Gamma-glutamyl transferase 5 overexpression in cerebrovascular endothelial cells improves brain pathology,cognition,and behavior in APP/PS1 mice

In patients with Alzheimer’s disease,gamma-glutamyl transferase 5(GGT5)expression has been observed to be downregulated in cerebrovascular endothelial cells.However,the functional role of GGT5 in the development of Alzheimer’s disease remains unclear.This study aimed to explore the effect of GGT5 on cognitive function and brain pathology in an APP/PS1 mouse model of Alzheimer’s disease,as well as the underlying mechanism.We observed a significant reduction in GGT5 expression in two in vitro models of Alzheimer’s disease(Aβ_(1-42)-treated hCMEC/D3 and bEnd.3 cells),as well as in the APP/PS1 mouse model.Additionally,injection of APP/PS1 mice with an adeno-associated virus encoding GGT5 enhanced hippocampal synaptic plasticity and mitigated cognitive deficits.Interestingly,increasing GGT5 expression in cerebrovascular endothelial cells reduced levels of both soluble and insoluble amyloid-βin the brains of APP/PS1 mice.This effect may be attributable to inhibition of the expression ofβ-site APP cleaving enzyme 1,which is mediated by nuclear factor-kappa B.Our findings demonstrate that GGT5 expression in cerebrovascular endothelial cells is inversely associated with Alzheimer’s disease pathogenesis,and that GGT5 upregulation mitigates cognitive deficits in APP/PS1 mice.These findings suggest that GGT5 expression in cerebrovascular endothelial cells is a potential therapeutic target and biomarker for Alzheimer’s disease.

Serum Gamma-glutamyl Transferase Levels Predict Functional Outcomes after Aneurysmal Subarachnoid Hemorrhage

Objective We aim to explore the potential association between serum gamma-glutamyl transferase levels and functional outcome after aneurysmal subarachnoid hemorrhage in a Chinese population. Methods A total of 386 aneurysmal subarachnoid hemorrhage patients were included in the study from September 2007 to February 2015. Baseline serum gamma-glutamyl transferase levels and 6-month follow-up functional outcomes were determined. A poor outcome was defined as a modified ranking scale score of ≥ 3. The multivariable logistic model was used to analyze the relationship between serum gamma-glutamyl transferase and clinical outcomes after aneurysmal subarachnoid hemorrhage. Results The adjusted poor outcome rates of patients with gamma-glutamyl transferase levels of 〈 30 U/L, 30-50 U/L and ≥ 50 U/L were 16.7%, 19.6%, and 34.4%, respectively （P 〈 0.01）. The age-sex and multivariable adjusted odds ratios （95% confidence intervals） of poor prognosis comparing the top group （≥ 50 U/L） with the lowest group （〈 30 U/L） were 5.76 （2.74-12.13）, 6.64 （2.05-21.52）, and 6.36 （1.92-21.02）. A significant linear trend existed between gamma-glutamyl transferase level and aneurysmal subarachnoid hemorrhage prognosis. This association was also observed among nondrinkers. Conclusion Patients with higher gamma-glutamyl transferase levels were more likely to have a poor prognosis. Serum gamma-glutamyl transferase can be considered to be an independent predictor of functional outcomes after aneurysmal subarachnoid hemorrhage.

Association of serum gamma-glutamyl transferase with treatment outcome in chronic hepatitis B patients

AIM:To investigate the association of serum gammaglutamyl transferase(GGT) levels with chronic hepatitis B infection and hepatitis B e antigen(HBe Ag) seroconversion.METHODS:A retrospective study was performed on clinical data collected from patients who had been positive for hepatitis B surface antigen for > 6 mo and who were antiviral-treatment na?ve(n = 215) attending the Hepatitis Clinic at Nanjing Drum Tower Hospital between August 2010 and December 2013. Healthy individuals without liver disease(n = 83) were included as controls. Patients were categorized into four groups based on disease status as recommended by the European Association for the Study of the Liver:immune tolerance(IT; n = 47),HBe Ag-positive hepatitis(EPH; n = 93),HBe Ag-negative hepatitis(ENH;n = 20),and inactive carrier(IC; n = 55). Prediction of complete response(CR) based on serum GGT was also examined in EPH patients(n = 33) treated for 48 wk with nucleos(t)ide analogue(NA) therapy,including lamivudine plus adefovir combination therapy(n = 20) or entecavir monotherapy(n = 13). CR was defined as a serum hepatitis B virus DNA level < 500 copies/m L and HBe Ag seroconversion by 48 wk of treatment. RESULTS:Serum GGT levels were significantly increased in EPH and ENH patients relative to the IT,IC,and healthy control groups(P < 0.01 for all). However,no significant difference in serum GGT levels was found between the EPH and ENH groups. Baseline serum GGT levels were significantly higher in patients who achieved CR(7/33; 21.2%) compared to patients in the non-CR group(26/33; 78.8%; P = 0.011). In addition,the decline in serum GGT was greater in CR patients compared to non-CR patients after 24 wk and 48 wk of treatment(P = 0.012 and P = 0.008,respectively). The receiver operating characteristic curve yielded a sensitivity of 85.71% and a specificity of 61.54% at a threshold value of 0.89 times the upper limit of normal for baseline serum GGT in the prediction of CR following NA therapy. CONCLUSION:Serum GGT is significantly elevated in EPH and ENH patients and is a potential biomarker for the prediction of HBe Ag seroconversion following NA therapy.

