Higher Serum Gamma-glutamyl Transferase Research Articles

Birthweight influences liver structure, function and disease risk: Evidence of a causal association.

Low birthweight is an issue during pregnancy associated with an increased risk of developing liver disease later in life. Previous Mendelian randomisation (MR) studies which explored this issue have not isolated the direct impact of the foetus on birthweight. In the present study, MR was used to assess whether direct foetal effects on birthweight were causally associated with liver structure, function and disease risk independent of intrauterine effects. We extracted single nucleotide polymorphisms (SNPs) from genome-wide association studies (GWAS) about direct foetal-affected birthweight (321 223 cases) to conduct univariable and multivariable MR analyses to explore the relationships between birthweight and 4 liver structure measures, 9 liver function measures and 18 liver diseases. A two-step MR analysis was used to further assess and quantify the mediating effects of the mediators. When isolating direct foetal effects, genetically predicted lower birthweight was associated with a higher risk of non-alcoholic fatty liver disease (NAFLD) (odds ratios [OR], 95% confidence interval [CI]: 1.61, 1.29-2.02, p < 0.001), higher magnetic resonance imaging [MRI] proton density fat fraction (PDFF) and higher serum gamma glutamyltransferase (GGT). Two-step MR identified two candidate mediators that partially mediate the direct foetal effect of lower birthweight on NAFLD, including fasting insulin (proportion mediated: 22.29%) and triglycerides (6.50%). Our MR analysis reveals a direct causal association between lower birthweight and liver MRI PDFF, as well as the development of NAFLD, which persisted even after accounting for the potential influence of maternal factors. In addition, we identified fasting insulin and triglycerides as mediators linking birthweight and hepatic outcomes, providing insights for early clinical interventions.

High serum gamma-glutamyltransferase level after hepatitisC virus elimination is a risk factor for the development of hepatocellular carcinoma.

Gamma-glutamyltransferase (GGT) is known as an oxidative stress marker, induced by alcohol consumption and metabolic disorders, and is reported as a predictor of hepatocellular carcinoma (HCC) development after hepatitisC virus (HCV) elimination. However, it is not clear whether GGT serves simply as a surrogate marker for overlapping metabolic diseases or reflects HCV-specific carcinogenicity. We investigated the association between GGT and hepatocarcinogenesis after achieving a sustained viral response (SVR), accounting for drinking habits or diabetes, and examined predisposing factors associated with GGT levels after SVR. This is a prospective, multicenter, and observational study using the database of 1001 patients after HCV eradication with direct-acting antiviral agents. The association of GGT at SVR with cumulative HCC development was examined in a multivariate analysis using Cox proportional hazard models after adjustment for covariates including alcohol and diabetes. The association between oxidative stress markers or genetic factors and GGT levels was analyzed. High GGT levels at SVR were associated with HCC development (HR] 2.38, 95% CI 1.10-5.17). This association was also significant when restricted to patients without alcohol consumption or diabetes (HR 8.38, 95% CI 2.87-24.47). GGT levels were correlated with serum growth differentiation factor 15 levels, a marker of mitochondrial dysfunction. Single-nucleotide polymorphisms of ZNF827 and GDF15 were associated with high GGT levels. High GGT levels at SVR were associated with HCC development after accounting for alcohol consumption and diabetes. GGT levels are influenced by genetic predisposition and may reflect mitochondrial dysfunction after HCV eradication.

Metabolic response of endangered goats fed spineless cactus associated with Tifton-85 hay or Maniçoba hay

The aim of this study was to evaluate the effects of replacement of Tifton-85 hay by maniçoba hay, in spineless cactus-based diets, on markers of energy, protein, mineral metabolism and serum enzyme activity of Moxotó goats. Sixteen uncastrated male Moxotó breed goats, with 20 months old and initial body weight of 21.7 ± 3.92 kg were used in a randomized blocks design, using the initial weight as the criterion for the formation of blocks, with two treatments and eight replicates per treatment. The experimental treatments consisted of two diets: diets containing Miúda spineless cactus associated with Tifton-85 hay (1) or maniçoba hay (2), with roughage:concentrate ratio of 70:30. Blood samples were collected fortnightly (baseline, 15 days, 30 days and 45 days) during the feedlot period. There was a higher serum concentration of total protein and fructosamine (P &lt; 0.05) in goats that received maniçoba hay. However, there was higher serum gamma-glutamyl transferase (GGT) enzyme activity in goats that ingested Tifton-85 hay (P &lt; 0.05). Concerning to the profile of blood metabolites in the different fortnightly collections, it was possible to verify a significant effect for urea, fructosamine, GGT enzyme activity, K and Cl levels (P &lt; 0.05). In conclusion, Tifton-85 hay and maniçoba hay combined with spineless cactus does not cause metabolic disorders in feedlot native goats.

