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1.
Mymensingh Med J ; 31(3): 614-621, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35780341

RESUMO

Obesity is a worldwide health concern due to its rising tendency both in developing and developed countries. Obesity is known to be associated with a number of disorders including type 2 diabetes mellitus, hypertension and cardiovascular diseases. Gamma glutamyl transferase (GGT) is synthesized in liver. GGT is considered as an oxidative stress marker. Serum GGT is increased in patients with cardiovascular diseases and diabetes mellitus (DM). Impaired fasting glucose (IFG) is a risk factor for cardiovascular diseases. The aim of this study was to find out the association of obesity and serum GGT with IFG. This cross-sectional analytical study was conducted in the Biochemistry department of Sir Salimullah Medical College, Dhaka from March 2018 to February 2019. The ages of the subjects were 25-55 years. The study subjects were 120 and were divided into two groups. The groups were Normal fasting glucose (NFG) group and IFG group according to WHO diagnostic criteria. Body mass index (BMI) was used as a measure of general obesity and waist circumference (WC) and waist-hip ratio (WHR) were used as measures of abdominal or central obesity. OGTT was performed from collected blood. GGT and lipid profile were measured from serum. In IFG group, BMI, WC, WHR and GGT levels were significantly elevated (p<0.01) than NFG group i.e. BMI (22.70±1.35 vs. 28.37±2.33kg/m²), WC (79.96±5.31 vs. 93.42±4.21cm), WHR (0.92±0.06 vs. 0.97±0.07), and GGT (24.19±8.41 vs. 67.23±14.40U/L). Fasting Plasma Glucose (FPG) level were significantly higher (p<0.01) in obese group than over weight and normal BMI groups 4.70±0.08, 5.30±1.3 and 6.50±0.3 respectively. FPG were higher in male and female obese group than normal WC group (4.8±1.1 vs. 6.3±0.60mmol/L) and (4.4±0.7 vs. 6.2±0.80mmol/L). Odds Ratio (OR) and (95% CI) for IFG were 6.53 and 21.0 with BMI tertile 2(23.1- 27.5kg/m²) and tertile 3(≥27.5kg/m²) where T1 (<23.0kg/m²) was considered as reference category. OR for IFG were 4.1 and 20.25 with GGT tertile 2(24.0-42.0) U/L and tertile 3(>42.0) U/L where T1 (<24.0) U/L was considered as reference category. Multiple regression analysis shows positive correlation of FPG with BMI, WC, WHR and GGT.


Assuntos
Glicemia , Obesidade , gama-Glutamiltransferase , Adulto , Bangladesh/epidemiologia , Glicemia/análise , Doenças Cardiovasculares , Estudos Transversais , Diabetes Mellitus Tipo 2 , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Centros de Atenção Terciária , gama-Glutamiltransferase/sangue
2.
Eur Rev Med Pharmacol Sci ; 26(11): 3958-3966, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35731066

RESUMO

OBJECTIVE: 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. PATIENTS AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.


Assuntos
Asma , gama-Glutamiltransferase/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Asiáticos , Asma/epidemiologia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Fatores de Risco , Adulto Jovem
3.
BMJ Open ; 12(5): e058793, 2022 05 30.
Artigo em Inglês | MEDLINE | ID: mdl-35636797

RESUMO

OBJECTIVES: Several studies have demonstrated the association between gamma-glutamyl transferase (GGT) and hyperuricaemia, but little is known about such relation in less-developed ethnic minority regions. DESIGN: We cross-sectionally analysed data from the China Multi-Ethnic Cohort (Yunnan region). SETTING: Cross-sectional study. PARTICIPANTS: 22 020 participants aged 30-79 years from Han ethnicity, Yi ethnicity and Bai ethnicity. OUTCOMES: The serum level of uric acid, GGT and other metabolic parameters were tested. Weight, height and blood pressure were measured. Smoking, drinking, ethnicity, education and medical history were obtained from questionnaires. RESULTS: In the crude model, compared with the lowest quintile, the second, third, fourth and fifth quintiles of serum GGT exhibited a positive association with hyperuricaemia risk (OR=1.69, 2.90, 4.34 and 7.70, 95% CI=1.42 to 2.01, 2.47 to 3.42, 3.71 to 5.09 and 6.60 to 8.98, respectively, p-trend<0.0001). In fully adjusted model, compared with the lowest quintile, the second, third, fourth and fifth quintiles of serum GGT also exhibited a positive association with hyperuricaemia risk (OR=1.26, 1.68, 2.02 and 3.02, 95% CI=1.04 to 1.51, 1.40 to 2.00, 1.69 to 2.42 and 2.51 to 3.64, respectively, p-trend<0.0001). Logistic regression model was conducted separately in ethnic groups. Compared with first quintile, the highest GGT level were related to higher risk of hyperuricaemia in three ethnic groups (OR (95% CI): 2.89 (2.26 to 3.68), 2.81 (1.93 to 4.11) and 3.04 (1.91 to 4.84) for Han, Yi and Bai ethnicity, respectively, p-trend <0.0001). The relationship between GGT and hyperuricaemia was also observed in different age groups or gender groups. CONCLUSIONS: High serum GGT level was related to a higher risk of hyperuricaemia in less-developed ethnic minority regions in China.


