谷草转氨酶和谷丙转氨酶水平与急性期缺血性脑卒中患者短期预后的关系

目的探讨血清谷草转氨酶(AST)和谷丙转氨酶(ALT)水平对急性缺血性脑卒中患者短期预后的影响。方法收集319例发病48 h以内的缺血性脑卒中病人,采集入院血标本,测定入院时ALT和AST浓度。对研究对象进行3个月随访,观察死亡或残疾的发生。采用多因素Logistic回归模型分析基线ALT和AST与3个月时死亡或残疾的关系。结果预后良好组的ALT水平显著高于预后不良组(P0.05),预后良好组的AST平均水平高于预后不良组,但无统计学差异(P0.05)。但是在年龄60岁和饮酒的缺血性脑卒中患者中,AST高水平组3个月后不良结局发生危险显著低于AST低水平组(P0.05)。结论血清中ALT和AST与缺血性脑卒中病人3个月预后相关。     

血清谷草转氨酶极度升高的病因学调查

血清谷草转氨酶（ＡＳＴ）存在于肝脏、心肌、骨骼肌、肾、脑等组织。血清ＡＳＴ水平升高对肝脏疾病是较特异的。已有文献阐述血清ＡＳＴ极度升高超过正常值上限１５倍，几乎均提示肝细胞病毒性或中毒性坏死［１］，而且其发生率极低。但近期有关文献报道：英国临床血清Ａ...     

老年人血清谷草转氨酶极度升高的临床分析

已有文献阐述血清谷草转氨酶(AST)极度升高超过正常值15倍,几乎均提示肝细胞坏死(病毒性或中毒性),近期我国一组调查表明血清AST极度升高的病因首要是急性低血压致肝损伤所致;为了解我院血清AST极度升高的发生率、病因及死亡关系,现将我院1999年1～12月成年病例作一调查,并将≥60岁(下称老年组)与<60岁(下称青壮年组)作一比较,旨在提高我们对老年人血清AST极度升高的病因认识,以利于临床鉴别诊断及预后判断。一、资料和方法将我院1999年度检查肝功能的8561例住院成年患者分为≥60岁老年组(3027例)、<60     

阿霉素为主的联合化疗对心电图及谷草转氨酶的影响

目的 了解阿霉素对心脏毒性和谷草转氨酶变化以便控制剂量和疗程。方法 分析1994－1996年82例恶性肿瘤应用阿霉素治疗前后对心电图及谷草转氨酶变化。结果 72例患不同剂量阿霉素出现心电图异常34例，82例谷草转氨酶异常40例。结论 使用阿霉素治疗时必须对其心脏毒性反应进行多种形式评价，然后决定最适总量及分流量。     

肝脏双重介入治疗时血清谷丙转氨酶动态观察的实验研究

肝脏双重介入治疗时血清谷丙转氨酶动态观察的实验研究任蓓苇，陈康，王履琨本文通过动物实验，研究正常肝脏双重治疗时，血清谷丙转氨酶（ＳＧＰＴ）的动态变化与病理改变。材料与方法健康犬１２只，术前测８ＧＰＴ值均正常，共分４组。经皮肝内无水酒精注射（ＰＥＩ）组...     

婴幼儿轮状病毒腹泻与肝脏转氨酶关系的研究

对163例腹泻患儿采用金标法检测大便轮状病毒（RV）抗原,按照RV抗原检测结果分为RV阳性组与RV阴性组。检测并比较两组血清谷丙转氨酶（ALT）、谷草转氨酶（AST）、肌酸激酶（CPK）水平。发现RV阳性组ALT、AST水平明显高于RV阴性组,CPK水平两组间无统计学差异。提示婴幼儿RV腹泻常伴有肝转氨酶升高。     

抗凝剂选择对谷丙转氨酶与总胆红素测定结果的影响

目的探讨抗凝剂的选择使用对生化检验中谷丙转氨酶与总胆红素测定结果的影响。方法分别用草酸钠和肝素钠两种抗凝剂的血浆测定谷丙转氨酶和总胆红素,并与不使用抗凝剂的血清进行比较。结果使用草酸钠抗凝剂组谷丙转氨酶显著低于不使用抗凝剂的血清组,使用肝素钠抗凝剂血浆总红素组明显高于不使用抗凝剂的血清组。结论在进行生化检验时应注意抗凝剂的选择,以免造成测定结果假阴性和假阳性,而造成误诊误治。     

