Gamma-glutamyl Transferase Concentrations Research Articles

Efficacy of Mozambican bentonite and diatomaceous earth in reducing the toxic effects of aflatoxins in chicks

The effectiveness of diatomaceous earth (DE) and bentonite clay (BC) in reducing the toxic effects of aflatoxin B1 (AFB1) in chicks was assessed. A total of 150 day-old male broiler chicks were assigned to six dietary treatments, with 5 replicate pens of five chicks per treatment. Dietary treatments were: (1) a positive control basal diet (BD) containing no AFB1, no BC and no DE; (2) BD + 0.50% BC but with no AFB1 and DE; (3) BD + 0.50% DE but with no AF and BC; (4) BD + 2 mg AFB1/kg diet but with no BC and DE; (5) BD + 0.50% BC + 2 mg AFB1/kg diet but with no DE; and (6) BD + 0.50% DE + 2 mg AFB1/kg diet but with no BC. Compared with controls, feed intake (FI) and body weight gain (BWG) were depressed (P<0.05) in chicks fed AFB1, with greater reduction in FI and BWG observed in birds fed the AFB1 plus 0.50% DE diet. Feed conversion ratio was similar. Chicks fed AFB1 alone had increased (P<0.05) relative liver weights compared to all other dietary treatments except for chicks fed AFB1+ DE. Chicks fed AFB1 alone and those fed AFB1+ DE had heavier (P<0.05) relative kidney weights compared to chicks fed other treatments. Compared with the control chicks, livers from birds fed dietary AFB1 and AFB1 plus DE were similar. Liver lesion score of chicks fed AFB1 plus BC was lower (P<0.05) than that of chicks fed AFB1 but higher (P<0.05) than that of control chicks. Compared to controls, serum concentrations of glucose, albumin, total protein globulin, and calcium were decreased (P<0.05) in chicks fed AFB1 alone, whereas serum concentrations of aspartate amino transferase and gamma glutamyl transferase were increased (P<0.05). It can be concluded that this concentration of BC was partially effective in reducing the toxic effects of 2 mg/kg AFB1, whereas DE at the same concentration was not effective in reducing the toxic effects of 2 mg/kg AFB1.

Use of the enzyme gamma-glutamyl transferase (GGT) as an indirect measure of passive transfer of immunity in holstein calves and association with the occurrence of diarrhea after birth

The objective of this study was to determine the gamma-glutamyl transferase (GGT) levels and its relationship with diarrhea and passive transfer of immunity in Holstein calves within 24 hours and 30 days of life from Leopolis municipality, the north Parana region. Colostrum is rich in immunoglobulins and vital for immunity to newborn calves, since bovine placenta does not allow the passage of immunoglobulin to the fetus. Calves undergo various challenges that can lead to disease and death in the first month of life, including diarrhea. Diarrhea has a multifactorial etiology, and the passive immunity transferred through ingestion of colostrum is able to protect the calf against many of these etiologic agents. GGT measurements indirectly infer the amount of immunoglobulin ingested by the calf. Higher serum GGT levels (381.72 IU / L) were found at 24 hours, and a significant reduction was observed at 30 days (66.22 IU / L). When the presence or absence of diarrhea was associated with GGT levels above and below 200 IU / L, no statistical significance (P> 0.05) was observed, since 80% of animals with diarrhea had serum GGT levels higher than 200 IU / L. Under the conditions of this study, there was no relationship between the GGT concentration and the occurrence of diarrhea, and no mortality was observed despite some animals presented diarrhea.

Effect of Spirulina supplementation on plasma metabolites in crossbred and purebred Australian Merino lambs

