某焦化厂职业接触多环芳烃焦炉工肝脏某些酶活性的变化

目的探讨多环芳烃(PAHs)对炼焦作业工人某些肝血清酶活性改变的可能影响。方法对乙肝表面抗原(HBsAg)阴性的炼焦作业工人和非PAHs职业接触工人进行总PAHs累积接触指数(CEL-PAHs)评估,尿中1-羟基芘(1-OHP)浓度等级划分,和血清中丙氨酸转移酶(ALT)、天门冬氨酸转移酶(AST)、γ-谷氨酰转移梅(GGT)、碱性磷酸酶(ALP)的检测。结果焦炉工职业性PAHs暴露水平明显高于对照组(P<0·05)。与对照组相比,血清ALT的明显升高可见于CEL-PAHs<50μg/(m3·a)组和尿中1-OHP浓度<2·3μmol/mol肌酐CEL-PAHs≥200μg/m3组,血清AST的明显升高可见于CEL-PAHs<50μg/(m3·a)组;当CEL-PAHs(200μg/(m3·a)或尿中1-OHP浓度≥10·0μmol/mol肌酐时,可发现四种肝生化指标实测值的明显升高(P<0·05),以及ALT、AST和GGT异常率的明显升高(P<0·05),以血清GGT水平的升高(10倍CEL-PAHs的上升导致1·24倍血清GGT水平的升高,10倍尿中1-OHP浓度的上升导致1·19倍的升高)和异常率的上升(logistic回归,调整OR值为6·2~7·2,P<0·05)最为明显。结论PAHs职业暴露可导致炼焦作业工人肝脏某些血清酶活性的升高。     

三氯乙烯药疹样皮炎患者肝功能动态变化

目的 观察职业性三氯乙烯( trichloroethylene,TCE)药疹样皮炎患者血清肝功能指标动态变化,为TCE药疹样皮炎肝损害的治疗提供依据.方法 收集10例职业性TCE药疹样皮炎并发肝损害患者不同时间点血清,采用全自动生化分析仪测定血清总蛋白(TP)、白蛋白( ALB)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、谷氨酰转移酶(GGT)、碱性磷酸酶(ALP)、AST/ALT比值、白蛋白/球蛋白比值(A/G)等11项指标,分析各指标动态变化.结果 10例TCE药疹样皮炎患者11项肝功能指标变化范围是TP:43.2～74.2 g/L,ALB:24.6～44.6 g/L,A/G:0.77～2.10,TBIL:3.7～268.2 μmol/L,DBIL:1.0～166.0 μmol/L,IBIL:2.4～167.5 μmol/L,ALT:11～5985 U/L,AST:14～5586 U/L,GGT:15～1500 U/L,ALP:35～309 U/L,S/L:0.07～1.94.TBIL、DBIL、ALT、AST、GGT、ALP浓度明显升高,尤以ALT、AST、GGT变化最明显;ALT最高达5985U/L,AST最高达5586 U/L,GGT最高达1500 U/L.TP、ALB、S/L明显降低,TP最低降到43.2g/L,S/L最低至0.07.A/G基本保持不变,IBIL变化不规律.结论 TCE药疹样皮炎患者早期肝损害严重,病情易反复发作.     

Abnormal liver function in workers exposed to low levels of ethylene dichloride and vinyl chloride monomer

We investigated whether exposure to ethylene dichloride (EDC) and vinyl chloride monomer (VCM) resulted in increased risk of liver damage. Epidemiological information, including occupational, medical, smoking, and drinking history, was obtained by interview from 251 male workers. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT) were used as indicators of liver damage. Exposure to moderate or low levels of ECD and VCM resulted in a higher risk of developing abnormal ALT levels than did exposure to lower levels of the chemicals. Results were similar for AST. GGT was not associated with EDC or VCM exposure. Combined exposure to EDC and VCM showed a dose-response relationship in association with abnormal ALT levels. We concluded that relatively low concentrations of VCM and EDC cause liver damage.     

