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Background Various body tissues of β-thalassemia patients are exposed to the destructive effects of iron overload due to chronic blood transfusions. Therefore, the decision to start regular blood transfusion therapy for these patients often leads to the administration of iron chelators. Deferasirox as an orally effective iron-chelating drug could cause some therapy-related adverse events, such as increased liver enzymes, serum creatinine, and gastrointestinal bleeding. Objective This study evaluates the effect of deferasirox on serum levels of ferritin and liver aminotransferases in transfusion-dependent β-thalassemia patients. Methods In this study, changes in the serum levels of ferritin and liver aminotransferases in β-thalassemia patients receiving deferasirox, who were referred to the thalassemia department of the 17 Shahrivar Hospital and Beesat Clinic in Rasht City, Iran, have been evaluated, retrospectively. In this regard, 104 β-thalassemia major patients over two years of age receiving regular blood transfusions and deferasirox for at least two consecutive years were enrolled. Information of patients, including age, sex, blood transfusion frequency, deferasirox administration duration and dosage, and serum levels of ferritin and liver enzymes between baseline and at least two years after iron chelation therapy with deferasirox was recorded. Results The decreased serum levels of ferritin (P=0.017), aspartate aminotransferase (P=0.0001), and alanine aminotransferase (P=0.015) in the last blood testing after deferasirox therapy were statistically significant. However, there was no statistical significance between the decreased serum levels of liver aminotransferases and factors, including age, sex, blood transfusion frequency, duration, and dosage of deferasirox administration. Conclusion After a few months of taking defrazirox, rather than causing mild and rare liver complications, it can have a protective role for the liver against iron overload in the body and significantly reduce liver aminotransferase. [ABSTRACT FROM AUTHOR]

Aims Fatty liver disease is a type of fat accumulation in the liver parenchyma that can be related to lifestyle. Therefore, this study compared the effectiveness of nutrition education with and without physical activity on blood lipids and liver aminotransferase enzymes in men with nonalcoholic fatty liver disease. Materials & Methods This study is a randomized clinical trial with a control group, carried out on 80 employees working in the South Pars gas complex in Jam, Iran, suffering from fatty liver. The participants were allocated to four nutrition education groups; a physical activity group, a nutrition education group with physical activity, an education group without physical activity, and a control group (20 people each) using a random block sampling method. In all four groups, 48 hours before the intervention, 3 and 6 months after the intervention, blood lipids and liver enzymes were measured and recorded in a form. Data were analyzed using SPSS 21 software and chi-score statistics, one-way ANOVA, and repeated measures ANOVA test. Findings Alanine aminotransferase enzyme showed a significant improvement in each of the 3 intervention groups compared to the control group at 3 and 6 months after the research intervention (p=0.001). Low-density lipoprotein showed a significant improvement in 6 months, which was related to the group of physical activity combined with nutrition education (p=0.005). Conclusion Exercise and education interventions are more effective over a longer period of time in preventing and treating non-alcoholic fatty liver disease. [ABSTRACT FROM AUTHOR]

Background: Rhabdomyolysis is a clinical syndrome that occurs due to the damage to striated muscles after various conditions, one of the most common of which is drug poisoning. This study examined rhabdomyolysis in all types of poisoned hospitalized patients and its relationship with paraclinical variables, such as Creatine Phosphokinase (CPK) and the patients' level of creatinine, blood urea, and liver enzymes (alanine aminotransferase and aspartate aminotransferase). Methods: A total of 105 patients suffering from rhabdomyolysis caused by poisoning were enrolled. The necessary information of the patients was extracted from their records, recorded in the research questionnaire, and analyzed using SPSS. Descriptive statistics indicators and Pearson's linear correlation coefficient were used for statistical analysis. Results: The prevalence of rhabdomyolysis was 7.2%. Ninety-seven (92.4%) and 8 (7.6%) poisoned patients suffering from rhabdomyolysis were male and female, respectively. The most prevalent poisoning resulting in rhabdomyolysis was methadone poisoning (31.42%). There was a significantly positive correlation between CPK and urea, Cr, and AST; i.e., by increasing CPK level, urea, Cr, and AST levels also increased, and by decreasing CPK level, urea, Cr, and AST levels also decreased. The incidence of an abnormal aminotransferase in the setting of rhabdomyolysis was high. In addition, the frequency of Acute Kidney Injury (AKI) ranged from 10.9 to over 16.9%. Conclusion: Xenobiotics (e.g., opioids, drugs, alcohol, and poisons), xenobiotic-induced coma, and/or xenobiotic-induced seizure are the causes of rhabdomyolysis in the present study. Briefly, the research findings revealed the highest prevalence of rhabdomyolysis in male youth poisoned by narcotics. [ABSTRACT FROM AUTHOR]

