Gamma-glutamyl Transpeptidase Levels Research Articles

Oxidative Stress Mediates the Association Between Dietary Fat Intake and Cognition in US Older Adults

OBJECTIVEDietary fat intake was considered as a modifiable factor influencing cognitive performance. The objective was to 1) examine the associations between different types of dietary fat intakes and cognitive outcomes among elder adults (≥60 years old); 2) assess whether peripheral oxidative stress and antioxidant biomarkers are potential mediators of dietary fat intake and cognitive impairment relationship. METHODSUsing data from National Health and Nutrition Examination Survey 2011-2014, total fat, saturated fatty acid (SFAT), monounsaturated fatty acid (MUFA), polyunsaturated fatty acid (PUFA), cholesterol, ω-3 and ω-6 fatty acids were used to evaluate dietary fat intakes. Cognitive outcomes were assessed by word learning and recall modules from the consortium to establish a registry for Alzheimer's Disease (CERAD), animal fluency test, and digit symbol substitution test (DSST). Antioxidant biomarkers were assessed by gamma glutamyl transpeptidase (GGT), bilirubin, uric acid, and vitamin D levels. Linear regression models and causal mediation analysis were applied to quantify the associations. RESULTSA total of 2,253 elder adults were included in the data analyses. Dietary intake of PUFA and ω-6 fatty acid were positively associated with DSST [β (95% CI): 0.06 (0.01,0.10), t statistic = 2.39, df= 2238, p = 0.02; β (95% CI): 0.06 (0.01,0.11), t statistic = 2.54, df= 2238, p = 0.01, respectively]. GGT was negatively associated with DSST [β (95% CI): -0.04 (-0.07, -0.01), t statistic = -2.73, df= 2239, p = 0.01], whereas uric acid was positively associated with CERAD total score [β (95% CI): 0.04 (0.00,0.08), t statistic = 2.03, df= 2233, p = 0.04]. The association between dietary intake of PUFA/ω -3/ω -6 and DSST performance was partially mediated by GGT level. CONCLUSIONOur findings support that PUFAs in dietary sources were associated with lower risks for cognitive impairment partially via lowering oxidative stress. Dietary PUFA supplementation may potentially reduce risk of cognitive impairment via antioxidative mechanism.

Cardiometabolic risk profile in non-obese children with obstructive sleep apnea syndrome.

Taken together, these findings suggested a worse cardiometabolic profile in non-obese children with OSAS. Given the pivotal pathogenic role of inflammation both for hypoxiemia and metabolic derangements, therapeutic strategies for OSAS might also counteract the increased cardiometabolic risk of these patients, by improving their long-term quality of life. • Pediatric OSAS has shown a close relationship with obesity and its cardiometabolic comorbidities. • Inflammation represents the hallmark of both obesity and OSAS. • Non obese children with OSAS presented with a worse cardiometabolic risk profile. • OSAS treatment might serve as an effective approach also for the increased cardiometabolic risk of these children.

The health effects of low blood lead level in oxidative stress as a marker, serum gamma-glutamyl transpeptidase level, in male steelworkers.

This study aimed to investigate the association between lead exposure and serum gamma-glutamyl transpeptidase (γGT) levels as an oxidative stress marker in male steelworkers. Data were collected during the annual health examination of workers in 2020. A total of 1,654 steelworkers were selected, and the variables for adjustment included the workers' general characteristics, lifestyle, and occupational characteristics. The association between the blood lead level (BLL) and serum γGT level was investigated by multiple linear and logistic regression analyses. The BLL and serum γGT values that were transformed into natural logarithms were used in multiple linear regression analysis, and the tertile of BLL was used in logistic regression analysis. The geometric mean of the participants' BLLs and serum γGT level was 1.36 μg/dL and 27.72 IU/L, respectively. Their BLLs differed depending on age, body mass index (BMI), smoking status, drinking status, shift work, and working period, while their serum γGT levels differed depending on age, BMI, smoking status, drinking status, physical activity, and working period. In multiple linear regression analysis, the difference in models 1, 2, and 3 was significant, obtaining 0.326, 0.176, and 0.172 (all: p < 0.001), respectively. In the multiple linear regression analysis stratified according to drinking status, BMI, and age, BLLs were positively associated with serum γGT levels. Regarding the logistic regression analysis, the odds ratio of the third BLL tertile in models 1, 2, and 3 (for having an elevated serum γGT level within the first tertile reference) was 2.74, 1.83, and 1.81, respectively. BLL was positively associated with serum γGT levels in male steelworkers even at low lead concentrations (< 5 μg/dL).