GAMMA GLUTAMYL TRANSFERASE LEVELS IN PATIENTS WITH ACUTE STROKE: AN ANALYTICAL STUDY

Objectives: Stroke is a significant global health issue with a major socioeconomic burden, ranking as the second leading cause of death worldwide. While stroke rates have declined in high-income countries, they have increased in low- to middle-income countries, including India. The World Health Organization defines stroke as a disturbance of cerebral function caused by vascular factors, classified as ischemic or hemorrhagic. Methods: Ischemic stroke is primarily caused by atherosclerosis in the brain’s arteries, including the proximal aorta, leading to embolus formation. Other factors contributing to stroke include arterial stenosis, coexisting thrombosis, artery-to-artery embolism, micro atheroma, lipohyalinosis, and occlusive diseases of small brain arteries. Cardiogenic embolism, often associated with atrial fibrillation, contributes to a significant proportion of ischemic strokes. Gamma-glutamyl transferase (GGT), commonly used as a marker for alcohol consumption and liver diseases, is also linked to oxidative stress, inflammation, and atherosclerosis. Elevated GGT levels are associated with various stroke risk factors. Results: GGT plays a crucial role in cellular intake of glutathione, an important antioxidant. Paradoxically, it can generate reactive oxygen species in the presence of certain metals. Studies have found a correlation between high serum GGT levels and stroke risk, potentially due to oxidative stress and atherosclerosis progression. Conclusion: Despite its primary use as an alcohol consumption marker, GGT has emerged as a potential independent biomarker for vascular diseases, including stroke. However, limited research exists on the association between GGT and acute stroke. This study aims to evaluate GGT levels in patients with acute stroke, exploring potential differences among stroke types to better understand the impact of GGT on acute stroke.

All-Cause Mortality and Its Predictors in Haemato-Oncology Patients with Febrile Neutropenia.

Febrile neutropenia (FN) is one of the most important life-threatening complications in haemato-oncology. Our objective was to report all-cause mortality rates in patients ill with a hematological malignancy (HM) hospitalized with a first FN episode and to identify predictors for mortality. We conducted a historical retrospective cohort study of consecutive patients with an HM, >18 years of age, admitted between January 2012 and August 2018 for a first episode of FN. Data on all-cause mortality 12 months after admission for FN were obtained. The Kaplan-Meier curve was used to describe mortality during the follow-up period. Univariate and multivariable analyses identified predictors for 1,3 and 12-month mortality. One hundred and fifty-eight patients (mean age 69.5, 49.4% males) were included. Overall, 54 patients died (15.8%, 25.9%, and 34.1% died after 1, 3, and 12 months, respectively). Lower serum albumin, higher serum gamma-glutamyl transferase (GGT), lower estimated glomerular filtration rate (eGFR), older age, higher temperature, and lower absolute lymphocyte count at admission were independent predictors of all-cause mortality after 12 months. Further studies are needed to confirm our results and identify therapeutic strategies to improve survival.

Evaluation of gamma glutamyl transferase activity in sera of patients with Alzheimer’s disease

