Serum γ-GTP Research Articles

Effects of the herbal medicine inchinko-to on liver function in postoperative patients with biliary atresia—a pilot study

Background/Purpose: A continuation of liver fibrosis after undergoing successful Kasai operation has become the important clinical issue in the long-term follow-up of patients with biliary atresia (BA). The aim of this study is to evaluate the efficacy of the herbal medicine Inchinko-to (TJ-135) on the treatment of liver fibrosis in patients with BA without jaundice, especially from the viewpoint of the long-term effects of TJ-135. Methods: Six postoperative patients with BA ranging between 3 and 13 years of age with normal serum total bilirubin levels (total bilirubin < 1.0 mg/dL [17 μmol/L]) received TJ-135 from 2 to 4 years. The liver enzyme (glutamic oxaloacetic transaminase [GOT], glutamic pyruvic transaminase [GPT], gamma glutamyl transpeptidase[γ-GTP]transpeptidase[γ-GTP] levels and hyaluronic acid (HA) levels were compared before and after the administration of TJ-135. The monthly collected data were averaged on a 1-year basis. The record of one postoperative patient with BA and a normal serum total bilirubin level was incorporated as a control. This patient showed portal hypertension and did not receive TJ-135. Results: Five of the six patients who showed abnormal values for liver enzymes, exhibited a significant decrease in serum GOT, γ-GTP, or GPT levels after a 1 to 3-year administration of TJ-135, and the improvement in these parameters persisted thereafter. Furthermore, one patient who had an abnormally high value of HA also showed a significant decrease in the serum level of HA. In the remaining patient with normal liver enzyme values, no significant change was observed during the administration of TJ-135. The control patient exhibited a chronological decrease in the serum GOT and GPT levels by 5 years of age, but the serum γ-GTP and HA levels remained stable throughout the postoperative period. Conclusions: The long-term effectiveness of TJ-135 was only found in those patients with abnormal liver enzyme levels and HA, thereby suggesting that TJ-135 has a protective and antifibrotic effect on the liver.

Relations of plasma high-sensitivity C-reactive protein to traditional cardiovascular risk factors

Variations of circulating C-reactive protein (CRP) levels are supposed to reflect chronic inflammatory process of the cardiovascular system. In particular, it has been reported that high-sensitivity CRP (hsCRP) is a promising marker of coronary heart disease. In the present study, we assessed the relationship between hsCRP and classic cardiovascular risk factors, such as age, blood pressure, smoking habit and serum lipids. Plasma hsCRP was measured by ELISA in 908 subjects, aged 30–79 years, who entered our health-check program. Plasma hsCRP level was 0.54±0.02 mg/l in 566 subjects without any disease currently treated. The level was significantly higher in patients treated for hypertension (0.74±0.06 mg/l, P=0.002), diabetes mellitus (0.77±0.09 mg/l, P=0.016) or coronary artery disease (0.99±0.16 mg/l, P=0.008) than in subjects without diseases. In a simple regression analyses of the 566 subjects without diseases, plasma hsCRP positively correlated with male gender, smoking, body mass index, systolic blood pressure, white blood cell count, blood hemoglobin, fasting blood glucose, serum γ-GTP, uric acid and triglycerides, and inversely correlated with serum albumin and HDL-cholesterol. In multiple regression analysis, white blood cell count ( r=0.276, P<0.001), body mass index ( r=0.246, P<0.001), age ( r=0.122, P=0.001) and smoking ( r=0.112, P=0.009) showed independent correlations with plasma hsCRP. It is suggested that variation of circulating hsCRP, even within normal range, is involved in the interrelation of cardiovascular risk factors, such as age, smoking, obesity, high blood pressure and dyslipidemia, which are supposed to promote atherosclerosis and ultimately provoke cardiovascular diseases, such as coronary artery disease.