Особенности двигательной активности и коморбидные состояния у лиц с ожирением

Obesity is one of the diseases that cause concern due to social, psychological and metabolic problems. The purpose — to determine the features of relationship between the body mass index, physical activity and comorbid conditions in obese individuals. Material and methods. The study involved 60 patients. The patients’ body mass index was calculated. The patients were divided into 2 groups: group 1 — patients with a BMI of 18.5–30 kg/m2, 27 people; group 2 — with a BMI above 30 kg/m2, 33 people. The patients underwent a general blood test, a biochemical blood test, and echocardiography. To assess physical activity, the ODA 23+ and IPAQ questionnaires were used, and a six-minute walking test was performed. Results. The level of physical activity and fitness for it according to the ODA 23+, IPAQ questionnaires and the SMW test was significantly higher in group 1 (p &lt; 0.05). In group 2, an inverse relationship was found between the level of physical activity according to the ODA 23+ questionnaire with the level of gamma-glutamyltranspeptidase (p = 0.03; r = -0.59), alkaline phosphatase (p = 0.03; r = -0.55) and bilirubin (p = 0.049; r = -0.35). In this group, according to the results of the IPAQ questionnaire, we found a correlation of the physical activity with the alcohol consumption (p = 0.03; r = -0.38). The number of stops during a 6-minute walking test had a correlation with the presence of proteinuria (p = 0.04; r = 0.39). Conclusion. Thus, obesity is accompanied by a decrease in physical activity, which correlates with damage to the hepatobiliary system and kidneys.

Клінічні та біохімічні аспекти хронічного гепатиту С за умови дисбіозу кишківника

Prolonged intestinal dysbiosis (DB) increases the risk of developing metabolic liver diseases, such as nonalcoholic fatty liver disease (NAFLD), cholestasis, hepatocellular dysfunction and dyskinetic disorders of the biliary tract. According to various studies, hepatic steatosis is observed in almost 50% of patients with chronic hepatitis C (HCV). The presence of NAFLD in patients with CHC contributes to the onset and further progression of fibrosis from the initial stages to cirrhosis of the liver within a short time. The purpose of the research is to study the clinical and biochemical features of the course of chronic HCV in the conditions of intestinal dysbiosis. Materials and methods. There were 142 patients with chronic HCV under observation. The control group consisted of 20 healthy people. The diagnosis of chronic HCV was made according to the International Classification of Diseases of the 10th revision and confirmed by the detection of total IgG antibodies to HCV by enzyme-linked immunoassay, as well as the detection of RNA-HCV in the blood by polymerase chain reaction. All patients were determined the functional state of the liver by the level of activity of alanine and asparagine aminotransferases (ALT, AST), alkaline phosphatase (AP), conjugated bilirubin, gammaglutamyl transpeptidase (GGTP), trophological status was assessed and a microbiological study of feces was performed. To determine the degree of steatosis and fibrosis of the liver, a noninvasive diagnostic method – FibroMax was used. The obtained results allowed to divide all patients into two groups: 1 group (n = 84) of patients with chronic HCV + dysbiosis DB and 2 group (n = 58) of patients with chronic HCV without dysbiosis of the intestine. The analysis and processing of the patients’ examination results were carried out using the Statisticsfor Windows v.7.0 computer program (StatSoftInc, USA). Results and Discussion. It was found that the intestinal dysbiosis had 59.2% (84 out of 142) of patients with chronic HCV, and 52 of them had increased body weight, which was 61.9%. Clinical manifestations of intestinal microbiocenosis disorders in 58 patients were predominant constipation (69%) and minimization of typical diarrheal syndrome in 26 people (31%). A large number of patients with chronic HCV with the intestinal dysbiosis (82.1%) complained of decreased ability to work, headaches, depressed mood and sleep disorders, which confirmed the presence of asthenovegetative syndrome. Analysis of biochemical indicators demonstrated that cholestasis syndrome prevails in patients with chronic HCV in the conditions of intestinal dysbiosis, proving significantly higher levels of total bilirubin, AP and GGTP, compared with patients without dysbiosis (p &lt; 0.05). Also, in patients with chronic HCV, in conditions of intestinal dysbiosis in 3.5 times (p &lt; 0.001) were more often detected increased levels of liver enzyme activity (ALT, AST, GGTP), compared to patients without dysbiosis, which characterizes the cytolysis syndrome. In patients with chronic HCV with intestinal dysbiosis, in 1.6 times more often than in patients without dysbiosis, steatosis of the S1-2 degree was registered, and in 2.4 times more often S2-3. Inflammation in different degrees of hepatic steatosis in 2 times more common in patients with chronic HCV with dysbiosis than in patients without dysbiosis. It was found that in patients with chronic HCV combined with intestinal dysbiosis deep stages of liver fibrosis (F2-3 and F3-4) are registered in 3.6 times more often compared to patients only with chronic HCV (53.6% vs. 24.1% and 11, 9% vs. 3.4% p &lt; 0.05). Conclusions. Intestinal dysbiosis is more often recorded in patients with chronic HC with increased body weight and is characterized by an atypical course, in the predominance of constipation (in 69% of patients). In patients with chronic HCV in the conditions of intestinal dysbiosis dyspeptic, asthenovegetative and cholestatic syndrome, as well as high activity of ALT and AST are more often observed, compared to patients without dysbiosis. According to Fibromax, patients with CHC with intestinal dysbiosis are in 2.4 times more likely to have hepatic steatosis of 2–3 degree (S2-3) and steatohepatitis (N2,) which characterizes the existing metabolic disorders.

