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1.
Alcoholic liver disease (ALD) is due to excessive alcohol intake for long duration. Distinguishing ALD from non-ALD (non-alcoholic steatohepatitis, hepatitis of viral origin) is difficult as patient may deny alcohol abuse. Clinical examination, histology and serology may not differentiate these conditions. Accurate diagnosis is important as management of ALD differs from non-ALD patients. The aim of our study was (1) To evaluate the patients of ALD and non-ALD by biochemical parameters compared to controls, (2) To assess whether these parameters can differentiate ALD from non-ALD. Study was carried out on 50 patients of ALD in group I and 35 patients of NASH (non-alcoholic steatohepatitis) and acute viral hepatitis each in group II. Age matched healthy controls n = 50. Selection criteria—history of alcohol intake (amount and duration), clinical examination, sonography of abdomen, serum alanine transaminase (ALT) and bilirubin levels. Blood samples were analyzed for bilirubin, aspartate transaminase (AST), ALT, alkaline phosphatase (ALP), gamma glutamyl transferase (GGT) by kinetic method. Statistical analysis was done by Student unpaired ‘t’ test. Patients of ALD have raised AST/ALT ratio (De Ritis ratio) (>2), ALP and GGT compared to controls (P < 0.01).There is significant difference in AST/ALT ratio, serum GGT and ALP in ALD group compared to that in NASH and acute viral hepatitis (P < 0.05). This study suggests that De Ritis ratio >2 in ALD patients may be due to alcohol induced hepatic mitochondrial injury and pyridoxine deficiency. High GGT and ALP values may indicate enzyme induction by alcohol and mild cholestasis. Thus ALD patients have severe hepatic damage. De Ritis ratio <1 and normal to mild elevation in GGT level in NASH and acute viral hepatitis suggest mild hepatic injury of non-alcoholic origin. Our study concludes that ALD patients can be differentiated from NASH and acute viral hepatitis with certainty by measuring serum AST/ALT ratio, GGT and ALP. These biochemical parameters may help clinicians to support the diagnosis of ALD and non-ALD.  相似文献   

2.
Medically diagnosed alcoholics can be differentiated reliably from non-alcoholics using clinically laboratory tests. In the present study, patients with liver diseases either due to alcohol or without alcohol compared with a group of normal healthy persons. Heavy drinkers showed significantly lower body weight and percent body fat, and low BMI compared with other groups. The percentage of hemoglobin and total number of RBC were found to be significantly decreased, whereas mean corpuscular volume (MCV) significantly increased in alcoholic liver disease (ALD). Hyperbilirubinemia, hyperuricemia and hypoalbuminemia correlate with alcohol intake. Albumin/globulin ratio significantly decreased in ALD. In acute liver injury AST/ALT ratio is ≤1.0, whereas in alcoholic hepatitis it is always >1.0. Moderately elevated level of ALP and high GGT values are good discriminator of alcoholic patients. Alcohol-induced liver injury is linked to oxidative stress as observed by decreased level of reduced glutathione and ascorbic acid, and increased level of thiobarbituric acid reactive substances.  相似文献   

3.
A variety of laboratory tests are available to assist in the diagnosis of alcohol consumption and related disorders. The levels of intake at which laboratory results become abnormal vary from person to person. Laboratory tests are particularly useful in settings where cooperativeness is suspected or when a history is not available. Several biochemical and hematological tests, such as γ-glutamyltransferase (GGT) activity, aspartate aminotransferase (AST) activity, high-density lipoprotein cholesterol (HDL-C) content of serum, and erythrocyte mean corpuscular volume (MCV) are established markers of alcohol intake. Their validity as markers is based largely on correlations with recent intake at a single time point and on decreases in elevated values when heavy drinkers abstain from alcohol. These readily available laboratory tests provide important prognostic information and should be integral part of the assessment of persons with hazardous alcohol consumption. There are several other markers with considerable potential for more accurate reflection of recent alcohol intake. These include carbohydrate deficient transferrin, β-hexosaminidase, acetaldehyde adducts and the urinary ratio of serotonin metabolites, 5-hydroxytryptophol and 5-hydroxyindoleacetic acid. These markers provide hope for more sensitive and specific aids to diagnosis and improved monitoring for intake.  相似文献   