血清谷丙转氨酶在正常范围内对非酒精性脂肪性肝病的预测

目的:分析血清谷丙转氨酶(ALT)与非酒精性脂肪性肝病(NAFLD)之间的关系,探讨正常范围ALT对NAFLD发生的预测价值.方法:选择2006-04-07/2010-01-09湖南省人民医院体检个体共4076例,排除过量饮酒、乙肝标志物阳性、严重感染及MS资料不全者,共2830例纳入研究,其中1367例在1-3年后再...     

急性心肌梗死血清标志物——肌酸激酶和肌酸激酶同工酶及谷草转氨酶等临床应用的比较

心肌损伤的常用实验室检测项目有磷酸肌酸激酶(CK)、谷草转氨酶(AST)、乳酸脱氨酶(LDH)和磷酸肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)、肌红蛋白(MYO)等,这些项目各有特点.我们同时观察了血清CK、CK-MB、AST、LDH、cTnI、MYO在急性心肌梗死(AMI),不稳定性心绞痛(UAP)及稳定性心绞痛(SAP)患者中的动态变化,并对陈旧性心肌梗死患者介入治疗前后血清cTnI、CK-MB、MYO进行动态观察,比较这些项目在AMI诊断和治疗中的价值.     

N-乙酰半胱氨酸对TACE肝癌患者凝血酶原、胆红素和谷丙转氨酶的影响

目的观察N-乙酰半胱氨酸(NAC)对肝动脉化疗栓塞术(TACE)肝癌患者脱γ-羧基凝血酶原(DCP)、总胆红素(TBil)和谷丙转氨酶(ALT)的影响。方法纳入2016年1月至2018年1月于我院收治的60例TACE肝癌患者为研究对象,按照抽签随机方法分为两组,各30例,其中对照组予以常规护肝治疗,观察组在此基础上予以NAC治疗。对比两组治疗前后DCP及氧化应激指标丙二醛(MDA)、超氧化物歧化酶(SOD)水平,并分析治疗前后TBil、ALT及谷草转氨酶(AST)、清蛋白(ALB)水平。结果观察组治疗后DCP、MDA水平显著低于治疗前及对照组治疗后(P0.05),SOD水平显著高于治疗前及对照组治疗后(P0.05)。观察组治疗后TBil、ALT、AST水平较术前均无统计学意义(P0.05),但均显著低于对照组治疗后(P0.05);观察组治疗后ALB水平较治疗前及对照组治疗后均无统计学意义(P0.05)。结论 NAC能减轻TACE肝癌患者脂质过氧化反应,改善肝功能。     

Upper limit of normal serum alanine and aspartate aminotransferase levels in Korea

Background and Aim: The widely accepted range of upper limits of normal (ULN) alanine aminotransferase (ALT) levels (ULN < 40 U/L) was recently challenged by several reports. Both ALT and aspartate aminotransferase (AST) are commonly used as surrogate markers of liver disease, but almost all studies of aminotransferase activity were conducted on ALT. We investigated not only ULN of ALT but also AST activity and to identify factors modulating them in healthy Korean. Methods: A cross‐sectional study of 411 240 registered blood donors in all nationwide blood banks belonging to the Korean Red Cross were conducted. ULN of ALT and AST was evaluated adjusting their age according to the national population census database. “Decision tree model” was used to identify the affecting factors of ALT and AST and optimal cut‐off points of affecting factors. Results: “ULN of ALT” was 34 U/L in men and 24 U/L in women and “ULN of AST” was 32 U/L in men and 26 U/L in women in the blood donor database. Decision tree analysis showed that ALT levels were mostly influenced by body mass index level and its critical two cut‐off points were 23.5 kg/m² and 25.8 kg/m², respectively. The most affecting factor of AST was gender. Conclusion: Upper limits of normal of ALT and AST in Koreans were lower than conventional accepted values (< 40 U/L) but higher than recently suggested values (male < 30 U/L and female < 19 U/L). Body mass index was the most determining factor for ALT and gender was the most influencing factor for AST activity.     