Assuntos
Hiperuricemia , gama-Glutamiltransferase , China/epidemiologia , Estudos Transversais , Etnicidade , Humanos , Hiperuricemia/epidemiologia , Grupos Minoritários , gama-Glutamiltransferase/sangue
4.
BMC Endocr Disord ; 22(1): 49, 2022 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-35216556

RESUMO

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) has become the most common causes of liver disease in children and adolescents. Although several reports have confirmed the significant correlation between NAFLD and growth hormone (GH)-insulin-like growth factor 1(IGF-1) axis, no study further investigates whether or not recombinant human GH (rhGH) treatment can improve NAFLD in obese children. METHODS: This study was a randomized, open-label study comprising 44 boys with obesity and NAFLD (11.76 ± 1.67 year) to evaluate the effects of 6 months of rhGH administration for boys with obesity and NAFLD. The subjects were randomized divided into treatment group (subjects with recombinant human GH (rhGH)) and control group for 6 months. RESULTS: After 6 months, IGF-1 increased significantly during rhGH treatment, in comparison with the control group (582.45 ± 133.00 vs. 359.64 ± 129.00 ng/ml; p < 0.001). A significant reduction in serum alanine aminotransferase(ALT) (15.00 vs. 28.00 U/L; p = 0.001), aspartate aminotransferase(AST) (20.00 vs. 24.50U/L; p = 0.004), gamma glutamyl transferase(GGT) (14.50 vs. 28.50 U/L; p < 0.001) was observed in the GH-treated boys. In addition, the rhGH group showed a significant decrease in C reactive protein (CRP) (1.17 ± 0.76 vs. 2.26 ± 1.43 mg/L) and body mass index standard deviation scores (BMI SDS) (2.28 ± 0.80 vs. 2.71 ± 0.61) than the control group (p = 0.003, p = 0.049 respectively). GH treatment also reduced low density lipoprotein cholesterol (LDL-C) (2.19 ± 0.42 vs. 2.61 ± 0.66 mmol/L; p = 0.016) and increased high density lipoprotein cholesterol (HDL-C) (1.30 vs. 1.15 mmol/L; p = 0.005), and there were no changes in total cholesterol (TC), triglycerides (TG) and uric acid(UA) between the treatment group and the control group. CONCLUSION: Our findings suggest that 6 months treatment with rhGH may be beneficial for liver enzyme and can improve obesity-related other cardiovascular and metabolic complications in boys with obesity and NAFLD.


Assuntos
Fatores de Risco Cardiometabólico , Hormônio do Crescimento Humano/administração & dosagem , Fígado/enzimologia , Hepatopatia Gordurosa não Alcoólica/tratamento farmacológico , Obesidade Pediátrica/complicações , Adolescente , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Proteína C-Reativa/análise , Criança , Hemoglobina A Glicada/análise , Hormônio do Crescimento Humano/sangue , Humanos , Fator de Crescimento Insulin-Like I/análise , Fígado/diagnóstico por imagem , Fígado/efeitos dos fármacos , Masculino , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/complicações , Obesidade Pediátrica/sangue , Proteínas Recombinantes/administração & dosagem , gama-Glutamiltransferase/sangue
5.
Sci Rep ; 12(1): 1711, 2022 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-35110625

RESUMO

Dyslipidemia, a major contributor to cardiovascular diseases, is rapidly increasing in Asian countries including Bangladesh. In addition to the cardiovascular system, abnormal lipid levels are also known to cause complications in renal and hepatic systems. The data regarding dyslipidemia and its relationship with liver enzymes are scarce for the Bangladeshi population. Therefore, this study was conducted to estimate the prevalence of dyslipidemia and determine the relationship between lipid profile and liver enzymes in Bangladeshi adults. A total of 405 participants (318 males and 87 females) were enrolled in the study. Serum levels of TG, TC, LDL, HDL and liver enzymes including ALT, AST, GGT and ALP were analyzed using standard methods. Dyslipidemia and liver function tests abnormalities were defined according to the international standard guidelines. The association between elevated lipid profile markers and liver enzyme abnormalities was assessed by logistic regression analysis. Overall, the prevalence of elevated TG, TC, LDL and low HDL were 30.9%, 23.7%, 26.2% and 78.8%, respectively. On the other hand, the prevalence of elevated liver enzymes ALT, AST, GGT and ALP were 18.8%, 21.6%, 12.9% and 21.9%, respectively. Dyslipidemia and liver enzyme abnormalities were higher in diabetic and hypertensive participants than in the healthy participants. About 61% of participants with dyslipidemia had at least one or more elevated liver enzymes. In regression analysis, an independent association was observed between serum GGT and all lipid components. In conclusion, a high prevalence of dyslipidemia and liver enzyme abnormalities were observed among the study participants. Of the four liver enzymes, the serum levels of GGT showed an independent association with all lipid components. Moreover, this study indicates that subjects with dyslipidemia often have a higher chance of having liver diseases than subjects with no dyslipidemia. However, large-scale prospective studies are needed to understand the underlying mechanisms of lipid-induced hepatic dysfunction in the Bangladeshi population.


