皮革企业接触二甲基甲酰胺作业工人健康监护结果

目的探讨接触二甲基甲酰胺（DMF）对作业工人肝功能的影响,提出预防职业病危害的有关建议。方法根据工厂近几年车间空气中DMF的监测数据,将作业工人分为对照组、低浓度组及高浓度组。收集2010年度4家皮革企业共236名作业工人的健康检查报告涵盖各组研究对象的基本情况：年龄、性别、工龄等）,体重、吸烟、饮酒和作业时间等另行问卷调查,对结果进行分析。结果高浓度组消化道症状出现率明显高于对照组,且有从对照组、低浓度组向高浓度组逐渐升高的趋势;低浓度组和高浓度组血清中丙氨酸转氨酶（ALT）及γ-谷氨酰转肽酶（γ-GT）水平明显高于对照组,高浓度组血清天冬氨酸转氨酶（AST）水平高于低浓度组;高浓度组肝脏指数（L iVer index）明显高于对照组和低浓度组。结论接触DMF浓度与时间对人体肝功能影响较大,应通过做好作业岗位通风排毒、限制接触时间来保护作业工人身体健康,同时,根据DMF作用机制,建议规范职业健康监护（周期、项目）,做好员工的预防性用药。     

二甲基甲酰胺对作业工人肝肾损害和脂代谢的影响

目的探讨聚氨酯合成革业二甲基甲酰胺（DMF）对作业工人肝肾损害与脂代谢的影响。方法选择某聚氨酯合成革厂作业工人260名为对象，根据各岗位连续3d空气DMF浓度监测结果，计算时间加权平均（TWA）浓度，分为高浓度接触组（TWA〉55mg／m^3）、中浓度接触组（TWA15-45mg／m^3）、低浓度接触组（TWA2-10mg／m^3）和对照组。测定血清中丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、γ-谷氨酰转肽酶（γ-GT）、碱性磷酸酶（ALP）、血清总胆红素（STB）、总胆固醇（CHO）、三酰甘油（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）和尿β2-微球蛋白（β2-MG）。结果接触组工人自述恶心19．31％、腹痛15．45％、腹胀13．73％、食欲减退9．01％；接触组肝功能ALT、AST、γ-GT异常检出率分别为34．33％、37．33％和38．20％；肝功能指标ALT、AST、γ-GT在高、中、低各组间比较，差异有统计学意义（P〈0．05）；高浓度接触组尿β2-MG和血清HDL检出值高于其他组别，差异有统计学意义（P〈0．05）。结论DMF主要靶器官为肝脏，对肝功能的损害存在明显的剂量-反应关系；高浓度接触可对肾功能产生损害，对脂代谢可能产生一定的影响。     

2015年张家港市二甲基甲酰胺对接触工人肝功能的影响

目的分析二甲基甲酰胺(DMF)对接触工人肝功能的影响,为该行业劳动者的职业病防治提供科学依据。方法对2015年张家港市接触二甲基甲酰胺的工人451人和对照组189人进行职业健康体检,并对其肝功能结果进行分析。结果接触组的脂肪肝、脂肪肝趋势的发病率均高于对照组,差异有统计学意义;无脂肪肝组、脂肪肝组、脂肪肝趋势组在AST/ALT比值的分布上存在统计学差异;接触组与对照组中的脂肪肝发病人群中,接触组AST/ALT<1的人数高于对照组,差异有统计学意义;接触组AST/ALT<0.6的人数高于对照组,差异有统计学意义。结论 DMF能导致肝细胞脂肪变性,AST/ALT比值可以作为DMF引起的肝脏损伤的评价指标之一。DMF对接触工人的健康有一定影响,接触DMF的工人应进一步加强自身防护。     

职业接触灭蚁药物人群的肝功能损伤

[目的]探讨职业性接触氯丹、含砷化合物灭蚁药物对作业人员肝功能水平的影响。[方法]对作业人员进行血清丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、γ-谷氨酰转移酶(γ-GT)、碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)、甘胆酸(CG)、氯丹和尿液砷水平进行了检测分析。并对工龄、吸烟、饮酒和体内毒物的浓度对肝功能各项指标的影响进行统计学分析。[结果]职业接触灭蚁药物使血清γ-GT、LDH和CG水平增高(P<0.05),并与接触工龄相关;饮酒能加重含砷和氯丹类灭蚁药物对职业人群肝脏的损伤作用(P<0.05),使血清γ-GT、LDH和CG水平显著增高,吸烟对接触含砷或氯丹类灭蚁药物的职业人群肝脏的损伤没有影响;血清γ-GT、LDH和CG水平均与血清氯丹和尿砷含量呈正相关。[结论]接触灭蚁药物能使职业人群肝功能水平明显损伤。     