Gamma glutamyl transferase (GGT) plays a role in cellular glutathione uptake, which is an important element of antioxidant mechanisms. An increase in serum GGT is thought to be an early and sensitive marker of oxidative stress. Oxidative stress has a role in the pathogenesis of Alzheimer’s disease (AD). The aim of present study was to investigate the levels of serum Gamma glutamyl transferase (S.GGT) in samples from patient with Alzheimer’s disease.The study included 67 AD patients and 70 individuals as normal controls . Serum Gamma glutamyl transferase GGT and C-reactive protein (CRP) were determined. The study revealed that the S.GGT activity was significantly higher in patients with Alzheimer’s disease (75±2.1IU/L) than in control (healthy individuals) (25±2.1IU/L). The study was carried out in optimum pH (8.2) and optimum temperature 37ć. The results showed that There was a significant positive correlation between age and S.GGT activity in males (r=0.75); and females (r=0.72). Increase in age was significantly associated with raised GGT levels in control group and patients group. The mean serum C-reactive protein (CRP) levels were significantly (p &lt; 0.001) greater in patients group ((33.9 ± 2.3) when compared with control group (4.8±0.2). The high serum GGT concentration may play a critical role in the oxidative stress present in AD brain and, consequently, may play a central role in the pathogenesis of the disease.

Apparently healthy adults with high serum gamma-glutamyl transferase levels are at increased risk of asthma development in the near future: a Korean nationwide cohort study.

Serum gamma-glutamyl transferase (GGT), an indicator of oxidative stress and/or a chronic inflammatory process, is associated with the levels of leukotrienes and other inflammatory mediators that play a critical role in the pathogenesis of asthma. This study aimed at investigating whether apparently healthy subjects with higher serum GGT levels at a national health check-up are at an increased risk of developing asthma in the near future. We analyzed 564,213 Korean adults, aged 20-80 years who underwent a national general health examination, including measurement of baseline serum GGT between 2003 and 2015, using data from a large-scale representative cohort of the Korean population. Data were analyzed using a Cox proportional hazards regression analysis. In total, 516,956 participants were included in the final analysis. During the mean follow-up period of 8 years (standard deviation, 4.0), 7,439 incident asthma events occurred. We then classified the male and female participants according to quartiles of blood GGT levels (males: ≤ 20, 21-30, 31-51, and ≥ 52 IU/L; females: ≤ 12, 13-16, 17-22, and ≥ 23 IU/L, respectively). The adjusted hazard ratio (aHR) for incident asthma was significantly greater for subjects in the highest GGT quartile than for those in the lowest GGT quartile (aHR, 1.47; 95% confidence intervals, 1.36-1.59). Further, there was a significant linear trend across quartiles with regard to asthma (ptrend<0.001). We estimated the optimal cut-off values (using the minimum p-value approach) as 35 IU/L for the total population, 35 IU/L for males, and 36 IU/L for females, respectively. Clinicians should be aware of the risk of incident asthma in healthy subjects with elevated GGT levels. Our findings advance our understanding of asthma pathogenesis.

Case-control exercise challenge study on the pathogenesis of high serum gamma-glutamyl transferase activity in racehorses.

High serum γ-glutamyl-transferase (GGT) activity syndrome in racehorses has been associated with maladaption to exercise. Investigation of affected horses before and immediately after standard exercise may provide critical insight into the syndrome's pathophysiology. To investigate blood biomarker changes in actively competing racehorses with high GGT activity associated with an exercise challenge. Case-control study. High GGT case (age: 2-3 years) and normal GGT control (age: 2-7 years) pairs (3 Thoroughbred, 4 Standardbred pairs) at least 3months into their training/racing season were included. Horses with a recent history of high GGT activity (≥50 IU/L) without additional biochemical evidence of liver disease were identified by veterinarians. Horses were tested again in the week prior to a planned exercise challenge to confirm persistent increases in GGT activity. Controls from the same stable with similar training/racing intensity and serum GGT activity ≤36 IU/L were matched with each case. Blood samples were obtained immediately before, 15 and 120 min after exercise. Pre-exercise serum samples were analysed for baseline select serum chemistries, selenium and vitamin E concentrations. Cortisol concentration and markers of oxidative status were measured in serum or plasma for all time points. Individual serum bile acid and coenzyme Q10 concentrations, plasma lipid mediator (fatty acids, oxylipids, isoprostanes) concentrations and targeted metabolomics analyses were performed using liquid chromatography-mass spectrometry. Serum viral PCR for equine hepaci- and parvovirus was performed in each animal. Cases had higher baseline concentrations of total glutathione, taurocholic acid, cortisol and cholesterol concentrations and higher or lower concentrations of specific oxylipid and isoprostane mediators, but there were no case-dependent changes after exercise. Small sample size. Results indicated that glutathione metabolism was altered in high GGT horses. Enhanced glutathione recycling and mild cholestasis are possible explanations for the observed differences.

