Search Results (1,524)

Objectives: Kadsura coccinea fruit is a traditional medicinal plant rich in dibenzocyclooctadiene lignans, with established hepatoprotective effects. Binankadsurin A (BKA), a dibenzocyclooctadiene lignan isolated from the K. coccinea fruits. This study aims to evaluate its hepatoprotective efficacy in an acetaminophen (APAP)-induced mouse liver injury model. Methods: The structure of BKA was elucidated by HR-ESI-MS, NMR, single-crystal X-ray diffraction and comparison of their data with those of the literature. Mice were randomly divided into five groups: Control, APAP (400 mg/kg, single intraperitoneal injection), APAP + bicyclol (50 mg/kg), APAP + low-dose BKA (50 mg/kg), and APAP + high-dose BKA (100 mg/kg). Untargeted metabolomics, immunohistochemistry, Western blot analysis, and molecular docking were performed. Results: BKA was determined as a dibenzocyclooctadiene lignan, and the single-crystal structure is reported for the first time. The untargeted metabolomics revealed that metabolites and pathways are closely associated with oxidative stress. In vivo studies showed that pretreatment with BKA can mitigate liver injury. BKA reduced serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) and stored hepatic glutathione (GSH) levels. Immunohistochemical analysis results also showed that CYP2E1 expression in the mouse liver could be improved through BKA pretreatment. Furthermore, Western blot analysis presented that BKA could increase the protein expression of Nrf2, HO-1, and NQO-1. Additionally, molecular docking indicated that BKA directly blocks the binding site of Nrf2 with Keap1. Conclusions: BKA reduces APAP-induced acute liver damage by inhibiting oxidative stress by activating the Keap1/Nrf2/HO-1 signaling pathway, providing a theoretical basis for BKA as a potential therapeutic agent for APAP-induced liver injury. Full article

To explore a safe and effective approach for producing strontium-enriched fish, in this study, we modified the feed for juvenile hybrid sturgeon (Acipenser baerii ♀ × Acipenser schrenckii ♂) and set three different levels of strontium chloride content in their diet (0 mg/kg (Sr0, control), 80 mg/kg (Sr80), and 160 mg/kg (Sr160)) for a period of 8 weeks, analyzing their growth performance, strontium enrichment, muscle nutrition, and hepatic physiological, biochemical, and transcriptomic characteristics. The results show that dietary strontium had no significant impact on sturgeon growth or survival rate (p > 0.05). The strontium content in tissues increased with dietary strontium levels, with the highest enrichment in bone plates (p < 0.05). However, muscle crude fat in the strontium-supplemented groups decreased significantly; the Sr160 group had higher glutamic acid, valine, docosahexaenoic acid methyl ester, lower myristic acid, palmitic acid, etc. (p < 0.05). In addition, strontium treatment alleviated hepatic lipid accumulation and mitochondrial swelling. Biochemical analyses revealed reduced plasma levels of Triglyceride (TG), Total Cholesterol (TC), Alanine Aminotransferase (ALT), and Aspartate Aminotransferase (AST), as well as decreased hepatic Malondialdehyde (MDA) content, while hepatic Glutathione (GSH) levels increased (p < 0.05). Transcriptomic data further showed that strontium downregulated the expression of fasn and tfrc and upregulated the expression of cpt1a, apoa1, cyp7a1, and slc3a2 (p < 0.05). In conclusion, dietary supplementation with 80–160 mg/kg strontium enables safe strontium enrichment in hybrid sturgeon, improves muscle nutritional quality, and protects liver function by regulating the genes related to lipid metabolism and antioxidant defense, providing a scientific basis for the development of strontium-enriched fish products. Full article

Viper envenomation in dogs represents a significant medical emergency in regions where vipers are endemic. Despite its clinical relevance, detailed data on the haematological and biochemical alterations in canine viper envenomation remain limited. This study aimed to evaluate the clinical presentation and haematological, biochemical and coagulative changes occurring in dogs following bites from the Vipera aspis species, and to assess their diagnostic and prognostic significance. Twelve dogs with suspected Vipera aspis envenomation were encompassed in the study. Clinical data were gathered and blood samples were collected at hospital admission (T1), 24 h (T2) and 48 h later (T3). Complete blood counts, biochemical profiles and coagulation parameters were analysed using standard automated systems. Common clinical signs included local pain and swelling, depression, fever, haematuria and melena. Haematological evaluation revealed progressive anaemia, leucocytosis and thrombocytopenia. Biochemical findings showed elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and creatine kinas (CK), indicating hepatic and muscular injury; however, no consistent evidence of renal failure was found. Coagulation analysis revealed a significant shortening of activated partial thromboplastin time (aPTT) and prothrombin time (PT) over time, alongside marked increases in fibrinogen and antithrombin III. This indicates an inflammatory rather than consumptive coagulopathy. Viper envenomation in dogs induces complex haematological and biochemical alterations, reflecting both direct venom toxicity and systemic inflammatory responses. Early recognition, supportive care and continuous laboratory monitoring are essential for improving prognosis. Full article