湿热型黄疸新生儿血清S100B和γ-谷氨酰转肽酶表达与疾病严重程度的相关性

目的探究湿热型黄疸新生儿血清S100B和γ-谷氨酰转肽酶(γ-GT)表达与疾病严重程度的相关性。方法选取2018年6月-2020年6月在该院就诊的120例急症湿热型黄疸新生儿为观察组,另选择同期在该院分娩的120例无黄疸健康新生儿为对照组。采用酶联免疫吸附法(ELISA)检测两组新生儿血清S100B水平;采用全自动生化检测仪检测两组新生儿血清γ-GT、谷草转氨酶(AST)、谷丙转氨酶(ALT)、总胆红素(TBIL)及直接胆红素(DBIL)水平;采用Pearson法分析湿热型黄疸新生儿血清S100B和γ-GT与ALT、AST、DBIL及TBIL水平的相关性;采用多因素Logistic回归分析新生儿发生湿热型黄疸的影响因素。结果观察组新生儿血清AST、ALT、DBIL、TBIL、S100B及γ-GT水平均显著高于对照组,差异均有统计学意义(均P0.05)。Pearson相关性分析结果显示,血清S100B和γ-GT水平均与AST、ALT、DBIL及TBIL呈正相关关系(均P0.05)。多因素Logistic回归分析结果显示,血清TBIL、S100B及γ-GT高表达均是新生儿发生湿热型黄疸的危险因素(均P 0.05)。结论急症湿热型黄疸新生儿血清S100B和γ-GT表达水平均显著升高,两者参与湿热型黄疸的发生发展,并与疾病严重程度有一定关系。     

二甲基甲酰胺作业工人肝肾损害和尿中甲基甲酰胺含量的关系

目的　探讨二甲基甲酰胺 (DMF)作业工人肝肾损害和其尿中甲基甲酰胺含量的关系。方法　选择某PU革厂 10 5名男性DMF作业工人为接触组 ;选择同一地区不接触DMF和其他有害因素的食品厂 5 2名男性工人为对照组。测定血清中总蛋白 (TP)、白蛋白 (ALB)、球蛋白 (GLB)、丙氨酸转氨酶 (ALT)、天冬酸转氨酶 (AST)、γ 谷氨酰转肽酶 (γ GT)、肌酐 (CREA)和尿素氮 (BUN)等生化指标 ;气相色谱法检测DMF作业工人班末尿中甲基甲酰胺 (NMF)含量 ;区域比例取样测定全身体表DMF污染总量。结果　接触组腹痛、恶心和食欲减退发生率分别为 4 0 .95 %、9.5 2 %和 11.4 3% ,与对照组相比 ,差异有显著性 (P <0 .0 1,P <0 .0 5 ) ;接触组ALT、AST和γ GT异常率分别高达 5 7.1%、37.1%和 38.1% ,ALT和AST异常率高于对照组 ,差异有显著性 (P <0 .0 1) ;2 1名工人尿NMF含量与ALT、AST值之间分别存在明显的正相关 (r=0 .4 99,r =0 .5 0 1,P <0 .0 5 ) ;接触组工龄与ALT、AST和γ GT值之间均无明显相关 (P >0 .0 5 ) ;2 1名接触DMF工人全身皮肤染总量与尿NMF含量之间无明显相关 (P >0 .0 5 )。结论　DMF主要经呼吸道吸收 ,在体内无累积作用 ,肝脏是主要靶器官 ;尿NMF含量检出可作为DMF作业工人的生物监测指标。     