4.
The present study was conducted to evaluate some of the components of antioxidant defense system and oxidative damage in 20 male patients of alcoholic liver disease (ALD). The results were compared with 20 healthy male smokers and 20 healthy male non-smokers volunteers. Patients were subjected to detailed clinical examination and laboratory investigations. Blood samples were collected for estimating reduced glutathione (GSH), total thiols (T-SH) malondialdehyde (MDA), transaminases (AST, ALT), glutathione-S-transferease (GST) and gammaglutamyl transferase (GGT). Serum aspartate amino transferase (AST)/alanine amino transferase (ALT) ratio was significantly (p<0.01) reduced in ALD patients as compared to the controls. However, the core of utility of MDA and GST was found to be significantly (p<0.01) increased in ALD patients compared to controls. There was a significant negative correlation of MDA with both GSH and TSH. Plasma GGT levels were significantly (p<0.01) increased in alcoholics and the enzyme showed a significant positive correlation with MDA. These results give enough evidence of increased oxidative stress and compromised antioxidant defense system in patients with ALD.  相似文献   

5.
Gamma Glutamyl Transferase (γ-GT) is a microsomal enzyme. Its activity in serum is assayed in alcoholics with liver abscess and alcoholics without liver abscess after screening by ultrasonography. The enzyme activity in serum is increased by 334% in the patients with liver abscess compared to normal control subjects (p<0.0001), and 172% when compared to patients with chronic alcoholism without liver abscess (p<0.0001). The enzyme activity was increased by 59.3% in the serum of patients without liver abscess compared to the normal control subjects (p<0.001). Measurement of γ-GT in serum appears to be a sensitive index in the diagnosis of alcoholics with liver abscess.  相似文献   

6.

Introduction:

In this work we report on the possible effect of the medical therapy on CDT concentration in a chronic alcohol abuser, with known medical history (July 2007 – April 2012) and alcohol abuse confirmed by relatives.

Case history:

At the end of 2007, patient displayed the following laboratory results: AST 137 U/L, ALT 120 U/L, GGT 434 U/L, MCV 101 fL and CDT 3.3%. On December 2007, after double coronary artery bypass surgery, he began a pharmacological treatment with amlodipine, perindopril, atorvastatin, isosorbide mononitrate, carvedilol, ticlopidine and pantoprazole. In the next months, until may 2011, the patient resumed alcohol abuse, as confirmed by relatives; however, CDT values were repeatedly found negative (0.8% and 1.1%) despite elevated transaminases and GGT, concurrent elevated ethyl glucuronide concentration (> 50 mg/L) and blood alcohol concentration (> 1 g/L). Alcohol consumption still continued despite increasing disulfiram doses ordered by an Alcohol Rehab Center. On May 2011, the patient was transferred to a private medical center where he currently lives.

Conclusions:

This study suggests the possibility that a medical therapy including different drugs may hamper the identification of chronic alcohol abusers by CDT.  相似文献   

7.
High sensitive C-reactive protein (hs-CRP), a non-specific marker of inflammatory status has considerable interest focused due to its ability to predict myocardial infarction, stroke, peripheral arterial disease and sudden cardiac death. Alcoholics are known to be associated with inflammation of heart. This study was taken up to look for an association between consumption of alcoholic beverages over 10 years and serum concentration of hs-CRP. 3 groups were studied, 30 age matched control, 30 non-drinkers with cardio vascular complications and 30 alcoholics with history of cardio-vascular disease. Blood was analyzed for hs-CRP. Results indicated that the level of hs-CRP was 0.17 ± 0.16 mg/lit in group 1; 0.79 ± 0.41 mg/lit in group 2 and 1.67 ± 0.16 mg/lit in group 3. A correlation was also obtained between the hs-CRP levels and cardiac efficiency in chronic alcoholics. The elevated hs-CRP levels in chronic alcoholic with heart disease could probably be due to enhanced damaging effect of alcohol on the heart and other organs.  相似文献   