Olive and Chinese olive are rich sources of bioactive compounds with reported sensory and hepatoprotective activities; however, the synergistic effect between their functional components have not been systematically evaluated. In this study, DF3 (functional fraction isolated from olive) and GF3 (functional fraction isolated from Chinese olive) were obtained using a combination of solvent extraction, supercritical fluid extraction, and polyamide column chromatography. To investigate potential synergistic effects, the two fractions were blended at different ratios (1:1, 2:1, and 1:2), and their taste-modulating properties, antioxidant capacity, and anti-intoxication and hepatoprotective activities were assessed using sensory analysis, radical scavenging assays, and biochemical indicators. Compared with the individual fractions, the blended formulations exhibited enhanced taste intensity, improved antioxidant capacity, and stronger hepatoprotective effects, as evidenced by greater reductions in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Quantitative assessment using a combination index approach revealed a clear positive interaction between DF3 and GF3, with the GF3–DF3 (2:1) blend showing the most pronounced overall enhancement across multiple functional endpoints. Overall, this study provides a systematic and quantitative evaluation of synergistic effect between functional bioactive fractions and offers methodological guidance for the rational optimization of functional formulations. Full article

Background: The combination of hepatic arterial infusion chemotherapy (HAIC) with immune checkpoint inhibitors (ICIs) and anti-angiogenic agents represents a potential therapeutic strategy for advanced hepatocellular carcinoma (HCC). This study aimed to compare the efficacy and safety of triple therapies combining HAIC with ICIs and either bevacizumab or tyrosine kinase inhibitors (TKIs) in these patients. Methods: This retrospective single-center study enrolled 65 consecutive patients with advanced HCC who received HAIC combined with ICIs plus either bevacizumab (bevacizumab group, n = 31) or TKIs (TKIs group, n = 34) between June 2021 and June 2023. Primary endpoints included progression-free survival (PFS), objective response rate (ORR), duration of response (DOR), and safety profiles. Results: The bevacizumab group demonstrated significantly prolonged median PFS (10.9 vs. 7.4 months, p = 0.001) and higher ORR (83.9% vs. 61.8%, p = 0.047) compared with the TKIs group. DOR was longer in the bevacizumab group (7.9 vs. 5.3 months, p = 0.008). Median overall survival (OS) was not reached in the bevacizumab group versus 22.6 months in the TKIs group. Grade 3–4 adverse events occurred in 67.7% of the bevacizumab group and 73.5% of the TKIs group, with distinct toxicity profiles. Gastrointestinal hemorrhage (45.2%) and gastric ulcer (22.6%) predominated in the bevacizumab group, whereas the TKIs group exhibited more hepatic enzyme elevations (aspartate aminotransferase, 67.6%; alanine aminotransferase, 61.8%), proteinuria (29.4%), diarrhea (26.5%), hand-foot syndrome (20.6%), and reactive cutaneous capillary endothelial proliferation (11.8%). Conclusions: Bevacizumab-containing triplet therapy was associated with improved tumor control and delayed progression compared to TKIs-based regimens in advanced HCC. The higher bleeding risk in the bevacizumab group highlights the necessity of standardized baseline evaluation and adequate preventive measures. Full article