The effect of supplementing purebred and crossbred Merino lambs with Arthrospira platensis (Spirulina) on plasma metabolite concentrations under pasture-based management system and the influences of sire breed and sex were investigated. A completely randomized experimental design balanced by 4 sire breeds (Merino, White Suffolk, Dorset and Black Suffolk), 3 Spirulina supplementation levels (0, 100 and 200ml representing the control, low and high, respectively) and 2 sexes (ewe and wether lambs) was utilised. All lambs had ad libitum access to the basal diet of ryegrass pastures and barley. Lambs in the treatment groups were individually drenched daily with Spirulina prior to being released with the control group of lambs for grazing over a 6-week period following a 3-week adjustment phase. At the start and completion of the feeding trial, blood samples were centrifuged and plasma metabolites measured. Data were analysed with Spirulina supplementation level, sire breed, sex and their second-order interactions fitted as fixed effects and metabolite concentrations as dependent variables. Gamma-glutamyl transferase (GGT) concentrations decreased (from 79.40 to 69.25UI) and glucose increased (from 3.81 to 4.19mmol/L) as the level of Spirulina supplementation increased from 0ml in the control to 200ml in the high treatment groups (P<0.05). Lambs supplemented at low Spirulina levels had the highest creatinine concentrations (61.75μmol/L). Interactions between sex and supplementation level significantly affected glucose, aspartate aminotransferase (AST) and Mg concentrations (P<0.05), while sire breed and supplementation level interactions influenced albumin to globulin (A/G) ratio, creatinine and GGT concentrations. It was demonstrated that Spirulina supplementation does not negatively impact lamb health and productivity.

Serum Gamma-glutamyl Transferase Concentration Within the Reference Range is Related to the Coronary Heart Disease Risk Prediction in Korean Men: Analysis of the Korea National Health and Nutrition Examination Survey (V-1, 2010 and V-2, 2011).

Background:Limited data exist on the association of serum gamma-glutamyl transferase (GGT) level within the reference range with the increased risk of coronary heart disease (CHD) prediction in men. The study examined the association between serum GGT concentration within the reference range and the CHD risk prediction in Korean men.Methods:The study employed data from Korean National Health and Nutrition Examination Survey (V-1, 2010 and V-2, 2011) where a total of 1301 individuals were analyzed. A 10-year CHD risk prediction was computed using the Framingham Risk Score (FRS) modified by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III).Results:Positive correlations were established between log-transformed GGT concentration and FRS (r = 0.237, P < 0.001). After adjustment of body mass index, the amount of alcohol intake and low-density lipoprotein-cholesterol, the odds ratio (95% confidence interval) for intermediate risk and beyond of 10-year CHD prediction (10-year risk ≥10%) with lowest quartile of participants was 1.21 (0.78–1.87) for second quartiles, 1.39 (0.88–2.21) for third quartiles and 2.03 (1.23–3.34) for highest quartiles.Conclusions:Higher serum GGT within its reference range was significantly correlated with a 10-year CHD risk prediction estimation using NCEP ATP III in Korean men.

Ad libitum Pasture Feeding in Late Pregnancy Does Not Improve the Performance of Twin-bearing Ewes and Their Lambs.

The present study evaluated the effect of controlled ryegrass-white clover herbage availability from day 128 until day 142 of pregnancy in comparison to unrestricted availability, on the performance of twin-bearing ewes of varying body condition score (BCS; 2.0, 2.5, or 3.0) and their lambs. It was hypothesised that under conditions of controlled herbage availability, the performance of lambs born to ewes with a greater BCS would be greater than those born to ewes with a lower BCS. During the period that the nutritional regimens were imposed, the pre- and post-grazing herbage masses of the Control regimen (1,070±69 and 801±30 kg dry matter [DM]/ha) were lower than the ad libitum regimen (1,784±69 and 1,333±33 kg DM/ha; p<0.05). The average herbage masses during lactation were 1,410±31 kg DM/ha. Nutritional regimen had no effect on ewe live weight, BCS and back fat depth or on lamb live weight, indices of colostrum uptake, maximal heat production, total litter weight weaned or survival to weaning (p>0.05). The difference in ewe BCSs and back fats observed among body condition groups was maintained throughout pregnancy (p<0.05). At weaning, ewes from the BCS2.0 group had lower BCS and live weight (2.4±0.2, 74.3±2.6 kg) than both the BCS2.5 (2.6±0.2, 78.6±2.4 kg) and BCS3.0 ewes (2.7±0.2, 79.0±2.6 kg; p<0.05), which did not differ (p>0.05). Ewe BCS group had no effect on lamb live weight at birth or weaning or on maximal heat production (p>0.05). Serum gamma glutamyl transferase concentrations of lambs born to BCS3.0 ewes were higher within 36 hours of birth than lambs born to BCS2.0 ewes and BCS2.5 ewes (51.8±1.9 vs 46.5±1.9 and 45.6±1.9 IU/mL, respectively [p<0.05]). There was, however, no effect of ewe body condition on lamb plasma glucose concentration (p>0.05). Lamb survival was the only lamb parameter that showed an interaction between ewe nutritional regimen and ewe BCS whereby survival of lambs born to BCS2.5 and BCS3.0 ewes differed but only within the Control nutritional regimen ewes (p<0.05). These results indicate farmers can provide twin-bearing ewes with pre- and post-grazing ryegrass-white clover herbage covers of approximately 1,100 and 800 kg DM/ha in late pregnancy, provided that herbage covers are 1400 in lactation, without affecting lamb performance to weaning. The present results also indicate that under these grazing conditions, there is little difference in ewe performance within the BCS range of 2.0 to 3.0 and therefore they do not need to be managed separately.

