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Investigation of Relationship among Serum Malondialdehyde, Paraoxonase and Liver Function Tests in Acute Poisoning Patients

Year 2007, Volume: 12 Issue: 3, 184 - 189, 01.06.2007

Abstract

Objectives: Aim of this study is to determine serum levels of paraoxonase (PON), malondialdehyde (MDA), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamil transferase (GGT) at 6th and 24th hour after the intake of poisonous substances and to investigate the role of these parameters in the follow up and treatment of the patients and the correlation between them. Material and Methods: The study was performed in the emergency department of Firat University Faculty of Medicine between the dates of December 2003 and June 2004 with 82 poisoning patients older than 16 years and matching inclusion criteria prospectively. Results: Eighty-two patients were included to the study. Mean MDA1 and MDA2 levels of these patients were 0.39±0.2 and 0.45±0.3 mmol/mL respectively. Mean PON1-1 and PON1-2 levels were 153.33±77.3 and 146.25±70.7 U/mL respectively. Mean AST1, AST2, ALT1, ALT2, GGT1 and GGT2 levels were 21.53±8.1, 26.73±47.7, 20.16±9.6, 20.87±21.6, 20.75±15.3 and 20.77±20.0 U/L respectively. No statistically significant difference was found among the patients taking tricyclic antidepressants, acetaminophen, mushroom, alcohol, and organophosphates according to serum levels of MDA, PON1, AST, ALT and GGT. Conclusion: We think that the values of MDA, PON1, AST, ALT and GGT at 6th and 24th hour have no role in first 24 hour follow up and treatment of acute poisoning patients. New laboratory parameters may be investigated for the follow up and treatment of poisonings, which are important health problems. ©2007, Firat University, Medical Faculty