Hepatic technetium‐99m‐mebrofenin iminodiacetate scans and serum γ‐glutamyl transpeptidase levels interpreted in series to differentiate between extrahepatic biliary atresia and neonatal hepatitis

Hepatic technetium‐99m‐mebrofenin iminodiacetate (99mTc‐mebrofenin IDA) scans and serum γ‐glutamyl transpeptidase (GGTP) have high sensitivity for extrahepatic biliary atresia (EHBA). This study was based on the hypothesis that the interpretation of results of 99mTc‐mebrofenin IDA scans and serum GGTP levels in series would result in a reduction of the false positivity observed with these tests individually. The aetiology of neonatal cholestasis in 132 study patients was: 25% (33/132) EHBA, 45.5% (60/132) neonatal hepatitis (NH) with an identifiable cause and 19.7% (26/132) idiopathic NH. Of the various clinical, biochemical and imaging parameters that were significantly different between patient groups, sensitivity for EHBA was: serum GGTP ≥ 150 IU 1−1(100%), 99mTc‐mebrofenin IDA scans (100%), pale stools (82.8%) and total serum bilirubin ≥ 12mg d1−1 (66%). However, specificity ranged from 48.5 to 79%. Of the 63 patients who had non‐excreting IDA scans, operative cholangiograms could be avoided on the basis of a specific aetiological diagnosis of NH, made concurrently, in only 9 infants. The rest (54) underwent operative cholangiograms; 21 (39%) of these had patent biliary trees and therefore underwent the procedure unnecessarily. If serum GGTP (&lt;150 IU 1−1) had been used as a screen after IDA scanning in these 54 patients, operative cholangiograms could have been avoided in another 12 patients and thereafter only 9/42 (21%) of the operative cholangiograms would have been considered unnecessary. Conclusion: A diagnostic algorithm is proposed wherein serum GGTP level (at a cut‐off level that maintains 100% sensitivity for EHBA) is used in series with non‐excreting 99mTc‐mebrofenin IDA scans (for patients with no specific aetiological label). This strategy reduces the false positivity of individual tests.

A type 2 diabetic patient with liver dysfunction due to human insulin

A 45-year-old man had been complaining of thirst and polydypsia for the last 3 months and was diagnosed as having type 2 diabetes mellitus because his fasting blood glucose showed 221 mg/dl with positive urinary ketone. He was hospitalized to a private hospital and Penfil 30R® was started. However, serum γ-GTP and aminotransferases began to elevate after insulin treatment and exceeded 1000 IU/l. Insulin was discontinued and serum γ-GTP and aminotransferases returned close to the normal range. Since his glycemic control became poor again, Penfil 30R® was restarted and serum γ-GTP and aminotransferases elevated again. Therefore, insulin was discontinued and the patient was referred to the Third Department of Internal Medicine, Yamanashi Medical University Hospital because of liver dysfunction. His plasma glucose decreased by diet therapy, and improved further by the administration of glibenclamide. After obtaining informed consent, Humalin R® was challenged. Seven days after insulin injection, serum aminotransferases began to elevate again. Lymphocyte stimulation test was negative against three preparations (Penfil R®, Penfil N® and Humalin R®). The present case suggests that human insulin itself can cause liver dysfunction and we need to pay more attention to liver function tests when we start insulin treatment.

E211 健康診断におけるGOT、GPT、γ-GTPと諸検査項目との関連性 : II. GPT、GOT/GTP比と諸検査項目との関係

E211 健康診断におけるGOT、GPT、γ-GTPと諸検査項目との関連性 : II. GPT、GOT/GTP比と諸検査項目との関係

E212 健康診断におけるGOT、GPT、γ-GTPと諸検査項目との関連性 : III. GOT、GPT、γ-GTPと血圧との関係

E212 健康診断におけるGOT、GPT、γ-GTPと諸検査項目との関連性 : III. GOT、GPT、γ-GTPと血圧との関係

E210 健康診断におけるGOT、GPT、γ-GTPと諸検査項目との関連性 : I. 重回帰分析による検討

E210 健康診断におけるGOT、GPT、γ-GTPと諸検査項目との関連性 : I. 重回帰分析による検討

Beneficial effect of ursodeoxycholic acid on serum gamma-GTP in patients with biliary atresia following living related liver transplantation.

Beneficial effect of ursodeoxycholic acid on serum gamma-GTP in patients with biliary atresia following living related liver transplantation.