Clinical course of infection and viral tissue tropism of hepatitis C virus-like nonprimate hepaciviruses in horses.

Hepatitis C virus (HCV) has a very narrow species and tissue tropism and efficiently replicates only in humans and the chimpanzee. Recently, several studies identified close relatives to HCV in different animal species. Among these novel viruses, the nonprimate hepaciviruses (NPHV) that infect horses are the closest relatives of HCV described to date. In this study, we analyzed the NPHV prevalence in northern Germany and characterized the clinical course of infection and viral tissue tropism to explore the relevance of HCV-related horse viruses as a model for HCV infection. We found that approximately 31.4% of 433 horses were seropositive for antibodies (Abs) against NPHV and approximately 2.5% carried viral RNA. Liver function analyses revealed no indication for hepatic impairment in 7 of 11 horses. However, serum gamma-glutamyl transferase (GGT) concentrations were mildly elevated in 3 horses, and 1 horse displayed even highly elevated GGT levels. Furthermore, we observed that NPHV infection could be cleared in individual horses with a simultaneous emergence of nonstructural (NS)3-specific Abs and transient elevation of serum levels of liver-specific enzymes indicative for a hepatic inflammation. In other individual horses, chronic infections could be observed with the copresence of viral RNA and NS3-specific Abs for over 6 months. For the determination of viral tissue tropism, we analyzed different organs and tissues of 1 NPHV-positive horse using quantitative real-time polymerase chain reaction and fluorescent in situ hydridization and detected NPHV RNA mainly in the liver and at lower amounts in other organs. Similar to HCV infections in humans, this work demonstrates acute and chronic stages of NPHV infection in horses with viral RNA detectable predominantly within the liver.

Dietary patterns and serum gamma-glutamyl transferase in Japanese men and women.

BackgroundAlthough specific foods and nutrients have been examined as potential determinants of serum gamma-glutamyl transferase (GGT) concentrations, the relationship between dietary patterns and GGT remains unknown. The present cross-sectional study aimed to determine relationships between dietary patterns and GGT concentrations, and the effects of lifestyle factors on GGT.MethodsRelationships between dietary patterns and GGT were analyzed in 9803 Japanese individuals (3723 men and 6080 women age 40–69 years) without a history of liver diseases or elevated serum aminotransferase. We examined major dietary patterns by factor analysis of 46 items determined from a validated, short food frequency questionnaire.ResultsWe defined dietary patterns as healthy, Western, seafood, bread, and dessert. The healthy pattern was inversely related to GGT in men (odds ratio [OR] for highest vs lowest quartile, 0.72; 95% confidence interval [CI], 0.57–0.92; P < 0.01 for trend) and women (OR 0.82; 95% CI, 0.66–1.0; P = 0.05 for trend), whereas the seafood pattern was positively related to GGT in men (OR 1.27; 95% CI, 1.01–1.61; P = 0.03 for trend) and women (OR 1.21; 95% CI, 0.98–1.49; P = 0.05 for trend). Male-specific inverse associations with GGT were found for bread and dessert patterns (OR 0.63; 95% CI, 0.50–0.80 and OR 0.53; 95% CI, 0.41–0.68, respectively; P < 0.01 for both trends). Seafood or bread patterns and alcohol consumption significantly interacted with GGT in men (P = 0.03 and <0.01 for interaction, respectively) and between the dessert pattern and body mass index or smoking habit in women (P = 0.03 and <0.01, respectively, for interaction).ConclusionsDietary patterns may be important determinants of GGT, and their possible clinical implications warrant further investigation.