BACKGROUND: Considering the conflicting results and limited studies on the association between elevated liver enzyme levels and COVID-19 outcomes, in the present study, we aimed to investigate the association between hepatic enzyme changes and the prognosis of COVID-19 during hospital admission. METHODS: In this prospective study, 1017 consecutive patients with COVID-19 participated and were followed up from admission until they were discharged or deceased. The liver enzyme levels were recorded on admission. The patient/disease-related information was recorded by trained nurses using questionnaires. The primary endpoint was the association between elevated liver enzymes and liver injury and mortality from COVID. RESULTS: The mean age of the participants was 62.58 ± 17.45 years; 55.4% of them were male. There was no significant difference between groups regarding the COVID-19 outcomes except for the need for ICU admission (P = 0.02). Moreover, all COVID-19 outcomes were significantly higher in patients with liver injury compared with other patients except for the quick sequential organ failure assessment (qSOFA) score. After adjusting for covariates, the patients with Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) levels of more than 40 (IU/L) and participants with liver injury on admission had significantly greater odds of death, ICU admission, and mechanical ventilation requirements. CONCLUSION: The results of the present study support the hypothesis that poor outcomes of COVID-19 infection were higher in patients with elevated liver enzyme levels and liver injury. Therefore, liver chemicals should be closely monitored during the illness and hospital admission, and patients with COVID-19 and an elevated level of transaminases should be followed up carefully, and necessary interventions should be considered to prevent poor outcomes. [ABSTRACT FROM AUTHOR]

Aim: This this study aimed to investigate the causes and prognoses of liver re-transplantation in patients referred to Imam Khomeini Hospital Liver Transplantation Center. Background: Organ shortage is a major problem in the world, a high demand for liver transplantation has exacerbated this problem. Thus, providing more information on the causes of liver re-transplantation, its prognosis, and other issues related to this procedure is of great importance. Methods: This study was conducted in 2018 as a historical cohort. In this study, the records of liver transplantation patients at Imam Khomeini Hospital Liver Transplantation Center between 2000 and 2016 were studied, and data was extracted from the records of patients undergoing liver transplantation. Patient data was entered into SPSS 20 software and analyzed. Results: In this study, 1030 patients with a mean age of 43.15 ± 14.57 years were studied. There were 426 women (41.4%) and 604 men (58.6%). The number of primary transplants was 966 with a mean age of 43.19 ± 14.72, and the number of re-transplants was 64 with a mean age of 42.56 ± 12.82. Significant differences were found between the two groups in terms of MELD and CHILD scores, cold ischemic time, total and direct bilirubin levels, liver function factors (ALT, AST, and alkaline phosphatase), hemoglobin, and WBC. There was no significant difference between the two groups in terms of age, sex, or platelets (> 0.05). The mortality rate was 241 (23.39%) in all patients and the mortality rate was 206 (21.32%) and in liver transplant patients was 35 (54.68%). The mortality rate in the transplant group was statistically higher (p<0.001). Secondary was primary non-functional graft (PNF) (37.5%) with 1-, 3, and 5-year survival rates of 82%, 81%, and 70% in primary group and 59%, 43% and 32% in re-transplantation, respectively. There was a significant difference in survival between the two groups (p <0.05). Hemoglobin and alkaline phosphatase were predictors of survival rates in transplant patients. Conclusion: The results of this study showed that the survival rate of re-transplant patients was significantly lower than that of primary transplant patients, and the mortality rate in re-transplant patients was significantly higher. [ABSTRACT FROM AUTHOR]