Assuntos
Dislipidemias/sangue , Enzimas/sangue , Lipídeos/sangue , Hepatopatias/sangue , Adulto , Alanina Transaminase/sangue , Fosfatase Alcalina/sangue , Aspartato Aminotransferases/sangue , Bangladesh/epidemiologia , Biomarcadores/sangue , Ensaios Enzimáticos Clínicos , Estudos Transversais , Dislipidemias/diagnóstico , Dislipidemias/epidemiologia , Feminino , Humanos , Hepatopatias/diagnóstico , Hepatopatias/epidemiologia , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Prevalência , Medição de Risco , Fatores de Risco , Regulação para Cima , gama-Glutamiltransferase/sangue
6.
Sci Rep ; 12(1): 2625, 2022 02 16.
Artigo em Inglês | MEDLINE | ID: mdl-35173187

RESUMO

Excessive alcohol consumption has been associated with different components of the metabolic syndrome (MetS) such as arterial hypertension, dyslipidemia, type 2 diabetes or obesity. We aimed to analyze the prevalence and associations of MetS in patients with Alcohol Use Disorder (AUD). Cross-sectional study in heavy drinkers admitted for the treatment of AUD between 2013 and 2017. Medical comorbidity, anthropometric data, alcohol use and biological parameters were obtained. MetS was established according to the harmonized definition. A total of 728 patients (22% women) were included; median age was 47 years (IQR: 40-53.5), median alcohol consumption was 160 g/day (IQR: 115-240) and prevalence of MetS was 13.9%. The multivariate analysis showed a significant dose-response effect of estimated glomerular filtration (eGFR) and MetS: relative to patients with eGFR > 90 mL/min, those with eGFR (60-90 mL/min) and those with eGFR < 60 mL/min were 1.93 times (95% CI 1.18-3.15) and 5.61 times (95% CI 1.66-19.0) more likely to have MetS, respectively. MetS was significantly associated with hyperuricemia (OR 2.28, 95% CI 1.36-3.82) and elevated serum GGT (OR 3.67, 95% CI 1.80-7.46). Furthermore, for every increase of 1 year in age, the probability of MetS increased significantly (OR 1.03, 95% CI 1.01-1.05). MetS in heavy drinkers is independently associated with reduced kidney function and metabolic risk factors including hyperuricemia and elevated serum GGT.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Alcoolismo/complicações , Alcoolismo/epidemiologia , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Adulto , Fatores Etários , Alcoolismo/sangue , Alcoolismo/fisiopatologia , Comorbidade , Feminino , Taxa de Filtração Glomerular , Humanos , Hiperuricemia/epidemiologia , Hiperuricemia/etiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , gama-Glutamiltransferase/sangue
7.
Medicine (Baltimore) ; 101(1): e28443, 2022 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-35029891

RESUMO

ABSTRACT: Gamma-glutamyl transferase (GGT) is a marker of oxidative stress and cholestasis. Because of its low specificity, clinicians usually ignore its diagnostic value.To compare and analyze the clinical features of GGT in primary biliary cholangitis (PBC), drug-induced liver injury (DILI), alcoholic liver disease (ALD), and non-alcoholic fatty liver disease (NAFLD) from the perspective of different causes instead of the severity of the disease.We observed the distribution characteristics and the rate of abnormality of GGT in the above 4 diseases. The relationship between GGT and alanine aminotransferase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), total serum bilirubin, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol was analyzed using Spearman correlation.The highest level of GGT was up to 1000.00 to 2000.00 U/L in PBC and DILI, and the highest level of GGT was more than 2000.00 U/L in ALD, yet the difference was not statistically significant (P > .05). The highest level of GGT was only about 200.00 U/L in NAFLD and was the lowest in 4 liver diseases. Also, GGT was positively correlated with ALP, TC in PBC and DILI. Also, in ALD, GGT was positively correlated with ALT, AST, ALP, TG, and TC. In NAFLD, GGT was positively correlated with ALT, AST, and TG.The abnormal GGT in PBC and cholestasis DILI was associated with cholestasis; in ALD, it was associated with oxidative stress and cholestasis, and in NAFLD, it was associated with oxidative stress. GGT levels had different characteristics in different liver diseases, which were closely related to the pathogenesis of liver diseases.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas , Cirrose Hepática Biliar , Hepatopatias Alcoólicas , Fígado/patologia , Hepatopatia Gordurosa não Alcoólica , gama-Glutamiltransferase/sangue , Idoso , Biomarcadores/sangue , Doença Hepática Induzida por Substâncias e Drogas/sangue , Doença Hepática Induzida por Substâncias e Drogas/patologia , Colestase/patologia , Feminino , Humanos , Cirrose Hepática Biliar/sangue , Cirrose Hepática Biliar/patologia , Hepatopatias Alcoólicas/sangue , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/patologia , Prognóstico
8.
Lancet Gastroenterol Hepatol ; 7(3): 245-253, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34998471