社区人群血清肝酶水平与糖代谢异常的相关性

目的探讨社区人群血清肝酶水平与糖耐量、胰岛素抵抗及胰岛分泌功能的相关性。方法对南京市三个社区的20岁及以上常住居民进行糖尿病筛查,并测定血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)和γ-谷氨酰转肽酶(GGT),合格研究对象共5 375人,平均年龄58.3±9.4岁,正常糖耐量(NGT)3 010人、糖调节受损(IGR)1 707人,新诊糖尿病(DM)658人。利用稳态模式法计算HOMA_IR和HOMA_%B。结果非条件Logistic回归分析显示,随着ALT、GGT水平的升高,IGR、DM的患病风险均逐渐增加(P均<0.001),而AST水平与IGR、DM的患病风险无统计学关联(P均>0.05)。多元线性回归分析显示,随着ALT、GGT水平升高,HOMA_IR的平均水平均逐渐升高(标准化回归系数β分别为0.12和0.1,P均<0.001)。随着ALT水平升高,HOMA_%B的平均水平逐渐升高(β=0.05,P=0.003)。未发现GGT与HOMA_%B间存在线性趋势(β=-0.04,P=0.25)。结论ALT或GGT水平升高可能成为IGR、DM的早期预测指标。     

学龄期儿童肥胖相关性脂肪肝及血脂代谢异常对照研究

目的 探讨兰州市学龄期儿童肥胖非酒精性脂肪肝(nonalcoholic fatty liver disease, NAFLD)、血脂代谢异常及其相关因素。方法 2011年6-10月选取3所小学1至6年级7~14岁小学生作为研究对象。选取年龄、性别匹配体质指数(body mass index, BMI)正常儿童作为对照。行腹部B超、采空腹静脉血5 mL进行实验室检查, 包括天冬氨酸氨基转移酶(aspartate aminotransferase, AST)、丙氨酸氨基转移酶(alanine aminotransferase, ALT)、谷氨酰转肽酶(gamma glutamyl transpeptidase, GGT)、总胆固醇(total cholesterol, CHOL)、甘油三酯(triglyceride, TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol, HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol, LDL-C)。结果 筛查出肥胖儿童80例, 与51例正常对照儿童比较, 肥胖组儿童的AST、ALT、GGT、CHOL、TG、LDL-C增高, HDL-C减低, 差异有统计学意义(P<0.05)。AST、ALT、GGT、TG、LDL-C与NAFLD发病呈正相关且为危险因素;HDL-C呈负相关为保护因素。肥胖儿童NAFLD检出率为27.5%(22/80);对照组未检出NAFLD, 肥胖儿童的NAFLD发生率明显高于正常儿童(P<0.05)。肥胖伴有NAFLD组较肥胖不伴NAFLD组AST、ALT、GGT、TG升高, HDL-C降低;差异具有统计学意义(P<0.05)。结论 肥胖导致学龄期儿童的肝功能损害、血脂代谢异常甚至可造成非酒精性脂肪肝的发生;非酒精性脂肪肝更进一步加重了肝功能损害及血脂代谢紊乱。     

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.     

Serum liver function profiles in coking workers

Coking workers are regularly exposed to coke oven emissions (COE), which consist mainly of polycyclic aromatic hydrocarbons and volatile organic compounds. In a previous cross-sectional study, we found that coking and by-product workers with heavy exposure to COE in the older of two coke operation areas in Taiwan had higher serum activities of hepatic aminotransferase than the controls. In this study, we further examine the relationship of exposure to COE with liver function profiles in coking workers. Liver function profiles included serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and total bilirubin (BIL). The exposed group included 88 workers working 3 months or more in the older coke oven plant. Fifty-nine referents, not visiting the coke operation areas in the last 3 months, came from the administrative area in the same company. Each participant wore a personal monitor that was used to measure benzene soluble fraction (BSF) of total particulates, as a surrogate of COE, for 3 consecutive days between August 1995 and February 1996. Serum liver function profiles, hepatitis B surface antigens, and anti-hepatitis C antibodies were examined in the morning following the exposure measurements. Exposure levels were categorized by exposure situations (high, medium, low) among coking workers. The high exposure group (n = 23) worked topside of the oven. The medium exposure group (n = 44) worked at the sideoven for more than 4 hr/day, whereas the low exposure group (n = 21) worked at the sideoven for less than 4 hr/day and mostly remained in the control rooms. The low exposure group was used as an internal comparison group. The median BSF concentrations for various exposure situations were as follows, high exposure group: 372 μg/m³, medium exposure group: 61 μg/m³, low exposure group: 49 μg/m³, and referents: 10 μg/m³. The coking workers (n = 88) did not significantly differ from the referents (n = 59) in any of the liver function profiles. Excluding the referents, workers in the high exposure group had a mean AST level that was 31% higher (95% confidence interval (CI) = 9–57%) and a mean ALT level that was 46% higher (95%CI = 7–98%) than those in the low exposure group after adjusting for appropriate confounders in multivariate models. The prevalence of an abnormal hepatocellular pattern (AST > 37 IU/L or ALT > 39 IU/L) was more common in the high exposure group than in the low exposure group (adjusted odds ratio = 4.4; 95% CI = 0.9–22.6). However, these associations were not found in GGT, ALP, or BIL. After controlling for the possible effects of nonoccupational factors on serum activity of AST and ALT, we conclude that increased AST and ALT levels among topside coking workers may be caused by heavy inhalation exposure to COE. Additionally, the adverse hepatic effect seems to be caused by a mixture of hazards, rather than a unique identifiable chemical. Am. J. Ind. Med. 32:478–486, 1997. © 1997 Wiley-Liss, Inc.     