浙江省制衣业二甲基甲酰胺职业危害状况调查

选择生产与使用仿皮面料的13家企业进行劳动卫生学调查,以接触DMF的1296名工人为接触组,不接触有毒有害物质的386名工人为对照组,进行问卷与健康体检。结果生产仿皮面料厂160份空气样品中DMF超标率为48·8%,使用仿皮面料厂13份空气样品中DMF超标率为38·46%;仿皮面料样品4份浸出液中DMF范围为0·15~14·4mg/g。接触组消化系统、神经系统主诉症状高于对照组,其ALT、AST、γ-GT、外周血象异常率亦均高于对照组,接触组42名工人DMF尿中代谢产物NMF浓度平均为164·93mg/gCr,对照组工人未检出,NMF含量与空气中DMF浓度及ALT、AST值之间有相关性。     

职业接触砷工人肝功酶谱及肝功能变化

目的　通过对486名职业接触砷工人的尿砷、肝功酶谱及肝功等指标的测定,探讨砷对肝脏的毒性作用以及各种指标的敏感性。方法　根据尿砷的测定值将486名砷作业工人分为二组,第一组3 3 8名,尿砷小于0 . 1mg/L ,均值为(0 . 0 6±0 . 0 5 )mg/L ;第二组14 8名,尿砷大于0 . 1mg/L ,均值为(0 . 17±0 . 0 6)mg/L ;选取无肝脏毒物接触史的工人10 0名为对照组,尿砷的测得值为(0 . 0 2±0 .0 3 )mg/L。测定各组工人的血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰基转移酶(GGT)、碱性磷酸酶(ALP)、总胆红素(TBIL)、直接胆红素(DBIL)、总蛋白(TP)、白蛋白(ALB)。结果　砷作业工人无论第一组还是第二组尿砷含量都明显高于对照组;第一组血清ALT、AST、GGT和ALP活性显著高于对照组,但仍属正常参考值范围;第二组血清ALT、AST、GGT和ALP活性都显著高于对照组,ALT、AST和GGT活性明显高于第一组,ALT、AST活性高于正常参考值,其他肝功指标均无显著变化。比较不同工龄砷作业工人肝功酶谱的变化,工龄10～15年的工人血清ALT、AST活性显著高于对照组;工龄≥15年时,血清ALT、AST、GGT、ALP的活性都高于对照组,其中ALT和AST活性高于正常参考值。结论　职业接触砷的工人尿砷显著高于对照组,对肝脏有一定的损伤     

脂肪肝患者ALT、AST、γ-GT水平及意义

目的探讨脂肪肝患者血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(γ-GT)水平及意义。方法选取2017年1月~2018年8月在火箭军特色医学中心治疗的脂肪肝患者110例(观察组),其中酒精性脂肪肝患者46例,非酒精性脂肪肝患者64例;轻度患者32例,中度患者51例,重度患者27例。同时选取健康志愿者100例作为健康对照组。检测并比较两组血清ALT、AST、γ-GT水平。结果观察组血清ALT、AST、γ-GT分别为(38.10±8.21)U/L、(29.03±6.12)U/L和(45.59±12.12)U/L,明显高于健康对照组,而AST/ALT为(0.76±0.20)明显低于健康对照组,差异有统计学意义(P<0.05);观察组酒精性脂肪肝AST、AST/ALT和γ-GT为(32.10±5.83)U/L、(0.83±0.20)和(67.82±9.29)U/L,明显高于非酒精性脂肪肝,差异有统计学意义(P<0.05);观察组重度患者ALT、AST和γ-GT分别为(42.59±7.23)U/L、(32.37±3.18)U/L和(54.40±9.99)U/L,明显高于轻度和中度患者,差异有统计学意义(P<0.05)。结论脂肪肝患者ALT、AST及γ-GT有所升高,与脂肪肝类型及严重程度有一定关系。     