Effect of <i>Lactobacillus brevis</i>SBC8803 on Gamma-Glutamyl Transferase in Japanese Habitual Drinkers: A Double-Blind, Placebo-Controlled Study

A randomized, double-blind, placebo-controlled clinical trial in Japanese habitual drinkers was conducted to evaluate the efficacy of Lactobacillus brevis SBC8803 to alleviate adverse effect of alcohol. Subjects who drank habitually and had moderately higher levels of gamma-glutamyl transferase (GGT) (50 - 100 IU/L) were enrolled. The levels of transaminases in these subjects were almost within normal levels (aspartate transaminase (AST) <30 IU/L and alanine transaminase (ALT) <40 IU/L). Either the capsules containing placebo (n = 23) or 130 mg (4.0 × 1010 colony-forming units) of live L. brevis SBC8803 (n = 22) per day were administered for the continuous eight weeks (56 days). During the period, the subjects both in test group and placebo groups have kept each drinking behavior as usual. Regarding lipid metabolism, triacylglycerol (TG) levels in the male test group significantly decreased at week 4 as compared with week 0. Biomarkers of hepatocytes-damage;AST and ALT levels showed no significant differences between the pla- cebo and test groups at both weeks 4 and 8. Oxidative stress marker;GGT at weeks 4 was significantly lower in the test group than that in the placebo group (p = 0.017), but not at weeks 8. However, taking a reduced rate of GGT at weeks 8 comparing with that at week 0, that in the test group showed larger value comparing with that in the placebo group. These data about TG and GGT suggest that, although efficacy of L. brevis SBC8803 is limited in this study, intake of the probiotic may alleviate alcoholic influence in lipid metabolism and oxidative stress.

The Micro-determination of Serum Gamma-Glutamyl Transferase

The method of serum gamma-glutamyl transferase colorimeter assay was modified by changing the wave length from 420 nm to 400 nm, the incubated temperature from 37℃ to 50℃, the sample amount from 30 μl to 6μl. The modified method was proved to be more sensitive, with CV of intra-group being 2. 06% and accuracy 97. 4%. The method is suitable for clinical application with small-amount blood samples collected frorri earlobe or finger tip.

Oxidative stress-elevated high gamma glutamyl transferase levels, and aging, intake of tropical food plants, migration and visual disability in Central Africans

·AIM:To investigate the independent pathogenic role of high serum gamma-glutamyl transferase (GGT) levels, sociodemographic data, dietary and environmental risk factors for visual disability (VD). ·METHODS:This was a case-control study, run in 200 black Congolese patients managed in Saint Joseph Hospital Ophthalmology Division from Kinshasa town. Logistic regression model was used to identify determinants of VD (n = 58) among sex, age, cigarette smoking, alcohol abuse, rural-urban migration, education levels, aging ≥60 years, intake of red Beans, Safou fruit and Taro leaves, lipid profile, residence, socioeconomic status, and GGT. ·RESULTS:After adjusting for confounding factors, we identified migration (OR=3.7 95% CI:1.2-11.3; P =0.023), low education level (OR=3.1 95% CI 1.1-8.5; P =0.026), no intake of Safou fruit (OR=34.2 95% CI 11.5-102; P < 0.0001), age ≥60 years (OR=2.5 95% CI 1.01-6.5; P = 0.049), and serum GGT ≥10U/L (OR=3.6 95% CI 1.3-9.6; P = 0.012) as the significant and independent determinants of VD. ·CONCLUSION:VD appears as a major public health problem in Central Africa to be prevented or delayed by control of migration, lifestyle changes, antioxidant supplements, appropriate diet, nutrition education, and blocking of oxidative stress.