The Relationship between Coffee Drinking and Liver Function Tests in Korean Men

Background: Coffee is known to have a protective effect on liver enzymes. There are a limited number of Asian studies on this subject. We investigated the relationship between coffee and liver function tests in Korean men on a large scale. Methods: Study participants were consecutive men who had a regular health checkup in a university hospital in Korea. Information on coffee intake, alcohol drinking, and smoking was collected through self-administered questionnaires. Results: A total of 3,844 men were enrolled in this study. Coffee drinking was positively associated with smoking and alcohol drinking. Coffee drinking was inversely associated with aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT) concentrations (r=−1.33, p=0.008 and r=−6.35, p=0.007, respectively). Also, increasing levels of coffee consumption was inversely associated with AST and GGT in a multivariate model (p<0.001 and p<0.001, respectively). The relationship between coffee drinking status and alanine aminotransferase...

Assessment of γ-GT functions as novel risk factor in patients suffering from angina, myocardial infarction and congestive heart failure

BackgroundCardiovascular disease is a leading cause of morbidity and mortality both in developed and developing country. The spectrum of cardiac diseases starting from hypertension to acute coronary syndrome is interplay of a number of modifiable and non-modifiable risk factors. Free radicals triggering oxidative events influence atherosclerotic plaque formation and thereby, initiate the vicious cycle of cardiovascular mortality. Traditionally, GGT (gamma glutamyl transferase) is used as marker of hepatobiliary dysfunction and alcohol intake. With the advent of biomedical science the last decade has seen the development in the physiological role of γ-GT related to oxidative stress. GGT is established as novel, low-cost, sensitive laboratory marker in the definition of risk factor for coronary heart disease and ischeamia in Australian, Norwegian population. ObjectivesThe objective of this study was to estimate the serum concentration of GGT in patients suffering from myocardial infarction, angina and congestive heart failure and to see its association with cardiovascular mortality. MethodIn this cross-sectional study serum GGT concentration was estimated in patients of myocardial infarction, angina and congestive heart failure and compared with control group. All the study subjects were evaluated with ECG and Echocardiography for cardiac changes. Statistical analysis was performed using SPSS 16 to see whether GGT is increased in cases and associated with the risk factors. ResultsThe serum concentration of GGT was significantly higher in cases. There was significant association with the established risk factors. ConclusionGGT is associated with risk factors of cardiovascular disease.

Comparison of serum biochemistry and haematology values in captive and free-ranging wild boar (Sus scrofa)

The purpose of this study was to compare haematology and biochemistry data for captive and free-ranging wild boar in the UK and to evaluate whether significant differences were present between these two boar populations. The samples from the captive wild boar comprised 18 adult females housed in three interconnected outdoor paddocks, whilst the samples from free-ranging wild boar comprised 19 adult females living in unrestricted woodland. Samples were obtained under general anaesthesia during health checks. Free-ranging wild boar had significantly lower serum concentrations of total protein, globulin, ionised calcium, urea, creatinine and gamma-glutamyl transferase (GGT) activity and significantly higher serum concentrations of phosphate, bile acids and alkaline phosphatase (ALP) activity compared with captive wild boar. Haematological values for free-ranging wild boar showed significantly higher red blood cell counts (RBC), white blood cell counts (WBC) and neutrophil counts and significantly lower mean cell volume (MCV) and mean corpuscular haemoglobin (MCH). These results provide evidence that significant differences in serum biochemistry and haematology values may exist between captive and free-ranging populations of the same native species. Such differences may need to be considered when studies are undertaken or reported from wild animal populations in semi-natural husbandry situations. Potential sources of these differences may include nutritional state, level of activity and environmental stress.

Evaluation of ultrasonography as a diagnostic tool for hepatic hydatid cysts in sheep