References

  • Hack JB, Hoffman RS. General Management of Poisoned patients. In: Tintinalli JE, Kelen GD, Stapczynski JS (Editors). Emergency Medicine A Comprehensive Study Guide. 5th ed, New York: Mc Graw-Hill, 2000: 1057-1062.
  • Watson WA, Litovitz TL, Klein Schwartz W, et al. 2003 annual report of the american association of poison control centers toxic exposure surveillance system. Am J Emerg Med. 2004; 22: 335404.
  • Delaney AK. Hepatic Principles. In: Goldfrank LR, Flomenboum NE (Editors). Goldfrank’s Toxicologic Emergencies. 6th ed, New York: McGraw-Hill, 1998: 213-228.
  • Synder WJ, Osterloh DJ. Laboratory Principles and Techniques to Evaluate the Poisoned or Overdose Patient. In: Goldfrank LR, Flomenboum NE (Editors). Goldfrank’s Toxicologic Emergencies. 6th ed, New York: McGraw-Hill, 1998: 63-75.
  • Gutteridge JM. Lipid Peroxidation and antioxidant biomarkers of tissue damage. Clin Chem 1995; 41: 1819-1828.
  • Ohkawa H, Ohishi N, Yagi K. Assay for lipid peroxides in animal tissue by thiobarbitüric acid reaction. Anal Biochem 1979; 95: 351-358.
  • Loguercio C, Clot P, Albano E, et al. Free radicals and not acetaldehyde influence the circulating levels of glutathione after acute or chronic alcohol abuse: in vivo and invitro studies. Ital J Gastroenterol Hepatol 1997; 29: 168-173.
  • Özaras R, Tahan V, Aydın S, Uzun H, Kaya S, Sentürk H. Nacetylcysteine attenuates alchol-induced oxidative strees in the rat. World J Gastroenterol 2003; 9: 125-128.
  • Esterbauer H, Schaur RJ, Zollner H. Chemistry and biochemistry of 4-hydroxynonenal, malonaldehyde and related aldehydes. Free Radic Biol Med 1991; 11: 81-128.
  • Azarsız E, Sözmen EY. Paraoksonaz ve Klinik Önemi. Türk Biyokimya Dergisi 2000; 3: 109-119.
  • Mackness B, Durrington PN, Mackness MI. Human serum paraoxonase. Gen Pharmacol 1998; 31: 329-336.
  • Akgur SA, Ozturk P, Solak I, Moral AR, Ege B. Human serum paraoxonase (PON1) activity in acute organophosphorous insecticide poisoning. Forensic Sci Int 2003; 133: 136-140.
  • Musaoğlu A. Karaciğer hastalıklarında laboratuvar testleri. Đliçin G, Biberoğlu K, Ünal S, Akalın S, Süleymanlar G (Editör). Ankara: Güneş Kitabevi, 1996: 1096-1109.
  • Evans RW. Hepatıc disorders and hepatıc faılure. In: Tintinalli JE, Kelen GD, Stapczynski JS. (Editors). Emergency Medicine A Comprehensive Study Guide 5th ed, New York: Mc Graw Hill, 2000: 580-587.
  • Satoh K. Serum lipid peroxide in cerebrovascular disorders determined by a new colorimetric method. Clin Chim Acta. 1978; 90: 37-43.
  • Yagi K. Assay for blood plasma or serum. Methods in enzymol.1984; 105: 328-331.
  • Juretic D, Tadijanovic M, Rekic B, Simeon-Rudolf V, Reiner E, Baricic M. Serum Paraoxonase activities in hemodialyzed uremic patients: cohort study. Croat Med J 2001; 42: 146-150.
  • Pannbacker RG. Paraoxonase (PON1) in health and dissease: basic and clinical aspects. Toxicology Letters 2003; 143: 93.
  • Mackness MI, Mackness B, Arrol S, Wood G, Bhatnagar D, Durrington PN. Presence of paraoxonase in human interstitial fluid. FEBS Letters 1997; 416: 377-380.
  • Pekdemir M, Kavalcı C, Durukan P, Yıldız M. Acil Servisimize Başvuran Zehirlenme Olgularının Değerlendirilmesi. Acil Tıp Dergisi 2002; 2: 36-40.
  • Slatter DA, Bolton CH, Biley AJ. The importance of lipidderived malondialdehyde in diabetes mellitus. Diabetologia 2000; 43: 550-557.
  • Kaya P, Öğüş E, Akbulut S, ve ark. Yoğun bakım ünitesinde izlenen unstabil anjina pektoriste ve stabil anjina pektoriste eritrosit ve plazma malondialdehid düzeyleri. Dahili Tıp Bilimleri 2003; 9: 1-2.
  • Cengiz G, Aksoy N, Aktay G, Söylemezoğlu T. Effects of paracetamol and aspirin on lipid peroxidation in plasma and liver. Ankara Ecz. Fak. Derg 1999; 28: 47-60.
  • Oak S, Choi BH. The effects of glutathione glycoside in acetaminofen-induced liver cell necrosis. Exp Mol Pathol 1998; 65: 15-24.
  • Lukaszewicz-Hussain A. Organophosphate insecticide chlorfenvinphos affects superoxide dismutase, catalase and malondialdehyde in rat liver. Polish Journal of Enviromental Studies 2001; 10: 279-282.
  • Skrzydlewska E, Forbiszewski R. Lipid peroxidation and antioxidant status in the liver, erythrocytes and serum of rats after methanol intoxication. J Toxicol Environ Health A 1998; 53: 637-664.
  • Zentella de PM, Corona S, Rocha-Hernandez AE, Saldana Balmori Y, Cabrera G, Pina E. Restoration by piroxicam of liver glutathione levels decreased by acute ethanol intoxication. Life Sci 1994; 54: 1433-1439.
  • Akgur SA, Ozturk P, Solak I, Moral AR, Ege B. Human serum paraoxonase (PON1) activity in acute organophosphorous insecticide poisoning. Forensic Sci Int 2003; 133: 136-140.
  • Sozmen EY, Mackness B, Sozmen B, et al. Effect of organophosphate intoxication on human serum paraoxonase. Hum Exp Toxicol 2002; 21; 247-252.
  • Ozaras R, Tahan V, Aydin S, Uzun H, Kaya S, Senturk H. Nacetylcysteine attenuates alcohol-induced oxidative stress in the rat. World J Gastroenterol 2003; 9: 125-128.
  • Larrey D, Pageaux GP. Drug induced acute liver failure. Eur J Gastroenterol Hepatol 2005; 17:141-3.
  • Kuffner EK, Dart RC, Bogdan GM, Hill RE, Casper E, Darton L. Effect of maximal daily doses of acetaminophen on the liver of alcoholic patients: a randomized, double-blind, placebo controlled trial. Arch Intern Med 2001; 161: 2247-2252.
  • James LP, Wells E, Beard RH, Farrar HC. Predictors of outcome after acetaminophen poisoning in children and adolecents. J Pediatr 2002; 140: 522-526.
  • Gyamlani GG, Parikli CR. Acetaminophen toxicity: suicidal vs. accidental. Crit Care 2002; 6:155-159.
  • Knight TR, Farris MW, Farhood A, Jaeschke H. Role of lipid peroxidation as mechanism of liver injury after acetaminophen overdose in mice. Toxicol Sci 2003; 76: 229-236.
  • Husain K, Mejia J, Lalla J, Kazim S. Dose response of alcoholinduced changes in BP, nitric oxide and antioxidants in rat plasma. Pharmacol Res 2005; 51: 337-343.
  • Li YM, Chen SH, Yu CH, Zhang Y, Xu GY. Effect of acute alcoholism on hepatic enzymes and oxidation/antioxidation in rats. Hepatobiliary Pancreat Dis Int 2004; 3: 241-244.

