摘要
Dear Editors,We read with great interest the recently published article“Subnormal Serum Liver Enzyme Levels:A Review of Pathophysiology and Clinical Significance”by Youssef and colleagues.1 While much attention is given to elevations of liver enzymes,the authors highlight clinically important,often unrecognized reasons leading to low liver enzyme levels.For example,chronic kidney disease was cited as a cause of low serum aspartate aminotransferase(AST)proportional to the progression of the disease,but the cause(s)are not well defined.Little is known about the possible influence of nephrotic syndrome(NS)on liver enzymes.