Modulating influence of cytochrome P-450 MspI polymorphism on serum liver function profiles in coke oven workers

OBJECTIVES: It was reported previously that topside oven workers with heavy exposure to coke oven emissions had increased serum activities of hepatic aminotransferase in one coke oven plant. This study was conducted to investigate the modifying effect of CYP1A1 MspI polymorphism on liver function profiles in coke oven workers. METHODS: 88 coke oven workers from a large steel company in Taiwan were studied in 1995-6. Exposure was categorised by work area: topside oven workers and sideoven workers. Liver function profiles including serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), r-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and total bilirubin (BIL) were examined in the morning after personal exposure measurements. The MspI polymorphism was determined by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). RESULTS: Five of 23 (22%) topside oven workers and seven of 65 (11%) sideoven workers had the CYP1A1 MspI homozygous variant genotype. With sideoven workers with the combined wild type and heterozygous variant as the reference group in multiple regression models, it was found that topside oven workers with the combined traits had mean AST and ALT activities that were 21% and 46% higher (95% confidence interval (95% CI) 4% to 42% and 12% to 91%, respectively) than the reference group after adjusting for appropriate confounders. Also, topside oven workers with the homozygous variant trait had mean AST, ALT, and GGT activities that were 59%, 68%, and 157% higher (95% CI 21% to 109%, 6% to 168%, and 39% to 374%, respectively) than the reference group. The prevalence of an abnormal hepatocellular pattern (AST > 37 IU/l or ALT > 39 IU/l) was more common in the topside oven workers with the homozygous variant than in the sideoven workers with the other combined genotypes (adjusted odds ratio 9.9, 95% CI 1.2 to 82.3) after adjusting for appropriate confounders. CONCLUSIONS: The CYP1A1 MspI polymorphism may modify the biotransformation of coke oven emissions, which results in hepatocellular damage in coke oven workers.     

肝脏酶谱诊断肝病在临床的应用

目的 探讨肝脏酶谱在诊断肝病中的应用价值.方法 对270例不同肝病患者进行血清肝脏酶谱酶活性的鉴定,并将其与108例非肝病患者的肝脏酶谱进行分析,观察不同肝病患者的肝脏酶谱与非肝病患者有无明显区别.结果 肝病患者的血清肝脏酶谱均出现增高,不同疾病的肝脏酶谱增高幅度不同,与非肝脏疾病的患者相比,差异无统计学意义,其中,急性肝炎的天门冬氨酸氨基转移酶( AST)为(356.28±162.54) U/L,肝硬化碱性磷酸酶(ALP)和谷酰转肽酶(GGT)分别为(87.38±90.46)U/L和(109.21±73.64)U/L,肝癌的ALP和GGT分别为(110.24±109.41)U/L和(138.44±46.26)U/L,乙醇性肝炎GGT、丙氨酸氨基转移酶(ALT)和AST分别为(157.35±68.38)U/L、(89.34±59.52) U/L和(78.66±61.64)U/L,其他肝病的ALP及GGT和ALP与非肝病患者相比,差异有统计学意义.结论 肝脏酶谱在肝病的临床诊断和治疗中有很大的临床应用价值.     