Biallelic loss-of-function ZFYVE19 mutations are associated with congenital hepatic fibrosis, sclerosing cholangiopathy and high-GGT cholestasis

BackgroundFor many children with intrahepatic cholestasis and high-serum gamma-glutamyl transferase (GGT) activity, a genetic aetiology of hepatobiliary disease remains undefined. We sought to identify novel genes mutated in children with...

Association Between Sex-Specific Serum Gamma-Glutamyltransferase and Incidence of Hypertension in a Chinese Population Without Metabolic Syndrome: A Prospective Observational Study.

Background: Higher serum gamma-glutamyltransferase (GGT) is associated with high risk of hypertension. We aimed to examine the association between sex-specific serum GGT levels and incident of hypertension in a Chinese population without metabolic syndrome.Methods: Participants who were free of hypertension and metabolic syndrome from the First Affiliated Hospital of Wenzhou Medical University between 2009 and 2014 were included. Participants were grouped into sex-specific quartiles of GGT levels (Q1–Q4) defined as: ≤19, 20–26, 27–38, and ≥39 U/L for male; ≤12, 13–15, 16–19, and ≥20 U/L for female. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incidence of hypertension according to sex-specific quartiles of GGT levels. Kaplan–Meier analysis and interaction analysis were conducted.Results: Among 38,806 participants included (average age 36.0 years, 54.0% men), 4,505 of them developed hypertension. In the overall study population, using Q1 as the reference group, participants in Q2, Q3, and Q4 showed a higher risk of developing hypertension, with HRs (95% CIs) of 1.126 (1.029–1.232), 1.187 (1.083–1.302), and 1.300 (1.182–1.431), respectively (P < 0.001), after adjusting for known confounders. Sex-specific analysis showed that the adjusted HRs for participants in Q4 (reference: Q1) were greater in females [1.321 (1.100–1.586, P < 0.001)] than in males [1.268 (1.133–1.420, P < 0.001)] (P for interaction = 0.047). Moreover, interaction analysis showed that this association was consistently observed when the participants were stratified by age, body mass index, and fatty liver status.Conclusion: Among Chinese adults without metabolic syndrome, serum GGT level was positively associated with incidence of hypertension, and the association was stronger in females than in males.

Preduodenal Portal Vein Associated With Intestinal Malrotation as a Possible Cause of Intermittent Acholia.

A 2 week old girl, born at 32 weeks gestational age and birth weight 1900 g, presented with occasional acholic stools. Abdominal examination was normal. Biochemical study revealed high-serum gamma-glutamyl transferase (GGT) levels (114 U/l [normal: 11--50 U/L]), normal alkaline phosphatase (252 U/L [150--400 U/L] and normal conjugated bilirubin (0.2 mg/dL [0--0.2 mg/dL]). Doppler ultrasound showed inversion of the superior messenteric vessels and a normal biliary system. Gastrointestinal contrast study revealed intestinal malrotation (Fig. 1). Exploratory laparoscopy confirmed a nonrotation of the midgut (malrotation type 1A) (1) and a preduodenal portal vein (PPV) causing partial obstruction (Fig. 2). After a Ladd bands procedure, laparotomy was necessary to perform an end-to-end duodenojejunal anastomosis anterior to the PPV. Stools became normal after the operation, and the GGT levels decreased to 25 U/L 3 months later.FIGURE 1: Gastrointestinal transit showing a duodenum with no rotation, which remains on the right of the midline with the rest of the small intestine.FIGURE 2: Intraoperative image showing a preduodenal portal vein (blue vessel loop) compressing the duodenum.PPV is an infrequent cause of duodenal obstruction (4%) (2). Three-fourths of them have a defective situs determination. Half of children remain asymptomatic. We, however, suspect its involvement in our patient intermittent acholia. On the other hand, intestinal malrotation has an incidence of 0.2% (3) and a PPV should be considered during its operative correction (4). Duodenoduodenostomy and duodenojejunostomy are the most described surgical treatments when this vascular anomaly leads to a complete or partial blockage (5).

