{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T09:16:11Z","timestamp":1780391771611,"version":"3.54.1"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,12,18]],"date-time":"2018-12-18T00:00:00Z","timestamp":1545091200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["17lk0310036h0001"],"award-info":[{"award-number":["17lk0310036h0001"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["18lk0310049h0001"],"award-info":[{"award-number":["18lk0310049h0001"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Basic Clin Pharma Tox"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Glycyrrhizin is used to treat chronic hepatitis, but it also plays an important role in pseudoaldosteronism. Multidrug resistance\u2010associated protein 2 is important for glycyrrhizin excretion. Dysfunction of this transporter increases the serum levels of direct bilirubin, glycyrrhizin and its metabolites. Hence, elevated direct\u2010bilirubin levels could predict the risk of pseudoaldosteronism. This study aimed to evaluate the relationship between elevated direct\u2010bilirubin levels and hypokalaemia, which is the most sensitive marker of pseudoaldosteronism. This retrospective cohort study was conducted in a Japanese university hospital. The occurrence of hypokalaemia is defined as a serum potassium level of \u22643.5\u00a0mEq\/L after the administration of a glycyrrhizin\u2010containing medication, and a further decline of \u22650.5\u00a0mEq\/L or an increase of \u22650.5\u00a0mEq\/L after discontinuing the glycyrrhizin\u2010containing medication was examined in patients with chronic hepatitis between January 2009 and December 2015. This analysis involved 1392 patients, including 596 women. Hepatitis C virus infections were the most common cause of chronic hepatitis in this study. Seventy\u2010nine patients received glycyrrhizin (exposed group; mean age: 60.5\u00a0\u00b1\u00a014.2) and 1313 did not receive glycyrrhizin (control group; mean age: 58.3\u00a0\u00b1\u00a015.8\u00a0years). Synergistic effects of glycyrrhizin\u2010containing medications and elevated direct\u2010bilirubin levels were associated with hypokalaemia. Elevated direct\u2010bilirubin levels and hypoalbuminaemia were associated with hypokalaemia in the exposed group. Older age, female sex, high daily glycyrrhizin dosage, longer duration of glycyrrhizin intake, and potassium\u2010lowering medications were not associated with hypokalaemia after the model adjustment. Elevated direct\u2010bilirubin levels and hypoalbuminaemia may predict pseudoaldosteronism caused by glycyrrhizin.<\/jats:p>","DOI":"10.1111\/bcpt.13178","type":"journal-article","created":{"date-parts":[[2018,11,24]],"date-time":"2018-11-24T16:04:46Z","timestamp":1543075486000},"page":"607-614","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Risk factors associated with pseudoaldosteronism in patients with chronic hepatitis: A retrospective cohort study"],"prefix":"10.1111","volume":"124","author":[{"given":"Akihiro","family":"Komatsu","sequence":"first","affiliation":[{"name":"Division of Pharmaceutical Care Sciences Keio University Faculty of Pharmacy Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuhiro","family":"Yoshino","sequence":"additional","affiliation":[{"name":"Center for Kampo Medicine Keio University School of Medicine Tokyo Japan"},{"name":"Linus Pauling Institute Oregon State University Corvallis Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomonori","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Division of Pharmaceutical Care Sciences Keio University Faculty of Pharmacy Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takanori","family":"Kanai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Center for Kampo Medicine Keio University School of Medicine Tokyo Japan"},{"name":"Faculty of Environment and Information Studies Keio University Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/ctg.2017.29"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12562"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1968.03140330034006"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1248\/bpb.b13-00997"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1248\/yakushi.126.973"},{"key":"e_1_2_8_7_1","first-page":"607","article-title":"The present condition of licorice induced pseudoaldosteronism in Japan","volume":"8","author":"Morimoto Y","year":"1991","journal-title":"J Tradit Med"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1089\/acm.2013.0454"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1124\/dmd.108.021089"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1124\/dmd.113.055772"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/tkm2.1058"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcpt.13059"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1248\/cpb.36.440"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.111.190009"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-014218"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1756-0500-2-105"},{"key":"e_1_2_8_17_1","unstructured":"Ministry of Health Labor and Welfare.Manual for handling disorders due to adverse drug reactions. Pseudoaldosteronism;2006. [Article in Japanese]"},{"key":"e_1_2_8_18_1","unstructured":"Ministry of Health.General notification from pharmaceutical affairs director no.158. How to deal with medications containing glycyrrhizin;1978. [Article in Japanese]."},{"key":"e_1_2_8_19_1","unstructured":"Minophagen Pharmaceutical Co. Ltd. Glycyron\u00ae tablets;2016.http:\/\/www.minophagen.co.jp\/Japanese\/medical\/product\/pdf\/glt_12.pdf. Accessed December 18 2017. [Article in Japanese]."},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2042-7158.1994.tb03756.x"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(87)91014-2"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.80.6.1929"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajh.2008.152"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2010.07.007"}],"container-title":["Basic &amp; Clinical Pharmacology &amp; Toxicology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fbcpt.13178","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bcpt.13178","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/bcpt.13178","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bcpt.13178","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T16:51:11Z","timestamp":1694364671000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/bcpt.13178"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,18]]},"references-count":23,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.1111\/bcpt.13178"],"URL":"https:\/\/doi.org\/10.1111\/bcpt.13178","archive":["Portico"],"relation":{},"ISSN":["1742-7835","1742-7843"],"issn-type":[{"value":"1742-7835","type":"print"},{"value":"1742-7843","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,18]]},"assertion":[{"value":"2018-09-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-11-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}