108例轮状病毒肠炎合并肝脏损害临床分析

目的探讨轮状病毒肠炎合并肝脏损害的临床特征。方法对485例轮状病毒肠炎患儿作肝功能及肝脏B超检查,并对其中108例合并肝脏损害者的临床特征进行分析。结果(1)108例轮状病毒肠炎合并肝脏损害患儿中,单纯丙氨酸转移酶(ALT)升高者30例,占27.8%,单纯天冬氨酸转移酶(AST)升高者18例,占16.7%,单纯γ-谷氨酰转肽酶(γ-GT)升高者10例,占9.3%,ALT和AST2项酶同时升高者24例,占22.3%,ALT、AST和γ-GT3项酶同时升高者12例,占11.1%,转氨酶升高伴胆红素(TBIL或DBIL)升高者3例,占2.7%,转氨酶升高伴白蛋白(ALB)降低者3例,占2·7%,肝功能异常伴肝脏肿大者8例,占7.4%;ALT升高总例数为66例,占61.1%,AST升高总例数为54例,占50%,γ-GT升高总例数为22例,占20.4%。(2)经病毒唑及能量合剂等护肝治疗后,2周内ALT恢复正常者60例,占全部ALT升高病例的90.9%,AST恢复正常者51例,占全部ALT升高病例的94.4%,γ-GT恢复正常者21例,占全部γ-GT升高病例的95.5%;合并TBIL或DBIL升高及ALB降低、肝脏肿大者,均于2周内全部恢复正常。结论轮状病毒肠炎可同时合并肝脏损害,其中,以ALT及AST升高者最多见,经一般抗病毒及护肝等治疗后,预后良好,绝大多数患儿在2周内肝功能及肝脏大小均可恢复正常。     

Body weight, alcohol consumption and liver enzyme activity--a 4-year follow-up study

BACKGROUND: This prospective study was performed in order to investigate the effect of baseline body mass index (BMI), BMI changes, baseline alcohol consumption, and changes in alcohol consumption on liver enzyme activity. METHODS: This study population consisted of 6846 male workers in a steel manufacturing company who had undergone health examinations in 1994 and 1998. RESULTS: The risk for elevated both aspartate aminotransferase (AST) and alanine aminotransferase (ALT) values over the four years increased with the baseline BMI and BMI changes, but not with alcohol consumption. Compared with the subject BMI < 20, the adjusted odds ratios (OR) for those with baseline BMI 20-21.9, 22-24.9, 25- were 1.2, 1.6, 1.7 in AST and 1.4, 2.4, 2.8 in ALT, respectively. Compared with subjects who either lost or maintained their weight, the adjusted OR for men with slight, moderate, and heavy weight gain were 1.7, 2.6, 6.8 in AST and 2.4, 3.9, 11.3 in ALT, respectively. However gamma-glutamyl transferase (GGT) was associated with BMI changes and baseline alcohol consumption, not with baseline BMI and changes in alcohol consumption. Compared with subjects who lost or maintained weight, the adjusted OR for men with slight, moderate, and heavy weight gain were 2.4, 4.4 and 8.5, respectively. In comparison with non-drinkers, the adjusted OR for light, moderate and heavy drinkers were 1.8, 2.1 and 5.8, respectively. CONCLUSION: These data suggest that body weight, rather than alcohol consumption, may be the major factor in determining the serum level of liver enzymes. Even when body weight was not generally considered to be overweight, slight to moderate gains in weight were associated with increases in serum liver enzymes.     

Liver function assessment in workers exposed to vinyl chloride

Objective: To investigate liver function in vinyl chloride workers and assess its relation with current/past occupational exposure to vinyl chloride monomer (VCM). Methods: A medical examination including the execution of liver function tests (LFTs) and liver ultrasonography was executed in a group of 757 workers with a long-standing service in the production of VCM/polyvinylchloride (PVC). Cumulative and maximum VCM exposures were calculated. History of viral hepatitis and alcohol intake were carefully investigated. Regression analysis explored the association between abnormal LFTs and a group of possible determinants (VCM cumulative and maximum exposure, BMI, age, history of viral hepatitis, alcohol and triglyceride levels). Also, synergistic effect between VCM and a history of hepatitis was analysed, as well as the possible association between VCM exposure and aspartate aminotransferase/alanine amino transferase (AST/ALT) ratio >1. Distribution of abnormal LFTs was also assessed in relation to the results provided by liver ultrasonography. Results: The most frequently abnormal serum parameters were, in decreasing order: total cholesterol (27.3%), triglycerides (12.2%), total bilirubin (9.1%), gamma glutamil transpeptidase (GGT; 9.0%) and ALT (8.2%). The AST/ALT ratio >1 was present in 28.1% of workers. Abnormal LFTs were not found to be associated with current or past VCM exposure. High ALT resulted positively associated with BMI, AST with alcohol intake, GGT with alcohol intake and triglycerides. No synergistic effect on LFTs of exposure to VCM and a history of hepatitis was observed. The AST/ALT ratio >1 was not found to be associated with VCM exposure. The prevalence of abnormal LFTs was higher in case of liver steatosis (ALT) or periportal fibrosis (GGT), but not in case of pure hepatomegaly, as documented by ultrasonography. Conclusions: Liver function assessment only including LFTs is not able to detect VCM-induced liver damage, but reveals alterations due to non-occupational factors, such as dietary and/or metabolic disfunctions. The LFTs are however of importance to detect conditions that could recommend avoidance of exposure to VCM and are useful for medical counselling and health promotion purposes.     