Introduction: The health care burden of chronic hepatitis B virus (CHB) infection can be reduced by appropriate workup, treatment, and monitoring. Methods: As a primary objective, we determined whether adequate initial hepatitis B virus (HBV) laboratory workup in CHB patients is associated with improved CHB complications risk. Secondary outcomes assessed included: mortality, hospitalization, emergency department, and liver specialist visits. We conducted a retrospective cohort study from 1 January 2012 to 31 December 2018. Participants were followed from 12 months post index event until outcome occurrence, death, loss of eligibility, or 31 March 2023. Health administrative data from Ontario, Canada was utilized. The study cohort included individuals with at least one positive result of either hepatitis B surface antigen, hepatitis B e antigen, or HBV DNA viral load documented during the study window. The exposure of interest was defined as adequate laboratory workup, defined as having subsequent quantitative HBV DNA, and alanine aminotransferase testing completed within 12 months of the index event. CHB-related complications were assessed using previously validated diagnostic codes. Modified Poisson regression modelling was used to estimate relative risks. Results: The study cohort consisted of 30,794 CHB patients, with a mean age 45.7 years. The majority were male (53.5%) and within the lowest two income quintiles (50.2%). In total, 68.0% underwent adequate workup. Individuals with adequate workup were more likely to be older, male, urban based, and of the highest racialized and newcomer populations quintile. The risk for CHB complications was 1.50 (95% CI 1.36–1.65) times greater among those with adequate workup. By multivariable analysis, adequate workup was associated with a lower risk of mortality (RR 0.78; 95% CI 0.69–0.87), all-cause hospitalizations (RR 0.77; 95% CI 0.74–0.80), all-cause (RR 0.77; 95% CI 0.75–0.78), and liver-related (RR 0.67; 95% CI 0.60–0.75) ED visits. Conclusions: Adequate CHB clinical workup is associated with improved patient outcomes. Our findings advocate for the comprehensive evaluation of CHB patients using key laboratory tests to optimize clinical management and improve long-term health outcomes. We identified gaps in the workup of young adults, females, and those residing in rural settings, which should be addressed to ensure equity of HBV care. Full article

Background: Administering several separate childhood vaccines can reduce adherence to immunization schedules due to missed appointments and the burden of repeated injections. A hexavalent formulation targeting diphtheria, tetanus, pertussis, hepatitis B, Haemophilus influenzae type B, and poliovirus offers a practical approach to improve compliance and streamline immunization. Methods: Toxicity testing was performed in Wistar rats and New Zealand White rabbits (60 rats and 30 rabbits). Animals were distributed into three groups: hexavalent vaccine + low-dose sIPV, hexavalent vaccine + high-dose sIPV, and control. Each animal received a 0.5 mL intramuscular injection at weeks 0, 4, 8, and 12. Clinical observations were conducted throughout the study. Serum samples were collected one day before each injection and at the endpoint, while liver tissue was collected at the endpoint. ALT and AST concentrations were analyzed using an automated analyzer, and hepatic morphology was evaluated microscopically. Results: No abnormal clinical signs related to vaccination were observed. ALT concentrations showed no significant differences (p > 0.05). AST differences (p < 0.05) were detected between the high-dose group and the control on day 27 in female rabbits and on day 83 in female rats; however, all values remained within normal physiological limits. Histopathological examination revealed no irreversible hepatic lesions, including hydropic degeneration, portal inflammation, focal necrosis, or connective tissue proliferation, and no significant differences were noted (p > 0.05). Conclusions: Repeated administration of the hexavalent vaccine candidate at low and high doses produced no toxicological effects in animal models, supporting its safety for further clinical development. Full article

Cimicifuga racemosa extracts, particularly the ethanolic extract Ze 450, are widely used to alleviate menopausal symptoms, such as hot flushes and excessive sweating. While their clinical efficacy is well established, the effects of these interventions on systemic energy metabolism remain unclear. This pilot study investigated the impact of Ze 450 on body composition, metabolic markers, and voluntary physical activity in non-ovariectomized female Wistar rats. Animals (N = 36) received Ze 450 at either 30 mg/kg or 130 mg/kg body weight, with or without access to voluntary wheel running over four weeks. Neither treatment influenced body weight gain or final body weight, indicating normal growth across all groups. Post-mortem analyses included visceral fat mass, serum cholesterol, and leptin levels. Both Ze 450 and running reduced visceral fat mass, adipocyte size, and circulating leptin levels, suggesting that they share overlapping mechanisms. Serum cholesterol was significantly lowered by running but remained unaffected by Ze 450, while liver weight and alanine aminotransferase activity were unchanged, confirming hepatic safety. Collectively, Ze 450 improved key metabolic parameters related to adiposity and appetite without affecting hepatic integrity, highlighting its potential as a safe, non-hormonal metabolic modulator complementary to physical activity. Full article

