Alterations in gut microbiota and elevated serum bilirubin in primary biliary cholangitis patients treated with ursodeoxycholic acid

2021 ◽  
Author(s):  
Weijia Han ◽  
Chunyang Huang ◽  
Qi Zhang ◽  
Shuhui Tao ◽  
Xiaomin Hu ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Ursodeoxycholic Acid ◽  
Serum Bilirubin ◽  
Elevated Serum ◽  
Primary Biliary Cholangitis

scholarly journals Prognostic Factors in Primary Biliary Cholangitis: A Retrospective Study of Joint Slovak and Croatian Cohort of 249 Patients

2021 ◽  
Vol 11 (6) ◽  
pp. 495
Author(s):  
Jakub Gazda ◽  
Sylvia Drazilova ◽  
Martin Janicko ◽  
Ivica Grgurevic ◽  
Tajana Filipec Kanizaj ◽  
...  
Keyword(s):  
Ursodeoxycholic Acid ◽  
Treatment Response ◽  
Total Bilirubin ◽  
Primary Biliary Cholangitis ◽  
Regression Analyses ◽  
Laboratory Parameters ◽  
Liver Decompensation ◽  
Treatment Responses ◽  
The Relationship ◽  
Therapy Treatment

Objective: To identify pretreatment laboratory parameters associated with treatment response and to describe the relationship between treatment response and liver decompensation in patients with primary biliary cholangitis treated with ursodeoxycholic acid. Methods: We defined treatment response as both ALP ≤ 1.67 × ULN and total bilirubin ≤ 2 × ULN. Multiple logistic regression analyses were performed to adjust for confounding effects of sociodemographic variables. Results: Pretreatment total bilirubin ((TB); OR = 0.3388, 95%CI = 0.1671–0.6077), ALT (OR = 0.5306, 95%CI = 0.3830–0.7080), AST (OR = 0.4065, 95%CI = 0.2690–0.5834), ALP (OR = 0.3440, 95%CI = 0.2356–0.4723), total cholesterol ((TC); OR = 0.7730, 95%CI = 0.6242–0.9271), APRI (OR = 0.3375, 95%CI = 0.1833–0.5774), as well as pretreatment albumin (OR = 1.1612, 95%CI = 1.0706–1.2688) and ALT/ALP (OR = 2.4596, 95%CI = 1.2095–5.5472) were associated with treatment response after six months of treatment. Pretreatment TB (OR = 0.2777, 95%CI = 0.1288–0.5228), ALT (OR = 0.5968, 95%CI = 0.4354–0.7963), AST (OR = 0.4161, 95%CI = 0.2736–0.6076), ALP (OR = 0.4676, 95%CI = 0.3487–0.6048), APRI (OR = 0.2838, 95%CI = 0.1433–0.5141), as well as pretreatment albumin (OR = 1.2359, 95%CI = 1.1257–1.3714) and platelet count (OR = 1.0056, 95%CI = 1.0011–1.0103) were associated with treatment response after 12 months of treatment. Treatment response after 6 months of UDCA therapy is significantly associated with treatment response after 12 months of UDCA therapy (OR = 25.2976, 95% CI = 10.5881–68.4917). Treatment responses after 6 and 12 months of UDCA therapy decrease the risk of an episode of liver decompensation in PBC patients (OR = 12.1156, 95%CI = 3.7192–54.4826 and OR = 21.6000, 95%CI = 6.6319–97.3840, respectively). Conclusions: There are several pretreatment laboratory parameters associated with treatment response in patients with primary biliary cholangitis. Treatment response after six months is significantly associated with treatment response after 12 months of ursodeoxycholic acid (UDCA) therapy. Treatment responses after 6 and 12 months of UDCA decrease the risk of an episode of liver decompensation.

Practice Parameter: Management of Hyperbilirubinemia in the Healthy Term Newborn

PEDIATRICS ◽  
1994 ◽  
Vol 94 (4) ◽  
pp. 558-565
Author(s):  
◽  
Keyword(s):  
Serum Bilirubin ◽  
Elevated Serum ◽  
The United States ◽  
Total Serum ◽  
Brain Cells ◽  
Albumin Concentration ◽  
Specific Level ◽  
Term Newborn ◽  
Term Newborns ◽  
The Brain

Each year approximately 60% of the 4 million newborns in the United States become clinically jaundiced. Many receive various forms of evaluation and treatment. Few issues in neonatal medicine have generated such long-standing controversy as the possible adverse consequences of neonatal jaundice and when to begin treatment. Questions regarding potentially detrimental neurologic effects from elevated serum bilirubin levels prompt continuing concern and debate, particularly with regard to the management of the otherwise healthy term newborn without risk factors for hemolysis. Although most data are based on infants with birth weights ≥2500 g, "term" is hereafter defined as 37 completed weeks of gestation. Under certain circumstances, bilirubin may be toxic to the central nervous system and may cause neurologic impairment even in healthy term newborns. Most studies, however, have failed to substantiate significant associations between a specific level of total serum bilirubin (TSB) during nonhemolytic hyperbilirubinemia in term newborns and subsequent IQ or serious neurologic abnormality (including hearing impairment). Other studies have detected subtle differences in outcomes associated with TSB levels, particularly when used in conjunction with albumin binding tests and/or duration of exposure. In almost all published studies, the TSB concentration has been used as a predictor variable for outcome determinations. Factors influencing bilirubin toxicity to the brain cells of newborn infants are complex and incompletely understood; they include those that affect the serum albumin concentration and those that affect the binding of bilirubin to albumin, the penetration of bilirubin into the brain, and the vulnerability of brain cells to the toxic effects of bilirubin.

scholarly journals Mildly elevated serum bilirubin is associated with a lower risk of hearing loss in Chinese adults

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Fei Xue ◽  
Huai Zhang ◽  
Qiu-Yue Chen ◽  
Chen-Hui Li ◽  
Shi-Chang Wang ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Lower Risk ◽  
Serum Bilirubin ◽  
Elevated Serum ◽  
Chinese Adults
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