8.
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 36.00 M, GGT—34.58 F vs 36.20 M) 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 27.00 IU/L and GGT—37.59 vs 35.26 IU/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.  相似文献   

9.
The present study was undertaken to explore the relationship of plasma homocysteine with other biochemical parameters in ischemic heart disease. Plasma levels of total homocysteine was measured by HPLC—fluorescence detection with internal standard in 60 ischemic heart disease patients and were compared with 30 age matched normal healthy controls. The significant increase of plasma homocysteine was observed in both myocardial infarction and chronic stable ischemic heart disease patients when compared with the controls. The hyperhomocysteinemia appears be to due to increased body demand of vitamins such as folic acid, vitamin B12, B6, B2 either alone or in combination to regulate normal homocysteine metabolism.  相似文献   

10.
Serum levels of leucine amino peptidase (LAP) was studied along with bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), gamma glutamyl transpeptidase (GGT), alkaline phosphatase (ALP) and the ratio of AST/ALT and GGT/AST in 25 healthy subjects and 52 patients with hepatobiliary malignancies of which 12 were with hepatocellular carcinoma, 12 with liver metastasis, 6 with obstructive jaundice, 9 with carcinoma of gall bladder, 6 with carcinoma of pancreas and 7 with periampullary carcinoma. 24 Of the 52 patients studied had jaundice and 28 were without jaundice. LAP as compared to the other enzymes AST, ALT, GGT, ALP and AST/ALT ratio and GGT/AST ratio showed 100% elevation in obstructive jaundice, carcinoma of gall bladder and pancreas and periampullary carcinoma, 91.7% elevation in hepatocellular carcinoma and 83.3% elevation in liver metastasis. On comparing the levels of these enzymes in non jaundiced and jaundiced groups, LAP was elevated in both jaundiced and non jaundiced groups in 95.8% and 92.9% cases respectively whereas the other enzymes AST showed increase from 67.9% to 100%, ALT from 21.4% to 83.3%, GGT from 71.4% to 95.4% and ALP from 82.1% to 100% in non jaundiced and jaundiced groups respectively indicating that LAP rises in hepatic dysfunction due to hepatobiliary malignancy whereas the other liver function enzymes showed increased hepatic dysfunction due to hepatobiliary malignancy with the onset of jaundice thereby indicating that LAP is a better indicator of hepatobiliary malignancy as compared to other enzymes. The quantitative methods used for determination are reliable, accurate, simple, rapid and cost effective and therefore have better application in a clinical setting.  相似文献   

11.
Rats were fasted for 8 hours and then fed 3 ml of 25% (v/v) ethanol per 100g body weight and subsequently sacrificed 18 hours later. The levels of triacylglycerols and total cholesterol were significantly raised in serum and liver of alcohol fed rats. However, when rats were fed on aqucous extract of onions (300 mg per 100g body weight) with 25% ethanol, no rise in serum and liver lipids was observed. Alcohol fed to the fats with or without onion extract had no effect on serum, AST, ALT and alkaline phosphatase levels. The increase in serum urea in ethanol-fed rats was not altered in rats fed a mixture of alcohol and onion extracts. Values of liver MDA was lower in rats fed ethanol with or without onion extract compared to controls. Onion extract seemed to show a hypolipidemic effect in alcohol fed rats.  相似文献   

12.
Wistar rats of 6–8 weeks in age weighing between 120–150 g were exposed to the fixed doses of each of the carbamate pesticides such as cartap (50% LD50) and carbofuran (50% LD50) as well as a combination of these two with 25% LD50 of each for one week. The effect of treatments was studied in terms of serum lipid parameters such as high-density lipoprotein, total cholesterol, triglyceride, low-density lipoprotein and very low-density lipoprotein. Treatment with individual doses of carbofuran (50% LD50) and cartap (50 % LD50) caused significant alterations in the levels of serum lipid parameters. The pesticides treatment resulted in marked decrease in the level of serum high-density lipoprotein where as that of other lipids got significantly elevated. Further, the rats exhibited relatively higher impact of pesticides when treated with the compounds in combination (25 % LD50 of each). The results indicated that these compounds when used together may exert enhanced effect on the levels of serum lipids in rat.  相似文献   