Dimethylformamide-induced liver damage among synthetic leather workers

Prevalence of liver injury associated with dimethylformamide (DMF) exposure was determined. Medical examinations, liver function tests, and creatine phosphokinase (CPK) determinations were performed on 183 of 204 (76%) employees of a synthetic leather factory. Air concentrations of solvents were measured with personal samplers and gas chromatography. The concentration of DMF in air to which each worker was exposed was categorized. High exposure concentrations of DMF (i.e., 25-60 ppm) were significantly associated with elevated alanine aminotransferase (ALT) levels (ALT greater than or equal to 35 IU/l), a result that did not change even after stratification by hepatitis B carrier status. Modeling by logistic regression demonstrated that exposure to high concentrations of DMF was associated with an elevated ALT (p = .01), whereas hepatitis B surface antigen (HBsAg) was slightly but independently associated with an elevated ALT (p = .07). In those workers who had normal ALT values, there occurred still significantly higher mean ALT and aspartate aminotransferase (AST) activities, especially among those who were not HBsAg carriers. A significant association existed between elevated CPK levels and exposure to DMF. However, an analysis of the CPK isoenzyme among 143 workers did not reveal any specific damage to muscles. This outbreak of liver injury among synthetic leather workers is ascribed to DMF. It is recommended that the occupational standard for DMF and its toxicity among HBsAg carriers be evaluated further.     

Elevated liver enzyme activity in construction workers: prevalence and impact on early retirement and all-cause mortality

Background: Gamma-glutamyl transferase (GGT), alanine transaminase (ALT), and aspartate transaminase (AST) are widely used as markers of hepatobiliary disorders in occupational health surveillance. Little is known, however, about the prevalence and occupational and non-occupational determinants of elevated levels of these enzymes in specific occupational groups or about the prognostic value of elevated levels with respect to long-term outcomes such as all-cause mortality and vocational disability. Methods: A cohort study was conducted among 8,043 male construction workers aged 25–64 years who had undergone occupational health examinations in 6 centers in southern Germany from 1986 to 1988 and had been followed until 1994. The prevalence of elevated levels of GGT, ALT, and AST, depending on the sociodemographic and medical characteristics determined at the baseline examination and the risk of vocational disability and all-cause mortality in relation to elevated liver enzyme activity at baseline were assessed. Covariates considered in multivariate analysis included age, nationality, occupation, body mass index (BMI), smoking, and alcohol consumption. Results: The baseline prevalence of elevated activity levels of GGT (>28 U/l at 25 °C), ALT (>22 U/l), and AST (>18 U/l) was 32%, 22%, and 12%, respectively. Factors most strongly related to elevated serum activity levels for all three enzymes were self-reported alcohol consumption, diabetes, and hypertension. BMI was strongly associated with elevations in GGT and ALT but not in AST. Elevated levels of AST and GGT were strongly related to early retirement and all-cause mortality. Men with AST levels exceeding 18 U/l had a 2-fold risk of early retirement and a 3 times higher risk of all-cause mortality as compared with men with lower AST levels. No significant association was observed between ALT and either of the long-term outcomes. Conclusions: Our findings suggest that screening for elevated GGT and AST levels, which are a common finding among construction workers, may be a␣powerful tool for the identification of individuals at increased risk of early retirement and preterm mortality and may be helpful in targeting of prevention efforts. Received: 8 December 1997 / Accepted: 28 March 1998     