The associations between birthweight and adult markers of liver damage and function

Evidence suggesting an effect of fetal growth on liver development and function stems from both animal and human studies. The association of birthweight with adult markers of liver damage and function was examined in a random sample of 2101 British women aged 60-79 years. Age-adjusted natural logged levels of alanine aminotransferase (ALT) and gamma glutamyltransferase (GGT) decreased linearly across increasing thirds of birthweight. Alkaline phosphatase (ALP) levels were higher in women of the lowest third of the birthweight distribution compared with other women. No evidence was found for associations of birthweight with aspartate aminotransferase (AST), total bilirubin and albumin. After full adjustment for social class, physical activity, smoking and alcohol consumption, an increase in one standard deviation of birthweight (691 g) was associated with a 2% ([95% CI 0%, 4%], P = 0.021) decrease in the geometric mean of ALT, a 4% decrease in GGT ([95% CI 1%, 6%], P = 0.008) and a 2% decrease in ALP ([95% CI 0%, 3%], P = 0.001). Associations of birthweight with ALT and GGT, but not with ALP, were attenuated when adjusting for components of the metabolic syndrome. These findings suggest that factors affecting intrauterine growth may increase the propensity for adult liver damage. The attenuation of associations with adjustment for components of the metabolic syndrome is in line with non-alcoholic fatty liver disease, indicated by elevated ALT and GGT, being the hepatic manifestation of the metabolic syndrome, and of the influence of perinatal factors on this syndrome.     

Examination of the relationships between environmental exposures to volatile organic compounds and biochemical liver tests: Application of canonical correlation analysis

This study was to explore the relationships between personal exposure to 10 volatile organic compounds (VOCs) and biochemical liver tests with the application of canonical correlation analysis. Data from a subsample of the 1999-2000 National Health and Nutrition Examination Survey were used. Serum albumin, total bilirubin (TB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), and γ-glutamyl transferase (GGT) served as the outcome variables. Personal exposures to benzene, chloroform, ethylbenzene, tetrachloroethene, toluene, trichloroethene, o-xylene, m-,p-xylene, 1,4-dichlorobenzene, and methyl tert-butyl ether (MTBE) were assessed through the use of passive exposure monitors worn by study participants. The first two canonical correlations were 0.3218 and 0.2575, suggesting a positive correlation mainly between the six VOCs (benzene, ethylbenzene, toluene, o-xylene, m-,p-xylene, and MTBE) and the three biochemical liver tests (albumin, ALP, and GGT) and a positive correlation mainly between the two VOCs (1,4-dichlorobenzene and tetrachloroethene) and the two biochemical liver tests (LDH and TB). Subsequent multiple linear regressions show that exposure to benzene, toluene, or MTBE was associated with serum albumin, while exposure to tetrachloroethene was associated with LDH and total bilirubin. In conclusion, exposure to certain VOCs as a group or individually may influence certain biochemical liver test results in the general population.     

Serum enzyme tests in hepatosplenic schistosomiasis

The serum activities of monoamine oxidase (MAO), gamma-glutamyl transferase (GGT) and glutamic dehydrogenase (GDH) enzymes were measured in 25 patients with Schistosoma mansoni infection (Group I), 26 patients with schistosomal hepatosplenomegaly and ascites (Group II) and 21 normal controls. The activities of these enzymes were compared with those of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP). The mean levels of MAO, GGT and GDH of Group I were not significantly different from controls. The mean levels of MAO and GGT in Group II, however, were significantly different from corresponding mean levels of Group I and the controls at P less than .001. Changes in the mean level of GDH and ALT were not significant. By contrast, the levels of AST and ALP in both groups showed significant elevation over control levels at P less than .001. These results indicate that estimation of the two enzymes MAO and GGT may aid in the biochemical differentiation of the stages of schistosomiasis and their associated hepatic complications.     

胶原蛋白多肽-铬(Ⅲ)螯合物对四氧嘧啶致小鼠肝脏损伤的保护作用

目的:研究胶原蛋白多肽-铬(Ⅲ)螯合物(CPCC)对四氧嘧啶致小鼠肝脏损伤的保护作用。方法:将小鼠随机分成正常、模型和胶原蛋白多肽-铬(Ⅲ)螯合物三组,正常组与模型组灌胃蒸馏水,CPCC组灌胃CPCC水溶液(Cr3+40μg/kg?d),灌胃4w后模型组和CPCC组腹腔注射四氧嘧啶造模,测定小鼠肝指数及血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)和碱性磷酸酶(ALP)活性,测定肝匀浆中超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)活性及丙二醛(MDA)含量,同时观察肝组织病理变化。结果:CPCC组可以非常显著地降低造模后小鼠肝指数及血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)和碱性磷酸酶(ALP)活性。肝匀浆SOD、GSH-Px活力及丙二醛(MDA)含量均显著下降,肝细胞损伤明显减轻。结论:CPCC对四氧嘧啶致小鼠肝脏损伤有保护作用。     