RESUMO

BACKGROUND: Camrelizumab, an anti-PD-1 antibody, has shown moderate efficacy in oesophageal squamous cell carcinoma. Apatinib, a selective inhibitor of VEGFR2, has a synergistic effect with immunotherapy. We aimed to assess the combination of camrelizumab and apatinib as second-line treatment for advanced oesophageal squamous cell carcinoma. METHODS: This single-arm, open-label, phase 2 study was conducted at eight centres in China. Eligible patients were aged 18-75 years, with an Eastern Cooperative Oncology Group performance status of 0 or 1, who had unresectable locally advanced, locally recurrent, or metastatic oesophageal squamous cell carcinoma, and had progressed after or were intolerant to first-line chemotherapy. Patients received intravenous camrelizumab 200 mg once every 2 weeks plus oral apatinib 250 mg once daily for a 28-day cycle until disease progression, unacceptable adverse events, or withdrawal of consent. The primary endpoint was investigator-assessed confirmed objective response rate. Efficacy was analysed in patients who had received at least one dose of study drug, and safety was analysed in patients who received the study drug and had at least one post-baseline safety assessment. The study of this cohort is complete and this trial is registered with ClinicalTrials.gov, number NCT03736863. FINDINGS: Between Dec 5, 2019, and Feb 10, 2021, 52 patients were enrolled and included in analyses. At data cutoff (June 20, 2021), median follow-up was 7·5 months (IQR 4·0-11·2). 18 (34·6%, [95% CI 22·0-49·1]) of 52 patients had a confirmed objective response. 23 (44%) of 52 patients had grade 3 or worse treatment-related adverse events. The most common grade 3 or worse treatment-related adverse events were increased aspartate aminotransferase (10 [19%]), increased gamma-glutamyltransferase (10 [19%]), and increased alanine aminotransferase (five [10%]). No treatment-related deaths occurred. INTERPRETATION: Camrelizumab combined with apatinib showed promising activity and manageable toxicity, and might be a potential second-line treatment option for patients with advanced oesophageal squamous cell carcinoma. Another cohort of this study, enrolling patients previously treated with first-line immunotherapy, is ongoing. FUNDING: Jiangsu Hengrui Pharmaceuticals.


Assuntos
Anticorpos Monoclonais Humanizados/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Esofágicas/tratamento farmacológico , Carcinoma de Células Escamosas do Esôfago/tratamento farmacológico , Piridinas/administração & dosagem , Idoso , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago/mortalidade , Carcinoma de Células Escamosas do Esôfago/patologia , Feminino , Humanos , Masculino , Intervalo Livre de Progressão , gama-Glutamiltransferase/sangue
9.
Eur J Clin Invest ; 52(4): e13720, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34817878

RESUMO

INTRODUCTION: Serum gamma-glutamyl transferase activity (GGT) seems to predict cardiovascular events in different populations. However, no data exist on patients with congenital heart disease (CHD). METHODS: Observational, analytic, prospective cohort study design involving CHD patients and a control population to determine the effect of GGT levels on survival. RESULTS: A total of 589 CHD patients (58% males, 29 ± 14 years old) and 2745 matched control patients were followed up. A total of 69 (12%) CHD patients had a major acute cardiovascular event (MACE) during the follow-up time (6.1 [0.7-10.4] years). Patients with CHD and a GGT >60 U/L were significantly older, more hypertensive and dyslipidemic, had a worse NYHA functional class and a greater anatomical complexity than CHD patients with a GGT ≤60 U/L. The binary logistic regression analysis showed that age, a great CHD anatomical complexity, and having atrial fibrillation/flutter were the predictive factors of higher GGT levels (>60 U/L). The Kaplan-Meier analysis showed that patients with CHD and a GGT concentration above 60 UL showed the lowest probability of survival compared to that of CHD with GGT ≤60 U/L and controls irrespective of their GGT concentrations (p < .001). Similarly, the multivariable Cox regression analysis found an independent association between higher GGT levels (>60 U/L) and a worse prognosis (HR 2.44 [1.34-4.44], p = .003) among patients with CHD. CONCLUSION: Patients with CHD showed significant higher GGT levels than patients in the control group having those with higher GGT concentrations (>60 U/L) the worst survival.


Assuntos
Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/etiologia , Cardiopatias Congênitas/sangue , Cardiopatias Congênitas/complicações , gama-Glutamiltransferase/sangue , Adolescente , Adulto , Estudos de Coortes , Feminino , Humanos , Masculino , Estudos Prospectivos , Adulto Jovem
10.
Gastroenterol Hepatol ; 45(1): 47-58, 2022 Jan.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34029644

RESUMO

INTRODUCTION: Correctly identifying patients with biliary atresia (BA), while avoiding invasive diagnostic methods is challenging. The purpose of this study was to determine the value of serum immune indicators for distinguishing BA from other causes of cholestasis in infants. PATIENTS AND METHODS: The data of infants with a surgical/histological diagnosis of BA and those with other causes of cholestatic jaundice were retrospectively analyzed. Patients were divided into a BA group and a cholestasis control (CC) group. Biochemical parameters, major lymphocyte subsets, immunoglobin and C3 and C4 complement levels were compared between the groups. RESULTS: A total of 129 infants with BA and 63 with other causes of cholestasis (CC control group) with a median age of 2.2 months were included in the analysis. The levels of CD3+ T cells, CD3+CD4+ T cells, and premature T cells and the levels of C3 and C4 were all significantly higher in the BA group compared to the CC group (all P<0.05). Pair-wise correlation analyses indicated that C3 and C4 had a significant positive correlation with γ-GT in the BA group, but not in the CC group. Five indices were found to be significantly associated with BA: stool color, globulin, γ-GT, C3 and C4. A model incorporating stool color, gamma-glutamyl transpeptidase level, and C3 level exhibited an area under the ROC curve (AUC) of 0.93, and a sensitivity of 93% and specificity of 83% for the diagnosis of BA. CONCLUSIONS: Models incorporating serum C3 levels may be useful for accurately diagnosing BA in infants.