The Effect of Semaglutide on Glycolipid Metabolism in Type 2 Diabetes Mellitus and Non-Alcoholic Fatty Liver Disease

The research was to investigate the effect of semaglutide on glycolipid metabolism in patients with both type 2 diabetes mellitus and non-alcoholic fatty liver disease. A total of 150 patients with both type 2 diabetes mellitus and non-alcoholic fatty liver disease admitted to our hospital from January 2020 to June 2020 were selected. They were divided into 2 groups using random number table, with 75 cases in each. The control group was treated with metformin hydrochloride tablets twice/d and 0.5 g/time, and the observation group was treated with semaglutide by hypodermic injection in the morning for a course of 3 mo. After 3 mo of treatment, both groups showed lower levels of 2 h postprandial blood glucose, fasting blood glucose, glycated hemoglobin A1c and homeostatic model assessment of insulin resistance, than before (all p<0.05), with distinctly lower levels in the observation group than in the control group. Fasting insulin levels in the observation group were significantly increased compared to that in the control group, with significant differences (p<0.05). Both groups showed decreased levels of triglyceride, total cholesterol and low-density lipoprotein cholesterol after treatment than before; with distinctly lower levels in the observation group than in the control group. After treatment, the level of high-density lipoprotein cholesterol in the observation group was higher than that in the control group. Both groups showed decreased levels of aspartate aminotransferase, alanine aminotransferase and gamma-glutamyl transpeptidase than before (p<0.05), with distinctly lower level in the observation group than in the control group. The observation group showed more significantly increased patients with mild result of color ultrasound and decreased patients with moderate to severe results than the control group. The treatment of semaglutide for patients with both type 2 diabetes mellitus and non-alcoholic fatty liver disease significantly alleviated the glycolipid metabolism and can significantly improve the fatty liver classification and the liver serum level of alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transpeptidase, which has considerable clinical application value.

Mechanism of SARS-CoV-2 Invasion into the Liver and Hepatic Injury in Patients with COVID-19.

Many studies have shown that patients with Coronavirus disease 2019 (COVID-19) have different degrees of liver injury. However, the mechanisms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) invasion into the liver are still not fully understood. This review mainly summarizes the recently published works on the abnormal liver biochemical indicators and the mechanism of viral invasion with liver injury in COVID-19 patients. Generally, SARS-CoV-2 infection of the liver was caused by blood circulation or retrograde infection of the digestive tract, which led to the liver injury through direct cytopathic effect induced by virus or immunopathological effect caused by excessive inflammation. Besides these, hypoxia, endothelial injury and drug-induced jury were also the main reasons of liver injury in COVID-19 patients. In the liver function indicators, elevated alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase, and lactate dehydrogenase levels with reduced albumin levels were observed in COVID-19 patients.

Hematological, Biochemical, and Skeletal Muscle Metabolic Responses to Exercise Related Myopathy in Endurance Horses