Akut Zehirlenme Hastalarında Serum Malondialdehid, Paraoksonaz ve Karaciğer Fonksiyon Testleri Arasındaki İlişkinin Araştırılması

Year 2007, Volume: 12 Issue: 3, 184 - 189, 01.06.2007

Abstract

Giriş: Bu çalışmanın amacı akut zehirlenme hastalarında, serum paraoksonaz (PON), malondialdehid (MDA), aspartat aminotransferaz (AST), alanin aminotransferaz (ALT), gama-glutamil transaferaz (GGT) değerlerinin, hastaların zehirlenme maddelerini alımından sonraki 6. ve 24. saatlerdeki düzeylerinin belirlenerek, hastaların takibi ve bu değerlerin hastaların tedavisindeki rollerini, aralarında korelasyon olup olmadığını araştırmaktır. Gereç ve Yöntem: Çalışma Fırat Üniversitesi Tıp Fakültesi Acil Servise Aralık 2003 - Haziran 2004 tarihleri arasında zehirlenme nedeniyle başvuran, çalışmaya dahil edilme kriterlerine uyan 16 yaş ve üzeri 82 hasta ile prospektif olarak gerçekleştirildi. Bulgular: Çalışmaya 82 hasta alınmıştır. Bu hastaların MDA1 ve MDA2 değerleri sırasıyla ortalama 0.39±0.2 ve 0.45±0.3 mmol/mL olarak bulunmuştur. PON1-1 ve PON1-2 değerleri sırasıyla ortalama 153.33±77.3 ve 146.25±70.7 U/mL olarak bulunmuştur. AST1, AST2, ALT1, ALT2, GGT1 ve GGT2 değerleri sırasıyla ortalama olarak 21.53±8.1, 26.73±47.7, 20.16±9.6, 20.87±21.6, 20.75±15.3 ve 20.77±20.0 U/L bulunmuştur. Yapılan istatistiksel analiz sonucunda trisiklik antidepresan, asetaminofen, mantar, alkol ve organofosfat zehirlenmesi ile başvuran hastalarda MDA, PON1, AST, ALT ve GGT değerleri arasında istatistiksel olarak anlamlı bir fark bulunmamıştır (p>0.05). Sonuç: Akut zehirlenme hastalarında 6. ve 24. saatlerde alınan MDA, PON1, AST, ALT, GGT değerlerinin ilk 24 saatteki hasta takibi ve tedavisinde yeri olmadığını düşünmekteyiz. Zehirlenme gibi önemli bir sorunun takip ve tedavisinde yeni laboratuvar parametrelerinin araştırılması gerektiğini düşünmekteyiz. ©2007, Fırat Üniversitesi, Tıp Fakültesi

