Association Between Elevated Liver Enzymes and C-Reactive Protein

Kerner, Arthur; Avizohar, Ophir; Sella, Ron; Bartha, Peter; Zinder, Oren; Markiewicz, Walter; Levy, Yishai; Brook, Gerald J.; Aronson, Doron

doi:10.1161/01.atv.0000148324.63685.6a

Cited by 211 publications

(86 citation statements)

References 44 publications

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“…A positive correlation between CRP/IL-6 and TG concentrations exists (Fredrikson et al, 2004). Dietary carbohydrates stimulate TG production in the liver and may cause secondary hepatic inflammation with associated higher CRP concentrations (Kerner et al, 2005). This increase in TG seems to be intermittent and the concentrations decrease again over time indicating that DF might counteract the hypertriglyceridaemic effect of carbohydrates (Rivellese et al, 1994).…”

Section: Discussionmentioning

confidence: 99%

The effects of dietary fibre on C-reactive protein, an inflammation marker predicting cardiovascular disease

2009

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Background: C-reactive protein (CRP), a sensitive marker of inflammation, is an independent predictor of future cardiovascular disease (CVD), which is a major cause of death worldwide. In epidemiological trials, high-fibre intakes have consistently been associated with reduction in CVD risk and CRP levels. Objective: The objective of this study was to assess the influence of dietary fibre (DF) on CRP in clinical trials. Data sources: Databases were searched from the earliest record to April 2008 and supplemented by crosschecking reference lists of relevant publications. Study selection: Human adult intervention trials, at least 2 weeks in duration, with an increased and measurable consumption of DF were included and rated for quality. Data synthesis: Seven clinical trials were included, and six of these reported significantly lower CRP concentrations of 25-54% with increased DF consumption with dosages ranging between 3.3-7.8 g/MJ. The seventh trial with psyllium fibre supplementation failed to lower CRP levels significantly in overweight/obese individuals. Weight loss and altered fatty acid intakes were present in most of the studies. Conclusions: In the presence of weight loss and modified saturated, monounsaturated and polyunsaturated fat intakes, significantly lower CRP concentrations (k25-54%) are seen with increased fibre consumption (X3.3 g/MJ). Mechanisms are inconclusive but may involve the effect of DF on weight loss, and/or changes in the secretion, turnover or metabolism of insulin, glucose, adiponectin, interleukin-6, free fatty acids and triglycerides. Clinical studies of high-and low-fibre diets are needed to explore the potential favourable effects as observed epidemiologically, and to understand individual susceptibility to its antiinflammatory effect and long-term cardiovascular reduction.

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Section: Discussionmentioning

confidence: 99%

The effects of dietary fibre on C-reactive protein, an inflammation marker predicting cardiovascular disease

2009

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“…Levamisole, a nonspecific inhibitor of ALP, could also reduce aortic calcification of uremic rat (17). Apart from vascular calcification, previous studies suggested that inflammation indicated by a higher level of CRP or the counts of white blood cells might be associated with elevated ALP and then participate in higher mortality (3,20,21). N/L is widely used as a marker of inflammation and a strong predictor for overall and cardiovascular mortality in PD patients (22).…”