基于术前血清学指标AFP和GGT的标准在预测肝细胞癌患者肝移植术后长期生存中的作用研究

目的分析术前血清学指标对肝细胞癌(HCC)患者肝移植术后长期生存和肿瘤复发的预测作用,探索其对扩大米兰标准的意义。方法回顾性分析669例HCC肝移植受者的临床资料,采用受试者工作特征(ROC)曲线计算最佳截取值,采用单因素和多因素回归分析影响HCC患者肝移植术后总生存率和无复发生存率的危险因素,分析术前血清肝酶与肿瘤病理学特征的相关性,比较甲胎蛋白(AFP)联合γ-谷氨酰转移酶(GGT)以及不同肝移植标准对HCC患者肝移植术后生存和复发的预测价值。结果超米兰标准、肿瘤直径之和(TTD)>8 cm、AFP>200 ng/mL和GGT>84 U/L是影响HCC患者肝移植术后总生存率和无复发生存率的独立危险因素(均为P<0.05)。相关性分析结果显示,术前血清GGT水平与TTD,肿瘤数量,静脉侵犯,微卫星病变,包膜侵犯,肿瘤、淋巴结、转移(TNM)分期,Child-Pugh评分,超米兰标准均存在相关性(均为P<0.05)。将米兰标准、TTD与血清肝酶指标(AFP和GGT)结合,提出Milan-AFP-GGT-TTD(M-AGT)标准。符合M-AGT标准者(其中111例超米兰标准)术后5年总生存率和无复发生存率均高于符合杭州标准者(均为P<0.05),与符合加州大学旧金山分校(UCSF)标准者的术后5年总生存率和无复发生存率比较差异均无统计学意义(均为P>0.05)。结论术前血清学指标AFP和GGT可有效预测HCC患者肝移植术后长期生存和肿瘤复发,建立基于血清学指标的M-AGT标准有助于补充米兰标准,且简单易行。

血清GGT及其高分子形式定量检测的临床意义

对68例原发性肝癌、136例肝外胆道梗阻和其他肝病、以及30名健康献血员,采用聚丙烯酰胺凝胶梯度电泳分离高分了γ-谷氨酰移换酶区带(HM-GGT),并进行定量检测。结果表明各肝胆疾病组GGT总活力及HM-GGT均有不同程度升高(肝外胆道梗阻》原发性肝癌》肝内胆汁郁积≥急、慢性肝炎≥肝硬化)。资料显示:(1)GGT升高是肝胆受累的灵敏指标,GGT正常几可除外肝病;(2)GGT>350u/L,HM-GGT>35u/L,H/T≥30%一般仅见于肝外胆道梗阻,有别于肝内胆汁郁积及其他肝病。但无助于肝外良恶性胆道梗阻的鉴别。

血清Lp-PLA2 GGT与冠心病及冠状动脉病变严重程度的相关性分析

目的分析血清脂蛋白相关磷脂酶A2(Lp-PLA2)、γ-谷氨酰转移酶(GGT)与冠心病(CHD)及冠状动脉病变严重程度的相关性。方法选择2018-06~2019-06于郑州大学第二附属医院心内科首次就诊的170例疑似CHD患者的临床资料,根据冠状动脉造影检查结果分为CHD组(103例)和非CHD组(67例)。检测患者血清Lp-PLA2、GGT水平,分析血清Lp-PLA2、GGT与CHD及冠状动脉病变严重程度的关系。结果CHD组Lp-PLA2、GGT、甘油三酯(TG)、低密度脂蛋白(LDL)、Gensin积分水平以及合并高血压、糖尿病人数比例显著高于非CHD组(P<0.05),而高密度脂蛋白(HDL)水平显著低于非CHD组(P<0.05)。Spearman相关分析结果显示,CHD患者血清Lp-PLA2、GGT水平与冠状动脉病变支数呈正相关(rs=0.681,P=0.000;rs=0.603,P=0.000)。Pearson相关分析结果显示,CHD患者血清Lp-PLA2、GGT水平与Gensin积分呈正相关(r=0.799,P=0.000;r=0.621,P=0.000)。多因素logistic分析结果显示,较高水平的Lp-PLA_(2)、GGT和LDL,以及合并高血压是促进CHD发生的危险因素(P<0.05);而较高水平的HDL是抑制CHD发生的保护因素(P<0.05)。结论较高水平的血清Lp-PLA2、GGT是促进CHD发生的危险因素,可较好地反映冠状动脉病变严重程度,可作为评估CHD发生、进展的可靠指标。