Taurine attenuates the serum γ-GTP-decreasing effect of ursodeoxycholic acid in chronic hepatitis patients

The effect of concomitant administration of taurine (Taurine Powder, 3 g day −1) and ursodeoxycholic acid (UDCA) (Urso, 600 mg day −1) on the results of liver function tests was investigated in chronic hepatitis C patients. The mean ALT, ALP, γ-GTP, and total bile acid (TBA) values during the 3 months before UDCA and/or taurine administration and the 3 months after the start of the administration were compared in each patient. The results showed that ALT and γ-GTP improved 25 and 34%, respectively, and TBA increased 115% in the 32 patients treated with UDCA alone. This increase in TBA is thought to reflect UDCA-induced enlargement of the bile acid pool in the enterohepatic circulation. γ-GTP did not improve in the four patients simultaneously given taurine and UDCA. In addition, when taurine was administrated to nine patients treated with UDCA for more than 6 months, γ-GTP increased 16% and TBA decreased 22%, and the sequential changes in γ-GTP and TBA levels were mirror images of each other. No marked changes in γ-GTP or TBA were noted in the seven patients treated with taurine alone. These findings indicate that taurine attenuates the effect of UDCA in decreasing serum γ-GTP levels, probably because of the reduced bile acid pool size.

Dual Effects of Bezafibrate on Lipid Metabolism and Hepatobiliary Enzymes

We encountered a patient with Sjogren’s syndrome showing high levels of serum alkaline phosphatase (ALP) and gamma glutamyl transpeptidase (γ-GTP) whose hepatobiliary function was considerably improved by treatment with bezafibrate. In order to clarify the mechanism by which bezafibrate decreases these hepatobiliary enzymes, 400mg of this drug was administered daily to 26 patients with hyperlipidaemia for 7 months, and biochemical and haematological parameters were determined. Serum ALP decreased significantly (p < 0.001) from the baseline level of 174.5 IU/L to 116.7 IU/L (−26.5%), and γ-GTP from 64.4 IU/L to 34.4 IU/L (−29.5%). Other biochemical and haematological parameters remained unchanged. We compared bezafibrate-induced changes in serum lipids with those in serum ALP and γ-GTP. There was a slight correlation between γ-GTP and triglyceride levels, but not between ALP and total cholesterol, triglycerides or high density lipoprotein cholesterol. A close correlation was observed between ALP and γ-GTP (r = 0.81, p < 0.001).

Pruritus in chronic hepatitis C: association with high serum bile acids, advanced pathology, and bile duct abnormalities.

Pruritus is a common symptom of chronic cholestatic liver diseases but is considered rare in chronic hepatitis. We observed pruritus to be an unusually common complaint in patients with advanced chronic hepatitis C. We reviewed the records of 175 chronic hepatitis C patients to identify patients with severe, diffuse, unexplained pruritus; 12 consecutive prospective patients undergoing liver biopsy for chronic hepatitis C served as controls. Assessment included laboratory biochemical tests and assessment of liver pathology by stage, grade, hepatic activity index, and a bile duct score. Pruritus was present in nine (5.1%) patients. Serum AST, ALT, alkaline phosphatase, GGTP, total bilirubin, and ferritin were similar in pruritics and controls. Pruritics had higher serum bile acids (2028.4 +/- 223.1 mmol/liter vs 423.1 +/- 194.3, P < 0.001), higher transferrin saturation (57.5 +/- 6.8% vs 33.2 +/- 3.3, P < 0.01), and lower HCV RNA by bDNA (24.5 +/- 12.7 x 10(5) vs 172.7 +/- 54.1 x 10(5), P < 0.05). Pathology revealed cirrhosis in 6/9 (66.6%) pruritics vs 1/12 (8.3%) controls (P < 0.01). Pruritics had higher pathologic stage (3.7 +/- 0.2 vs 2.2 +/- 0.4, P < 0.01), grade (4.4 +/- 0.2 vs 2.1 +/- 0.2, P < 0.001), activity index (14.3 +/- 1.9 vs 8.6 +/- 1.9, P < 0.025), and bile duct score (7.6 +/- 0.6 vs 4.7 +/- 0.4, P < 0.01). Of eight pruritics treated with IFN-alpha2b, two had complete ALT response and one relapsed. Pruritus followed a relapsing course and only three patients partially responded despite a variety of interventions. In conclusion, pruritus is a common complication of advanced CHC. Its presence is associated with high serum bile acids, advanced pathology and bile duct abnormalities. The clinical course of pruritus is relapsing and response to therapy is inconsistent. These features suggest that pruritus in CHC has a pathogenesis that may vary from that of chronic cholestatic diseases.