Determination of the upper cut-off values of serum alanine aminotransferase and aspartate aminotransferase in Chinese

AIM:To determine the upper cut-off values of serumalanine aminotransferase(ALT)and aspartate aminotransferase(AST)in a Northern Chinese population.METHODS:A total of 3769 subjects in Jilin Province Northeast China were stratified to determine the potential factors affecting serum ALT and AST levels.The upper cut-off values of serum ALT and AST in these subjects were determined using receiver operating characteristic analysis and their sensitivity and specificity were evaluated.RESULTS:Stratification analysis revealed that serum ALT and AST levels were associated with gender,alcohol consumption,serum cholesterol and triglyceride levels,and body mass index.The upper cut-off values of serum ALT and AST were 22.15 U/L and 25.35 U/L for healthy men and 22.40 U/L and 24.25 U/L for healthy women,respectively.The new cut-off values had a higher sensitivity,but a slightly lower specificity than the current standards.CONCLUSION:Our results indicate that the new upper cut-off values of serum ALT and AST are markedly lower than current standards and may be valuable for the evaluation of liver function.     

Individual and combined relationship of serum uric acid and alanine aminotransferase on metabolic syndrome in adults in Qingdao,China

Background and aimsAssociations of alanine aminotransferase (ALT) and serum uric acid (SUA) with metabolic syndrome (MetS) remain controversial. We aimed to explore individual and combined effects of ALT and SUA on MetS in community residents.Methods and resultsA population-based cross-sectional survey involving randomly selected Chinese adults aged 35–74 years was conducted in 2009 in Qingdao, China, and 4642 participants were included in the current study. Based on a combination of SUA and ALT levels in the tertile, subjects were grouped into Group 1-9. The individual and combined relations of SUA and ALT to MetS were analyzed by logistic regression models. The prevalence of MetS was 28.50% in males and 22.30% in females. ALT and SUA were independently associated with MetS and ORs (95% CIs) were 1.55 (1.42–1.70) and 1.92 (1.72–2.14), respectively, after adjusting for potential confounders. With the elevation of ALT and SUA levels, the risk of developing MetS increased. Compared to Group 1, ORs (95% CIs) of combined ALT and SUA for MetS were 2.21 (1.70–2.88), 4.02 (3.10–5.21), 2.19 (1.62–2.97), 2.53 (1.91–3.34), 4.69 (3.60–6.12), 1.76 (1.17–2.64), 3.65 (2.63–5.06) and 7.15 (5.41–9.46) in Group 2–9, respectively.ConclusionsALT and SUA were both related to MetS independently. Combined elevation of ALT and SUA levels could increase the risk of MetS and its components than an elevation in SUA and ALT alone. Therefore, measures should be taken to lower SUA and ALT levels to reduce the risk of having MetS.     

Normal serum alanine aminotransferase activity in uncomplicated obesity

AIM: To evaluate serum alanine aminotransferase (ALT) activity in a well-characterized group of uncomplicated obese subjects and its correlation with insulin resistance, plasma adiponectin, and leptin concentrations. METHODS: One hundred and five uncomplicated obese subjects (87 women, 18 men, age 34.3±9.6 years, BMI 39.9±8.3 kg/m2)were studied. Serum ALT activity was evaluated. Insulin sensitivity was assessed by euglycemic hyperinsulinemic clamp (M index) and fasting insulin. Plasma leptin and adiponectin levels were also measured. RESULTS: Serum ALT concentration in the whole group of uncomplicated obese subjects was 17.73±6.33 U/L with none of the subjects presenting ALT levels greater than 43 U/L and only 9 (11%) women and 3 (19%) men showed ALT levels >19 and >30 U/L for women and men, respectively. No significant difference was detected in serum ALT levels between severe obese subjects (BMI >40 kg/m2) and those with BMI <40 kg/m2 (18.63±6.25 vs 17.26±6.02 U/L). ALT was significantly correlated with fasting insulin (r=0.485, P= 0.02) and triglycerides (r= 0.358, P=0.03). CONCLUSION: Serum ALT activity is practically normal in uncomplicated obese subjects, independently of their obesity degree. These findings suggest the role of obesityrelated comorbidities and not of BMI as main risk factors for elevated ALT levels in obese subjects.     