References

  • Hack JB, Hoffman RS. General Management of Poisoned patients. In: Tintinalli JE, Kelen GD, Stapczynski JS (Editors). Emergency Medicine A Comprehensive Study Guide. 5th ed, New York: Mc Graw-Hill, 2000: 1057-1062.
  • Watson WA, Litovitz TL, Klein Schwartz W, et al. 2003 annual report of the american association of poison control centers toxic exposure surveillance system. Am J Emerg Med. 2004; 22: 335404.
  • Delaney AK. Hepatic Principles. In: Goldfrank LR, Flomenboum NE (Editors). Goldfrank’s Toxicologic Emergencies. 6th ed, New York: McGraw-Hill, 1998: 213-228.
  • Synder WJ, Osterloh DJ. Laboratory Principles and Techniques to Evaluate the Poisoned or Overdose Patient. In: Goldfrank LR, Flomenboum NE (Editors). Goldfrank’s Toxicologic Emergencies. 6th ed, New York: McGraw-Hill, 1998: 63-75.
  • Gutteridge JM. Lipid Peroxidation and antioxidant biomarkers of tissue damage. Clin Chem 1995; 41: 1819-1828.
  • Ohkawa H, Ohishi N, Yagi K. Assay for lipid peroxides in animal tissue by thiobarbitüric acid reaction. Anal Biochem 1979; 95: 351-358.
  • Loguercio C, Clot P, Albano E, et al. Free radicals and not acetaldehyde influence the circulating levels of glutathione after acute or chronic alcohol abuse: in vivo and invitro studies. Ital J Gastroenterol Hepatol 1997; 29: 168-173.
  • Özaras R, Tahan V, Aydın S, Uzun H, Kaya S, Sentürk H. Nacetylcysteine attenuates alchol-induced oxidative strees in the rat. World J Gastroenterol 2003; 9: 125-128.
  • Esterbauer H, Schaur RJ, Zollner H. Chemistry and biochemistry of 4-hydroxynonenal, malonaldehyde and related aldehydes. Free Radic Biol Med 1991; 11: 81-128.
  • Azarsız E, Sözmen EY. Paraoksonaz ve Klinik Önemi. Türk Biyokimya Dergisi 2000; 3: 109-119.
  • Mackness B, Durrington PN, Mackness MI. Human serum paraoxonase. Gen Pharmacol 1998; 31: 329-336.
  • Akgur SA, Ozturk P, Solak I, Moral AR, Ege B. Human serum paraoxonase (PON1) activity in acute organophosphorous insecticide poisoning. Forensic Sci Int 2003; 133: 136-140.
  • Musaoğlu A. Karaciğer hastalıklarında laboratuvar testleri. Đliçin G, Biberoğlu K, Ünal S, Akalın S, Süleymanlar G (Editör). Ankara: Güneş Kitabevi, 1996: 1096-1109.
  • Evans RW. Hepatıc disorders and hepatıc faılure. In: Tintinalli JE, Kelen GD, Stapczynski JS. (Editors). Emergency Medicine A Comprehensive Study Guide 5th ed, New York: Mc Graw Hill, 2000: 580-587.
  • Satoh K. Serum lipid peroxide in cerebrovascular disorders determined by a new colorimetric method. Clin Chim Acta. 1978; 90: 37-43.
  • Yagi K. Assay for blood plasma or serum. Methods in enzymol.1984; 105: 328-331.
  • Juretic D, Tadijanovic M, Rekic B, Simeon-Rudolf V, Reiner E, Baricic M. Serum Paraoxonase activities in hemodialyzed uremic patients: cohort study. Croat Med J 2001; 42: 146-150.
  • Pannbacker RG. Paraoxonase (PON1) in health and dissease: basic and clinical aspects. Toxicology Letters 2003; 143: 93.
  • Mackness MI, Mackness B, Arrol S, Wood G, Bhatnagar D, Durrington PN. Presence of paraoxonase in human interstitial fluid. FEBS Letters 1997; 416: 377-380.