Introduction: According to the World Health Organization, the incidence of severe acute hepatitis of unknown origin in children is increasing worldwide. However, there are no known causes and treatments to deal with this disease. This study presents three children with severe acute hepatitis of unknown origin in a hospital medical center in Iran. Case Presentation: Two 12-year-old children and a six-year-old child were admitted to the hospital with jaundice. Laboratory tests showed markedly elevated liver enzymes and total and direct bilirubin in these patients. However, hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibodies (Ab), hepatitis A virus (HAV) IgM, HEV IgM, Epstein-Barr virus (EBV) IgM, anti-microsomal Ab, anti-liver kidney (LKM Ab), anti-smooth muscle antibodies (ASMA), anti-nuclear antibodies (ANA), and total IgG were all negative. After excluding the probable infectious causes of acute hepatitis and per the progressive course of fulminant hepatic failure, intravenous methylprednisolone was started for two of three cases during hospitalization. These children were discharged from the hospital in good general condition, and the liver function tests gradually decreased and approximated to near normal during the follow-up visits. Conclusions: General practitioners and pediatricians are advised to examine the underlying causes and consider severe acute hepatitis of unknown origin when visiting children under 16 years with severe jaundice and very high transaminases. [ABSTRACT FROM AUTHOR]

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Objectives: Regarding the inconsistent reports on the potential relationship between cardiometabolic disorders, including metabolic syndrome (MetS), diabetes, hypertension (HTN) and chronic kidney disease (CKD), and elevated serum levels of liver enzymes, we conducted this study to test this hypothesis. Methods: Men and women aged ≥ 19 years participated in the sixth examination of Tehran Lipid and Glucose study (TLGS) were recruited. Anthropometric and demographic measurements, as well as biochemical tests, were done for all participants. The odds ratio of cardiometabolic disorders in each tertile category of liver function tests (LFTs), including alanine transaminase (ALT), aspartate transaminase (AST), ALT/AST ratio, alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and lactate dehydrogenase (LDH) were estimated using the multivariable logistic regression models. Results: The mean age (± SD) of participants was 48.2 (± 17.1) years, and 42.3% of the participants were men. After adjustment for confounding variables, elevated serum concentrations of ALT, AST, ALT/AST ratio, GGT, and ALP were positively associated with increased chance of develop MetS (OR = 3.80, 95% CI = 2.46 - 5.87 for ALT, OR = 1.52, 95% CI = 1.04-2.23 for AST, OR = 3.08, 95% CI = 2.05 - 4.63 for ALT/AST ratio, OR = 2.71, 95% CI = 1.80 - 4.09 for GGT, OR = 1.64, 95% CI = 1.12 - 2.38 for ALP). Elevated serum concentrations of ALT, ALT/AST ratio, GGT and ALP were also positively associated with risk of diabetes (OR = 4.32, 95% CI = 2.40 - 7.79 for ALT, OR = 3.28, 95% CI = 1.92 - 5.61 for ALT/AST ratio, OR = 2.52, 95% CI = 1.46 - 4.34 for GGT, OR = 1.74, 95% CI = 1.05 - 2.88 for ALP). Also, increased levels of ALT, GGT and ALP were positively associated with HTN (OR = 2.63, 95% CI = 1.66 - 4.17 for ALT, OR = 2.01, 95% CI = 1.30 - 3.13 for GGT, and OR = 1.90, 95% CI = 1.26 - 2.87 for ALP). Moreover, the elevated level of LDH was positively associated with CKD (OR = 2.43, 95% CI = 1.09 - 5.43). Conclusions: Based on the results of the present study, LFT could be helpful for the early detection of cardiometabolic disorders. [ABSTRACT FROM AUTHOR]