Equine exertional rhabdomyolysis (ER) is a well-recognized disease affecting racehorses therefore this study was performed to evaluate haemato-biochemical alterations in 20 adult Arabian horses after 120 km race with trial of treatment. Horses were classified into 2 main groups: the first group (n:5) included healthy control horses while the second group(n:15) included horses showed signs of distress, moderately depressed, muscle stiffness, shifting hind limb lameness, elevated respiratory rate, sweating, firm painful hindquarter muscles, myoglobinuria and reluctance to move that lasts for several hours after ending of race. Based on the history and the through clinical examination of diseased horses, they were tentatively diagnosed as suffering from ER syndrome. Whole blood and serum samples were collected from both healthy control horses and diseased ones before and after treatment. Hemogram of examined horses showed only significant increased PCV (%) values of diseased horses with more prominent thrombocytopenia but with treatment their values showed marked improvement, where other haematological parameters showed non-significant changes in both groups either before or after treatment. Serum analysis of ER affected horses showed a higher serum enzymatic activities of creatine phosphokinase (CK) and aspartate aminotransferase (AST) with significantly increased values of total proteins, albumin, globulins, total bilirubin, glucose, creatinine and potassium. But with effective treatment protocol, these higher values began to be improved towards normal values again. While non-significant changes were observed in serum levels of Gamma-glutamyl transpeptidase (GGT), calcium, sodium and blood urea nitrogen (BUN) in ER affected horses. Based on obtained results, ER has negative impact on haemato-biochemical biomarkers with remarkable serum elevation of skeletal muscular specific enzymes, as well as by paralytic myoglobinuria.

Effects of hypokalemia on clinical outcomes in hospitalized patients with Covid-19 pneumonia

Purpose: We investigated the effects of hypokalemia on clinical outcomes in hospitalized patients with Covid-19 pneumonia.&#x0D; Materials and Methods: In this single-center retrospective study, we recorded characteristics of hospitalized covid-19 pneumonia patients and laboratory test results on the first hospital day. Duration of hospitalization, requiring intensive care including mechanical ventilation and survival, were determined.&#x0D; Results: Our study included 185 patients and of them 111 male (60% male) patients with mean age of 64 ± 14.5 (23-90). Patients were grouped as hypokalemic (16.8%) and normokalemic patients (83.2%). The number of diabetic patients was higher in the normokalemic group. Serum total protein and albumin levels were lower in hypokalemic group, while alkaline phosphatase, gamma-glutamyl transpeptidase, total bilirubin, direct bilirubin, blood pH and bicarbonate level were higher. In multiple logistic regression analyses, alkalosis increased risk of hypokalemia 5.73 times. Duration of hospitalization, requirement of intensive care and hospital mortality were similar in hypokalemia and normokalemia patients. &#x0D; Conclusion: In patients with Covid-19 pneumonia, hypokalemia has been found to be quite common as high as 16.8% at the first presentation. Hypokalemia was related to metabolic alkalosis but unrelated to the duration of hospitalization, requirement of intensive care including mechanical ventilation and hospital mortality.

CEUS detection of biliary ischaemia during the first 4 weeks after liver transplantation predicts non-anastomotic biliary stricture

Biliary ischaemia is an important factor in the pathogenesis of non-anastomotic biliary stricture (NAS) after liver transplantation (LT). Contrast-enhanced ultrasound (CEUS) can be used to detect biliary ischaemia, but no study has examined the utility of CEUS in predicting NAS. To evaluate whether repeated CEUS as a non-invasive method of biliary ischaemia can identify NAS. Consecutive LT patients who underwent CEUS examinations at 1-4 weeks after LT from September 2012 to December 2015 at our institution were included. The CEUS images and clinical data were analysed. Among 116 eligible LT patients, 39 (33.6%) were diagnosed with NAS within 1 year after LT. The patients with NAS had a significantly higher CEUS score at weeks 2-4 (all P < 0.05) and a higher slope of CEUS score progression (0.480 vs -0.044, P < 0.001). The accuracy of CEUS in identifying NAS improved over time after LT, reaching its maximum at week 4, with a sensitivity of 66.7%, a specificity of 87.9%, a positive predictive value (PPV) of 75.9%, a negative predictive value (NPV) of 82.3%, and an accuracy of 80.2%in the full cohort when a CEUS score≥3 was used as the cut-off. Multivariate analysis identified gamma-glutamyl transpeptidase (GGT), alanine transaminase (ALT) and the CEUS score at week 4 as independent predictors of NAS. In the task of identifying NAS, an NAS score combining the above 3 variables at week 4 showed areas under the receiver operating characteristic curve of 0.88 (95%CI, 0.78-0.99) in the estimation group (n = 60) and 0.82 (95%CI, 0.69-0.96) in the validation group (n = 56). An NAS score cut-off of 0.396 identified 87.2%of NAS cases in the estimation group, with a PPV of 93.3%; and 75.0%of NAS cases in the validation group, with a PPV of 58.8%. CEUS examination during the first 4 weeks is useful in assessing the risk of NAS within 1 year after LT. In particular, an NAS score combining the CEUS score, GGT level, and ALT level at week 4 can be used to accurately predict the risk of NAS in LT patients.