This retrospective study was designed to evaluate the use of ultrasonography for the diagnosis of hepatic hydatid cysts. This study was conducted on 22 sheep, which were classified into 2 groups according to their liver health group (healthy liver = 13 and cystic liver = 9). Biochemically, serum concentrations of gamma-glutamyl transferase, aspartate aminotransferase, total bilirubin, and globulins were significantly increased (P < 0.01) while albumin was lowered (P < 0.01) in sheep with cystic livers. Ultrasonographically, rounded, anechoic, and unilocular hydatid cysts with elliptical circumferences ranging from 6 to 10 cm were seen. The interiors of cysts contained echogenic particulate materials, septations, or fine echoes. At the 10th intercostal space (ICS), ventral margin, size, thickness, and angle of livers increased in sheep with hepatic cysts, while the diameter of portal vein decreased in sheep with liver cysts. At the 9th ICS, the circumference of the gall bladder was lowered in sheep with hepatic cysts (P < 0.01). The sensitivity, specificity, and positive and negative predictive values of ultrasonography for diagnosis of hepatic hydatid cysts were 80%, 100%, and 100% and 83%, respectively. In conclusion, ultrasonography alone or in combination with some biochemical parameters reflecting liver function could be helpful for the diagnosis of hepatic hydatid cysts in sheep.

Higher Serum Heavy Metal May Be Related with Higher Serum gamma-Glutamyltransferase Concentration in Koreans: Analysis of the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V-1, 2, 2010, 2011)

BackgroundAbnormal serum gamma-glutamyltransferase (γ-GT) may be an early and sensitive marker for oxidative stress. This study was performed to evaluate the association between serum heavy metals and γ-GT concentration.MethodsThis study is a cross-sectional analysis based on data from Korean National Health and Nutrition Examination Survey (V-1, 2, 2010, 2011) regarding serum heavy metal concentrations (lead, mercury, and cadmium) as well as serum γ-GT. Serum heavy metals were categorized into tertiles, and serum γ-GT concentration was compared using an analysis of covariance test after relevant variable adjustments. In addition, we evaluated the odds ratio (OR) of having the highest tertile of serum γ-GT in each heavy metal tertile using logistic regression.ResultsThe mean serum lead, mercury, and cadmium concentrations were 2.67, 5.08, and 1.02 µg/dL in men and 1.95, 3.60, and 1.21 µg/dL in women, respectively. Partial correlation showed a significant positive relation between each heavy metal and serum γ-GT concentration. Comparing serum γ-GT concentration by the tertile of each heavy metal, serum γ-GT concentration showed a significant increase as the tertiles of serum mercury and cadmium in men and that of serum mercury in women increased, but not with lead. The OR of having the highest tertile of serum γ-GT was significant for cadmium in men (OR, 4.02; 95% confidence interval [CI], 2.54 to 6.35) and mercury in women (OR, 2.00; 95% CI, 1.29 to 3.10) in the top tertile of each heavy metal.ConclusionHigher serum heavy metal concentration may be related with higher serum γ-GT concentration. In particular, serum cadmium in men and mercury in women showed significant correlation with serum γ-GT concentration.

Endothelial dysfunction and carotid atherosclerosis in non-alcoholic fatty liver disease

Endothelial dysfunction and carotid atherosclerosis in non-alcoholic fatty liver disease

Commentary

Mika Kivimaki initiated the Individual Participant Data (IPD) Meta-Analysis Consortium, which currently has 50 members. The Consortium recently published several research reports on the relationship between job strain (high psychological demands and low decision latitude at work), on the one hand, and cardiovascular disease and its risk factors, on the other hand. Since IPD repre- sents a novel way to conduct epidemiological research collaboration and as some of the findings from the IPD Consortium have been criticized, this commentary aims to address the rationales behind the approach and discuss some of the main criticisms of the Consortium.Researchers must tackle many problems when inter- preting associations between a psychosocial work envi- ronment factor and a health outcome. First of all, work environment factors belong to a "distal" rather than a "proximal" group. In other words, the closer one gets to a biological mechanism relevant for disease development, the more likely it is that a relevant association will be strong. For instance, small samples are needed to establish an individual "brain" factor associated with depression or emotional exhaustion - simply because the brain factor is more or less depression. Factors related to work orga- nization, on the other hand, are more "distal" since there are many factors that influence the relationship between the environment and the body's organs. Accordingly, it is sometimes difficult to obtain sufficient statistical power for the establishment of an undisputable association. For instance, the long "distance" between job strain and the outcome, myocardial infarction (MI), explains why we should expect a weaker association than in the study of "proximal" factors, for instance myocardial metabolism in relation to MI. Nevertheless, on a societal level, job strain is very important since it affects many working people, with a prevalence in the working population (in the IPD Consortium study's operational definition) of around 15%. Accordingly, if an unequivocal association is established, it is of major importance to those respon- sible for work organization and interventions designed to improve working conditions. However, large samples are needed to establish unequivocal proof.Since Karasek introduced his demand-control model (1), there have been many studies of the association between job strain and risk of MI. These studies have become increasingly sophisticated over the years. In addi- tion, there is accumulated indirect evidence from longitu- dinal studies of the relationship between job strain, on the one hand, and blood pressure variations and endocrine, metabolic, and immunological parameters, on the other hand. The results from these studies give us a plausible physiological explanation of the assumed relationship between job strain and MI risk.A reason why this research field has attracted strong attention is that MI is an undisputable illness outcome. The study of MI risk, therefore, serves as a good scientific model for studying the relationship between job strain and adverse health outcomes in general.Establishment of and rationale behind the IPD ConsortiumThere have been divided opinions about the relationship between job strain and risk of MI. The main reason for the controversy has been that, despite the relatively large size of several of the published cohort studies with number of observation years often in the range of 50 000, the statistical power has been too small for an unequivocal establishment of an association. As a result, Mika Kivimaki invited a number researchers, who had included psychosocial job factors in their study protocols and had or had not published results on the relationship between job strain and MI risk, to establish the IPD Consortium. Including unpublished cohorts was important as this provided a possibility to address the problem of publication bias - the tendency of research- ers and journals to publish only positive findings that can lead to inflated associations. …