注射用益气复脉(冻干)联合芪苈强心胶囊治疗酒精性心肌病疗效观察及对GGT、IGF-1、VEGF的影响

目的:观察酒精性心肌病(ACM)患者在临床应用注射用益气复脉(冻干)联合芪苈强心胶囊治疗对患者γ谷氨酰转移酶(GGT)、胰岛素样生长因子-1(IGF-1)、血管内皮生长因子(VEGF)影响。方法:将酒精性心肌病患者76例随机分为2组,观察组使用注射用益气复脉(冻干)联合芪苈强心胶囊进行治疗,对照组单纯使用芪苈强心胶囊治疗,观察记录治疗前及治疗2周后的治疗疗效、心电图指标变化、6 min步行试验及GGT、IGF-1、VEGF的变化。结果:治疗后,观察组总有效率为76.3%,对照组为52.6%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组脑钠肽(BNP)表达量下降,6 min步行试验及左室射血分数(LVEF)均提高,差异有统计学意义(P<0.05),治疗后,观察组上述指标改善优于对照组,差异有统计学意义(P<0.05)。与治疗前比较,2组治疗后GGT、IGF-1及VEGF含量均下降(P<0.05)。与对照组治疗后比较,观察组下降程度更大,差异有统计学意义(P<0.05)。结论:与单纯使用芪苈强心胶囊相比,联合注射用益气复脉(冻干)进行治疗,疗效更显著,心电图指标变化更明显,且可以降低患者血清中GGT、IGF-1、VEGF的含量。

射血分数保留的心力衰竭患者血清TSP-2、γ-GGT水平与心功能及心血管事件的关系

目的探讨射血分数保留的心力衰竭(HFpEF)患者血清血小板吸附蛋白2 (TSP-2)、γ-谷氨酰转移酶(γ-GGT)水平与心功能及心血管事件的关系。方法选择2017年1月至2019年1月延安大学咸阳医院心内科收治的80例HFpEF患者(HFpEF组)和50例门诊体检的健康志愿者(对照组)作为研究对象。采用酶联免疫吸附试验检测两组受检者的血清TSP-2、γ-GGT和B型利钠肽原(BNP)水平,超声心动图和三维斑点追踪技术检测两组受检者的左室射血分数(LVEF)、左心室整体应变(LVGS)、左心室纵向峰值应变(LVGLS)、圆周峰值应变(LVGCS)、径向峰值应变(LVGRS);采用Pearson相关性分析TSP-2、γ-GGT与患者血清BNP水平、LVEF、LVGS、LVGLS、LVGCS、LVGRS的相关性。以HFpEF组血清TSP-2、γ-GGT水平的均值为界,将患者分为高TSP-2水平组、低TSP-2水平组、高γ-GGT水平组、低γ-GGT水平组,Kaplan-Meier生存曲线分析TSP-2、γ-GGT水平与HFpEF患者心血管事件的关系。结果 HFpEF组患者的血清TSP-2、γ-GGT、BNP水平分别为(23.09±5.13) ng/mL、(36.65±6.12) U/L、(256.32±71.46) pg/mL,明显高于对照组的(14.15±2.21) ng/mL、(26.32±3.06) U/L、(22.25±12.65) pg/mL,差异均有统计学意义(P<0.05);HFpEF组患者的LVGS、LVGLS、LVGCS、LVGRS分别为(30.21±4.19)%、(16.34±3.26)%、(24.35±4.59)%、(39.23±5.46)%,明显低于对照组的(36.24±6.12)%、(22.34±2.46)%、(27.46±3.46)%、(44.25±6.15)%,差异均有统计学意义(P<0.05);相关性分析结果显示,TSP-2、γ-GGT与HFpEF患者血清BNP水平均呈正相关(r=0.563、0.505,P<0.05),与LVGS、LVGLS呈负相关(r=-0.473、-0.482;-0.591、-0.564,P<0.05);Kaplan-Meier生存曲线分析结果显示,高TSP-2组和高γ-GGT组患者的心血管事件发生率分别为31.37%、32.65%,明显高于低TSP-2组、低γ-GGT组患者的6.90%、6.45%,差异均有统计学意义(Log Rank2=4.857、5.618,P<0.05)。结论 HFpEF患者血清TSP-2、γ-GGT水平明显升高,高水平TSP-2、γ-GGT与HFpEF患者心功能下降和不良心血管事件的发生有关。