This study was focused on the assessment of fungal occurrence, mycotoxin dynamics, aflatoxin carry-over, and associated biochemical responses in dairy cattle. Moisture emerged as the dominant factor for fungal communities, promoting the co-proliferation of fungal genera adapted to high water activity conditions (a_w > 0.90) and antagonism against xerotolerant and xerophilic species. Aspergillus spp. dominated dry substrates (a_w < 0.75), Fusarium spp. showed strong positive associations with high-moisture matrices (a_w > 0.90), and Penicillium spp. exhibited intermediate, substrate-dependent behavior. Mycotoxin levels fluctuated non-linearly, independently of fungal counts: ochratoxin A (OTA) concentrations in corn silage increased from approximately 12 μg/kg at the onset of the ensiling period to >240 μg/kg at silo opening, indicating dynamic mycotoxin accumulation during storage, while zearalenone (ZEA) oscillated from 40 to 170 µg/kg. Despite the variation in total aflatoxins (AFLA-T) across feed matrices, aflatoxin M1 (AFM1) in milk remained low (0.0020–0.0093 μg/kg), confirming limited carry-over. Serum biochemical parameters—alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), total bilirubin (BIL-T), total protein (PROT-T)—remained within physiological limits, yet multivariate analyses revealed metabolic modulation linked to aflatoxin exposure. AFM1 explained >7% of the variance in serum biochemical profiles according to PERMANOVA (p = 0.002), showed significant MANOVA effect (Pillai = 0.198), and displayed a significant canonical association (p < 10⁻¹³). Linear discriminant analysis further separated Normal vs. Borderline hepatic profiles, indicating subclinical physiological adaptation to chronic low-dose exposure. Full article

Background/Objectives: Sex-specific differences in metabolic dysfunction-associated fatty liver disease (MAFLD)-related hepatocellular carcinoma (HCC) remain poorly understood. This study aimed to clarify sex-associated disparities in disease progression and recovery using a diethylnitrosamine (DEN) plus Western diet/fructose-induced murine model combined with artificial intelligence (AI)-assisted histological analysis. Methods: Male and female C57BL/6J mice received a single diethylnitrosamine injection and were fed a Western diet/fructose regimen for 38 weeks, followed by an 8-week recovery period on standard chow. Serum biochemical parameters were measured, and liver histology was assessed using second harmonic generation/two-photon excitation fluorescence (SHG/TPEF) microscopy. Steatosis and fibrosis were quantified within tumor and adjacent non-tumor regions using AI-based image analysis. Results: Male mice developed more severe disease phenotypes, including greater tumor burden and higher serum alanine aminotransferase levels, compared with females. Following dietary recovery, female mice showed substantial reductions in tumor number and hepatic steatosis, particularly in non-tumor regions; in contrast, male mice demonstrated only minimal improvement. AI-assisted quantification confirmed considerable regression of both steatosis and fibrosis in females and moderate fibrosis improvement in both sexes. Conclusions: These findings indicate sexual dimorphism in the progression and regression of MAFLD-related HCC, with females exhibiting enhanced metabolic and histological recovery. The results underscore the importance of considering sex as a biological variable in preclinical metabolic dysfunction–associated fatty liver disease-related hepatocellular carcinoma research and highlight the value of AI-enhanced imaging for precise, objective evaluation of liver histology. Full article

Background: Metabolically associated fatty liver disease (MASLD) constitutes a major burden. Glucagon-like peptide-1 agonists (GLP-1) could improve hepatic steatosis as well as weight loss. However, the effect of GLP-1 agonists on patients with and without diabetes and the effect of newer drugs (dual and triple agonists) are unclear. Objective: To investigate the effect of GLP-1 agonists, including dual and triple agonists, in patients with metabolic-associated liver steatosis and steatohepatitis, while exploring their effect on patients with and without type 2 diabetes. Methods: We searched PubMed, Scopus, and Web of Science in October 2025 for randomized parallel controlled trials that investigated the effect of GLP-1 agonists in patients with MASLD or metabolic-associated steatohepatitis (MASH). We assessed the quality of the included studies using Cochrane ROB2. We performed the analysis using RevMan 5.4. We performed subgroup analysis based on the status of diabetes, the control group, and the class of GLP-1 agonist (single, dual, or triple). Results: We included twenty studies. Compared to the control group, GLP-1 agonists were associated with a statistically significant increase in the resolution of MASH without worsening fibrosis (RR 3.03, p < 0.0001) and at least one stage of liver fibrosis without the worsening of MASH compared to the control group (RR: 1.45, p < 0.00001). GLP-1 agonists were associated with a statistically significant weight reduction (SMD −1.11, p < 0.0001), glycosylated hemoglobin (SMD −0.81, p < 0.00001), levels of aspartate aminotransferase (SMD −0.48, p = 0.008), and alanine aminotransferase (SMD −0.54, p = 0.008). However, in patients without type 2 diabetes, GLP-1 agonists had no significant effect on weight loss (SMD −0.97, p = 0.12) or improvement in fibrosis (RR 1.54, p = 0.24). There was a statistically significant increase in the overall adverse events (RR 1.10, p < 0.00001), while there was no significant difference in serious adverse events (p = 0.35). Conclusions: GLP-1 agonists improved liver fibrosis, steatohepatitis, weight loss, HbA1c, and liver enzymes in patients with MASLD or MASH. Overall, GLP-1 agonists were associated with a significantly higher risk of adverse events compared to the control, while serious adverse events were comparable between both groups. There was no significant effect on weight loss or improvement in fibrosis in patients without type 2 diabetes. However, there was a limited number of studies in this population. Thus, further research is needed before recommendations can be made for this subgroup. Full article