Significant Physical and Exercise-Related Variables for Exercise-Centred Lifestyle: Big Data Analysis for Gynaecological Cancer Patients

This study investigated the characteristics of gynaecological cancers and is aimed at identifying significant risk variables using the National Health Insurance Sharing Service database to develop practical interventions for affected patients. Data regarding patients with uterine and ovarian cancer from the National Health Insurance Sharing Service database were collected and analysed using Student's t-test, logistic regression, and receiver operating characteristic curve analyses. Student's t-test analyses revealed that age, body mass index, blood pressure, and waist variables differed significantly among patients with uterine cancer. Gamma-glutamyl transpeptidase levels were higher in patients with ovarian cancer than in patients with uterine cancer. Physical fitness function tests reflected the status of patients with cancer. Moreover, physical disability was associated with an increased incidence of ovarian cancer. Intensive exercise for 20 min more than 1 time per week must be avoided to prevent uterine cancer. Receiver operating characteristic curve analyses showed that the optimal cutoff value for one-leg standing time, a prognostic and preventive factor in ovarian cancer, was 9.50 s (sensitivity, 94.9%; specificity, 96.9%). Controlling significant variables for each gynaecological cancer type in an individualised and optimised manner is recommended, including by maintenance of an adjusted exercise-centred lifestyle.

Method for diagnosing non-alcoholic liver steatosis

Purpose of the study.Development of a non-invasive method for the diagnosis of non-alcoholic hepatic steatosis.Material and methods.The study involved 21 patients with confrmed non-alcoholic hepatic steatosis on ultrasound examination with an average age of 42.1 ± 10.1 years. The control group consisted of 10 apparently healthy individuals. The following indicators were determined: body mass index (BMI), the level of gamma-glutamyl transpeptidase (GGTP), vasculoendothelial growth factor (VEGF) and interleukin-6 (IL-6) in serum, and the steatosis index (IS) was calculated using the formula IS = –1.2390 + 0.0575 × BMI + 0.0064 × GGTP +0.0006 × VEGF + 0.0001 × IL-6. The index of the presence of hepatic steatosis according to liver ultrasound data was used as a dependent variable.Results.According to the examination results, BMI and serum concentrations of GGTP, VEGF, and IL-6 in patients with steatosis were signifcantly higher than in the control group (p &lt; 0.001, p &lt; 0.001, p &lt; 0.001, and p &lt; 0.001, respectively), which indicates the presence of cholestasis syndrome, signs of inflammation and endothelial dysfunction. The correlation coeffcient between BMI and the presence of non-alcoholic hepatic steatosis was 0.9; between GGTP and the presence of steatosis was 0.80; between VEGF and the presence of steatosis was 0.85; between IL-6 and the presence of steatosis was 0.80. The predictive value of each parameter of the model was assessed using a scale of values of the area under the ROC-curve (AUC). The model is effective (multiple correlation coeffcient R = 0.809; the share of the influence of the sum of the factors included in the model is R2 • 100 = 65.5%), statistically signifcant (criterion F = 12.318; p &lt; 0.0001) and has excellent diagnostic characteristics.Conclusion.The proposed non-invasive method makes it possible to diagnose hepatic steatosis with a sensitivity of 95.2% and a specifcity of 97.0%: with IS equal to 0.5 or more, the presence of non-alcoholic hepatic steatosis is diagnosed, with IS less than 0.5 is not.

Increased Uric Acid, Gamma-Glutamyl Transpeptidase and Alkaline Phosphatase in Early-Pregnancy Associated With the Development of Gestational Hypertension and Preeclampsia.

Background: Previous studies have reported that biomarkers of liver injury and renal dysfunction were associated with hypertensive disorders of pregnancy (HDP). However, the associations of these biomarkers in early pregnancy with the risk of HDP and longitudinal blood pressure pattern during pregnancy were rarely investigated in prospective cohort studies.Methods: A total of 1,041 pregnant women were enrolled in this prospective cohort study. BP was assessed in four stages throughout pregnancy. The following biomarkers were measured at early pregnancy before 18 weeks gestation: lactate dehydrogenase (LDH), aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), uric acid (UA), and estimated glomerular filtration rate (eGFR). Linear mixed-effects and logistic regression models were used to examine the associations of these biomarkers with longitudinal BP pattern during pregnancy and HDP incidence, respectively.Results: In unadjusted models, higher serum UA, GGT, ALP, and LDH levels, as well as lower eGFR and AST/ALT, were associated with higher BP levels during pregnancy and an increased risk of HDP. After adjustment for maternal age, pre-pregnancy BMI and other potential confounders, UA, GGT, ALP, and LDH remained positively associated with both BP and HDP. However, eGFR and AST/ALT were not associated with HDP after adjusting for potential confounders. When including all 6 biomarkers simultaneously in multivariable analyses, increased UA, GGT, and ALP significantly associated with gestational hypertension and preeclampsia.Conclusion: This study suggests that increased UA, GGT, and ALP in early-pregnancy are independent risk factors of gestational hypertension and preeclampsia.