Assuntos
Atresia Biliar/sangue , Atresia Biliar/diagnóstico , Complemento C3/análise , Área Sob a Curva , Atresia Biliar/complicações , Complemento C4/análise , Feminino , Humanos , Imunoglobulinas/sangue , Lactente , Icterícia Obstrutiva/etiologia , Subpopulações de Linfócitos , Masculino , Estudos Retrospectivos , Sensibilidade e Especificidade , gama-Glutamiltransferase/sangue
11.
J Clin Pharmacol ; 62(1): 110-117, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34415063

RESUMO

The discovery of new biomarkers and the causality of drug-induced liver injury (DILI) is a major focus in modern medicine. Alcoholism is considered a risk factor for DILI. However, the extraction and assessment of alcohol history are difficult due to noncooperation by patients and intermittent management. Therefore, we conducted a case-control study of 1277 patients diagnosed with DILI according to the Roussel Uclaf Causality Assessment Method scale to evaluate gamma-glutamyl transferase (GGT) as a biomarker for predicting DILI in Vietnamese patients, where the proportion of alcoholism is quite high. Further, we built and validated a logistic regression model to predict the risk of DILI in hospitalized patients. The risk of DILI increased by 10% for 1 UI/L higher levels of GGT before prescription (odds ratio [OR], 1.01; 95% confidence interval [CI], 1.00-1.01). A history of alcoholism was not a risk factor for DILI occurrence (OR, 1.83; 95%CI, 0.99-3.04; P = .057). A logistic regression model was successfully built and validated based on age; sex; initial levels of alanine aminotransferase, alkaline phosphatate, GGT, likelihood score of the suspected drug, and history of liver disease; the area under the receiver operating characteristic curve of the model was 0.883 (95%CI, 0.868-0.897). Our results thus suggest the necessity of exercising caution when prescribing to patients without a history of alcoholism but having high GGT levels. This model can be applied clinically to assess the risk of DILI before prescribing to reduce the risk of DILI in the patient.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas/diagnóstico , Doença Hepática Induzida por Substâncias e Drogas/patologia , gama-Glutamiltransferase/sangue , Adulto , Fatores Etários , Idoso , Biomarcadores , Causalidade , Diagnóstico Precoce , Feminino , Humanos , Hepatopatias Alcoólicas/diagnóstico , Hepatopatias Alcoólicas/patologia , Testes de Função Hepática , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Curva ROC , Fatores de Risco , Fatores Sexuais , Vietnã
12.
Basic Clin Pharmacol Toxicol ; 130(1): 182-190, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34591374

RESUMO

BACKGROUND: The aim of this study was to evaluate the quantitative relation between common clinical chemical analyses and ethanol use, measured by a combination of the two alcohol markers phosphatidylethanol (PEth) and carbohydrate-deficient transferrin (CDT). METHODS: Results of PEth and CDT in whole blood and serum, respectively, were included, together with information on 10 different commonly measured clinical chemical analytes, as well as age and sex. PEth was analysed by UPC2 -MS/MS and CDT was measured by capillary electrophoresis. RESULTS: Samples from 4873 patients were included. The strongest relation to alcohol consumption as measured by PEth, when correcting for age and sex, was found for HDL-C (standardized ß = 0.472, p < 0.001), AST (standardized ß = 0.372, p < 0.001), ferritin (standardized ß = 0.332, p < 0.001) and GGT (standardized ß = 0.325, p < 0.001). The relation to PEth was weak for total cholesterol, TG and ALP. No relation was found for Hb and LDL-C. CONCLUSIONS: When using PEth as a marker for alcohol consumption, this study demonstrated the quantitative relation to commonly used test as AST or GGT, but also an important relation to ferritin or HDL-C. In clinical practice, elevated levels of these clinical chemical analytes should initiate further work-up on possibly harmful alcohol use.


Assuntos
Consumo de Bebidas Alcoólicas/sangue , Glicerofosfolipídeos/sangue , Transferrina/análogos & derivados , Adulto , Consumo de Bebidas Alcoólicas/metabolismo , Aspartato Aminotransferases/sangue , Biomarcadores/sangue , HDL-Colesterol/sangue , Feminino , Ferritinas/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Espectrometria de Massas em Tandem , Transferrina/metabolismo , gama-Glutamiltransferase/sangue
13.
Ann Hepatol ; 27(1): 100544, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34571267

RESUMO

INTRODUCTION AND OBJECTIVES: Evaluation of liver fibrosis is important for treatment decisions, complications and to predict prognosis in patients with chronic hepatitis B (CHB). Our aim was to develop a new non-invasive fibrosis scoring method and prove its accuracy in the differentiation of no/low grade and advanced fibrosis in patients with CHB. PATIENTS AND METHODS: Our study included 273 chronic hepatitis B patients who underwent liver biopsy from February, 2007 to February, 2019 with medical records retrospectively reviewed. Preparations of these patients were divided into two groups as ≤ 3 no-low grade fibrosis (n=236) and ≥ 4 advanced fibrosis (n=37) according to histological ISHAK fibrosis scoring system. RESULTS: The newly developed AGAP score and other non-invasive fibrosis scores; Fibrosis-4 index, Aspartate aminotransferase to platelets ratio, Gamma glutamyl transpeptidase to platelet ratio, Goteborg University Cirrhosis Index, King's score, Albumin-bilirubin index, Fibrosis cirrhosis index, Fibrosis index, Fibrosis quotient, Lok score and mean and/or median values of Fibroindex were significantly higher in the advanced fibrosis group compared to the no/low grade fibrosis group (p<0.001). However, there was no significant difference in AAR score among the groups (p=0.265). With cut-off value of 4.038, AUROC value of 0.803, sensitivity of 75.7%, specificity of 73.7% and accuracy of 0.740, AGAP score showed the best performance in advanced fibrosis differentiation compared to 12 other non-invasive fibrosis scoring methods. CONCLUSIONS: The newly developed AGAP score showed better performance in patients with CHB compared to 12 other non-invasive fibrosis scores in differentiation of no/low grade fibrosis and advanced fibrosis.