13.
In the present study, the role of serum lipid peroxide and serum nitric oxide as oxidants and erythrocytic superoxide dismutase & serum vitamin E as antioxidants were determined in the 50 neonates with hypoxic ischaemic encephalopathy. (HIE) as against 25 healthy neonates as controls 50 patients of HIE were further divided into two groups i. e. mild and moderate HIE patients. All subjects were in the age group of 37–41 weeks of gestation. The levels of serum lipid peroxide, serum nitric oxide and erythrocytic superoxide dismutase were significantly elevated in both groups of neonates with HIE than those of controls (P<0.001), whereas serum vitamin E levels were significantly decreased in both groups of HIE patients than those of controls (P<0.001). A positive correlation was obtained between serum lipid peroxide and erythrocytic superoxide dismutase (r=+0.86). Alterations in the status of oxidants and antioxidants indicate role of free radicals in the development of HIE.  相似文献   

14.
Thyroid hormones regulate the renal hemodynamics and basal metabolic rate of most cells. This hospital-based case-control study was done to evaluate the changes in biochemical markers of liver and kidney function in hypothyroid subjects before and after treatment. The study included 176 subjects randomly selected from Thyroid clinics. Serum T3, T4, TSH, Liver and Kidney Function tests were analysed using standard kits. Forty-six hypothyroid patients were re-evaluated 6 weeks after thyroxine substitution therapy. Hypothyroid subjects (n=80) showed significantly raised serum creatinine and uric acid levels as compared to euthyroid subjects (n=96). After 6 weeks of thyroxine replacement, serum creatinine and uric acid decreased significantly and were comparable to euthyroid group. A positive correlation of ALT, AST, uric acid, protein and albumin with TSH levels (p<0.05) and negative correlation of serum T4 levels with ALT, AST, proteins (p<0.05) was observed in the hypothyroid group. Hypothyroidism results in reversible impairment of hepatorenal function.  相似文献   

15.
Till date no community based data on plasma homocysteine is available in North Eastern Region. Hence, the present study was conducted to analyze and correlate the plasma homocysteine level with some life style factors like diet, alcohol intake, smoking habit and body weight, in a cross-section of population. 12 h fasting samples of 970 apparently healthy, Assamese population of both genders in the age group of 35–86 years, mostly from the urban area of Assam were tested for plasma total homocysteine level over a period of 3 years. Out of 970 volunteers, hyperhomocysteinemia was detected in 533 (55%) individuals with a mean value of 18.41 μmol/l. Of that hyperhomocysteinemia, 89.1% were in the range of moderately high and rest 10.9% were intermediate high. Another finding was that males had a tendency towards greater value (mean = 20.36 μmol/l) than females (mean = 16.37 μmol/l). It was observed that the relationship of homocysteine levels to gender and some of the life style factors were also significant.  相似文献   

16.
Homocysteine(Hcy) has been implicated as a novel risk factor of Coronary Artery Disease (CAD) among Asian Indians, but many studies done in India failed to reveal any direct correlation. It has also been reported that Folic acid and Vitamin B12 levels inversely affect serum levels of homocysteine. In this study, we looked at the levels of homocysteine among patients with CAD. The effect of Vitamin B12, Folate and other risk factors on homocysteine levels were also evaluated. Mean homocysteine levels in cases (22.81±13.9, n=70) were significantly higher (p=<0.001) than the controls (7.77±7.3, n=70). However no statistically significant correlation could be deduced between homocysteine Vitamin B12, and Folate. Cumulative analysis have indicated an increase in homocysteine levels among patients with CAD with every additional risk factor.  相似文献   