Correlation between APRI, FIB-4 and GPR Indices to Fibroscan and HBeAg Status in Patients with Chronic Hepatitis B

Liver fibrosis is a complication of chronic hepatitis B. Early detection of liver fibrosis is important for therapy. The aspartate aminotransferase index (AST)-to-platelet ratio index (APRI) and the fibrosis index based on 4 factors (FIB-4) in chronic hepatitis B have been widely studied despite the inconsistent results. Research on other serum markers is extensively carried out, including Gamma-Glutamyl Transpeptidase (GGT)-to-platelet ratio (GPR). Previous studies have shown that the GPR index was more accurate than APRI and FIB-4. HBeAg status is an indication for therapy. There have not been many studies on the correlation of serum markers with HBeAg status. This study aimed to determine the correlation of APRI, FIB-4, and GPR with Fibroscan and HBeAg status in chronic hepatitis B patients. A cross-sectional study was carried out from June to September 2020 and found 50 chronic hepatitis B patients. Platelet count was measured using a Sysmex XN-1000 hematology device; AST, alanine aminotransferase (ALT), and GGT levels were measured using the Dimension RXL clinical chemistry device; and the degree of fibrosis was determined using transient elastography (Fibroscan). Spearman correlation test was used in this study for the correlation analysis. The results showed a significant correlation between APRI, FIB-4 and GPR indices with Fibroscan (r=0.454, p 0.001; r=0.610, p &lt; 0.001; r=0.540, p &lt; 0.001, respectively). A significant correlation was found between APRI, FIB-4 and GPR indices with negative (-) HBeAg (r=0.486, p 0.004; r=0.648, p &lt; 0.001; r=0.595, p &lt; 0.001, respectively). In addition, a significant correlation was found between FIB-4 and positive (+) HBeAg (r=0.499, p 0.049), but no correlation was found between APRI and GPR with positive (+) HBeAg (r=0.295, p 0,267; r=0.386, p 0.140, respectively).

Does the gut microbiome partially mediate the impact of air pollutants exposure on liver function? Evidence based on schizophrenia patients

Air pollution may alter the composition of gut microbiome and subsequent liver-related metabolic disorders. Schizophrenia was often accompanied by liver dysfunction. But it was still unclear whether air pollutants affected liver function in patients with schizophrenia through gut microbiome. We aimed to clarify the impacts of long-term air pollutants on the gut microbiome and liver function in schizophrenia and to evaluate the intermediary effect of microbiome. Schizophrenia patients were recruited then serum biochemical indicators were tested. Air pollutant exposure in the previous year was retrospectively estimated by inverse distance weighting. The associations among air pollutants, gut microbiome, and liver function indicators in schizophrenia were estimated. Then the mediating effect of gut microbiome was further explored. The results showed that nitrogen dioxide (NO2), carbonic oxide (CO), ozone (O3), particulate matter with aerodynamic diameter ≤10 μm (PM10), and fine particulate matter (PM2.5) explained 2.68%–10.77% of the variation in gut microbiome composition (order level) in schizophrenia (all P < 0.05). Network correlation analysis indicated that air pollutants and liver function indicators were mainly related to Firmicutes, Actinobacteria, and Proteobacteria in schizophrenia. Long-term NO2 exposure significantly increased the levels of gamma-glutamyl transpeptidase (GGT) and glutamic pyruvic transaminase (GPT) in schizophrenia. Coriobacteriales mediated 13.98% and 49.56% (all P < 0.05) of the associations of long-term NO2 with GGT and GPT, respectively. To conclude, long-term NO2 exposure is positively associated with liver dysfunction in schizophrenia, in which gut microbiome plays an intermediary role. The two pathways, “NO2-Coriobacteriales-GGT” and “NO2-Coriobacteriales-GPT”, would provide scientific evidence for the intervention of schizophrenia with liver dysfunction.

Moderate alcohol consumption and carotid intima-media thickness in type 2 diabetes.

