Diurnal variation of serum alanine transaminase activity in chronic liver disease

Córdoba, Juan; O’Riordan, Kenneth J.; Dupuis, Josée; Borensztajn, Jayme; Blei, Andrés T.

doi:10.1002/hep.510280640

Cited by 36 publications

(28 citation statements)

References 8 publications

(10 reference statements)

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“…Al igual que en los estudios descritos anteriormente, este estudio mostró que la ALT disminuyó después de una dieta libre de gluten, pero el mismo comportamiento no se observó con la AST. Una posible limitación pudo haber sido la falta de control sobre los factores que afectan los niveles de ALT y AST, tales como día de la recolección, índice de masa corporal, actividad física, almacenamiento de recolección, anemia hemolítica y lesiones musculares (31)(32)(33)(34). Ya que se trataba de un estudio retrospectivo, no se midieron los niveles de ALT y AST en momentos específicos en relación con el diagnóstico o el comienzo de la dieta, pero ambas aminotransferasas se midieron en la misma recolección, lo cual refleja el día a día de la atención clínica a estos pacientes.…”

Section: Discussionunclassified

El efecto de la dieta libre de gluten en la alanina- aminotransferasa (ALT) en pacientes celíacos

Hatanaka

Silva

Dantas-Corrêa

et al. 2016

Rev. Colomb. Gastroenterol.

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El efecto de la dieta libre de gluten en la alaninaaminotransferasa (ALT) en pacientes celíacosThe effect of a gluten-free diet on alanine aminotransferase (ALT) in celiac patients ResumenIntroducción: la enfermedad celíaca es una enfermedad autoinmune provocada por la ingestión de gluten que afecta aproximadamente al 0,5%-1% de la población mundial. Las señales extraintestinales incluyen elevados niveles de alanina-aminotransferasa (ALT). Objetivo: evaluar los efectos de una dieta libre de gluten en los niveles ALT en pacientes con enfermedad celíaca. Métodos: este estudio transversal se llevó a cabo en la clínica ambulatoria de gastroenterología de un hospital universitario. Resultados: se incluyeron veintiséis pacientes con enfermedad celíaca con edad de 34,1 ± 11,4 años; 15,4% fueron hombres. Los sujetos del estudio tenían un nivel promedio de ALT de 54,6 ± 36,3 (mediana 40,5) U/L. Hubo una mayor proporción de individuos con hepatitis B en el grupo con ALT ≥50 U/L en comparación con sujetos con ALT <50 U/L. Entre los pacientes evaluados después del tratamiento con dieta libre de gluten se observó una reducción significativa de los valores de ALT (36,0 versus 31,0 U/l; p= 0,008). Conclusión: el treinta y cinco por ciento de los pacientes con enfermedad celíaca tenía ALT por encima del tercil superior. Se encontraron niveles más altos de ALT en pacientes con hepatitis viral B y en aquéllos que no se adhirieron a la dieta. Hubo una reducción de aminotransferasas como resultado de una dieta libre de gluten. Palabras claveTransaminasas, enfermedad celíaca, alanina-transaminasa, aminotransferasas aspartato, dieta, libre de gluten. AbstractIntroduction: Celiac disease is an autoimmune disease triggered by ingestion of gluten. It affects approximately 0.5% to 1% of the world population. Extra intestinal manifestations include elevated alanine aminotransferase (ALT) levels. Objective: The objective of this study was to evaluate the effects of a gluten-free diet on ALT levels in patients with celiac disease. Methods: This cross-sectional study was conducted in the gastroenterology outpatient clinic of a university hospital. Results: Twenty-six patients with celiac disease were included. Average patient age was 34.1 ± 11.4 years, and 15.4% of the patients were men. Study subjects had a mean ALT level of 54.6 ± 36.3 U/L (median 40.5). There was a higher proportion of individuals with hepatitis B in the group with ALT ≥ 50 U/L than in the group of subjects with ALT < 50 U/L. Among patients tested after treatment with a gluten-free diet, we observed a significant reduction in ALT values (36.0 vs. 31.0 U/L; P = 0.008). Conclusion: Thirty-five percent of celiac disease patients had ALT levels above the upper tertile. Higher ALT levels were found in patients with viral hepatitis B and in those who do not adhere to the diet. There was a reduction of aminotransferases with a gluten-free diet.

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Section: Discussionunclassified

El efecto de la dieta libre de gluten en la alanina- aminotransferasa (ALT) en pacientes celíacos

Hatanaka

Silva

Dantas-Corrêa

et al. 2016

Rev. Colomb. Gastroenterol.

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“…Yet we are still confronted with interpretation-related problems, particularly in paediatrics, as the there is no real consensus on the threshold value to adopt for detecting liver disease. The difficulties are due to a number of biological factors such as the circadian rhythm, anthropometric and demographic characteristics (49)(50)(51)(52). The recent review of Pacifico et al (53) covers the subject in details.…”

Section: Aminotransferases As Biomarkersmentioning

confidence: 99%

Pediatric Nonalcoholic Fatty Liver Disease

Goran¹

2016

Childhood Obesity

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Summary:The rapidly increasing prevalence of childhood obesity and its associated co-morbidities such as hypertriglyceridemia, hyper-insulinemia, hypertension, early atherosclerosis, metabolic syndrome, and non-alcoholic fatty liver disease are major public health concerns in many countries. Therefore the trends in child and adolescent obesity should be closely monitored over time, as in the near future, we may anticipate a major increase of young adults with the stigmata of the metabolic syndrome, and of the related non-alcoholic fatty liver disease (NAFLD), that may lead to non-alcoholic steatohepatitis.

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“…The peak levels that may be observed, if close serial serum samples are obtained for analyses, may be transient and may diminish or disappear within a few days after a single episode of damage. It has even been observed that there is considerable diurnal variation of serum ALT activity levels (Córdoba et al 1998), with afternoon peaks and predawn nadirs. A single determination of ALT or AST does not allow assessment of whether the elevated level of activity is rising or falling.…”

Section: How Can We Detect Drug-induced Liver Injury?mentioning

confidence: 99%

Unintended Hepatic Adverse Events Associated with Cancer Chemotherapy

Senior

2009

Toxicol Pathol

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Chemotherapy is meant to be toxic, but it is particularly aimed at the tumor cells. Collateral damage may occur to normal cells and tissues, especially if they are fairly rapidly regenerating, as is the case for bone marrow cells, intestinal epithelial cells, and liver cells after hepatic injury. The liver has a great capacity to resist injury, overcome it, and to regenerate, even after quite massive injury (resection of 50%-65%, for example). This capacity may make it susceptible to chemotherapeutic toxicity, and a struggle between injury and adaptation, leading to recovery and tolerance or to failure and death. If the chemotherapy is aimed just at delaying progression of the cancer for a few weeks or months, it may not be worth the risk of irreversible liver injury developing in that time. Close clinical observation and sound clinical judgment are required.

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Diurnal variation of serum alanine transaminase activity in chronic liver disease

Cited by 36 publications

References 8 publications

El efecto de la dieta libre de gluten en la alanina- aminotransferasa (ALT) en pacientes celíacos

El efecto de la dieta libre de gluten en la alanina- aminotransferasa (ALT) en pacientes celíacos

Pediatric Nonalcoholic Fatty Liver Disease

Unintended Hepatic Adverse Events Associated with Cancer Chemotherapy

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