Evaluation of gamma glutamyl transferase enzyme level in intensive care patients with sepsis related kidney function disturbance

Objective: The aim of this study is to determine the relationship between serum gamma glutamyl transferase enzyme level and early diagnosis of acute renal injury due to sepsis in intensive care units. Material and Methods: A total of 251 subjects were included in this retrospective study. 134 patients with sepsis-induced acute kidney injury were included in group 1 and 117 healthy volunteers in group 2. Results: Serum gamma glutamyl transferase enzyme levels was found higher in patients with sepsis-induced acute renal injury than healthy volunteers. There was no significant difference between the groups according to Acute Kidney Injury Network (AKIN) staging (p=0.09). Conclusion: High serum gamma glutamyl transferase enzyme levels may be used in early detection of acute renal injury in patients with sepsis.

Atrijalna fibrilacija i gama glutamil transferaza; aortopulmonalno premošćavanje sa i bez upotrebe pumpe za vantelesnu cirkulaciju

Introduction: Atrial fibrillation (AF) which can be seen as a complication of the open-heart surgery, may cause serious problems on postoperative period. The exact pathophysiology of AF is unknown but it is thought that factors such as oxidative stress might cause AF. Material and methods: We retrospectively surveyed the serum gamma-glutamyl transferase (GGT) levels which is accepted as a mediator of oxidative stres, for the Post Operative Atrial Fibrillation (POAF) that occur after of-pump versus on-pump Coronary Artery Bypass Graft (CABG) surgery. Our study included 183 cases (101 male, 72 female; median age 63 ± 4.3 years) of which CABG was performed. Results: Echocardiography, routine blood tests, electrocardiography (ECG), test for the serum GGT levels were performed in preoperative and postoperative period to all participants. AF developed in 34 patients (35 %) in Group I and 19 patients (20 %) in Group II. There were no significant differences between two groups (of-pump versus on-pump) in terms of gender, cardiovascular risk factors and the severity of the coronary artery disease. In patients who has developed AF in postoperative period had significantly higher serum GGT levels. Conclusion: This study has shown that serum GGT levels were found to be significantly higher in patients whom AF has developed after on-pump CABG surgery.

Inflammatory Bowel Disease in Children with Elevated Serum Gamma Glutamyltransferase Levels

To assess the characteristics of inflammatory bowel disease and disease prognosis among children with elevated gamma glutamyltransferase (GGT) and primary sclerosing cholangitis (PSC)-ulcerative colitis (UC). Our longitudinal, population-based cohort comprised all children and young adults diagnosed with UC in the Canadian province of Manitoba between 2011 and 2018. Diagnosis of PSC was confirmed based on a combination of cholestatic biochemical markers and cholangiographic features. The Fisher exact test with Bonferroni correction was used to examine the relationship between categorical variables. We enrolled 95 children with UC/Inflammatory bowel disease-unclassified with a median age at diagnosis of 14years (IQR: 10.4-15.9years) and 1399 person-years follow-up. Among them, 9 children developed PSC-UC, with an incidence rate of 6.43 new cases per 1000 person-years. In this cohort, 8 (72.7%) of 11 children with high baseline serum GGT levels developed PSC-UC in comparison with 1 (1.2%) of 84 children with normal serum GGT levels at baseline (P<.001). All children with high serum GGT levels at diagnosis had pancolitis in comparison with 63.9% of children with normal serum GGT levels (P=.01). Children with high serum GGT levels were more likely to be perinuclear neutrophil antibodies-positive than those with normal levels (90.9% vs 52.0%, P=.01). Our findings indicated that pediatric patients with UC and with even mild elevations of serum GGT levels, especially at baseline, might be predisposed to develop PSC.

Evaluation of serum gamma glutamyl transferase activity among type-2 diabetic patients in Erbil

Methods: A cross-sectional study was carried out from January to June 2016 in collaboration between the Clinical Biochemistry Department at the College of Medicine, Hawler Medical University and the Chemistry Department at the Faculty of Science and Health of Koya University. The study included 50 type 2 diabetic patients (group 1), and 50 healthy individuals (group 2). Results: The mean value of serum gamma glutamyl transferase activity was significantly higher in type 2 diabetic patients (group 1) than that of healthy individuals (group 2) (P &lt;0.001). The mean value of serum gamma glutamyl transferase activity in men diabetic patients was non significantly lower than women diabetic patients. The mean value of serum gamma glutamyl transferase activity in diabetic patients whose age was ≥50 years was non significantly higher than diabetic patients whose age was &lt;50 years. Conclusion: Based on the findings of the present study, it can be concluded that high serum gamma glutamyl transferase activity is an independent factor and has considerable potential in diagnosing and monitoring for type 2 diabetic patients.