Hepatic effects among workers exposed to ethylene glycol monoethyl ether acetate

Data about hepatic effects of ethylene glycol ethers had been limited and inconsistent. In this study, we determined whether ethylene glycol monoethyl ether acetate (EGEEA) was a hepatotoxin in exposed workers. Workers from one silk-screening shop (n=29), using EGEEA as the major cleaning solvent, were recruited as high exposure group. Another group of workers with indirect and low exposure to EGEEA (n=57) were selected as the comparison group. Air concentration of EGEEA was measured by 8-h personal sampling. The mean of air EGEEA concentration in the high exposure group was 7.41-16.5 ppm. The mean of air EGEEA concentration in the low exposure group was 0.07-3.62 ppm. Liver function profiles showed that the AST, ALT, ALP and gamma GT in both male and female EGEEA-exposed workers were not significantly different from those in the comparison group. After adjustment for potential confounders such as gender, body mass index, hepatitis B status, and duration of employment, no difference in hepatic dysfunction were found between exposed and comparison groups. In addition, a two-year follow-up study of these EGEEA-exposed workers, no significant change in hepatic function was noted either. The findings suggest that EGEEA is not a hepatotoxin in this workplace.     

Effects of coffee consumption against the development of liver dysfunction: a 4-year follow-up study of middle-aged Japanese male office workers

The association of coffee consumption with the development of increased serum aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) activities over 4 years was studied in 1221 liver dysfunction-free (serum AST and ALT < or = 39 IU/l and no medical care for or no past history of liver disease) Japanese male office workers aged 35 to 56 years. From the analysis using the Kaplan-Meier method, the estimated incidence of serum AST and/or ALT > or = 40 IU/l, > or = 50 IU/l, and > or = 60 IU/l decreased with an increase in coffee consumption. From the Cox proportional hazards model, coffee drinking was independently inversely associated with the development of serum AST and/or ALT > or = 40 IU/l (p = 0.019 by test for tendency), > or = 50 IU/l (p = 0.002), and > or = 60 IU/l (p = 0.007), controlling for age, body mass index, alcohol intake, and cigarette smoking. These results suggest that coffee may be protectively against the liver dysfunction in middle-aged Japanese men.     

ZnCl2对二甲基甲酰胺所致小鼠急性肝毒性的保护作用研究

目的 研究ZnCl2对二甲基甲酰胺(N,N-dimethylformamide,DMF)致小鼠急性肝损伤的保护作用,为保护DMF接触人群提供指导.方法 将80只动物随机分为8组:正常对照组、DMF组、ZnCl2-10 DMF组、ZnCl2-20 DMF组、ZnCl2-40 DMF组、ZnCl2-10组、ZnCl2-20组和ZnCl2-40组.所有ZnCl2给药组每天皮下注射一定剂量的ZnCl2溶液.ZnCl2-10、ZnCl2-20和ZnCl2-40组在DMF染毒之前,其余组在DMF染毒后48 h处死小鼠,测定其血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)和乳酸脱氢酶(LDH)的活力;制备肝匀浆,测定ZnCl2-10、ZnCl2-20和ZnCl2-40组小鼠肝金属硫蛋白(MT)含量;留取肝脏组织,常规石蜡包埋切片,HE染色,光镜观察肝脏组织病理变化.结果 与正常组比较,DMF组小鼠血清中ALT、AST和LDH活力明显升高,肝脏组织出现明显的肝细胞变性坏死;ZnCl2 DMF组的小鼠血清中ALT、AST和LDH活力与DMF组相比明显降低,肝脏组织病理损伤明显减轻.单独给予ZnCl2组小鼠MT含量升高.结论 ZnCl2对DMF引起的小鼠急性肝损伤具有明显的保护作用.     