4种血清酶在三硝基甲苯染毒致大鼠肝损伤中的变化及意义

[目的]观察三硝基甲苯(TNT)染毒致大鼠肝损伤时血清乳酸脱氢酶(LDH)、谷氨酸氨基移换酶(ALT)、天门冬酸氨基移换酶(AST)和碱性磷酸酶(ALP)的活力变化情况,并探讨其意义。[方法]以50、100和200mg/kg体重剂量的TNT对大鼠每天一次经口染毒,分别于染毒2、4、6和8周后处死,测定血和肝组织TNT代谢产物2,6-二硝基-4-氨基甲苯(DNAT)水平、血靛青绿(ICG)10min滞留率(ICG_(R10))和血清LDH、ALT、AST、ALP的变化情况。[结果]TNT染毒大鼠血和肝组织DNAT均比对照组有明显升高,TNT染毒剂量与大鼠血清或肝组织DNAT呈显著性相关(P<0.01),血清与肝组织DNAT呈显著性相关(P<0.01);各TNT染毒组大鼠血清ICG_(R10)明显高于对照组。TNT高剂量染毒组大鼠血清LDH、ALT、AST和ALP活力有所降低,其他剂量组与对照组相比未见显著性变化;血清或肝组织DNAT与血清LDH呈显著性负相关(P<0.05或0.01),与ALT、AST和ALP均负相关,但未见显著性(P>0.05)。[结论]血清LDH、ALT、AST和ALP指标对TNT染毒诱导的大鼠肝损伤的反应并不敏感,似与TNT代谢产物DNAT对血清4种酶活力可能具有的一定抑制作用有关。     

Comparing the Protective Effects of Curcumin and Ursodeoxycholic Acid after Ethanol-Induced Hepatotoxicity in Rat Liver

BackgroundAlcohol consumption can cause hepatitis and long-term cirrhosis of the liver. The aim of this study was to evaluate the protective effects of curcumin (CUR) and ursodeoxycholic acid (UDCA) alone and together in the prevention and treatment of liver damage caused by overuse of ethanol.MethodsAdult Wistar rats were divided into 8 groups of 5, including the control group and various combinations of ethanol, CUR and UDCA groups. Twenty-eight days after the oral treatment, serum levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT) and Arginase I (ArgI) as well as serum levels of Albumin (Alb), total protein (TP) and Blood Urea Nitrogen (BUN) were measured, and liver tissue was evaluated histopathologically.ResultsThe solo administration of CUR, UDCA and CUR+UDCA had no effect on the blood parameters and liver tissue compared to the control group (p>0.05). The solo administration of CUR and UDCA in ethanol-treated rats significantly reduced ALT, AST, ALP, GGT, ArgI and BUN levels (p<0.05), while the solo administration increased Alb and TP levels compared to the ethanol group (p<0.05). In these groups, a significant decrease in cell necrosis and local inflammation of hepatocytes was observed, and the liver damage was mild. However, co-administration of ethanol, CUR and UDCA made significantly greater decrease in ALT, AST, ALP, GGT, ArgI and BUN levels (p>0.05), while the co-administration greatly increased Alb and TP levels compared to the ethanol group (p<0.05). Histopathologically, a decrease in structural changes in liver tissue and inflammation was observed, resulting in the improvement of liver tissue.ConclusionThe solo administration of CUR and UDCA could reduce ethanol-induced liver damage in rats and improve liver''s serum and blood parameters. However, the coadministration of CUR and UDCA has a greater efficacy.     

饮水中微囊藻毒素对人群健康影响的横断面研究

目的 初步了解饮水中微囊藻毒素（ＭＣ）对人体健康的影响。方法 采用横断面研究方法,在泰兴肝癌高发区两个不同饮水类型的学校里分别随机抽取１１１名和９２名学生,对其进行调查,并采集静脉血,检测血清中乙型肝炎病毒（ＨＢＶ）感染标志物及血清丙氨酸氨基转移酶（ＡＬＴ）、γ－谷氨酰转移酶（γ－ＧＴ）、碱性磷酸酶（ＡＬＰ）水平。按照ＨＢＶ感染进行分层,比较两组人群血清三种酶学水平的差异。结果 两组人群三种酶学指     

gamma-Glutamyltransferase isoenzyme pattern in workers exposed to tetrachloroethylene.