Background: Over recent decades, with the increase in the prevalence of childhood overweight/obesity, the prevalence of pediatric non-alcoholic fatty liver disease (NAFLD) has increased. Objectives: The aim of this study was to investigate the prevalence of NAFLD and its predisposing factors in overweight and obese children of Urmia, Northwest of Iran. Methods: In this cross-sectional study, a total of 843 children aged 2 to 19 years were recruited out of 10800 children referred to the Digestive Disease Clinic of Shahid Motahari Hospital during 2016 - 2017. Anthropometric and laboratory measurements and abdominal ultrasound were performed for the children. Demographic data and their medical history were collected by a questionnaire. Unconditional logistic regression was used to predict the predisposing factors of NAFLD. Results: Fatty liver was diagnosed by ultrasound in 9.5% of overweight and 21.4% of obese children. The prevalence of NAFLD in obese children was 9.26% for the 2 - 5.9-year age group, 22.3% for the 6 - 11.9-year age group and 35.5% for the 12 - 19-year age group. Compared to the normal liver group, the adjusted odds ratios (ORs) [95% confidence interval (CI)] for predictive factors of NAFLD were as follows: ALT: 1.05 (1.03 - 1.09), ALK: 1.02 (1.01 - 1.03), AST: 1.04 (1.02 - 1.08), triglycerides: 1.1 (1. 08 - 1.21), TSH: 1.18 (1.1 - 1.40), FBS: 1.04 (1.01 - 1.08) and HOMA-IR: 1.19 (1.03 - 1.38). Compared to the age group of 2 - 5.9 years, the odds ratio of NAFLD was increased by 4 and 8 times in the age group 6 - 11.9 and 12 - 19 years, respectively. Conclusions: There was a strong relationship between pediatric NAFLD and ALT, AST and HOMA-IR in the overweight and obese children. Our findings emphasized the importance of prevention of obesity and early intervention to prevent abnormalities among obese children. [ABSTRACT FROM AUTHOR]

BACKGROUND Hepatic dysfunction has been associated with poor prognosis in critically ill patients. We aimed to investigate the incidence of early liver dysfunction and its association with probable predictive variables in a group of Iranian patients. METHODS The study was conducted on 149 pediatric patients referred to the pediatric intensive care unit (PICU), Shiraz University of Medical Sciences, Shiraz, Iran between April and October 2016. Serum levels of liver aminotransferase, alkaline phosphatase, total bilirubin, direct bilirubin, and international normalized ratio (INR) were recorded in 24, 48, and 96 hours after admission. RESULTS On the first day of admission, direct bilirubin was the least (9.1%) and abnormal alkaline phosphatase level was the most (66.9%) common abnormalities. Abnormal levels of all tests except alkaline phosphatase were predictive of increased rate of mortality. In univariable logistic regression, abnormal aminotransferases (ALT and AST), INR, total bilirubin, and direct bilirubin had significant relationship with patients' mortality after 24, 48, and 96 hours. In multivariable logistic regression only ALT and INR in the first 24 hours had significant relationship with mortality in final model. Although univariate logistic regression revealed a significant relationship between AST and ALT levels with PICU length of stay, no significant relationship was observed between these variables and PICU length of stay (except AST in the first 24 hours) in multivariable analysis. CONCLUSION Increase in liver enzymes may predict mortality and increased PICU length of stay in critically ill children. [ABSTRACT FROM AUTHOR]

Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most common reasons of enzyme increase in liver. In About 10 percent of patients with NAFLD, the disease progresses toward Non Alcoholic Steatohepatitis (NASH) and about one third of them may progress toward cirrhosis, liver dysfunction, and even hepatocellular carcinoma. Objectives: According to high prevalence of NAFLD and the fact that there is no consensus on treatment of this disease, the aim of this study was to assess the effects of metformin, pioglitazone, and silymarin on treatment of NAFLD. Patients and Methods: Sixty-six patients with NAFLD who were presented in the Endocrinology and Metabolism clinic of Boo'ali Hospital, Qazvin, Iran, were assigned randomly into three groups (n = 22). First group was treated by pioglitazone 15 mg/d, second group by metformin 500 mg/d, and third group by silymarin 140 mg/d. All patients underwent clinical and biochemical evaluations including weight, fasting blood sugar (FBS), lipid profiles, body mass index (BMI), aspartate aminotransferase (AST ), alanine aminotransferase (ALT), and serum insulin levels in pre- and post-intervention after eight-week follow up. Results: Before the treatment there was no significant difference between three groups with respect to average age, BMI and gender, FBS, lipid profile, AST, ALT, serum insulin level, and Homeostasis Model Assessment (HOMA) index for insulin resistance. After the intervention, a significant reduction was observed in average amount of FBS, lipid profile, ALT, AST, serum insulin level and HOMA index in three groups (P < 0.01). The most reduction in average FBS, TG, serum insulin level, and HOMA index was observed in pioglitazone group, the most reduction in average amount of cholesterol was seen in metformin group, and the most decrease in average amount of AST and ALT occurred in silymarin group. Conclusions: These results suggest that all drugs are beneficial in improving biochemical indices in patients with NAFLD. Changes in AST and ALT in silymarin group were demonstrated more than that in other groups and the average difference between changes was significant between silymarin and metformin groups. [ABSTRACT FROM AUTHOR]

This study was aimed to determine prevalence of Vitamin D deficiency and rickets in children with cholestatic liver diseases. Forty eight children with established cholestatic liver disease who referred to gastrointestinal clinic of Children Medical Center (Tehran, Iran) between April 2010 and March 2011 were enrolled in a cross-sectional study. Laboratory analysis including calcium, phosphate, albumin, total and direct bilirubin, aminotransferases, alkalinephosphatase (ALP), prothrombin time (PT), parathyroid hormone (PTH), total protein determined by routine laboratory techniques. Mean age of participants was 299.1 ± 676.8 days (range 2-3600 days) whereas twenty one were female (43.8%) and 27 (56.3%) were male. Twenty two (45.8%) had evidences of rickets in X-ray evaluation. Three children with rickets and two with normal X-ray had Vitamin D deficiency while ten in rickets group and 16 in normal group had Vitamin D insufficiency. The main underlying diseases were anatomical biliary atresia in cases with rickets and idiopathic in other group. Rickets and Vitamin D deficiency should be considered in chronic cholestatic children. [ABSTRACT FROM AUTHOR]

There is growing clinical interest in liver transaminases as novel biomarkers of cardiovascular risk. We investigated the possible association of serum liver transaminase activity with the presence and angiographic severity of premature coronary artery disease (CAD). A cross-sectional study was conducted on 187 younger patients (females <55 years and males <45 years) who underwent coronary angiography and had serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and high-sensitivity C-reactive protein (hsCRP) measured. Evaluation of coronary stenosis was by Gensini score. Both ALT and AST were significantly correlated with the presence of CAD in univariate and multivariate analyses. Both ALT and AST were also significantly correlated with Gensini score even after adjustment for potential confounders. Serum ALT and AST levels are independently positively associated with the risk and severity of premature CAD, suggesting that these enzymes could serve as surrogate markers for cardiovascular risk in this specific group of patients. [ABSTRACT FROM PUBLISHER]