Background/Objectives: Dengue is one of the leading causes of morbidity in children in endemic regions. Capillary leakage is the pathophysiological hallmark of severe dengue, and ultrasound has established as a sensitive tool for its early detection. However, evidence in the pediatric population remains limited. The aim of this study was to identify the presence of capillary leakage detected by ultrasound and its associations in children with dengue. Methods: Observational/descriptive/cross-sectional/retrospective study conducted in patients between 6 months and 14 years old with confirmed dengue and warning signs or severe dengue, treated at the Hospital Universitario del Valle in Cali, Colombia, between July 2019 and June 2020. Ultrasound examinations were performed and interpreted by radiologists following an institutional standardized protocol. Associations with capillary leakage were evaluated using the chi-square test and their respective OR and 95% CI. Results: A total of 132 children were included. Ultrasound capillary leakage was identified in 95.5%, mainly ascites (83.3%), pleural effusion (46.2%), hepatomegaly (40.9%), and vesicular thickening (39.4%). Associated factors were belonging to school/adolescent group (OR = 13.52; 95% CI = 1.41–646.51; p = 0.0031), elevated alanine aminotransferase (OR = 11.06; 95% CI = 1.32–94.82; p = 0.0007), and aminotransferase levels grades C–D (OR = 6.87; 95% CI = 0.82–54.59; p = 0.0110). Thrombocytopenia and hypoalbuminemia were common. Three deaths (0.9%) occurred in the initially confirmed cohort prior to ultrasound-based inclusion, all of whom presented multiple risk factors for capillary leakage. Conclusions: In this cohort ultrasound showed high sensitivity for detecting capillary leakage in pediatric dengue and was associated with school-age/adolescents and liver involvement. Its systematic use could improve early identification of severe forms and optimize clinical management in resource-limited settings. Full article

Background/Objectives: The study investigated the potential of mixed fruits and berries (MFB) as a dietary intervention to mitigate cafeteria (CAF) diet-induced gut microbiome dysbiosis and hepatic dysfunction associated with metabolic syndrome and steatohepatitis (MASH) in an adolescent rat model. Methods: Forty-eight adolescent male Sprague-Dawley rats (n = 3 cages per group (two rats per cage)) were divided into eight experimental groups, where NC received the normal AIN-93G basal diet, PC received the CAF diet and normal AIN-93G basal diet, T₁ and T₂ received MFB supplementation (3% and 6% levels) without CAF exposure, P₁ and P₂ received a MFB (3% and 6% levels) supplementation initiated at the onset of CAF feeding, and I₁ and I₂ received MFB supplementation initiated 2 weeks after CAF feeding. After 6 weeks, cecal 16S rRNA, hepatic histopathology, Oil Red O staining, and metabolic dysfunction-associated steatotic liver disease (MASLD)-related biomarkers (liver enzymes, alanine aminotransferase (ALT), and aspartate aminotransferase (AST)) were analyzed. Results: AST: ALT ratio was the highest in the PC group (3.63, p < 0.05) compared to the MFB groups. Oil Red O staining showed lower hepatic lipid accumulation, and histological analysis demonstrated a marked reduction in portal inflammatory cell infiltration in MFB. Alpha diversity (Simpson Index) decreased in PC (Kruskal–Wallis, p = 0.043). CAF increased Lactobacillus johnsonii (+75%, p < 0.05), while reducing L. murinus and L. intestinalis (~90%, p < 0.05). MFB supplementation restored Bifidobacterium Pseudolongum and increased Akkermansia muciniphila levels in the P₂, I₁, and I₂ groups (~20-fold, p < 0.05). Bacteroides dorei was present in all groups except the PC group. These bacteria presented a positive correlation with key SCFAs. Conclusions: The results from this study indicated that MFB supplementation modulated gut microbiota composition and enhanced SCFA production, thereby strengthening intestinal barrier integrity and reducing gut-derived inflammation. Collectively, these effects attenuated hepatic lipid accumulation and inflammation, highlighting the potential of MFB to restore gut–liver axis homeostasis disrupted by CAF-induced dysbiosis in adolescent rats. Full article

