Liver marker {e.g., alanine aminotransferase (ALT) and aspartate aminotransferase (AST)} levels independently predict insulin resistance. The aim of the present study is to examine how changes in liver markers are ass...Liver marker {e.g., alanine aminotransferase (ALT) and aspartate aminotransferase (AST)} levels independently predict insulin resistance. The aim of the present study is to examine how changes in liver markers are associated with changes in insulin resistance after exercise in Japanese community-dwelling adults. The participants were 76 women aged 67 ± 6 years from a rural village. Nordic walk (NW) exercise of 120 min per week was performed for 12 weeks. Before and at the end of the 12-week intervention, various confounding factors and insulin resistance {e.g., Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)} were measured. The baseline, follow-up, and changes in ALT/AST ratio (β = 0.390, P β = 0.393, P β = 0.321, P = 0.004, respectively) were each significantly and independently associated with HOMA-IR. When the data were further stratified by baseline and change in ASL/AST ratio, changes in HOMA-IR decreased more significantly in participants with baseline ASL/AST ratio ≥ 0.762 and change in ALT/AST ratio of < 0 than those with change in ALT/AST ratio of ≥ 0 (baseline ASL/AST ratio P = 0.002 and ASL/AST ratio ≥ 0.762, P = 0.047). This study is of interest because liver transaminase markers, which are inexpensive and routinely collected in clinical settings, may provide a simple and accurate enhancement to models currently used to identify subjects with changes in insulin resistance. These results suggest that a higher baseline and decreased change in ALT/AST ratio may be a predictor for decreased insulin resistance after a 12-week walking exercise in community-dwelling middle-aged and elderly women.展开更多
AIM: To evaluate the hepatic dysfunction in leptospirosis is usually mild and resolved eventually. However,sequential follow-up of liver biochemical data remained lacking..METHODS: The biochemistry data and clinical s...AIM: To evaluate the hepatic dysfunction in leptospirosis is usually mild and resolved eventually. However,sequential follow-up of liver biochemical data remained lacking..METHODS: The biochemistry data and clinical symptoms of 11 sporadic patients were collected and analyzed, focusing on the impacts of leptospirosis upon liver biochemistry tests.RESULTS: The results disclosed that of the 11 cases, 5 or 45% died. The liver biochemistry data in the beginning of the disease course were only mildly elevated.Nevertheless, late exaggerated aspartate transaminase (AST)elevations were noted in three cases who finally died when compared with the typical course. Besides, significant higher AST/alanine transaminase (ALT) ratios (AARs) of the peak levels for transaminase were also noted in the cases who eventually succumbed. The mean±SD of AARs for the survival group and dead group were 5.65±2.27 (n = 5)and 1.86±0.64 (n = 6) respectively (P= 0.006). The ratios of the cases who finally died were all more than 3.0.Conversely, the survival group's ratios were less than 3.0.CONCLUSION: Serial follow-up of transaminase might provide evidence to predict some rare evolutions in leptospirosis. If AST elevated progressively without a concomitant change of ALT, it might indicate an acute disease course with ensuing death. Additionally, AAR is another prognostic parameter for leptospirosis. Once the value was higher than 3.0, a grave prognosis is inevitable.展开更多
文摘Liver marker {e.g., alanine aminotransferase (ALT) and aspartate aminotransferase (AST)} levels independently predict insulin resistance. The aim of the present study is to examine how changes in liver markers are associated with changes in insulin resistance after exercise in Japanese community-dwelling adults. The participants were 76 women aged 67 ± 6 years from a rural village. Nordic walk (NW) exercise of 120 min per week was performed for 12 weeks. Before and at the end of the 12-week intervention, various confounding factors and insulin resistance {e.g., Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)} were measured. The baseline, follow-up, and changes in ALT/AST ratio (β = 0.390, P β = 0.393, P β = 0.321, P = 0.004, respectively) were each significantly and independently associated with HOMA-IR. When the data were further stratified by baseline and change in ASL/AST ratio, changes in HOMA-IR decreased more significantly in participants with baseline ASL/AST ratio ≥ 0.762 and change in ALT/AST ratio of < 0 than those with change in ALT/AST ratio of ≥ 0 (baseline ASL/AST ratio P = 0.002 and ASL/AST ratio ≥ 0.762, P = 0.047). This study is of interest because liver transaminase markers, which are inexpensive and routinely collected in clinical settings, may provide a simple and accurate enhancement to models currently used to identify subjects with changes in insulin resistance. These results suggest that a higher baseline and decreased change in ALT/AST ratio may be a predictor for decreased insulin resistance after a 12-week walking exercise in community-dwelling middle-aged and elderly women.
基金Supported by the Chang Gung Medical Research Project fund, No. CMRPG 33014
文摘AIM: To evaluate the hepatic dysfunction in leptospirosis is usually mild and resolved eventually. However,sequential follow-up of liver biochemical data remained lacking..METHODS: The biochemistry data and clinical symptoms of 11 sporadic patients were collected and analyzed, focusing on the impacts of leptospirosis upon liver biochemistry tests.RESULTS: The results disclosed that of the 11 cases, 5 or 45% died. The liver biochemistry data in the beginning of the disease course were only mildly elevated.Nevertheless, late exaggerated aspartate transaminase (AST)elevations were noted in three cases who finally died when compared with the typical course. Besides, significant higher AST/alanine transaminase (ALT) ratios (AARs) of the peak levels for transaminase were also noted in the cases who eventually succumbed. The mean±SD of AARs for the survival group and dead group were 5.65±2.27 (n = 5)and 1.86±0.64 (n = 6) respectively (P= 0.006). The ratios of the cases who finally died were all more than 3.0.Conversely, the survival group's ratios were less than 3.0.CONCLUSION: Serial follow-up of transaminase might provide evidence to predict some rare evolutions in leptospirosis. If AST elevated progressively without a concomitant change of ALT, it might indicate an acute disease course with ensuing death. Additionally, AAR is another prognostic parameter for leptospirosis. Once the value was higher than 3.0, a grave prognosis is inevitable.