Background: The effects of occupational exposure on liver function in oil refinery workers are not well known. In this study we evaluated the liver enzyme abnormalities among coal tar refinery workers. Methods: The oil refinery workers in central part of Iran (Isfahan city) underwent routine annual medical examination from 2006 to 2007. A total of 66 cases with abnormal levels of aminotransferases were included in this cross-sectional study. Liver diseases including viral, metabolic and autoimmune hepatitis were excluded by detailed investigations. The relationships of different findings and liver enzymes were evaluated through inferential statistics. Findings: All patients were male with the mean age of 36.7 ± 4.8 years. Thirty eight subjects had dyslipidemia (61.3%). There were significant correlations between triglyceride or cholesterol concentrations and aminotransferases levels. From 40 cases, 35 cases (87.5%) demonstrated ultrasonographic fatty livers. Also, significant correlations were found between cholesterol and Gamma-glutamyl transpeptidase (GGT) levels. There were not significant differences in levels of aminotransferases among different type of work (P > 0.05). Conclusion: Direct occupational exposure to oil refinery products may play an important role in liver enzyme abnormalities. Exposure to coal tar components such as phenols, poly aromatic hydrocarbons chemicals may be a risk factor for NASH (Non-alcoholic Steato-hepatitis). Liver biopsy and long term follow-up can be helpful for definite diagnosis and determination of prognosis. [ABSTRACT FROM AUTHOR]

Background: In the patients with chronic liver disease chronic increase in serum transaminases may remain of undetermined cause despite thorough investigations. Celiac disease (non tropical sprue) has been reported as one of the causes of elevated levels of serum transaminases. The aim of this cross sectional study was to evaluate the frequency of celiac disease among patients with liver disease with chronic unexplained hypertransaminasemia. Methods: One hundred patients with unexplained elevated liver enzymes who referred to gastroenterology and hepatology clinic of Imam Khomeini Hospital in Tehran, Iran from March 2009 to March 2010, and no cause were found for this elevation after initial clinical and paraclinical assessments and tests were enrolled in a cross sectional study. After measurement of Anti tTG IgA antibody in the serum of the patients, the biopsy of second part of duodenum were performed in cases with positive results and were assessed regarding evidences of celiac and finally the diagnosis of celiac diseas was confirmed. Results: The mean age of patients was 39.79±16.77 and 55% of patients were male. The celiac disease was confirmed in 6% of patients (CI: 95%: 2.78- 12.48%). There were no significant differences between frequency of both sexes and means of age, ALT, and AST in the study patients. Conclusion: In our study, the frequency of celiac disease among patients with chronic liver disease with unknown elevated liver enzymes was 6% which is near the frequency derived from other studies that has been reported. [ABSTRACT FROM AUTHOR]

Background and Aims: Hepatitis E virus (HEV) is mainly the causative agent of waterborne epidemics, but some authors have found that patients on chronic hemodialysis have an increased risk of exposure to HEV. We conducted this study to reveal HEV seroprevalence in hemodialysis patients as a specific group in Iran, and to evaluate age, duration of hemodialysis, and the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in them. Methods: The presence of immunoglobulin G antibodies to HEV(anti-HEV IgG) was measured by enzyme-linked immunosorbent assay (ELISA) in the patients' sera. Both ALT and AST serum levels were measured. The duration of hemodialysis and the age and sex of the participants were obtained from the medical records of patients, and the data were made into quantitative variables, which were expressed as mean ± standard deviation (SD). Results: 43 patients (29 males and 14 females) enrolled in this study. 3 of these patients (7% of the sample) were HEV antibody positive (2 males and 1 female). The mean levels of AST and ALT in all of the studied patients were 22.3 ± 23.3 IU/L and 21.3 ± 27.6 IU/L, respectively. An association between HEV positivity and duration of hemodialysis was revealed by our results, but there was no significant association between HEV antibody positivity and patient age. All 3 patients who were positive for anti-HEV antibody in our study also had elevated liver enzymes. Conclusions: The finding that HEV infection was associated with elevated liver enzymes in patients who were on chronic hemodialysis may indicate that hemodialysis is a route for HEV transmission, and more controlled studies are needed to explore this association in Iran. [ABSTRACT FROM AUTHOR]

