PE-163: Association Liver Enzymes with Blood Pressure in Diabetic Patients

( Shrestha Rojeet ),( Shrestha Nirajan ),( Bhatt Nirmal Prasad ),( Dahal Sudimna ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

Aims: Gamma-glutamytransferase (GGT) is routinely used laboratory investigation for liver damage and alcohol consumption. Serum GGT concentration is determined by body fat content, lipid and glucose levels, alcohol consumption and various medications. Several lines of evidence show that serum GGT is associated with cardiovascular and all-case mortality. It is also a marker of oxidative stress. Although serum GGT is associated with hypertension, the correlation between GGT and blood pressure has not been well established. The aim of the present study was to investigate the association between serum GGT and blood pressure in type 2 diabetic patients (T2DM). Methods: A total number of 105 patients with T2DM, who attended Nepal Medical College Teaching Hospital, Kathmandu, Nepal, were recruited for the study. There were 39 males (mean age: 56.6±5.2 years) and 66 females (mean age: 49.6±6.3). The patients with history of liver disease and alcohol intake were excluded from the study. After basic anthropometric measurement, fasting venous blood was collected and subjected for the estimation of liver enzymes. All data were expressed as mean± SD. p-values less than 0.05 were considered as statistically significant. Results: Although serum ALT and AST levels were significantly elevated within the normal range in T2DM compared to control, they are not correlated with systolic blood pressure (SBP) (r= 0.07 and 0.128, respectively) and diastolic blood pressure (DBP) (r= 0.08 and 0.02, respectively) in both men and women. However, serum GGT levels within their normal range were positively correlated with SBP (r=0.4, p<0.01) and DBP (r=0.275, p<0.05) in women. Interestingly, neither of these liver enzymes was correlated with blood pressure among men diabetic patients. Conclusions: These findings suggest that GGT may be linked with blood pressure balance in women and evaluating the levels of GGT could help in the monitoring of hypertension in diabetic individuals.

Waist Circumference, Not Body Mass Index, Is Associated with Increased Gamma-glutamyltranspeptidase in Type Diabetes Mellitus

( Nirajan Shrestha ),( Nirmal Prasad Bhatt ),( Sudimna Dahal ),( Rojeet Shrestha ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

Aims: Serum gamma-glutamyltranspeptidase ( GGT), a marker of liver injury, alcohol consumption, and oxidative stress, has been shown to be associated with obesity and diabetes mellitus. Obese individuals with higher GGT are associated with complications in type 2 diabetic patients. There is evidence that waist circumference (WC) measured obesity more accurately than body mass index (BMI). In the present study, we aimed to evaluate association of GGT with WC and BMI in diabetic subjects. Methods: The study subjects were 105 type 2 diabetic patients (39 men and 66 women), who attended outpatient department of Nepal Medical College Teaching Hospital, Kathmandu, Nepal. The patients with the history of alcohol intake and liver disease were excluded from the study. Anthropometric measurement was taken and venous blood was collected for biochemical analysis. Statistical analysis was done using SPSS 16.0. The p-values less than 0.05 were considered as significant. Results: The serum GGT levels were positively correlated with blood sugar levels in diabetic subjects. Similarly, GGT levels were positively associated with WC (r=0.269, p<0.05) in women diabetic patients. However, no such correlation was observed in men diabetic subjects (r=0.14). Also, there was no correlation between serum GGT levels and BMI (r=0.03), suggesting that regional fat distribution in type 2 diabetes is associated with the increased levels of serum GGT. Conclusions: In conclusion, WC, not the BMI, is correlated with serum GGT levels in women with type 2 diabetics. Hence, it is important to evaluate central obesity and GGT in patients with diabetes mellitus.

Correlating the Quantity and Bid Cost of Unit Price Items for Public Road Projects

Pramen P. Shrestha,Nipesh Pradhananga,Nirajan Mani 대한토목학회 2014 KSCE Journal of Civil Engineering Vol.18 No.6

In the United States, the majority of public road projects are constructed using the Design-Bid-Build (DBB) method. DBB projectsare procured by government agencies typically through the competitive bidding process. In DBB projects, the early estimates ofprobable cost of road projects is one of the major factors in making decision regarding which projects proceed to the bidding stage. The final cost of the project will be fixed based on the bid amount of the contractor. If the cost of the project can be estimated basedon the bid cost from the historical data, the estimated amount will be more accurate. This study attempted to determine the bid cost ofprojects by analyzing the bid data of 151 DBB road projects undertaken by the Clark County Department of Public Works insouthern Nevada from 1991 through 2008. The total value of construction was equivalent to $841 million when converted into a June2011 base cost. This study developed regression models to predict a future project’s bid cost of unit price items, based on thequantities of items. The validation of models also showed that these models predicted the unit bid cost accurately. These models willassist in assessing the effect of quantity in accurately estimating the cost of the unit price items and reduce variances that result inlarge discrepancies between engineers’ estimates and actual bid-award amounts.