  • Pekdemir M, Kavalcı C, Durukan P, Yıldız M. Acil Servisimize Başvuran Zehirlenme Olgularının Değerlendirilmesi. Acil Tıp Dergisi 2002; 2: 36-40.
  • Slatter DA, Bolton CH, Biley AJ. The importance of lipidderived malondialdehyde in diabetes mellitus. Diabetologia 2000; 43: 550-557.
  • Kaya P, Öğüş E, Akbulut S, ve ark. Yoğun bakım ünitesinde izlenen unstabil anjina pektoriste ve stabil anjina pektoriste eritrosit ve plazma malondialdehid düzeyleri. Dahili Tıp Bilimleri 2003; 9: 1-2.
  • Cengiz G, Aksoy N, Aktay G, Söylemezoğlu T. Effects of paracetamol and aspirin on lipid peroxidation in plasma and liver. Ankara Ecz. Fak. Derg 1999; 28: 47-60.
  • Oak S, Choi BH. The effects of glutathione glycoside in acetaminofen-induced liver cell necrosis. Exp Mol Pathol 1998; 65: 15-24.
  • Lukaszewicz-Hussain A. Organophosphate insecticide chlorfenvinphos affects superoxide dismutase, catalase and malondialdehyde in rat liver. Polish Journal of Enviromental Studies 2001; 10: 279-282.
  • Skrzydlewska E, Forbiszewski R. Lipid peroxidation and antioxidant status in the liver, erythrocytes and serum of rats after methanol intoxication. J Toxicol Environ Health A 1998; 53: 637-664.
  • Zentella de PM, Corona S, Rocha-Hernandez AE, Saldana Balmori Y, Cabrera G, Pina E. Restoration by piroxicam of liver glutathione levels decreased by acute ethanol intoxication. Life Sci 1994; 54: 1433-1439.
  • Akgur SA, Ozturk P, Solak I, Moral AR, Ege B. Human serum paraoxonase (PON1) activity in acute organophosphorous insecticide poisoning. Forensic Sci Int 2003; 133: 136-140.
  • Sozmen EY, Mackness B, Sozmen B, et al. Effect of organophosphate intoxication on human serum paraoxonase. Hum Exp Toxicol 2002; 21; 247-252.
  • Ozaras R, Tahan V, Aydin S, Uzun H, Kaya S, Senturk H. Nacetylcysteine attenuates alcohol-induced oxidative stress in the rat. World J Gastroenterol 2003; 9: 125-128.
  • Larrey D, Pageaux GP. Drug induced acute liver failure. Eur J Gastroenterol Hepatol 2005; 17:141-3.
  • Kuffner EK, Dart RC, Bogdan GM, Hill RE, Casper E, Darton L. Effect of maximal daily doses of acetaminophen on the liver of alcoholic patients: a randomized, double-blind, placebo controlled trial. Arch Intern Med 2001; 161: 2247-2252.
  • James LP, Wells E, Beard RH, Farrar HC. Predictors of outcome after acetaminophen poisoning in children and adolecents. J Pediatr 2002; 140: 522-526.
  • Gyamlani GG, Parikli CR. Acetaminophen toxicity: suicidal vs. accidental. Crit Care 2002; 6:155-159.
  • Knight TR, Farris MW, Farhood A, Jaeschke H. Role of lipid peroxidation as mechanism of liver injury after acetaminophen overdose in mice. Toxicol Sci 2003; 76: 229-236.
  • Husain K, Mejia J, Lalla J, Kazim S. Dose response of alcoholinduced changes in BP, nitric oxide and antioxidants in rat plasma. Pharmacol Res 2005; 51: 337-343.
  • Li YM, Chen SH, Yu CH, Zhang Y, Xu GY. Effect of acute alcoholism on hepatic enzymes and oxidation/antioxidation in rats. Hepatobiliary Pancreat Dis Int 2004; 3: 241-244.
There are 37 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Gürkan Alagöz This is me