Background and Aims: At least 5% of hepatitis B carriers worldwide are infected with Hepatitis D virus (HDV). This study aims to determine the prevalence, transaminase levels and histopathological findings of HDV among patients with chronic active hepatitis B in southern Iran. Methods: During 2003-2004, 93 patients ≥15 years with chronic active hepatitis B were enrolled from referrals to Shiraz University of Medical Sciences in southern Iran. Results: Nine (9.7%) patients were seropositive for the anti HDV antibody. 76.3% of patients were male and among the HDV positive group, all subjects were male too. A significantly higher AST and more advanced grade and stage of liver disease were observed in the HDV positive group. The most common mode of transmission in the positive group was intravenous drug use. Conclusions: The risk of liver disease progression in chronic hepatitis B appears to be higher in HDV infected patients. Intravenous drug abuse is an important risk factor for acquiring HDV infection. Checking anti-HDV is suggested in any patient with positive HBsAg, especially in males or those with history of intravenous drug abuse. [ABSTRACT FROM AUTHOR]

Background: To investigate the association of Aspartate aminotransferase (AST), Alanin aminotranferase (ALT) and Gamma glutamyl transferase (GGT) with incident type 2 diabetes. Methods: In a nested case-control study, AST, ALT, GGT as well as classic diabetes risk factors, insulin and C-reactive protein (CRP) were measured in 133 non-diabetic subjects at baseline of which 68 were cases and 65 were controls. Incident diabetes was defined by the WHO 1999 criteria. Conditional logistic regression was used to calculate the odds ratio (OR) of incident diabetes associated with different hepatic markers. We used factor analysis for clustering of classic diabetes risk factors. Results: In Univariate analysis both ALT and GGT were associated with diabetes with ORs of 3.07(1.21-7.79) and 2.91(1.29-6.53) respectively. After adjustment for CRP and insulin, ALT and GGT were still predictive of incident diabetes. When the model was further adjusted for anthropometric, blood pressure and metabolic factors, only ALT was independently associated with diabetes [OR = 3.18 (1.02-9.86)]. No difference was found between the area under the receiver operating characteristic curves of the models with and without ALT (0.820 and 0.802 respectively, P = 0.4) Conclusion: ALT is associated with incident type 2 diabetes independent of classic risk factors. However, its addition to the classic risk factors does not improve the prediction of diabetes. [ABSTRACT FROM AUTHOR]

Background: The geographic map of cancer prevalence differs due to environmental and dietary factors in various populations. High prevalence of a number of cancers in some regions is thought to be attributed to local dietary habits. Dorema aucheri (Bilhar) is used commonly as an herbal medicine in some regions including Iran. The aim of this study was to evaluate whether Dorema aucheri has carcinogenic effects in albino mice or not. Methods: The Dorema aucheri leaves were extracted by Soxhlet method and were injected intraperitoneally and randomly into 28 healthy albino mice which were divided into seven groups. One was put aside as the non-injected control group. The second control group was chosen to be injected by a known carcinogen. Another group was injected by carcinogen and then, Bilhar extract. The left four groups were injected the extracts in a dose-dependent manner, increasingly in the range of 0.4-3.2mLJkg. Extract injections were repeated every 48-hour intervals for three times. Then, liver and serum samples were analyzed biochemically and pathologically. Results: The pathologic and biochemical studies showed that the injection of plant extracts caused necrosis, inflammation of the liver tissue, cell proliferation, cholestasis, and there were significant increases in release of liver enzymes [ALP, ALT (SGPT) and AST (SGOT)] and bilirubin compared to the non-injected control group. The level of liver damage was dose dependent. Conclusions: Dorema aucheri has potential hepatotoxic capacities and possibly this may be related to the high prevalence of cancer in some regions of Iran. [ABSTRACT FROM AUTHOR]