46 HYPERAMINOACIDEMIA AND INTRAHEPATIC CHOLESTASIS IN INFANTS FOUND BY NEONATAL METABOLIC SCREENING.

Increased serum concentrations of tyrosine (Tyr) and methionine (Met) have been reported in cases of neonatal hepatitis (NH). We analyzed serum amino acid profile in infants with intrahepatic cholestasis, and found interesting findings in some patients. [Methods] Seven infants with intrahepatic cholestasis who had abnormalities of serum amino acid profile detected by neonatal metabolic screening (NH-I) were biochemicaly and histologically analyzed, and compared with nine patients with idiopathic NH (NH-II). [Results] 1) NH-I had increased serum levels of Tyr, Met, threonine (Thr), citrulline (Cit), and arginine (Arg). Serum Cit levels elevated more than ten-folds over the upper normal limit (5.0-17.5 mg/dl), but blood ammonium levels were within normal ranges. 2) Met, Thr, Cit and Arg levels in NH-I were significantly higher than those of NH-II (p<0.01). 3) Serum GGTP and total bile acids significantly greater than those of NH-II (p<0.01). 4) Liver histology showed macrovesicular fat deposits with cholestasis in all NH-I patients. 5) Abnormal aminograms persisted for a couple of months, improving spontaneously prior to the disappearance of cholestasis. [Conclusion] The pathogenesis in INH-I patients might be due to immaturity of hepatic enzyme activities related to amino acid metabolism in the neonatal period.

Physiological Correlates of Neonatal Mortality in an Overpopulated Herd of White-Tailed Deer

We examined the relationship of development, immunocompetence, and tick burdens to neonatal mortality in an overpopulated herd of white-tailed deer ( Odocoileus virginianus ) during 1990–1992 in northeastern Oklahoma. Risk of mortality to 21 days of age was inversely related to body mass, body mass/length3, delayed hypersensitivity to phytohem-agglutinin, and serum concentrations of gamma globulin and gamma-glutamyl transferase (GGTP) for young ≤3days old. Serum GGTP and gamma-globulin concentrations were the most significant predictors of mortality to 21 days of age using multivariate-logistic regression. Increased probability of mortality was associated with lower serum gamma globulin and concentrations of GGTP, which suggested that inadequate absorption of colostrum leads to a partial failure in the passive process of transferring immunity from mother to offspring, and predisposes young to mortality agents among high-density herds.

健診成績からみた精神薄弱者の健康状況

The purpose of this study is to evaluate health state of mentally retarded persons (MR) using health examination data and to discuss on preventive methods for chronic adult diseases among them. 338 adult MR accommodated in institutions were studied in physical and blood examinations and the results were compared with those of 7, 732 public officials. The result were as follows; 1) MR had lower abnormality rates of health examinations as compared with a general population. It may be due to relatively good control of life style among MR in institutions. 2) Young females of MR had higher abnormality rates of body weight, and serum total cholesterol, GOT, GPT, and γ-GTP, as compared with a general population. 3) Long term medication of neuroleptics may have adverse effects on liver function among MR. 4) Establishment of MR specific health care system for chronic adult diseases is necessary.

Serum γ‐Glutamyl Transpeptidase Levels and Hypertension in Non‐drinkers: A Possible Role of Fatty Liver in the Pathogenesis of Obesity Related Hypertension

The relationships between increases in body mass index (BMI) and increases in hypertension were compared between non-drinkers with elevated serum gamma-glutamyl transpeptidase (gamma-GTP) levels (> or = 50 U/l) and those with normal levels, who comprised 10,952 men and 22,107 women aged 40-59 years recruited from an occupational health clinic. Hypertension was found in 16.1% and 13.5% of the men and women, and elevated serum g-GTP was found in 10.8% and 2.8% of the men and women, respectively. The prevalences of hypertension and elevated serum gamma-GTP levels were both increased with increased BMI. Hypertension was, however, shown to be 1.5 times more prevalent in the persons with elevated serum gamma-GTP levels than in those with normal levels in both sexes, even after adjusting for BMI by a multiple logistic analysis. It can be concluded that elevations of serum gamma-GTP, which are probably a reflection of fatty liver in the non-drinkers, are closely related to the development of hypertension associated with increased obesity.