Assuntos
Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Hepatite B Crônica/complicações , Cirrose Hepática/diagnóstico , Fígado/patologia , gama-Glutamiltransferase/sangue , Biomarcadores/sangue , Biópsia , Feminino , Seguimentos , Hepatite B Crônica/sangue , Hepatite B Crônica/diagnóstico , Humanos , Cirrose Hepática/sangue , Cirrose Hepática/etiologia , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas , Prognóstico , Curva ROC , Estudos Retrospectivos , Índice de Gravidade de Doença
14.
Equine Vet J ; 54(1): 39-51, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33555643

RESUMO

BACKGROUND: High-serum γ-Glutamyl Transferase (GGT) activity has been associated with and thought to be a marker of maladaptation to training and possibly poor performance in racehorses, but the cause is unknown. OBJECTIVES: To investigate possible metabolic and infectious causes for the high GGT syndrome. STUDY DESIGN: Pilot case-control study and nested case-control study. METHODS: The case-control study in 2017 included 16 horses (8 cases and 8 controls with median [range] serum GGT 82 [74-148] and 22 [19-28] IU/L, respectively) from the same stable. In 2018, similar testing was performed in a nested case-control study that identified 27 case (serum GGT 50 ≥ IU/L)-control pairs from three stables for further testing. Serum liver chemistries, selenium measurements, viral PCR and metabolomics were performed. RESULTS: No differences were found in frequency of detection of viral RNA/DNA or copy numbers for equine hepacivirus (EqHV) and parvovirus-hepatitis (EqPV-H) between cases and controls. Mild increases in hepatocellular injury and cholestatic markers in case vs control horses suggested a degree of liver disease in a subset of cases. Metabolomic and individual bile acid testing showed differences in cases compared with controls, including increased abundance of pyroglutamic acid and taurine-conjugated bile acids, and reduced abundance of Vitamin B6. Selenium concentrations, although within or above the reference intervals, were also lower in case horses in both studies. MAIN LIMITATIONS: Observational study design did not allow us to make causal inferences. CONCLUSIONS: We conclude that high GGT syndrome is likely a complex metabolic disorder and that viral hepatitis was not identified as a cause for this syndrome in this cohort of racehorses. Our results support a contribution of oxidative stress and cholestasis in its pathophysiology.


Assuntos
Doenças dos Cavalos , Infecções por Parvoviridae , gama-Glutamiltransferase/sangue , Animais , Estudos de Casos e Controles , Doenças dos Cavalos/sangue , Doenças dos Cavalos/virologia , Cavalos , Infecções por Parvoviridae/veterinária , Parvovirus
15.
Biomed Res Int ; 2021: 2365399, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34853788

RESUMO

BACKGROUND: Nowadays, metabolic syndrome (MetS) has become a great public health crisis that threatens too many lives worldwide. Many previous studies have been investigated the association between MetS and anthropometric indices. This study is aimed at investigating the association between anthropometric indices with gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST). We were using data from a large population-based cohort of seemingly healthy women and men. METHODS: A total of 7216 participants were included in this study. The serum levels of GGT, ALP, ALT, and AST with bioimpedance measures were obtained at the time of enrollment. Multiple regression analysis was performed to assess the relationship between anthropometric indices and serum levels of the aforementioned laboratory tests. RESULTS: Serum levels of GGT, ALP, ALT, and AST significantly correlated with body mass index (BMI). Only ALP had a significant association with visceral fat area (VFA). AST, ALT, and ALP levels had a positive correlation with 50 kHz whole-body phase. CONCLUSION: From the findings of this study, body mass index consistently appeared a good predictor of elevated hepatic enzymes and triglycerides. Thus, it can be helpful in clinical settings to identify patients at risk of nonalcoholic fatty liver disease, which is closely related to metabolic syndrome.


Assuntos
Alanina Transaminase/sangue , Fosfatase Alcalina/sangue , Antropometria , Aspartato Aminotransferases/sangue , Síndrome Metabólica/sangue , gama-Glutamiltransferase/sangue , Adulto , Idoso , Biomarcadores/sangue , Índice de Massa Corporal , Cardiografia de Impedância , Estudos de Coortes , Feminino , Humanos , Modelos Lineares , Masculino , Síndrome Metabólica/etiologia , Síndrome Metabólica/patologia , Pessoa de Meia-Idade , Análise Multivariada
16.
Comput Math Methods Med ; 2021: 9809990, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34845414