In compliance with the mandatory medical surveillance of workers exposed to tetrachloroethylene (PCE) in Italy, isoenzyme fractioning of serum gamma-glutamyltransferase (GGT) was performed on 141 workers of both sexes and on 130 control subjects. None of the workers showed any clinical symptoms of liver disease and their enzymatic profiles, including AST, ALT, 5'-NU, ALP, and GGT, were within the normal reference limits. A statistically significant increase in total GGT serum level was found in the exposed subjects, which was associated with an increase in one of the two fractions normally present in healthy individuals (GGT-2), as well as with the appearance and progressive increase of the level of a fraction (GGT-4) considered to be an expression of hepato-biliary impairment. Further research is ongoing among these workers, which will clarify whether or not electrophoretic GGT tests may be useful in detecting liver function changes due to occupational exposure to PCE.     

Synergistic effect of hepatitis virus infection and occupational exposures to vinyl chloride monomer and ethylene dichloride on serum aminotransferase activity

Aims: To study the synergistic effect of occupational chemical exposure and hepatitis virus infection on serum aminotransferase activity. Methods: A total of 568 male workers who were employed in five polyvinyl chloride (PVC) or four vinyl chloride monomer (VCM) manufacturing factories were studied. Information relating to current job title, alcohol consumption, and cigarette smoking was obtained. Exposure level of chemical mixtures was classified by hygienic effect (a summation of personal time weighted average/reference permissible exposure level of each chemical) into high, moderate, and low exposure groups. Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT), hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), and anti-hepatitis C antibody were assayed. Results: Hepatitis virus infection and increased body mass index were associated with abnormal serum aminotransferase activity. In workers with hepatitis virus infection, those with high exposure had a higher prevalence of abnormal AST and ALT compared to low exposure; among those without hepatitis virus infection, the differences of prevalence of abnormal AST and ALT were not significant between different chemical exposure groups. There was a significant trend of increasing risks of increased AST and ALT in moderate and high exposure groups with hepatitis virus infection. Such a synergistic effect was more prominent among HBeAg-positive workers. Conclusions: Mixed exposures to 1,2-ethylene dichloride and VCM have a positive synergistic effect with hepatitis virus infection on liver damage. Assessment of fitness for work should be considered in workers with hepatitis B and C infection, when they have potential exposure to hepatotoxins in the workplace.     

Cholinesterase and other serum liver enzymes in underweight outpatients with eating disorders

OBJECTIVE: The present study aimed to evaluate serum liver enzymes in underweight outpatients with anorexia nervosa (A-NERV) or eating disorders not otherwise specified (EDNOS). METHOD: Serum alanine amino transferase (ALT), aspartate amino transferase (AST), lactic dehydrogenase (LDH), gamma glutamyl transferase (GGT), alkaline phosphatase (ALP), and cholinesterase (CHE) were determined in 97 patients with A-NERV, 66 patients with EDNOS, and 56 controls. RESULTS: In the A-NERV group AST, LDH, and GGT were higher, as compared with controls, and inversely related to weight, while ALP and CHE were lower. AST and GGT increased and CHE decreased in patients with EDNOS. Hypertransaminasemia occurred in 14.4 and 15.2%, and low CHE in 29.9% of the A-NERV group and 13.6% and EDNOS group, respectively. Three or more abnormalities were found in 9.3% of patients with A-NERV and 7.5% of those with EDNOS. CONCLUSION: Abnormalities in serum liver enzymes are common in outpatients with eating disorders plus underweight. CHE might be considered as a marker of the effects of primary malnutrition on liver function.     

The associations between height components (leg and trunk length) and adult levels of liver enzymes

STUDY OBJECTIVE: To examine the separate associations of leg length, a biomarker of prepubertal exposures and growth, and trunk length with adult levels of liver enzymes: alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), aspartate transaminase (AST) and alkaline phosphatase (ALP). METHODS: A cross-sectional analysis of baseline data from the British Women's Health and Heart Study, a random sample of British women aged 60-79 years. RESULTS: Leg length was inversely associated with age-adjusted levels of ALT, GGT and ALP. These associations remained when controlling for childhood and adulthood social class, physical activity, smoking, alcohol consumption, waist-to-hip ratio and trunk length. Trunk length was positively associated with ALT and inversely associated with ALP and the associations remained when adjusting for covariables. CONCLUSIONS: Adult liver function is affected by early life environmental exposures as reflected in leg length, and this may suggest common childhood influences on liver development and adult risk of diabetes and coronary heart disease. Further studies with detailed measures of early life exposures relevant to leg length would be valuable in identifying any specific exposures contributing to adult liver function and cardiovascular disease.