Alcoholic liver injury (ALI) is a major global public health issue, with oxidative stress imbalance as its core pathological mechanism. The Kelch-like ECH-associated protein 1–nuclear factor erythroid 2-related factor 2–heme oxygenase-1/glutathione peroxidase 4 signaling pathway (Keap1–Nrf2–HO-1/GPX4) signaling pathway is a key target for regulating hepatic antioxidant defense. This study integrated Ultra Performance Liquid Chromatography-Tandem Mass Spectrometry (UPLC-MS/MS), Global Natural Products Social Molecular Networking (GNPS) molecular networking, network pharmacology, and animal experiments to systematically explore the hepatoprotective effect and mechanism of Cornus officinalis yeast-fermentation (COF). Component characterization identified 25 bioactive components, including flavonoids, triterpenic acids, and other fermentation-derived metabolites. Network pharmacology identified 441 common targets and 36 core targets of COF and ALI, which were enriched in oxidative stress regulation, inflammatory response, and the Keap1–Nrf2 pathway via Gene Ontology (GO)/Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. Molecular docking showed that icariin and other components had stable interactions with Keap1 and Nrf2 (binding energy < −5 kcal/mol). Animal experiments confirmed that COF reduced the liver index of ALI mice, downregulated serum Alanine Aminotransferase (ALT)/Aspartate Aminotransferase (AST) activities, and ameliorated liver pathological damage. Western blot verified that COF inhibited Keap1 expression, promoted Nrf2 nuclear translocation, and upregulated HO-1/GPX4 expression. In conclusion, COF alleviates hepatic oxidative stress by regulating the Keap1–Nrf2–HO-1/GPX4 pathway, providing a scientific basis for its development as a functional food or candidate drug against ALI and a technical paradigm for fermentation-enhanced medicinal plant research. Full article

Background and Objectives: Retinopathy of prematurity (ROP) remains a leading cause of preventable childhood blindness, with its severity influenced by a complex interaction between nutritional status, metabolic maturation, and systemic vulnerability. This study aimed to evaluate whether early nutritional patterns and serum metabolic parameters, including hepatic and renal biomarkers, are associated with ROP severity and whether they may serve as potential predictors of disease progression. Materials and Methods: We conducted a retrospective study on 140 preterm infants, totaling 280 eyes, admitted between 2021 and 2024 in two neonatal intensive care units (NICU). Each eye was analyzed independently according to International Classification of Retinopathy of Prematurity (ICROP) criteria. Data on the timing of enteral feeding, duration and type of nutrition, and serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein, blood glucose, urea and creatinine were collected throughout the first 28 days of life. Statistical analysis included Kruskal–Wallis and Chi-square tests, with a significance threshold of p < 0.05. Results: ROP was identified in 53.57% of cases. Enteral feeding began earlier in infants without ROP, whereas delayed initiation and prolonged parenteral nutrition were associated with more advanced stages. Natural feeding decreased with increasing severity and was absent in aggressive retinopathy of prematurity (A-ROP). Severe disease stages showed higher AST, ALT, urea and creatinine levels, along with lower early total protein values. Glycemic instability was observed more frequently in stage 2 and stage 3. Conclusions: Early nutritional support, especially early enteral feeding and natural feeding, appears protective against ROP progression. Hepatic, renal and glycemic metabolic changes are closely correlated with disease severity, indicating that metabolic balance reflects overall vulnerability in preterm infants. Incorporating nutritional and metabolic assessment into routine screening may enhance early risk identification and optimize clinical monitoring. Full article