RESUMO

BACKGROUND: Liver inflammation indices reflect its inflammatory microenvironment, which may play a role in the proliferation, invasion, and migration of carcinoma. This study is aimed at exploring the prognostic significance of serum lactate dehydrogenase (LDH) levels and gamma-glutamyl transferase (GGT)/alanine aminotransferase (ALT) ratio in hepatocellular carcinoma after liver transplant (LT). METHODS: We retrospectively analyzed data from 155 patients with a pathologically confirmed diagnosis of hepatocellular carcinoma who received LT between January 2013 and September 2017. We used receiver operating characteristics (ROC) curves to determine the optimal LDH and GGT/ALT ratio cut-off values. The Kaplan-Meier method and the logarithmic rank test were used to compare the survival curves without recurrence (RFS) and overall survival (OS). Univariate and multivariate analyses were used to identify factors associated with survival. RESULTS: Serum LDH levels were significantly associated with the Child-Pugh score (P = 0.037), largest tumor size (<50 vs. ≥50 mm) (P = 0.017), tumor count (<3 vs. ≥3) (P = 0.009), microvascular invasion (P = 0.006), and the Milan criteria (P ≤ 0.001). The serum GGT/ALT ratio was significantly correlated with alpha-fetoprotein (AFP) levels (of <400 vs. ≥400 ng/ml) (P ≤ 0.001), largest tumor size (of <50 vs. ≥50 mm) (P ≤ 0.001), the Edmondson grade (I-II vs. III-IV) (P = 0.028), microvascular invasion (P ≤ 0.001), and the Milan (P = 0.002) and Hangzhou criteria (P = 0.018). The survival curves showed that the patients with high LDH and the GGT/ALT ratio were associated with poor RFS and OS (P < 0.05). Univariate and multivariate analyses showed that AFP levels of ≥400 ng/ml, largest tumor size of ≥50 mm, microvascular invasion, LDH levels of ≥213.5 U/l, and the GGT/ALT ratio of ≥3.1338 were factors independently associated with RFS. CONCLUSION: Elevated LDH levels and the GGT/ALT ratio before LT were associated with poor OS and RFS in the present study. These factors could be used in the prognostication of patients with hepatocellular carcinoma undergoing LT.


Assuntos
Alanina Transaminase/sangue , Biomarcadores Tumorais/sangue , Carcinoma Hepatocelular/sangue , Carcinoma Hepatocelular/cirurgia , L-Lactato Desidrogenase/sangue , Neoplasias Hepáticas/sangue , Neoplasias Hepáticas/cirurgia , Transplante de Fígado , gama-Glutamiltransferase/sangue , Adulto , Biologia Computacional , Intervalo Livre de Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Estudos Retrospectivos , Fatores de Risco
17.
BMC Cancer ; 21(1): 1117, 2021 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-34663242

RESUMO

BACKGROUND: Preoperative serum gamma-glutamyl transferase (γ-GT) levels is significantly related to the prognosis of hepatocellular carcinoma (HCC), but its clinical value in the management of postoperative adjuvant transarterial chemoembolization (PA-TACE) has rarely been explored. This study aimed to investigate whether γ-GT levels could be taken as a biomarker to guide the management of PA-TACE in resectable HCC. METHODS: HCC patients receiving radical resection were identified through the primary liver cancer big data (PLCBD) from December 2012 to December 2015. Prognostic factors of overall survival (OS) and disease-free survival (DFS) were identified by univariate and multivariate cox analyses, and subgroup analysis was conducted between PA-TACE group and non-TACE stratified by γ-GT levels before and after 1:1 propensity score matching (PSM). RESULTS: γ-GT level was found to be an independent risk factor of OS and DFS in 1847 HCC patients receiving radical resection (both P < 0.05), and patients with elevated γ-GT(> 54.0 U/L) have a shortened median OS and DFS, compared with those with normal γ-GT (both P < 0.001). In the subgroup of patients with normal γ-GT, there were no significant differences between groups of PA-TACE and non-TACE in terms of median OS and DFS before and after PSM (all P > 0.05), and PA-TACE was not a significant prognostic factor of both OS and DFS before and after PSM (all P > 0.05). In the subgroup of patients with elevated γ-GT, significant differences were found between groups of PA-TACE and non-TACE in terms of median OS and DFS before and after PSM (all P < 0.05), and PA-TACE was an independent prognostic factor of both OS and DFS (all P < 0.05). CONCLUSION: Currently, we concluded that patients with more advanced HCC also have more elevated γ-GT, and these patients with elevated γ-GT would be benefited more from PA-TACE after radical resection.


Assuntos
Biomarcadores Tumorais/sangue , Carcinoma Hepatocelular/enzimologia , Quimioembolização Terapêutica/métodos , Neoplasias Hepáticas/enzimologia , gama-Glutamiltransferase/sangue , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/terapia , Intervalo Livre de Doença , Feminino , Humanos , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/terapia , Masculino , Pessoa de Meia-Idade , Cuidados Pós-Operatórios/métodos , Período Pré-Operatório , Pontuação de Propensão , Modelos de Riscos Proporcionais , Fatores de Risco
18.
Ann Hepatol ; 26: 100562, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34653686

RESUMO

INTRODUCTION AND OBJECTIVE: To determine the prevalence of elevated liver enzyme levels and the fatty liver index according to specific sociodemographic, clinical, anthropometric, and metabolic risk factors in Mexican adult population. MATERIAL AND METHODS: The present analysis was conducted using data from the Mexican National Health and Nutrition Survey 2016. For the present study, 3,490 adults with complete information on liver enzymes, sociodemographic, lifestyle, and metabolic factors were analyzed. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) levels were determined from blood samples. We computed the fatty liver Index (FLI), as a surrogate marker of non-alcoholic fatty liver disease. The associations are reported as adjusted odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: At the national level, the prevalence of high serum levels of ALT, AST, and GGT were 7.9%, 13.5, and 12.9 respectively. We observed that men had higher prevalences of altered ALT, GGT and FLI compared to women. Additionally, we observe that individuals with obesity, metabolic syndrome and insulin resistance are significantly more likely to present elevated concentrations of AST, ALT, GGT and FLI. Finally, we found that the subjects of the lowest socioeconomic level and indigenous population were more likely to present elevated levels of AST, ALT, GGT, and FLI. CONCLUSION: In Mexico, non-alcoholic fatty liver disease affect people with obesity, diabetes, and metabolic syndrome as well as men, subjects of low socioeconomic status, subjects who live in rural areas and indigenous population. Interventions to reduce this condition should be a public health priority.


