Background – Small changes of bilirubin and liver enzymes are often detected during the acute phase of stroke, but their origin and significance are still poorly understood. Methods – On days 0, 3, 7, and 14 after admission, 180 patients with ischemic stroke underwent serial determinations of bilirubin, GOT, GPT, GT, alkaline phosphatase, C-reactive protein (CRP) and complete blood count. On days 0 and 7 common bile duct diameter was measured by ultrasound, and on day 3 cerebral infarct volume (IV) was calculated from CT scan slices. Results – During the first week GOT, GPT, GT (P<0.001) and CRP (P=0.03) increased with subsequent plateau, while significant decrements (P<0.001) concerned unconjugated bilirubin, erythrocytes and haemoglobin. Alkaline phosphatase, direct bilirubin and common bile duct diameter remained stable. IV correlated with CRP, leukocytes, GOT, GT (r>0.3, P<0.001 for all) and direct bilirubin (r=0.23, P=0.008). In multivariate analysis only CRP and GOT remained independently associated with IV (P<=0.001). The correlation of IV with GOT increased progressively from admission to day 14. GOT independently correlated with GPT which, in turn, correlated with GT. GT was also highly correlated with leukocytes. Unconjugated bilirubin correlated with haemoglobin, which was inversely correlated with CRP. Conclusions – The changes of bilirubin and liver enzymes during ischemic stroke reflect two phenomena, which are both related to IV: 1) inflammation, with consequent increment of CRP, leukocytes and GT, and decrease of haemoglobin and unconjugated bilirubin and 2) an unknown signal, independent from inflammation, leading to increasing GOT and GPT levels.

Changes of liver enzymes and bilirubin during ischemic stroke: mechanisms and possible significance / MUSCARI A; COLLINI A; FABBRI E; GIOVAGNOLI M; NAPOLI C; ROSSI V; VIZIOLI L; BONFIGLIOLI A; MAGALOTTI D; PUDDU GM; ZOLI M. - In: BMC NEUROLOGY. - ISSN 1471-2377. - ELETTRONICO. - 14:(2014), pp. 122-129. [10.1186/1471-2377-14-122]

Changes of liver enzymes and bilirubin during ischemic stroke: mechanisms and possible significance

MUSCARI, ANTONIO;VIZIOLI, LUCA;ZOLI, MARCO
2014

Abstract

Background – Small changes of bilirubin and liver enzymes are often detected during the acute phase of stroke, but their origin and significance are still poorly understood. Methods – On days 0, 3, 7, and 14 after admission, 180 patients with ischemic stroke underwent serial determinations of bilirubin, GOT, GPT, GT, alkaline phosphatase, C-reactive protein (CRP) and complete blood count. On days 0 and 7 common bile duct diameter was measured by ultrasound, and on day 3 cerebral infarct volume (IV) was calculated from CT scan slices. Results – During the first week GOT, GPT, GT (P<0.001) and CRP (P=0.03) increased with subsequent plateau, while significant decrements (P<0.001) concerned unconjugated bilirubin, erythrocytes and haemoglobin. Alkaline phosphatase, direct bilirubin and common bile duct diameter remained stable. IV correlated with CRP, leukocytes, GOT, GT (r>0.3, P<0.001 for all) and direct bilirubin (r=0.23, P=0.008). In multivariate analysis only CRP and GOT remained independently associated with IV (P<=0.001). The correlation of IV with GOT increased progressively from admission to day 14. GOT independently correlated with GPT which, in turn, correlated with GT. GT was also highly correlated with leukocytes. Unconjugated bilirubin correlated with haemoglobin, which was inversely correlated with CRP. Conclusions – The changes of bilirubin and liver enzymes during ischemic stroke reflect two phenomena, which are both related to IV: 1) inflammation, with consequent increment of CRP, leukocytes and GT, and decrease of haemoglobin and unconjugated bilirubin and 2) an unknown signal, independent from inflammation, leading to increasing GOT and GPT levels.
2014
Changes of liver enzymes and bilirubin during ischemic stroke: mechanisms and possible significance / MUSCARI A; COLLINI A; FABBRI E; GIOVAGNOLI M; NAPOLI C; ROSSI V; VIZIOLI L; BONFIGLIOLI A; MAGALOTTI D; PUDDU GM; ZOLI M. - In: BMC NEUROLOGY. - ISSN 1471-2377. - ELETTRONICO. - 14:(2014), pp. 122-129. [10.1186/1471-2377-14-122]
MUSCARI A; COLLINI A; FABBRI E; GIOVAGNOLI M; NAPOLI C; ROSSI V; VIZIOLI L; BONFIGLIOLI A; MAGALOTTI D; PUDDU GM; ZOLI M
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/382716
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