Association of Serum Aminotransferases with High Density Lipoprotein Cholesterol (HDL-C) in Diabetic Patients

( Nirmal Prasad Bhatt ),( Nirajan Shrestha ),( Sudimna Daha ),( Rojeet Shrestha ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

Aims: Alanine aminotransferase ( ALT) and aspartate aminotransferase AST) are commonly used markers of liver-disorders. Non-alcoholic fatty liver disease (NAFLD) is associated with lipid abnormalities and type 2 Diabetes. Previous studies have suggested elevation in levels of ALT and AST which may serve as markers for NAFLD. However, correlation of liver enzymes and lipid profile has not been well established. Hence, current study was performed to observe the association between aminotransferases and HDL-C in type-2 diabetic patients. Methods: The study was carried out in Department of Pathology, Nepal Medical College and Teaching Hospital, Kathmandu, Nepal. A total of 103 type 2 diabetic patients, 41 males (mean age: 55.9±13.4) and 62 females (mean age: 49.9±10.6) were included in this study. Patient’s anthropometric measurements were performed before collecting the fasting blood for aminotransferases and lipid profile analysis. The results were shown as mean ± SD. P-values less than 0.05 were considered as statistically significant. Results: In the present study, serum ALT and AST levels were correlated with fasting HDL (r= -0.419, P < 0.05 and r= -0.354, P < 0.05 respectively) in women with type 2 diabetes. However, there was no such correlation among these parameters in men diabetic patients. Furthermore, there was no correlation between aminotransferase and fasting TC, TG and LDL levels. Conclusions: This finding suggests the correlation between aminotransferase and FHDL in diabetic patients. Hence, measurement of aminotransferase and lipid profile has clinical significance in diabetic patients.

Hepatic Association with Increased ALT and GGT in Type 2 Diabetic Patients

( Nirmal Prasad Bhatt ),( Nirajan Shrestha ),( Sudimna Dahal ),( Rojeet Shrestha ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Diabetes mellitus (DM) has been associated with liver dysfunction and dyslipidemia, is a leading cause of global mortality, inducing various secondary complications, such as coronary heart disease, neuropathy and chronic kidney disease. DM is associated with non-alcoholic fatty liver disease (NAFLD), including its severe form, non-alcoholic steatohepatitis. NAFLD among diabetic patients in western countries is highly prevalent. However, there is a paucity of data showing such an association in Nepalese patients with DM. Thus, the current study was conducted for a better understanding of liver dysfunction in Nepalese patients with type 2 diabetes mellitus (T2DM). Methods: We conducted a prospective study to determine if any correlation exists between serum liver enzymes in T2DM and different confounding factors. One hundred and five patients (male:female= 0.6) with a median age of 52±1.09 years, newly diagnosed as having T2DM, were recruited from the outpatient department of tertiary hospital during one year. Results: We observed a marginal, yet statistically significant, increase of serum alanine transaminase and γ-glutamyl in the diabetic patients compared to healthy controls. However, elevation of serum AST was statistically insignificant. Conclusions: Elevation of the liver enzymes, ALT and GGT, within the normal range in T2DM may indicate initiation of pathological processes in the liver. Hence, regular monitoring of liver function is advantageous to prevent advanced liver injury in T2DM.

The fate of hepatocyte cell line derived from a liver injury model with long-term in vitro passage

Lokendra Chand,Prabodh Risal,Nirajan Shrestha,Dhruba Acharya,Yae Sul Jeong,Chan-Young Kim,Yeon Jun Jeong 대한독성 유전단백체 학회 2018 Molecular & cellular toxicology Vol.14 No.3

Backgrounds: Orthotopic Liver Transplantation (OLT) is the therapy of choice for the treatment of end-stage liver disease, but the severe shortage of organ donors, complex and expensive surgical procedure and increased mortality of prospective organ recipient limit the use of OLT. To overcome this problem the technique of hepatocyte transplantation has been considered as an alternative to OLT. Hepatocyte transplantation is less invasive, cost effective cryo-preservable and can be distributed from single donor to multiple recipients. In this study we have established and characterize the hepatocyte cell line possessing the morphological and functional characteristics of hepatocytes from chemically injured liver. Hence we hypothesized that the hepatocyte cell line derived from liver injury can be used for hepatocyte transplantation. Methods: To induce the priming of hepatocyte, mice were fed with 3,5-diethoxycarbonyl-1,4-dihydro-collidine (DDC) diet for 3 weeks and hepatocytes were obtained by two step collagenase perfusion method, hepatocytes hence obtained was expended by >300 passages and tested for various hepatocyte specific functions. Results: The cell line derived from liver injury model retains morphological and functional characteristics of hepatocytes in long-term in vitro culture. These cells transplanted to mice showed significant survival rate. Conclusion: The Hepatocyte cell line derived from liver injury model were used for hepatocyte transplantation and showed the significantly higher survival rate.