Serum GGT activity and hsCRP level in patients with type 2 diabetes mellitus with good and poor glycemic control: An evidence linking oxidative stress, inflammation and glycemic control

BackgroundDiabetes is undoubtedly one of the most challenging health problems in 21st century. Understanding the pathogenesis and preventing long term complications have been major goals of research in diabetes mellitus (DM). Research in the past few years has linked oxidative stress and inflammation to beta cell dysfunction. Aim of this study is to evaluate serum gamma-glutamyl transferase (GGT) activity (marker of oxidative stress) and high sensitivity C reactive protein (hsCRP) level (an inflammatory marker) in type 2 DM subjects with good and poor glycemic control. Further, we investigated correlation between serum GGT and hsCRP level with glycemic control (FBS, PP2BS, HbA1c) in subjects.MethodsA cross sectional study consists of 150 patients out of them 50 patients having type 2 DM with good control (Group II), 50 patients with type 2 DM with poor control (Group III) and 50 normal healthy control (Group I) were selected. Serum GGT, serum hsCRP, FBS, PP2BS, HbA1c, and other biochemical investigations include serum liver enzymes and lipids were measured.ResultsMean serum GGT and hsCRP concentration were statistically significantly higher in group III patients compared to group I and group II subjects as well as increased in group II compared to group I (p < 0.001). Further significant positive correlation was observed between GGT and hsCRP concentration as well as both with HbA1c, FBS, and PP2BS.ConclusionsOxidative stress and inflammation appears to be a key component and also associated with poor glycemic control and further pathogenesis of diabetes and its complications. All our finding suggesting a link between oxidative stress, inflammation and glycemic control in patient with type 2 diabetes mellitus.Electronic supplementary materialThe online version of this article (doi:10.1186/2251-6581-12-56) contains supplementary material, which is available to authorized users.

In vivo and in vitro antibacterial activities of Momordica charantia on Salmonella typhi and its effect on liver function in typhoid-infected rats

Typhoid fever is a disease prevalent in the tropics. In spite of the availability of various therapies, treatment of patients with the disease has been quite challenging in the face of resistance to drugs used. Momordica charantia has been used locally to treat typhoid. This study investigated the antimicrobial potency of methanolic extract of M. charantia leaves on Salmonella typhi in male albino rats (Sprague dawley) and the effects of treatment on liver function. There were 5 groups of 10 rats each. 1 ml aliquot of the 4th dilution of S. typhi was administered orally to rats in four of the groups to be infected with typhoid, while the last group served as the control. Infected groups were thereafter treated with 100 and 200mg/kg of M. charantia and 10mg/kg of chloramphenicol, respectively for seven days, while the remaining group was not treated after infection. The effect of treatment on infection level, body weight and liver enzymes were thereafter investigated. Marked reduction in infection level was observed in all treated rats. Rats treated with 200 mg/kg of the plant extract had total clearance by the sixth day, while significantly lower (p < 0.05) infection level was recorded in rats treated with the plant extract than those treated with the standard drug. Mean body weight of all treated rat groups increased during treatment. Concentrations of total and direct bilirubin, alanine aminotransferase (ALT), alkaline phosphatase (ALP), aspartate aminotransferase (AST) and gamma glutamyl transferase (GGT) were higher (p < 0.05) in untreated rats than the treated rats. In conclusion, these results suggest that leaf extract of M. charantia is a potent antimicrobial drug against S. typhi with hepatoameliorative potentials. Key words: Typhoid, Momordica charantia, liver, Salmonella typhi.