Epidemiological study of gastrointestinal and liver effects of carbon disulfide

Summary In the framework of an extensive health survey, 119 viscose rayon workers exposed to carbon disulfide (CS₂) and 79 workers from other plants not exposed to any toxic agent in the working environment underwent a gastrointestinal examination including a self-administered questionnaire, abdominal palpation, percussion and a number of liver function tests. In the viscose rayon factory the working conditions have not changed since 1932. Personal monitoring performed in 17 jobs showed CS₂ exposures varying from 4 to 112 mg · m^–3. For each individual a cumulative CS₂ exposure index (CS₂ index) was calculated. Univariate analysis of the questionnaire findings showed significantly higher prevalences of anorexia (37.0% vs 11.4%, P<0.0001), vomiting (12.6% vs 3.8%, P = 0.04), and recent weight loss (10.9% vs 1.3%, P = 0.009) in the exposed than in the non-exposed workers. The exposed workers had a larger total number of gastrointestinal complaints and a larger proportion reported at least one complaint at least once a month than the non-exposed ones. Abdominal tenderness was very rare in both groups. In multiple logistic regression analysis, adjusting for alcohol intake, smoking, body mass index (BMI), coffee consumption, commuting time, stress at work, shift work, educational level, family history of ulcer disease and intake of medication, significant associations with exposure were found for anorexia (P = 0.0001), nausea (P = 0.009), vomiting (P = 0.002) and flatulence (P = 0.03). Stress at work was a determinant for quite a few digestive complaints, but shift work was not significantly associated with any of them. The exposed workers had significantly lower median values for aspartate aminotransferase (AST) and alanine aminotransferase (ALT) than the non-exposed (11.0 vs 13.5 mU/ml, P = 0.0008; 12.0 vs 13.0 mU/mL, P = 0.01, respectively. The values for liver size and -glutamyltransferase (GGT) were significantly higher in the exposed than in the non-exposed workers (72 vs 67 mm, P = 0.002; 13 vs 11 U/1, P = 0.0003, respectively). The alkaline phosphatase (AP) activity did not differ significantly between the two groups. In multiple linear regression, adjusting for alcohol, pharmaceuticals consumption and BMI, there was a slightly significant negative association between exposure and AST (P = 0.04) and positive association with liver size (P = 0.002) and GGT (P = 0.0001). Alcohol was positively associated with GGT, and BMI with ALT and GGT.     

Effect of moderate alcohol consumption on liver enzymes increases with increasing body mass index

BACKGROUND: Although both ethanol consumption and overweight alter the activities of hepatic enzymes in circulation, the differentiation of an alcohol or nonalcohol basis for such changes remains problematic. The magnitude of alterations occurring among moderate drinkers has remained obscure. OBJECTIVE: We examined the links between moderate ethanol consumption, body mass index (BMI; in kg/m(2)), and liver enzymes. DESIGN: Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT) were recorded from 2,164 apparently healthy participants (1,028 men, 1,136 women) reporting either no alcohol (abstainers) or <40 g ethanol consumption per day (moderate drinkers). The study population was further classified according to BMI as follows: <19 (underweight), > or =19 and <25 (normal weight), > or =25 and <30 (overweight), and > or =30 (obese). RESULTS: Serum ALT (P < 0.05) and GGT (P < 0.001) but not AST (P = 0.805) activities in moderate drinkers were higher than those in abstainers. For all enzymes, a significant main effect was observed of increasing BMI, which was more striking in moderate drinkers than in abstainers. Tests of between-subjects effects indicated significant interactions with sex and drinking status, although not with sex and BMI. CONCLUSIONS: The effect of moderate alcohol consumption on liver enzymes increases with increasing BMI. These findings should be considered in the clinical assessment of overweight alcohol consumers and in the definition of normal ranges for liver enzymes. These results may also help to develop new approaches for examining patients with fatty liver induced by either ethanol or adiposity.     

Coffee consumption and serum aminotransferases in middle-aged Japanese men

We investigated the relation between coffee drinking and serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) concentrations among 7313 Japanese men receiving a health examination, excluding former alcohol drinkers and men with a history of chronic liver disease. Serum AST > 40 and/or ALT > 40 U/L was defined as liver inflammation. Adjustment was made for alcohol use, smoking, body mass index, serum marker for hepatitis virus infection, and other possible confounders. Adjusted odds ratios of liver inflammation were 1.00 (reference), 0.80, 0.69, and 0.61 for men drinking < 1, 1-2, 3-4, and > or = 5 cups of coffee daily, respectively. Among 6898 men without liver inflammation, serum AST and ALT were inversely associated with coffee consumption, and alcohol-related rise in AST was attenuated with coffee drinking. These findings suggest coffee may have an effect of suppressing the rise of serum aminotransferase, partly by inhibiting the alcohol-related elevation. Studies regarding biological mechanism are warranted.