Carotid intima-media thickness (IMT) is a risk predictor for myocardial infarction and stroke. Patients with type 2 diabetes mellitus are at higher risk for such conditions. The association of alcohol consumption with IMT is still controversial. We undertook a cross-sectional study of patients hospitalized in the Department of Endocrinology at Zhoushan Hospital from January 1st, 2013 to December 31st, 2015. Patients with a past medical history of cerebrovascular events, acute myocardial ischemia or unable to provide a detailed alcohol consumption history were excluded. Carotid IMT, together with blood biochemical examinations were collected. Data were analyzed using least significant difference t test, Tamhane's T2 test, Levene test, χ2-test and binary logistic regression model. 281 patients were enrolled in the study. The number of patients with elevated carotid IMT in moderate alcohol consumers was apparently less than alcohol non/heavy-consumers. In addition, the number of participants with elevated carotid IMT in liqueur consumers was higher than alcohol non-consumers and rice wine/beer consumers. Systolic blood pressure, C-reactive protein, glycosylated hemoglobin, low density lipoprotein cholesterol, triglyceride, gamma glutamyl transpeptidase, uric acid, cholesterol and creatinine levels were higher in elevated IMT patients, while high density lipoprotein cholesterol level was levels were significantly lower (p value<0.05). Moderate alcohol consumption has a protective effect on atherosclerosis in patients with type 2 diabetes mellitus, requiring consideration to dietary intake and physical activity, among other influences. Inflammation theory and lipid metabolism could be involved in such prophylaxis effects.

Dealing with redundant gamma glutamyl transpeptidase in primary care, when requested along with alkaline phosphatase

The use of gamma glutamyl transpeptidase (GGT) levels as screening test for liver function is controversial. The GGT main utility is in cases in which alkaline phosphatase (ALP) is elevated. We aimed to investigate the request over time for alanine amino transferase (ALT), ALP and GGT, study the effect of a new demand management (DM) intervention for optimal GGT measurement in primary care.Our descriptive study was conducted from January 2010 to December 2020. The intervention was established in November 2019 and consisted of the laboratory information system would automatically remove GGT, if the test had been ordered simultaneously with ALP and there was no prior pathological result on record. We counted the absolute number of measured ALT, ALP and GGT, and calculated the ratios for each of the three markers related to creatinine, and GGT related to ALT in a monthly basis.The number of measured GGT increased slightly and progressively along the study until October 2019, when a decrease was observed. The ALT and ALP request from primary care also increased slightly along years. However, the GGT/ALT ratio never reached the 0.2 goal. Out of the 57,614 GGT requested in primary care patients, 38,167 (66.2%) were not measured. 7633.4€ were saved in reagent.The DM intervention to reduce the measurement of GGT when requested redundantly with ALP in primary care was successful, and the results have been maintained over time as observed by monitoring the GGT/CREA and GGT/ALT indicator results.

Association Between Gamma-Glutamyl Transferase, Total Bilirubin and Systemic Lupus Erythematosus in Chinese Women.

BackgroundSystemic lupus erythematosus (SLE) affects many organs and systems of the human organism, at present, its specific pathogenesis is not completely clear, but inflammation is considered to be an important factor involved in the pathogenesis and progression of SLE. Gamma-glutamyl transpeptidase (GGT) and total bilirubin (TBIL) have different effects on inflammation: GGT has pro-inflammatory effects, on the contrary, TBIL has anti-inflammatory effects. Study has found that GGT and TBIL play opposite roles in metabolic diseases. However, the roles of them in SLE are unknown. Meanwhile, the relationship between GGT and SLE also remains unexplored.MethodWe recruited 341 SLE patients and 332 healthy individuals in Liaocheng People’s Hospital from August 2018 to May 2019. We diagnosed SLE using 2019 revised American College of Rheumatology (ACR) SLE criteria, and modeled the study outcomes using logistic regression to explore the respective relationship between GGT, TBIL and SLE. We also analyzed the interaction of GGT and TBIL in the progression of SLE.ResultsWe found that the levels of CRP, IL-6 and TNF-α in the aggravated group were significantly higher than those in the unaggravated group, the levels of C3 and C4 in the aggravated group were significantly lower than those in the unaggravated group. According to Spearman correlation analysis, GGT is proportional to CRP (rs=0.417) and IL-6 (rs=0.412), inversely proportional to C3 (rs=-0.177) and C4 (rs=0.-132). TBIL was inversely proportional to CRP (rs=-0.328) and TNF(rs=-0.360), and positively proportional to C3 (rs=0.174) and C4 (rs=0.172). In the fully adjusted model, compared to the lowest quartile, the highest quartile of GGT exhibited a positive association with the risk of SLE aggravation (OR=2.99, 95% CI: 1.42–6.31, P<0.001). At the same time, compared to the highest quartile, the quartile lowest of TBIL exhibited a positive association with the risk of SLE aggravation (OR=2.66, 95% CI: 1.27–5.59, P<0.001) in the fully adjusted model. Through interaction analysis, we found that women with high GGT levels had an increased risk of SLE aggravation when they had a low level of TBIL (OR=3.68, 95% CI: 1.51–9.01, for women with Q1 TBIL and Q4 GGT compared to women with Q2-Q4 TBIL and Q1-Q3 GGT, P for interaction <0.001), the combined AUC value (AUCCOMBINED=0.711) of high GGT level and TBIL were higher than their respective values (AUCGGT=0.612, AUCTBIL=0.614).ConclusionWe found that the effects of GGT and TBIL in the progression of SLE are opposite. High GGT level might be a risk factor for SLE aggravation, as GGT levels increased, so did the risk of SLE aggravation. At the same time, we found that low TBIL level might be a risk factor for SLE aggravation. Moreover, high GGT level and low TBIL level had a subadditive effect on the increased risk of SLE aggravation.