Determinants of endothelial dysfunction in patients with non-alcoholic steatohepatitis

We thank Balta et al. for their comments (1). In our study we investigated the presence of endothelial dysfunction and potential predictors of endothelial dysfunction (ED) in patients with non-alcoholic steatohepatitis (NASH) (2). We found that serum gamma glutamyl transferase (GGT) and alanine transaminase (ALT) concentrations were predictors of ED in patients with NASH. Balta et al. mention that if inflammatory markers were studied, impact of these markers on ED might have been found. Moreover, they state that inflammation plays a major role in the development of ED and atherosclerosis (3). Lack of data concerning inflammatory markers may be a limitation of our study. However, as shown previously, associations established between GGT and hs-CRP, which is a major inflammatory marker for cardiovascular risk, suggest that elevated serum GGT—as a marker of oxidative stress—is also involved in the inflammatory process, contributing to the pathogenesis of atherosclerosis (4-6). So, we may conclude that GGT indeed is of importance in the development of ED in patients with NASH. Moreover, Balta et al. mention that inflammatory mediators can be affected by atherosclerotic risk factors such as smoking, alcohol consumption, hypercholesterolemia, and hypothyroidism as well. Patients with daily alcohol consumption over 30 g, which may influence serum concentrations of GGT, AST, and ALT, were not included in our study. Furthermore, patients with a history of smoking and hyperlipidemia were excluded in our study (2). In addition, patients with known hypothyroidism were not enrolled. We also thank Dogru et al. for their valuable comments (7). Dogru et al. mention that the use of standard oral glucose tolerance tests (OGTT) would be more accurate than fasting plasma glucose (FPG) in identifying patients with or without diabetes. In our study we used FPG concentrations and the medical history of the patients to exclude diabetes. Utilization of OGTT would probably add valuable information in detecting patients with diabetes. However, American Diabetes Association guidelines state that FPG over 126 mg/dL is a diagnostic criterion for diabetes as well as OGTT (8). We consider that, taken together with the medical history, FPG is still a robust indicator of diabetes. Dogru et al. also argued from results of previous studies that there is only a weak correlation between carotid intima-media thickness (CIMT) and non-alcoholic fatty liver disease (NAFLD). However, in agreement with our results, Fracanzani et al. showed that CIMT was higher in patients with NAFLD compared with healthy controls in a study that included 125 subjects with NAFLD and 250 healthy subjects (9). Dogru et al. also concluded that NAFLD may not have a direct impact on carotid atherosclerosis and it may contribute to cardiovascular diseases by acting in concert with metabolic abnormalities. However, in our study serum triglyceride concentrations and FPG were similar in patients with NASH and in controls. Finally, as we showed by linear regression analysis, body mass index was not significantly associated with impaired flow-mediated dilatation (FMD) and increased CIMT in our patients. Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Non-alcoholic fatty liver disease may be associated with endothelial dysfunction

