Except for increased serum alkaline phosphatase (AP) effects on metabolic, synthetic, and excretory hepatic levels, the changes in liver function test (LFT) values functions. 2 The biliary excretion of bromosulfophthaduring normal pregnancy have not been clearly estab-lein decreases during pregnancy. 3,4 Some authors have lished, mainly because most studies do not include stated that there is a subclinical physiological cholestamatched controls. We therefore measured the serum val-sis during pregnancy. 5 The increase in plasma volume ues of routine liver tests including 5 -nucleotidase and that occurs during pregnancy leads to hemodilution 6,7 total bile acids in 103 healthy pregnant women (first tri-and decreases the serum protein concentrations. Semester, n Å 34; second trimester, n Å 36; third trimester, rum alkaline phosphatase levels increase in late pregn Å 33) and in 103 age-matched controls not receiving nancy because of both a production of the placental oral contraception. Fasting blood samples were taken.isoenzyme and an increase in the bone isoenzyme. [8][9][10] Because of hemodilution, serum albumin levels were significantly lower during all trimesters. As expected, AP It is therefore not surprising that changes in liver funcactivity was significantly higher in the third trimester. tion tests (LFTs) occur during pregnancy. NevertheSerum aspartate transaminase (AST) activity and total less, except for increased alkaline phosphatase levels, bile acid (TBA) concentrations did not differ between which have been clearly demonstrated, the changes in pregnant and nonpregnant women. Serum alanine the other LFT values have not been clearly established, transaminase (ALT) activity was slightly higher in the and a recent review in this field has shown that there second-trimester pregnant women than in controls (6.8 are some discordances in the literature. 11 The identifi-{ 4.5 vs. 8.2 { 5.8, P Å .04), although all values remained cation of these physiological changes is important for within normal limits. In pregnant women, total and free the diagnosis of liver diseases during pregnancy.bilirubin concentrations were significantly lower durThus, the aim of this study was to evaluate the ing all three trimesters, as was conjugated bilirubin during the second and third trimesters. Serum g-glutamyl changes in serum levels of routine LFTs, i.e., alkaline transpeptidase (GGT) activity was significantly lower in phosphatase (AP), alanine transaminase (ALT), asparthe second and third trimesters. Serum 5 -nucleotidase tate transaminase (AST), g-glutamyltranspeptidase activity was slightly but significantly higher in the sec-(GGT), total and conjugated bilirubin, 5 -nucleotidase, ond and third trimesters. The knowledge of these results and total bile acids (TBA) during normal pregnancy is useful for the interpretation of LFT values and the compared with a control group of nonpregnant women. hemodilution. The pregnant woman experiences physiological PATIENTS AND METHODSchanges to support fetal growth and development. Dur...

Parameters used are predictors for short-term in-hospital mortality of elderly patients hospitalized in an acute medical unit. The lean body mass is preferentially mobilized for energy during hospitalization.

This study examines the effect of the substitution of 6 g/day of fish oil in a saturated diet on glucose and fructose metabolism in healthy humans. Five subjects were submitted to two 3-wk controlled-diet periods (polyunsaturated/saturated = 0.21). During one period, 6 g/day of fat used for dressing were replaced by 6 g/day of fish oil [1.1 g/day of 20:5 (n-3) fatty acids and 0.7 g/day of 22:6 (n-3) fatty acids]. At the end of each period the subjects ingested a 1 g/kg fructose or glucose load 2 days apart. Plasma glucose fluxes were traced with the use of deuterated glucose and [U-13C]glucose. Substrate oxidation was measured by indirect calorimetry. Fish oil induced a 4% increase in basal and postload glycemia and a 40% decrease in insulinemia, whereas plasma C-peptide remained unaffected. Glucose fluxes were unaffected by fish oil, but carbohydrate (CHO) oxidation was reduced (fructose: 55.5 +/- 4.1 vs. 62.9 +/- 3.6 g/6 h; glucose: 36.7 +/- 4.7 vs. 50.5 +/- 4.7 g/6 h; all P < 0.05). Lipid oxidation was increased 35% by fish oil after both CHO loads. Nonoxidative glucose disposal was increased by fish oil (fructose: 9.4 +/- 2.5 vs. 2.9 +/- 1.1 g/6 h; glucose: 28.3 +/- 5.1 vs. 14.4 +/- 4.7 g/6 h; all P < 0.05). Fish oil could affect glucose transport and decrease CHO oxidation through the decrease in insulinemia and/or a specific effect on glycolytic pathway.

An increase in serum amylase and lipase activities during pregnancy should be taken into account, as in nonpregnant women.