Section: Discussionmentioning

confidence: 99%

Alkaline Phosphatase and Mortality in Patients on Peritoneal Dialysis

Liu

Guo

Feng

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives Elevated total serum alkaline phosphatase levels have been associated with higher mortality in the general population, CKD patients, and hemodialysis patients. However, in peritoneal dialysis patients, this association has received little attention. The aim of this study was to evaluate the association between alkaline phosphatase and all-cause and cardiovascular mortality in peritoneal dialysis patients.Design, setting, participants, & measurements In this single center retrospective cohort study, 1021 incident peritoneal dialysis patients from January 1, 2006, to December 31, 2010 with baseline serum alkaline phosphatase values were enrolled. Collected baseline data included demographic characteristics and clinical and laboratory measurements. All patients were followed until December 31, 2012. The associations of total serum alkaline phosphatase levels with allcause and cardiovascular mortality were assessed using multivariable-adjusted Cox models.Results Of 1021 patients, mean age was 47.5 (615.5) years, 59.1% of patients were men, and 22.8% of patients were diabetic. The median serum alkaline phosphatase level was 64 U/L (interquartile range=52-82 U/L). During a median 31-month (interquartile range=19-45 months) follow-up period, 203 patients died, of which 109 deaths were caused by cardiovascular disease. After adjusting for demographics, comorbid conditions, liver function, and bone metabolism parameters, the highest alkaline phosphatase quartile was significantly associated with a hazard ratio for all-cause mortality of 1.70 (95% confidence interval, 1.06 to 2.74, P=0.03) and a hazard ratio for cardiovascular mortality of 1.94 (95% confidence interval, 1.02 to 3.72, P=0.04). Each 10 U/L higher baseline alkaline phosphatase level was associated with 4% (95% confidence interval, 1.00 to 1.08, P=0.04) and 7% (95% confidence interval, 1.02 to 1.11, P=0.003) higher risk of all-cause and cardiovascular mortality, respectively. ConclusionHigher total serum alkaline phosphatase levels at the commencement of peritoneal dialysis were independently associated with all-cause and cardiovascular mortality in peritoneal dialysis patients.

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“…Elevated C-reactive protein (CRP) concentrations are related to insulin resistance, to MS, predict coronary heart disease, diabetes and have also been reported in NAFLD. 16,17 A high prevalence of nonorgan-specific autoantibodies, has been found in NAFLD associated with insulin resistance 18 and in patients with coronary atherosclerosis as well. 19 These data indicate that systemic subclinical inflammation typically associated with MS are also found in NAFLD.…”

Section: Pathogenesismentioning

confidence: 99%

Review article: the metabolic syndrome and non‐alcoholic fatty liver disease

Loria

Lonardo

Carulli

et al. 2005

Aliment Pharmacol Ther

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SUMMARYMetabolic syndrome represents a common risk factor for premature cardiovascular disease and cancer whose core cluster includes diabetes, hypertension, dyslipidaemia and obesity. The liver is a target organ in metabolic syndrome patients in which it manifests itself with nonalcoholic fatty liver disease spanning steatosis through hepatocellular carcinoma via steatohepatitis and cirrhosis. Given that metabolic syndrome and non-alcoholic fatty liver disease affect the same insulin-resistant patients, not unexpectedly, there are amazing similarities between metabolic syndrome and non-alcoholic fatty liver disease in terms of prevalence, pathogenesis, clinical features and outcome. The available drug weaponry for metabolic syndrome includes aspirin, metformin, peroxisome proliferator-activated receptor agonists, statins, ACE (angiotensin I-converting enzyme) inhibitors and sartans, which are potentially or clinically useful also to the non-alcoholic fatty liver disease patient. Studies are needed to highlight the grey areas in this topic. Issues to be addressed include: diagnostic criteria for metabolic syndrome; nomenclature of non-alcoholic fatty liver disease; enlargement of the clinical spectrum and characterization of the prognosis of insulin resistance-related diseases; evaluation of the most specific clinical predictors of metabolic syndrome/non-alcoholic fatty liver disease and assessment of their variability over the time; characterization of the importance of new risk factors for metabolic syndrome with regard to the development and progression of non-alcoholic fatty liver disease.

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Association Between Elevated Liver Enzymes and C-Reactive Protein

Cited by 211 publications

References 44 publications

The effects of dietary fibre on C-reactive protein, an inflammation marker predicting cardiovascular disease

The effects of dietary fibre on C-reactive protein, an inflammation marker predicting cardiovascular disease

Alkaline Phosphatase and Mortality in Patients on Peritoneal Dialysis

Review article: the metabolic syndrome and non‐alcoholic fatty liver disease

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