Dear Editor We read with great interest the article ‘Serum gamma glutamyl transferase and alanine transaminase concentrations predict endothelial dysfunction in patients with non-alcoholic steatohepatitis’ by Arinc et al. (1). They concluded that patients with non-alcoholic steatohepatitis (NASH) have impaired flow-mediated dilation (FMD) and increased carotid intima media thickness (cIMT) when compared with healthy controls. In patients with NASH, serum concentrations of gamma glutamyl transferase (GGT) and alanine transaminase (ALT) might have a predictive value for FMD and cIMT. Non-alcoholic fatty liver disease is recognized as the most common and emerging chronic liver disease. However, it has recently been demonstrated that people with non-alcoholic fatty liver have an increased risk of developing cardiovascular diseases, which represent the major cause of death in this setting. NASH is a hepatic manifestation of the metabolic syndrome (MetS) (2). It is also a clinical entity comprising risk factors such as hypertension, glucose intolerance, atherogenic lipid profile, abdominal obesity, lack of physical activity, and increased inflammatory state (3,4). Most recent studies demonstrate that there is a correlation between inflammatory mediators and the components of MetS. Elevated inflammatory indicators such as cIMT and FMD are commonly used to evaluate subclinical inflammation or endothelial dysfunction in coronary artery disease, cerebrovascular disease, peripheral arterial disease, known malignancy, and chronic inflammatory disease such as psoriasis (5). Inflammatory mediators can also be affected by atherosclerotic risk factors such as smoking, alcohol consumption, hypercholesterolemia, and hypothyroidism. In this context, Arinc et al. did not mention some of the factors affecting these markers in their study. In conclusion, in patients with NASH, serum concentrations of GGT and ALT might have a predictive value for FMD and cIMT as presented in the above-mentioned study. However, because NASH is one component of MetS, future studies should examine all inflammatory factors in patients with NASH.

Glutamine supplementation in preterm infants receiving parenteral nutrition leads to an early improvement in liver function.

The aim of study was to confirm the protective effects of parenteral glutamine supplementation on liver injury in premature infants and determine how quickly effects became evident. We performed a double-blind, randomized, controlled clinical study to assess the effect of parenteral nutrition (PN) supplemented with glutamine in premature infants. Thirty infants from two children's centers, were randomly assigned to either a control group (Standard PN; n=15) or a glutamine-supplemented group (GlnPN; n=15). The primary endpoint was hepatic function. The secondary endpoints were total duration of PN, weight and head circumference gain, length of hospitalization, and days on a ventilator. The serum level of alkaline phosphatase (AKP) after parenteral nutrition for 14 days was significantly higher (p<0.05) in the control group. But in the glutamine-supplemented group, the serum concentration of aspartate aminotransferase (AST) and gamma glutamyltransferase (GGT) significantly decreased after PN for 7 days and 14 days (p<0.05), and the level of alkaline phosphatase (AKP) showed no increase. The levels of AKP and GGT were significantly different with time by group interaction. Levels of AKP was higher in control group than glutamine-supplemented group, and GGT level was lower in glutamine-supplemented group compared with controls. There were no significant differences between the groups in terms of total duration of PN, weight gain (g/d), increase in head circumference (cm/w), length of hospitalization, and duration of mechanical ventilation. The longer the duration of parenteral nutrition, the more severe hepatic dysfunction became. Parenteral glutamine supplementation suggested a hepatoprotective effect.

Lipid profile and thyroid hormone concentrations in children with epilepsy treated with oxcarbazepine monotherapy: a prospective long‐term study

To evaluate prospectively the changes and possible associations in lipid and thyroid profiles in children treated with oxcarbazepine (OXC) monotherapy. Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), lipoprotein (a) [Lp(a)], free thyroxine (FT4), free triiodothyronine (FT3), thyrotropin (TSH) and gamma-glutamyltransferase (GGT) concentrations were measured in 23 children with epilepsy, before and at 8 and 18 months of OXC monotherapy. Total cholesterol was significantly increased at 8 months (P = 0.033), whereas LDL-C was significantly increased at 8 and 18 months (P < 0.001 and P = 0.004, respectively) of treatment. Lp(a) was significantly increased at 8 months (P = 0.042) and borderline significantly increased at 18 months (P = 0.050) of treatment. FT4 was significantly decreased at 8 and 18 months (P < 0.001 and P = 0.002, respectively), and TSH levels were significantly increased at 8 and 18 months (P = 0.002 and P = 0.001, respectively) of OXC monotherapy. GGT levels were significantly increased at 8 and 18 months (P < 0.001) of treatment. There were no significant alterations in HDL-C, TGs and FT3 levels during the study. Significant positive correlations were found between GGT and LDL-C levels at 8 (r = 0.468, P = 0.024) and 18 months (r = 0.498, P = 0.016), and between TSH and TC at 18 months (r = 0.508, P = 0.013) of treatment. OXC monotherapy may cause significant and persistent alterations in lipid and thyroid profiles in children with epilepsy. The increase in LDL-C and TC levels may be associated with liver enzymes induction and thyroid dysfunction. Further long-term prospective studies are required to confirm these findings and to determine their clinical significance.