Serum γ-glutamyltransferase, alanine aminotransferase, and aspartate aminotransferase activity in Iranian healthy blood donor men

AIM: To determine serum γ-glutamyltransferase (GGT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) activity, and to assess their correlation with demographic and clinical findings in healthy blood donors.METHODS: This cross-sectional study was performed in 934 male blood donors, aged 18 to 68 years, who consecutively attended Tehran blood transfusion service in 2006. All participants were seronegative for HBV or HCV infections, non alcohol users, and all underwent a standard interview and anthropometric tests. Clinical and biochemical parameters including AST, ALT, and GGT activities were determined. Patients taking drugs known to cause hepatic fat deposition were excluded. For AST, ALT, and GGT variables, we used 33.33 and 66.66 percentiles, so that each of them was divided into three tertiles.RESULTS: Mean AST, ALT, and GGT activities were 25.26 ± 12.58 U/L (normal range 5-35 U/L), 33.13 ± 22.98 (normal range 5-35 U/L), and 25.11 ± 18.32 (normal range 6-37 U/L), respectively. By univariate analyses, there were significant associations between increasing AST, ALT, or GGT tertiles and age, body weight, body mass index, and waist and hip circumferences (P < 0.05). By multiple linear regression analyses, ALT was found to be positively correlated with dyslipidemia (B = 6.988, P = 0.038), whereas ALT and AST were negatively correlated with age. AST, ALT, and GGT levels had positive correlation with family history of liver disease (B = 15.763, P < 0.001), (B = 32.345, P < 0.001), (B =24.415, P < 0.001), respectively.CONCLUSION: Although we did not determine the cutoffs of the upper normal limits for AST, ALT, and GGT levels, we would suggest screening asymptomatic patients with dyslipidemia and also subjects with a family history of liver disease.     

Effects of obstructive sleep apnea syndrome on serum aminotransferase levels in obese patients

PURPOSE: Obesity has been associated with obstructive sleep apnea and hepatic steatosis. We investigated the effects of obstructive sleep apnea and treatment with nasal continuous positive airway pressure (CPAP) on serum aminotransferase levels in obese patients. METHODS: We studied 40 obese men with obstructive sleep apnea syndrome. None had hepatitis B antigen or C antibody, autoimmune disease, or an excessive intake of alcohol. Serum levels of aspartate aminotransferase, alanine aminotransferase, triglyceride, glucose, insulin, and leptin were determined in the afternoon and in the morning immediately after sleep, before and after nasal CPAP treatment. RESULTS: Aminotransferase levels were abnormal in 35% (n = 14) of patients. Before treatment, mean (+/- SD) aspartate aminotransferase levels were higher in the morning than in the previous afternoon (presleep, 34 +/- 20 IU/L; postsleep, 39 +/- 28 IU/L; P = 0.006). The overnight mean increases in aminotransferase levels were less marked after the first night of nasal CPAP treatment (aspartate aminotransferase: from 6 +/- 11 IU/L to 2 +/- 6 IU/L, P = 0.0003; alanine aminotransferase: from 5 +/- 9 IU/L to 2 +/- 6 IU/L, P = 0.006). Leptin levels (n = 23) decreased significantly after treatment (P = 0.0002), whereas insulin resistance (calculated by the homeostasis model assessment method) and triglyceride levels were unchanged. Improvements in aspartate and alanine aminotransferase levels were maintained after 1 and 6 months of nasal CPAP treatment. CONCLUSION: Nasal CPAP therapy may have beneficial effects on serum aminotransferase abnormalities in obese patients who have obstructive sleep apnea.     

Hyaluronic acid and aspartate aminotransferase levels normalized by liver function can reflect sinusoidal impairment in chronic liver disease.