Diagnostic and monitoring values of circulating AFPmRNA and HS-GGT for hepatocellular carcinoma

Objective: Early finding of hepatocellular carcinoma(HCC) and monitoring of its metastasis are of the utmost importance. The objectives of this study were to investigate the values of circulating hepatoma-specific gamma-glutamyl transferase(HS-GGT) fraction and α-fetoprotein mRNA(AFP-mRNA) from peripheral blood mononuclear cells(PBMCs) in diagnosis or monitoring metastasis of HCC. Methods: Total RNA was extracted from hepatomas or PBMCs of patients, synthesized to AFP-cDNA through random primers and reverse transcriptase, amplified by using a nested PCR assay, and confirmed by sequencing. Simultaneity, the HS-GGT activities were quantitatively determined in sera of patients. The comprehensive assessments of two markers were investigated in HCC patients. Results: The amplified fragments of AFP-mRNA were identical to original designed ones(159 bp) and confirmed by sequencing. The lowest sensitivity was 2 ng/L of total RNA. The incidences of AFP-mRNA and HS-GGT were 60.4%(113 of 187) and 84.5%(158 of 187) in the HCC group, and their significantly higher(P < 0.01) than that in any of other groups. The high frequencies of HS-GGT and AFP-mRNA were 78.2% and 56.4% in the HCC patients with AFP < 50 ng/mL. All positive of AFP-mRNA was found in HCC patients with extrahepatic metastasis. No significant correlation was found between tumor size and AFP-mRNA or HS-GGT. The total incidence of combined AFP-mRNA and HS-GGT detection was 93.6 % for HCC diagnosis. Conclusion: HS-GGT and AFP-mRNA are specific markers for HCC diagnosis or differentiation, especially the former for early finding and the later for monitoring metastasis of HCC.

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

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

芒果苷对氧嗪酸钾所致慢性高尿酸血症大鼠尿酸及肝肾功能的影响

目的研究芒果苷对氧嗪酸钾所致慢性高尿酸血症大鼠尿酸及肝肾功能的影响。方法连续灌胃给予SD大鼠氧嗪酸钾(2.5 g·kg-1体重)复制慢性高尿酸血症大鼠模型。以苯溴马隆和别嘌醇为阳性对照,研究芒果苷灌胃给药5周对高尿酸血症大鼠血尿酸(uric acid,UA)、肌酐(creatinine,Cr)、尿素氮(blood urea nitrogen,BUN)、谷丙转氨酶(ALT)、γ-谷氨酰转肽酶(GGT)、谷草转氨酶(AST)等水平的影响。结果芒果苷(1.55和3.13 mg·kg-1)灌胃给药能剂量依赖性地降低氧嗪酸钾所致的慢性高尿酸血症大鼠的血清尿酸水平,其效价弱于别嘌醇,但不亚于苯溴马隆;对肌酐、尿素氮和尿量的影响不明显,对血清AST、GGT水平亦无明显影响,但可改善慢性高尿酸血症大鼠的血清ALT水平。结论芒果苷可降低氧嗪酸钾所致慢性高尿酸血症大鼠的尿酸水平,对肝肾功能无明显影响。

γ-谷氨酰转移酶参考品赋值方法的初步研究

目的 :研究γ 谷氨酰转移酶 (GGT)参考品活性的赋值。 方法 :用临床化学国际联盟 (IFCC)推荐方法测定该酶的活性 ,选择 5种厂家生产的试剂盒 ,首先进行实际K值的测定 ,然后对该酶参考品赋值。 结果 :瓶间变异系数 (CV) <1.0 %。GGT催化浓度以 95 %可信限赋值 ,复溶的冻干参考品为 (138± 8)U/L。 结论 :该赋值对于本品的试用和认证是有价值的。

前列地尔治疗重症急性胰腺炎肝损害临床研究

目的观察前列地尔对重症急性胰腺炎(SAP)肝损害的防护作用。方法将31例SAP肝损害患者按照平行对照设计原理,随机分为对照组15例和试验组16例。对照组采用常规治疗,试验组在常规治疗基础上加用前列地尔注射液治疗,以全自动生化分析仪测定血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、谷氨酰基转移酶(GGT)、总胆红素(TBIL)、白蛋白(ALB)水平;特定蛋白分析仪监测C反应蛋白(CRP)水平。结果试验组治疗1周后ALT、AST、TBIL、GGT明显低于对照组(P<0.05),治疗2周后ALB水平明显高于对照组(P<0.05),治疗1周后血浆CRP水平明显低于对照组(P<0.05)。结论前列地尔可对SAP肝损害起防护作用。