Prognostic significance of gamma-glutamyl transferase in patients with metastatic non-small cell lung cancer

ABSTRACTBackground: The prognostic significance of serum gamma-glutamyl transferase (GGT) level at diagnosis in patients with metastatic non-small lung cancer (NSCLC) is not clear. We aimed to assess the relationship between serum GGT level and overall survival (OS) and progression-free survival (PFS) in this patient population.Methods: Data of patients with metastatic NSCLC who were admitted to the medical oncology clinic of our hospital during April 2013–December 2017 were retrospectively analyzed. Patients were divided into two groups based on GGT levels, normal and high (as defined by normal reference levels), and then compared.Results: Significant differences between the high and normal GGT level groups were found regarding female sex, Eastern Cooperative Oncology Group performance score, weight loss at the time of diagnosis, and lactate dehydrogenase level (p < 0.05). The high GGT group had a shorter median OS (11.5 vs. 3.4 months, p < 0.001) and PFS (7.8 vs. 3.0 months, p = 0.001). High GGT level is an independent risk factor for OS (hazard ratio [HR] 2.270; 95% confidence interval [CI], 1.398–3.686; p < 0.001) and PFS (HR 2.489; 95% CI, 1.323–4.684; p = 0.005).Conclusions: High serum GGT level is an independent prognostic factor for OS and PFS in metastatic NSCLC patients.

Biallelic Loss-of-Function &lt;i&gt;ZFYVE19&lt;/i&gt; Mutations Are Associated with Congenital Hepatic Fibrosis, Sclerosing Cholangiopathy, and High-GGT Cholestasis

Background: For many children with intrahepatic cholestasis and high serum gamma-glutamyl transferase (GGT) activity, a genetic etiology of hepatobiliary disease remains undefined. We sought novel genes mutated in children with idiopathic high-GGT intrahepatic cholestasis and evaluated clinical, histopathologic, and functional correlations. Methods: In two cohorts of 29 children with undiagnosed high-GGT cholestasis and without clinical or imaging-study features of choledochal malformation, sclerosing cholangitis, cholelithiasis, or biliary-tract infection, we reviewed histopathologic findings; we identified mutations through whole-exome sequencing and targeted Sanger sequencing. Using immunofluorescence microscopy, we assessed the phenotypic effects of mutations in cultured fibroblast-like cells and human retinal pigmented epithelial cells. Findings: Nine Han Chinese cohort members harboured biallelic, predictedly complete-loss-of-function pathogenic mutations in ZFYVE19 (c.314C>G, p.S105X; c.379C>T, p.Q127X; c.514C>T, p.R172X; c.547C>T, p.R183X; c.226A>G, p.M76V). All had portal hypertension and histopathologic features of the ductal plate malformation/congenital hepatic fibrosis (DPM/CHF). Four required liver transplantation for recurrent gastrointestinal hemorrhage. DPM/CHF was confirmed at hepatectomy, with sclerosing small-duct cholangitis. ZFYVE19 depletion in cultured cells yielded abnormalities of centriole and axoneme. Interpretation: ZFYVE19 modulates abscission, the terminal event in cytokinesis, at the cytoplasmic-bridge midbody. The midbody and centriole subsequently migrate to the same cell-surface site and participate in ciliogenesis. In vivo, biallellic ZFYVE19 mutations can lead to high-GGT cholestasis and CHF. In vitro, they can lead to centriolar and axonemal abnormalities. We propose that mutation in ZFYVE19 results, through undefined mechanisms, in a ciliopathy. Funding Statement: Support for this study was provided by the National Natural Science Foundation of China, grant numbers 81570468 and 81873543 (to J.S.W.). Declaration of Interests: None declared. Ethical Approval Statement: The study was approved by the ethics committees of both hospitals and was in accordance with the ethical guidelines of the 1975 Declaration of Helsinki.

Higher level of GGT during mid-pregnancy is associated with increased risk of gestational diabetes mellitus.