Betatrophin Levels Are Related to the Early Histological Findings in Nonalcoholic Fatty Liver Disease.

Betatrophin, a liver hormone, regulates glucose and lipid metabolism. We investigated the betatrophin levels in nonalcoholic fatty liver disease (NAFLD) and searched for any relationship with histological severity and metabolic parameters. Fifty males with NAFLD [Nonalcoholic Steatohepatitis (NASH) (n = 32); non-NASH (n = 18)] and 30 healthy controls were included. Plasma betatrophin was measured by ELISA method. Insulin sensitivity was assessed by HOMA-IR index. Histological features were scored by the semi quantitative classification and combined as the NAFLD activity score (NAS). Betatrophin levels in the non-NASH group were significantly higher than the controls. Betatrophin was positively correlated to the age, waist circumference, total cholesterol, triglycerides, LDL cholesterol, glucose, insulin, HOMA-IR index and gamma glutamyl transpeptidase levels, and negatively correlated to the steatosis and NAS. In the stepwise linear regression analysis, the triglyceride (β = 0.457, p < 0.001), glucose (β = 0.281, p = 0.02) and NAS (β = −0.260, p = 0.03) were the independent determinants of betatrophin. Betatrophin levels are higher in the early stages of NAFLD and tend to decrease when the disease progresses. This could be an important preliminary mechanistic finding to explain the increased frequency of glucose intolerance during the course of NAFLD.

Statin liver safety in non-alcoholic fatty liver disease: A systematic review and metanalysis.

AimsStatin liver safety in non‐alcoholic fatty liver disease (NAFLD) patients is not well defined. We analysed differences in liver function tests, including alanine transaminase aminotransferase (ALT), aspartate transaminase (AST) and gamma‐glutamyl transpeptidase (GGT) in NAFLD patients treated or not treated with statins.MethodsWe performed a systematic review of MEDLINE via PubMed and EMBASE databases and metanalysis of clinical studies investigating levels of ALT, AST and GGT in NAFLD according to statin treatment. Mean difference (MD) and percentage MD were calculated between the two groups.ResultsWe included 22 studies with 2345 NAFLD patients. Overall, 16 were before‐after interventional, five were cross‐sectional and one was combined cross‐sectional/interventional study. In all interventional studies, except one, patients had raised ALT, AST and GGT at baseline. Interventional studies showed reduced ALT values with an MD reduction of −27.2 U/L (95% CI −35.25/−19.15) and a percentage MD reduction of −35.41% (95% CI −44.78/−26.04). Also, AST values were reduced after statin treatment in interventional studies with an MD of −18.82 U/L (95% CI −25.63/−12.02) (percentage −31.78%, 95% CI −41.45/−22.11). Similarly, GGT levels were reduced after statin treatment with an MD of −19.93 U/L (95% CI −27.10/−12.77) (percentage −25.57%, 95% CI −35.18/−15.97). Cross‐sectional studies showed no difference in AST and GGT values between patients treated with and without statins.ConclusionIn interventional studies, ALT, AST and GGT were reduced after statin treatment with a percentage mean difference of −35.41%, −31.78% and −25.57%, respectively, while observational studies showed a null effect, suggesting liver safety of statins in NAFLD patients.