Assuntos
Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Fígado/patologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Inquéritos Nutricionais , Medição de Risco/métodos , Adulto , Idoso , Feminino , Seguimentos , Humanos , Fígado/metabolismo , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/enzimologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem , gama-Glutamiltransferase/sangue
19.
Mymensingh Med J ; 30(4): 973-979, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605465

RESUMO

Impaired fasting glucose (IFG) is an important risk factor for overt diabetes. Gamma glutamyl transferase (GGT) is an oxidative stress maker that is synthesized in liver. Increased serum Uric Acid (UA) may reflect systemic inflammation and oxidative stress. Insulin secretion by pancreatic ß cells is impaired due to oxidative stress. Serum GGT and UA levels are elevated in patients with diabetes or cardiovascular disease. The aim of this study was to explore the relationship between serum GGT and UA with IFG. This cross-sectional study was conducted on 120 subjects aged 25-55 years. The study subjects were divided into two groups with either Normal fasting glucose (NFG) or IFG according to WHO diagnostic criteria. Blood was collected to perform OGTT. Serum was separated to measure GGT, UA and lipid profile. GGT and UA levels were significantly higher (p<0.01) in IFG group than NFG group (67.23±14.40 vs. 24.19±8.41) and (7.61±1.31 vs. 4.84±1.27). Odds Ratio (OR) for IFG were 4.1 and 20.25 with GGT tertile 2 (24.0-42.0) U/L and tertile 3 (>42.0) U/L where T1 (<24.0) U/L was considered as reference category. Odds Ratio (OR) for IFG were 2.05 and 17.69 with UA tertile 2 (5.7-7.5)mg/dl and tertile 3(>7.5) mg/dl where T1 (<5.7)mg/dl was considered as reference category. Multiple regression analysis of the relation between Fasting plasma glucose (FPG) with serum GGT and UA by adjustment of other factors revealed that IFG was significantly (p<0.01) associated with serum GGT and UA.


Assuntos
Ácido Úrico/sangue , gama-Glutamiltransferase/sangue , Adulto , Bangladesh/epidemiologia , Glicemia , Estudos Transversais , Jejum , Hospitais , Humanos
20.
BMC Pharmacol Toxicol ; 22(1): 63, 2021 10 25.
Artigo em Inglês | MEDLINE | ID: mdl-34696815

RESUMO

PURPOSE: In clinical practice, the risk factors for pegylated liposomal doxorubicin-related hand-foot syndrome remain unclear. The purpose of this study was to determine the risk factors associated with hand-foot syndrome in patients with lymphoma using pegylated liposomal doxorubicin. METHODS: This retrospective descriptive analysis included patients with lymphoma who received PLD treatment (≥ 2 cycles of chemotherapy) at our cancer centre and had complete follow-up data from January 2016 to February 2020. Clinical, laboratory data, as well as the occurrence of hand-foot syndrome (incidence, location, severity, impact on follow-up chemotherapy) were obtained. The primary end point was the incidence of hand-foot syndrome, which was classified according to the "Common Terminology Criteria for Adverse Events" (Version 4.0). A multivariate logistic regression analysis was used to identify risk factors for hand-foot syndrome in patients with lymphoma using doxorubicin liposomes. FINDINGS: A total of 167 patients met the inclusion criteria. 58 developed HFS, of which 45 occurred after the second course of chemotherapy. The multivariate logistic regression analysis revealed that a dose increase of pegylated liposomal doxorubicin and hepatobiliary dysfunction were significantly associated with an increased risk for hand-foot syndrome(dose intensity, OR = 6.479; 95% CI, 1.431-29.331 [P = 0.015]; history of gallstones, OR = 14.144, 95% CI, 1.512-132.346 [P = 0.020]; alanine aminotransferase, OR = 1.194, 95% CI, 1.056-1.350 [P = 0.005]; aspartate aminotransferase, OR = 1.162, 95% CI, 1.010-1.336 [P = 0.035]; and glutamine transpeptidase, OR = 1.092, 95% CI, 1.016-1.174 [P = 0.018]). IMPLICATIONS: These findings contribute to the risk assessment of patients with lymphoma before using pegylated liposomal doxorubicin. For patients with the above risk factors, preventive measures should be taken in advance to reduce the incidence of HFS.


Assuntos
Antibióticos Antineoplásicos/efeitos adversos , Doxorrubicina/análogos & derivados , Síndrome Mão-Pé , Linfoma/tratamento farmacológico , Alanina Transaminase/sangue , Antibióticos Antineoplásicos/administração & dosagem , Aspartato Aminotransferases/sangue , Relação Dose-Resposta a Droga , Doxorrubicina/administração & dosagem , Doxorrubicina/efeitos adversos , Feminino , Cálculos Biliares , Humanos , Masculino , Pessoa de Meia-Idade , Polietilenoglicóis/administração & dosagem , Polietilenoglicóis/efeitos adversos , Estudos Retrospectivos , Fatores de Risco , gama-Glutamiltransferase/sangue
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