This study was to explore the link between gamma-glutamyl transferase (GGT), alanine transaminase (ALT) and aspartate transaminase (AST) levels during early-middle pregnancy and subsequent risk of gestational diabetes mellitus (GDM). In a prospective cohort study, pregnant women enrolled prior to 16weeks of gestation were followed up until delivery. GGT, AST and ALT levels were tested during weeks 14-18 of gestation and oral glucose tolerance test was conducted during 24-28weeks to screen GDM. The GDM rate was 8.1% (122/1512). Mean GGT level was higher in GDM than non-GDM women (18.7±13.0 vs 14.5±7.0, P<.001). The higher GGT level was 26.9~74.0 U/L, which was significantly associated with increased risk of GDM. The adjusted RR (95% CI) comparing higher GGT level versus lower was 5.40 (3.36-8.68). No significant correlation was found between ALT or AST levels and the risk of GDM. The results suggest that pregnant women with higher serum GGT during early-middle pregnancy have higher risk of developing GDM. A GGT level >26.9 U/L may indicate an increased risk of developing GDM later and should be further concerned.

Association of serum gamma-glutamyltransferase and C-reactive proteins with neuromyelitis optica and multiple sclerosis

Many studies have demonstrated that serum gamma glutamyltransferase (GGT) within normal range might be an early marker of oxidative stress. However the role of GGT in neuromyelitis optica (NMO) and multiple sclerosis (MS) is unknown. We assessed the correlations among GGT and C-reactive protein (CRP) levels, as well as clinical characteristics of NMO and MS. Serum GGT and CRP levels were measured in 106 NMO patients, 87 MS patients, 79 patients with non-inflammatory neurological diseases (Parkinson disease) and 80 healthy controls (HC). Clinical parameters, blood-brain barrier (BBB) index and Delpech index of MS and NMO were also investigated. We found that NMO patients had higher serum GGT and CRP levels within their normal ranges compared to MS, PD, healthy controls. NMO patients exhibited significantly higher EDSS scores than MS patients. The BBB index in NMO patients was significantly higher than that in MS patients. Significant correlations existed between serum GGT and CRP levels and EDSS scores, BBB index in NMO and MS patients. Elevated GGT and CRP levels within their normal ranges in NMO and MS may be associated with inflammatory response, oxidative stress and BBB disturbance in the diseases. Further study into the underlying pathophysiology of this relationship is warranted.

Gamma Glutamyl Transferase Levels in Patients with Acute Coronary Syndrome: A Cross-Sectional Study

Background & Objectives: Oxidative stress is thought to play a key role in the progression of atherosclerosis. Many studies have identified Gamma glutamyl transferase (GGT) as a marker of oxidative stress and its relationship with coronary artery disease (CAD). There is limited data exploring the changes of GGT levels in acute coronary syndrome (ACS). The objective of present study was to assess the prevalence of raised GGT and its correlates in ACS patients. Methods: A cross-sectional study was performed in Intensive cardiac coronary unit of Medicine Department in tertiary care teaching hospital. All consecutive patients of ACS more than 18 years of age were included in this study. ACS was diagnosed on the basis of history, electrocardiogram and biochemical markers. All subjects underwent test for GGT by enzymatic calorimetric method. Magnitude of raised GGT in ACS was expressed in percentage. Unadjusted odds ratio (ORs) and multivariate logistic regression analysis were computed to assess the strength of association between independent variables and dependent variables. P value ≤0.05 was considered as significant. Results: We included 323 study subjects from November 2012 to October 2014. The magnitude of raised GGT among ACS was 41.80%. The magnitude of raised GGT in non ST elevated myocardial infarction (NSTEMI), ST elevated myocardial infarction (STEMI) and unstable angina (UA) was 57.32%, 37.85% and 32.81% respectively. The significant correlate of raised GGT were male sex [OR: 3.58 (95%CI: 1.88- 6.79) P=0.000] and NSTEMI as diagnosis of ACS [OR: 3.32 (95%CI: 1.51-7.30) P=0.003] in the study subjects. Interpretation & Conclusion: Gamma glutamyl transferase activity is increased in subjects with ACS. High levels of serum GGT on admission were associated with the burden of atherosclerosis in patients with ACS.