BACKGROUND/AIM: To evaluate the relationship between hyaluronic acid/aminopyrine breath test (HA/ABT) ratio and fibrosis score in chronic hepatitis, and between HA/ABT and clinical staging (child-turcotte-pugh'score, CTP; and model for end stage liver disease, MELD) in cirrhosis, as well as to evaluate the aspartate aminotransferase (AST)/ABT in relation to the HA/ABT. METHODS: We studied 48 patients with histologically proven chronic hepatitis C (CHC) and 35 patients with compensated cirrhosis (CIR). RESULTS: HA/ABT and AST/ABT showed a more significant correlation with the fibrosis score than HA or ABT or AST alone in the 48 CHC patients: r=0.568 (P<0.0001), r=0.610 (P<0.0001), r=0.450 (P=0.0021), r=-0.449 (P=0.0021), and r=0.472(P=0.0012), respectively. Progressive liver damage (fibrosis 1-2 vs fibrosis 3-6 vs cirrhosis) was significantly (P<0.05) reflected by both HA/ABT (mean+/-SEM: 4.0+/-0.9 vs 18.1+/-4.2 vs 149.9+/-33.1) and AST/ABT (6.3+/-1.8 vs 12.7+/-1.6 vs 42.1+/-14.6). A strong relationship was found between HA/ABT and AST/ABT (r=0.755 P<0.0001). In cirrhotic patients, the most significant relationship was observed between HA/ABT and CTP r=0.483 and P=0.0049, and MELD r=0.523 and P=0.0023. CONCLUSION: Considering that HA levels in chronic hepatitis depend on the progressive impairment of sinusoidal endothelial cells (SEC), related to progressive fibrosis, HA/ABT ratio would seem to be the most specific reflection of progressive impairment of the SEC. AST/ABT could be used as a possible surrogate of HA in identifying SEC impairment in chronic hepatitis.     

Large-scale population analysis reveals an extremely low threshold for "non-healthy" alanine aminotransferase that predicts diabetes mellitus

Background and Aims: Serum alanine aminotransferase (ALT) is commonly used to detect liver damage. Recent studies indicate that ALT levels at the upper range of normal limits are predictors of adverse outcomes, especially diabetes mellitus (DM) and the metabolic syndrome. The aim of our study was to define the ALT threshold for both men and women that may predict the onset of DM. Methods: We analyzed a large Health Maintenance Organization cohort of 157 308 healthy subjects with no evidence of liver disease and with baseline ALT levels ≤ 120 U/L, and identified those who developed DM within 6 years. Results: Overall, an elevated baseline serum ALT value was significantly associated with the development of DM, with an odds ratio of 3.3 when comparing the higher and the lower quartiles of the whole study population. A subgroup analysis revealed that baseline ALT values higher than 10 U/L among women and 22 U/L among men were already significantly associated with an increased risk for DM for any increment in ALT level. Notably, ALT values higher than ～55 U/L were associated with increased risk for DM that was relatively constant for any increment in ALT. Higher baseline ALT levels were stronger predictors for DM as compared with age, triglycerides and cholesterol levels. Conclusion: Our study implies that ALT values higher than 10 U/L and 22 U/L for women and men, respectively, may predict DM. We suggest redefining ALT values as either ‘normal’ or ‘healthy’, with the later reflecting much lower values, above which an individual is at increased risk for DM.     

Low alanine aminotransferase activity in older people is associated with greater long-term mortality

OBJECTIVES: To find possible association between liver enzymes and mortality in older people. DESIGN: A prospective cohort study. SETTING: Jerusalem. PARTICIPANTS: A systematically selected representative sample of 455 70-year-old ambulatory individuals was prospectively followed for 12 years. MEASUREMENTS: An extensive social and medical profile was developed at age 70 using a detailed interview and physical and ancillary examination. Information on mortality was obtained annually. Differences in survival between subjects stratified according to liver enzyme levels were assessed using the Kaplan-Meier method. Multivariable survival analyses using a Cox proportional hazards model were performed to determine the association between liver enzyme levels at age 70 and mortality over 12 years. RESULTS: Median alanine aminotransferase (ALT) activity of the study population was 11.00 U/L for women and 13.00 U/L for men. Twelve-year survival rates for women with ALT below and above the median levels were similar (78%). For men, these rates were 54% and 65%, respectively (P < .001). Proportional hazards models demonstrated that this greater mortality risk was independent of numerous common risk factors for mortality (hazard ratio (HR) = 1.5, 95% confidence interval (CI) = 1.08-2.19). Adding an interaction between sex and low ALT to the model demonstrated a higher risk of mortality for men with low ALT levels (HR = 2.42, 95% CI = 1.15-5.08). No such risk was demonstrated for the other liver enzymes. CONCLUSION: ALT activity represents a strong and independent surrogate marker for mortality in community-dwelling elderly men.