Background: Abnormal levels of liver enzymes, particularly aminotransferases, are prognostic features of non-alcoholic fatty liver disease (NAFLD). Considering the important role of dietary intakes in development of NAFLD, we aimed to determine possible association of unhealthy foods (fast foods, soft drinks, sweet and salty snacks) consumption with elevated levels of aminotransferases. Methods: This cross-sectional study was conducted within the framework of sixth phase of the Tehran Lipid and Glucose Study (2014–2017), on 187 adult men and 249 adult women (19–70 y). Usual intakes of unhealthy foods (kcal/week) were measured using a validated semi-quantitative 147-items food frequency questionnaire. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) were measured. Multivariable logistic regression models were used to estimate the odds of elevated aminotransferases in each tertile of energy-dense unhealthy foods. Results: Mean age of participants was 44.44 ± 15.09 years, 43% of participants were men. Higher consumption of fast foods (> 11.39% kcal/week) was associated with elevated ALT to AST ratio (OR: 3.27; 95% CI: 1.90–5.63) and elevated ALT (OR: 2.74; 95% CI: 1.57–4.76). Also, each 1 SD increased energy intakes from fast foods was related to increased chance of having elevated ALT and ALT to AST ratio by 35% (OR: 1.35; 95% CI: 1.08–1.68, OR: 1.35; 95% CI: 1.10–1.66, respectively). There was no significant association between consumption of soft drinks, sweet or salty snacks and elevated aminotransferases. Conclusions: Higher intakes of energy from fast foods seems to be associated with an elevated serum levels of ALT and ALT to AST ratio, as indicators of development of NAFLD. [ABSTRACT FROM AUTHOR]

Background: Since lifestyle changes are main therapies for non-alcoholic fatty liver disease (NAFLD), changing dietary components (nutritional or bioactive) may play a parallel important role. Few studies have assessed the effects of curcumin on NAFLD (mainly antioxidant and anti-inflammatory effects). We aimed to determine the effects of nano-curcumin (NC) on overweight/obese NAFLD patients by assessing glucose, lipids, inflammation, insulin resistance, and liver function indices, especially through nesfatin. Methods: This double-blind, randomized, placebo-controlled clinical trial was conducted in the Oil Company Central Hospital, Tehran. 84 overweight/obese patients with NAFLD diagnosed using ultrasonography were recruited according to the eligibility criteria (age 25–50 yrs., body mass index [BMI] 25–35 kg/m2). The patients were randomly divided into two equal NC (n = 42) and placebo (n = 42) groups. Interventions were two 40 mg capsules/day after meals for 3 months. Lifestyle changes were advised. A general questionnaire, a 24-h food recall (at the beginning, middle and end), and the short-form international physical activity questionnaire (at the beginning and end) were completed. Also, blood pressure, fatty liver degree, anthropometrics, fasting blood sugar (FBS) and insulin (FBI), glycated hemoglobin (HbA1c), homeostasis model assessment-insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), tumor necrosis factor-alpha (TNF-α), high sensitive c-reactive protein (hs-CRP), interleukin-6 (IL-6), liver transaminases, and nesfatin were determined at the beginning and end. Results: NC compared with placebo significantly increased HDL, QUICKI, and nesfatin and decreased fatty liver degree, liver transaminases, waist circumference (WC), FBS, FBI, HbA1c, TG, TC, LDL, HOMA-IR, TNF-α, hs-CRP, and IL-6 (P < 0.05). The mean changes in weight, BMI, body composition (BC), and blood pressure were not significant (P > 0.05). After adjustment for confounders, the changes were similar to the unadjusted model. Conclusion: NC supplementation in overweight/obese NAFLD patients improved glucose indices, lipids, inflammation, WC, nesfatin, liver transaminases, and fatty liver degree. Accordingly, the proposed mechanism for ameliorating NAFLD with NC was approved by the increased serum nesfatin and likely consequent improvements in inflammation, lipids, and glucose profile. Further trials of nano-curcumin's effects are suggested. Trial registration: Iranian Registry of Clinical Trials, IRCT2016071915536N3. Registered 2016-08-02. [ABSTRACT FROM AUTHOR]