应用半乳糖表型差异高效筛选α-1,3半乳糖苷转移酶基因缺失的猪成纤维细胞

【目的】筛选α-1,3半乳糖苷转移酶(α1,3galactosyl transferase,GGTA1)基因缺失的猪成纤维细胞。【方法】用同源重组载体pBS-GGTA1-SKO和pBS-GGTA1-DKO电转染GGTA1单等位基因敲除(GGTA1+/-)的五指山小型猪胎儿成纤维细胞,利用磁激活细胞分选(MACS)、MACS联合流式细胞术(FACS)、TcdA联合FACS等3种方法进行细胞筛选;对MACS筛选获得的单细胞克隆进行PCR和FACS鉴定,对MACS联合FACS、TcdA联合FACS获得的细胞集落进行PCR鉴定。【结果】经MACS筛选获得了11个细胞克隆,经鉴定2个是GGTA1-/-细胞克隆,阳性率为18.2%;MACS联合FACS筛选获得了3个细胞克隆,经鉴定无GGTA1-/-细胞克隆,阳性率为0;TcdA联合FACS筛选获得了3个细胞克隆,经鉴定均为GGTA1-/-细胞克隆,阳性率为100%。【结论】MACS法筛选和TcdA联合FACS法筛选这2种方法均可以高效筛选出GGTA1双等位基因缺失的猪成纤维细胞,可用于进一步制备供异种器官移植的基因修饰小型猪。

Increased liver markers are associated with higher risk of type 2 diabetes

AIM: To investigate the association between liver markers and the risk of type 2 diabetes(T2DM) and impaired fasting glucose(IFG).METHODS: A total of 8863 participants(3408 men and 5455 women) over 30 years of age were analyzed from the fifth Korean National Health and Nutrition Examination Survey(2010-2011). The associations of serum liver markers such as aspartate aminotransferase(AST), alanine aminotransferase(ALT), AST/ALT, and gamma-glutamyltransferase(GGT) with T2 DM and IFG were analyzed using logistic regression models. Participants were divided into sex-specific quartiles on the basis of liver markers.RESULTS: The prevalence of T2 DM and IFG were 11.3% and 18.3%. Increasing quartiles of ALT and GGT were positively and AST/ALT were negatively correlated with T2 DM and IFG. Analysis of the liver marker combinations showed that if any two or more markers were in the highest risk quartile, the risks of both T2 DM and IFG increased significantly. The risk was greatest when the highest ALT and GGT and lowest AST/ALT quartile were combined, with the riskof T2 DM at 3.21(95%CI: 1.829-5.622, P < 0.001) in men and 4.60(95%CI: 3.217-6.582, P < 0.001) in women. Men and women with the highest AST and ALT and lowest AST/ALT quartile had a 1.99 and 2.40 times increased risk of IFG.CONCLUSION: Higher levels of GGT and ALT and lower AST/ALT within the physiological range are independent, additive risk factors of T2 DM and IFG.

不同类型肝胆疾病肝损伤酶活性联合检测的诊断价值

目的探讨肝损伤酶活性指标在不同类型肝胆疾病中的诊断价值。方法选取100例慢性病毒性肝炎(甲组)和50例肝硬化(乙组)及50例肝癌(丙组)患者作为本次研究对象,另选取同期于医院健康体检的50例健康人群作为研究对照组。分别检测各研究对象血清总胆汁酸(TBA)和5’-核苷酸(5’-NT)、γ-谷氨酰基转移酶(GGT)及丙氨酸氨基转移酶(ALT)水平。结果甲乙丙三组患者血清5’-NT、TBA、GGT及ALT水平明显高于对照组,P<0.05;甲乙丙三组血清5’-NT、TBA、GGT及ALT水平比较,P<0.05。结论ALT水平并不能较好的反映出肝脏疾病患者病情严重程度,而低水平ALT可作为慢性病毒性肝炎伴肝硬化或肝癌的评价指标。对于肝硬化或慢性病毒性肝炎者来说,如患者GGT水平出现明显升高则可警惕肝癌发生。检测血清5’-NT和GGT水平可作为临床监测慢性病毒性肝炎伴肝硬化或肝癌的重要指标,且可作为临床判断肝脏疾病患者预后和病情转归的重要指标。