abdominal surgical patients. The epidural catheter was advanced cephalad from Th10-L2 interspace, for a distance of 4 to 5 cm. Anesthesia was induced with thiopental, and maintained with continuous epidural block plus N2O, O2 and low concentration of isoflurane inhalation. We started epidural block with 0.3 ml.kg-1 body weight of 1.5% lidocaine and added half of the initial dose every 30 minutes for 2 hours. Serum lidocaine concentration was measured every 15 minutes after the lidocaine injection into epidural space. The result revealed that the lower the serum albumin level and ChE activity were, the higher the serum lidocaine level was and, that it had no significant correlation with GPT and ICG R15. We conclude that any patient with hypoalbuminemia and low serum ChE activity might have higher blood lidocaine levels during the continuous epidural block.
Adult↗