Polat Durukan This is me

Mustafa Yıldız This is me

Mustafa Kemal Bayar This is me

Necip İlhan This is me

Yunsur Çevik This is me

Dilara Seçkin This is me

Publication Date June 1, 2007
Published in Issue Year 2007 Volume: 12 Issue: 3

Cite

APA Alagöz, G., Durukan, P., Yıldız, M., Bayar, M. K., et al. (2007). Akut Zehirlenme Hastalarında Serum Malondialdehid, Paraoksonaz ve Karaciğer Fonksiyon Testleri Arasındaki İlişkinin Araştırılması. Fırat Tıp Dergisi, 12(3), 184-189.
AMA Alagöz G, Durukan P, Yıldız M, Bayar MK, İlhan N, Çevik Y, Seçkin D. Akut Zehirlenme Hastalarında Serum Malondialdehid, Paraoksonaz ve Karaciğer Fonksiyon Testleri Arasındaki İlişkinin Araştırılması. Fırat Tıp Dergisi. June 2007;12(3):184-189.
Chicago Alagöz, Gürkan, Polat Durukan, Mustafa Yıldız, Mustafa Kemal Bayar, Necip İlhan, Yunsur Çevik, and Dilara Seçkin. “Akut Zehirlenme Hastalarında Serum Malondialdehid, Paraoksonaz Ve Karaciğer Fonksiyon Testleri Arasındaki İlişkinin Araştırılması”. Fırat Tıp Dergisi 12, no. 3 (June 2007): 184-89.
EndNote Alagöz G, Durukan P, Yıldız M, Bayar MK, İlhan N, Çevik Y, Seçkin D (June 1, 2007) Akut Zehirlenme Hastalarında Serum Malondialdehid, Paraoksonaz ve Karaciğer Fonksiyon Testleri Arasındaki İlişkinin Araştırılması. Fırat Tıp Dergisi 12 3 184–189.
IEEE G. Alagöz, P. Durukan, M. Yıldız, M. K. Bayar, N. İlhan, Y. Çevik, and D. Seçkin, “Akut Zehirlenme Hastalarında Serum Malondialdehid, Paraoksonaz ve Karaciğer Fonksiyon Testleri Arasındaki İlişkinin Araştırılması”, Fırat Tıp Dergisi, vol. 12, no. 3, pp. 184–189, 2007.
ISNAD Alagöz, Gürkan et al. “Akut Zehirlenme Hastalarında Serum Malondialdehid, Paraoksonaz Ve Karaciğer Fonksiyon Testleri Arasındaki İlişkinin Araştırılması”. Fırat Tıp Dergisi 12/3 (June 2007), 184-189.
JAMA Alagöz G, Durukan P, Yıldız M, Bayar MK, İlhan N, Çevik Y, Seçkin D. Akut Zehirlenme Hastalarında Serum Malondialdehid, Paraoksonaz ve Karaciğer Fonksiyon Testleri Arasındaki İlişkinin Araştırılması. Fırat Tıp Dergisi. 2007;12:184–189.
MLA Alagöz, Gürkan et al. “Akut Zehirlenme Hastalarında Serum Malondialdehid, Paraoksonaz Ve Karaciğer Fonksiyon Testleri Arasındaki İlişkinin Araştırılması”. Fırat Tıp Dergisi, vol. 12, no. 3, 2007, pp. 184-9.
Vancouver Alagöz G, Durukan P, Yıldız M, Bayar MK, İlhan N, Çevik Y, Seçkin D. Akut Zehirlenme Hastalarında Serum Malondialdehid, Paraoksonaz ve Karaciğer Fonksiyon Testleri Arasındaki İlişkinin Araştırılması. Fırat Tıp Dergisi. 2007;12(3):184-9.