17.
Coronary artery disease (CAD) has become the most common cause of mortality in the entire world. Homocysteine is implicated as an early atherosclerotic promoter. We studied the relationship between levels of serum homocysteine with severity of coronary artery disease. Total of 70 subjects who scheduled for coronary angiogram consented to participate in this study. In all the patients Gensini scoring system was used to assess the severity of CAD. Venous samples were taken from the patients in fasting state before angiography. Homocysteine levels in patients were measured by enzyme linked immunosorbant method and were compared with respective Genseni scores of participants. Fasting serum homocysteine levels in CAD patients were significantly higher than patients without coronary artery disease (p < 0.001). Also Homocyseine levels correlated significantly with increasing severity of CAD (p < 0.001). Serum homocysteine levels correlated well with the severity of CAD.  相似文献   

18.
The severity of alcoholic cirrhosis depends on the presence of liver inflammation and fibrogenesis. Previous studies have hypothesized that carbohydrate deficient transferrin can be used as marker of liver impairment in alcoholic liver disease patients. The present study was designed to assess whether carbohydrate deficient transferrin is associated with procollagen III peptide and predict fibrosis in alcohol cirrhosis patients. We enrolled 48 patients with alcoholic cirrhosis and 38 healthy controls. Serum carbohydrate deficient transferrin, procollagen III peptide and interleukin-6 levels were estimated in both groups. Serum carbohydrate deficient transferrin, procollagen III peptide and interleukin-6 were significantly increased in alcoholic cirrhosis patients compared to controls. Stepwise regression analysis showed that carbohydrate deficient transferrin (adjusted R2 = 0.313, β = 0.362, p = 0.003) and interleukin-6 (adjusted R2 = 0.194, β = 0.459, p = 0.001) were positively associated with procollagen III peptide when age, duration and amount of alcohol consumption were considered as covariates. We conclude that elevated carbohydrate deficient transferrin and interleukin-6 act as predictors of fibrosis in alcoholic cirrhosis.  相似文献   

19.
A 24 week follow-up study on lipid change following maintenance haemodialysis (MHD) in 25 chronic renal failure (CRF) patients revealed significantly raised serum Triacylglycerol (TAG) levels in these cases (P<0.001), while cholesterol and HDL-Cholesterol did not show any significant change, the extent of increase was 10.5±3.6% after 12 weeks and 23.0±5.8% after 24 weeks. Corresponding increase in CRF patients treated conservatively, without haemodialysis, were 3.1±1.2% and 7.2±2.7% at these intervals. Subsequent oral administration of L-Carnitine (5mg/kg body weight twice a day) for three weeks brought about a significant reversal of elevated serum TAG level in MDH group as well as in the conservatively treated group (P≤0.05). It is concluded that the haemodialysis induced Hyper-Triacylglycerolemia of CRF patients is revertible by Carnitine replenishment. Even the concomitant increase in conservatively treated group is revertible by carnitine administration.  相似文献   

20.
Infertility is well-established harmful effect in chronic alcoholism and so far, there is no effective treatment for this condition. The study was conducted to determine the effects of alpha tocopherol on ethanol induced testicular injuries in male albino rats of Wistar strain. Five groups (n=6) of animals were used. Group I served as control. Group II received daily 1.6g ethanol/kg body weight/day for 4 weeks orally. Group III received 1.6g ethanol+80mg alpha tocopherol/kg body weight/day for four weeks orally. Group IV received 1.6g ethanol/kg body weight for/day 4 weeks and followed by 80mg alpha tocopherol/kg body weight/day for four weeks orally. Group V received 1.6g ethanol/kg body weight/day orally for 4 weeks, followed by 4 weeks abstinence. Twently-four hours after the last treatment the rats were sacrificed using anesthetic ether. Testes were removed and used for the estimation of extent of lipid peroxidation and tissue levels of antioxidants and steroidogenic enzymes. Alpha tocopherol treatment increased the activities of testicularΔ 5, 3β-HSD. Moreover, the treatment was also associated with significant decrease in testicular oxidative stress. Ethanol-induced oxidative stress and decreased steroidogenesis can be reversed by treatment with alpha tocopherol.  相似文献   

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