Serum .GAMMA.-Glutamyl Transpeptidase Level and Daily Physical Activity.

Drinking habits and health are very important topics (Imura .et al., 1988; Morimoto et al., 1988). Bando et al. (1988) reported the results of a series of investigations conducted on this subject at the Japanese Association of Rural Medicine. They stated that serum γ-glutamyl transpeptidase (γ-GTP) activity is one of the most useful biochemical indices for an objective evaluation of the consumption of alcoholic beverages (Rosalki and Rau, 1972). On the other hand, there is rapidly rising interest in athletic activities such as jogging and the marathon. It is believed to be worthwhile in the field of sports medicine as well as for daily health management to establish the range of variation of serum γ-GTP activity levels in healthy individuals who engage in these athletic activities. Studies have been conducted on the relationship between physical activities and serum enzyme activity. However most of these studies were conducted on male adults, and female adults were rarely selected as subjects. Furthermore the subjects in many studies were athletes who engaged in intense physical activity and the data were obtained before and after the athletic activity (Krauss et al., 1977; Lewis et al., 1976). In this study, three types of tests were conducted to evaluate the relationship between serum γ-GTP level and physical activity; survey on energy expenditure, a shortterm exercise test, and a 6-week exercise program.

Fall and Rise Variations of Serum GGTP in Preoperative Infants with Biliary Atresia

Fall and Rise Variations of Serum GGTP in Preoperative Infants with Biliary Atresia

Fall and Rise Variations of Serum GGTP in Preoperative Infants with Biliary Atresia

Fall and Rise Variations of Serum GGTP in Preoperative Infants with Biliary Atresia

Relationship between serum .GAMMA.-glutamyl transpeptidase fraction pattern and the pattern of food intake.

The effects of the food intake pattern on the activity and fraction pattern of serum γ-glutamyl transpeptidase (γ-GTP) were examined in 257 healthy Japanese men.Applying the technique of factor analysis to the food intake data, the following three factors were extracted. The first factor (F1): meats, eggs, and vegetables had a highly positive factor loading. The second factor (F2): wheat had a highly positive factor loading, while rice had a highly negative factor loading. This factor was considered to be a “wheat versus rice factor”. The third factor (F3) could not be explained simply in terms of its factor. The scores of the first two factors for the 257 subjects were calculated.Significantly negative correlations were observed between the percentage of GT1 fraction and the factor score of F1 (r=-0.230, p<0.01), between the percentage of GT1 fraction and the factor score of F2 (r=-0.187, p<0.01). The total serum γ-GTP activity was not correlated with the factor score. These results suggested that the percentage of GT1 fraction is influenced by the pattern of food intake.

Control of alcohol addiction by SKV therapy — Its action on water, food intake, brain function and cell membrane composition

Alcohol being easily permeable through cell membrane causes toxic damage to many tissues. Rats drinking aqueous ethanol (25% v/v) for 120 days and 240 days showed an initial rise in body weight. The reduced rate in weight gain in chronic alcoholism is associated with a fall in food intake. Ethanol ingesting animals showed slow response to stimuli and increase in blood ethanol and serum GGTP levels. Liver plasma membrane, kidney brush-border membrane and pancreatic plasma membrane from alcoholic rats showed significant alterations in cholesterol/phospholipid molar ratio and membrane ATPases. Water retention with the enlargement of liver and kidney associated with increased fluid consumption are also seen during alcoholism. SKV by breaking alcohol dependence reduces drinking, lowers blood ethanol level and fluid intake without developing withdrawal symptoms. Restriction of ethanol intake by SKV therapy resulted in the reversal of organ enlargement and membrane composition in alcoholics.