Prognostic utility of gamma-glutamyl transpeptidase to platelet ratio in patients with solitary hepatitis B virus-related hepatocellular carcinoma after hepatectomy

BACKGROUND The prognostic impact of preoperative gamma-glutamyl transpeptidase to platelet ratio(GPR)levels in patients with solitary hepatitis B virus(HBV)-related hepatocellular carcinoma(HCC)following radical resection has not been established.AIM To examine the clinical utility of GPR for prognosis prediction in solitary HBVrelated HCC patients.METHODS A total of 1167 solitary HBV-related HCC patients were retrospectively analyzed.GPR levels were compared with 908 non-HCC individuals.Overall survival(OS)and recurrence-free survival(RFS)were evaluated,and cox proportional hazard model analyses were performed to identify independent risk factors.Differences in characteristics were adjusted by propensity score matching(PSM).Subgroup and stratified survival analyses for HCC risks were performed,and a linear trend of the hazard ratio(HR)according to GPR levels was constructed.RESULTS GPR levels of patients with solitary HBV-related HCC were higher than those with hepatic hemangiomas,chronic hepatitis B and healthy control(adjusted P<0.05).Variable bias was diminished after the PSM balance test.The low GPR group had improved OS(P<0.001)and RFS(P<0.001)in the PSM analysis and when combined with other variables.Multivariate cox analyses suggested that low GPR levels were associated with a better OS(HR=0.5,95%CI:0.36-0.7,P<0.001)and RFS(HR=0.57,95%CI:0.44-0.73,P<0.001).This same trend was confirmed in subgroup analyses.Prognostic nomograms were constructed and the calibration curves showed that GPR had good survival prediction.Moreover,stratified survival analyses found that GPR>0.6 was associated with a worse OS and higher recurrence rate(P for trend<0.001).CONCLUSION Preoperative GPR can serve as a noninvasive indicator to predict the prognosis of patients with solitary HBVrelated HCC.

Helicobacter pylori gamma-glutamyl transpeptidase and its pathogenic role

Helicobacter pylori(H.pylori)gamma-glutamyl transpeptidase(GGT)is a bacterial virulence factor that converts glutamine into glutamate and ammonia,and converts glutathione into glutamate and cysteinylglycine.H.pylori GGT causes glutamine and glutathione consumption in the host cells,ammonia production and reactive oxygen species generation.These products induce cell-cycle arrest,apoptosis,and necrosis in gastric epithelial cells.H.pylori GGT may also inhibit apoptosis and induce gastric epithelial cell proliferation through the induction of cyclooxygenase-2,epidermal growth factor-related peptides,inducible nitric oxide synthase and interleukin-8.H.pylori GGT induces immune tolerance through the inhibition of T cell-mediated immunity and dendritic cell differentiation.The effect of GGT on H.pylori colonization and gastric persistence are also discussed.

Helicobacter pylori γ-glutamyl transpeptidase:A formidable virulence factor

Helicobacter pylori(H.pylori)produce an enzyme known asγ-glutamyl transpeptidase(HpGGT)that is highly conserved and common to all strains.HpGGT has been gaining increasing attention as an important virulence factor of the bacterium,having been demonstrated to be an important colonization factor in several animal models and has also recently been strongly associated with the development of peptic ulcer disease.From the results of various independent researcher groups,it is clear that HpGGT acts through several pathways to damage gastric epithelial cells including the induction of apoptosis and cell cycle arrest,production of reactive oxygen species leading to DNA damage,promotion of inflammation by increasing cyclooxygenase-2 and interleukin-8 expression,and upregulation of heparin-binding epidermal growth factor-like growth factor resulting in cell survival and proliferation.In addition,the potential role of HpGGT in promoting gastric carcinogenesis will also be discussed in this review.Apart from affecting the gastric epithelium,HpGGT also has immunomodulatory actions on host immune cells where it displays an antiproliferative effect on T cells by inducing cell cycle arrest and also works with other H.pylori virulence factors to skew dendritic cells towards a tolerogenic phenotype,possibly contributing to the persistence of the pathogen in the gastric mucosa.

急性NSTEMI患者PCI术后血清FAR、γ-GGT、NT-proBNP水平及对预后的预测价值研究

目的探讨并分析急性非ST段抬高心肌梗死(NSTEMI)患者经皮冠状动脉介入治疗(PCI)术后血清纤维蛋白原/白蛋白值(FAR)、γ-谷氨酰转肽酶(γ-GGT),N端脑钠肽前体(NT-proBNP)水平对预后的预测价值。方法回顾性分析2020年2月至2023年2月邯郸市中心医院收治的实施PCI的急性NSTEMI患者93例,根据术后30 d主要不良心血管事件(MACE)发生情况将其分为MACE组(n=21)及无MACE组(n=72)。比较术前、术后30 d MACE组及无MACE组血清FAR、γ-GGT、NT-proBNP水平,采用单因素和多因素Logistic回归分析对影响急性NSTEMI患者术后30 d MACE发生的危险因素进行分析,采用受试者操作特征(ROC)曲线分析血清FAR、γ-GGT、NT-proBNP水平对急性NSTEMI患者术后MACE发生的预测价值。结果MACE组年龄为(65.37±3.46)岁;Killip分级为Ⅰ级2例,Ⅱ级3例,Ⅲ级5例,Ⅳ级11例;病变支数双支5例,3支16例;术后30 d血清FAR、γ-GGT、NT-proBNP水平分别为(2.87±0.55)%、(53.27±3.06)U/L、(914.35±84.35)ng/mL。无MACE组的年龄为(58.71±2.86)岁;Killip分级为Ⅰ级32例,Ⅱ级27例,Ⅲ级7例,Ⅳ级6例;病变支数为双支53例,3支19例;术后30 d血清FAR、γ-GGT、NT-proBNP水平分别为(2.12±0.51)%、(44.33±3.35)U/L、(656.82±75.63)ng/mL。MACE组和无MACE组的年龄、Killip分级、病变支数及术后30 d血清FAR、γ-GGT、NT-proBNP水平比较,差异均有统计学意义(P<0.05),两组性别、吸烟史、高血压史、高血脂史、糖尿病史及术前1 d血清FAR、γ-GGT、NT-proBNP水平比较差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,血清FAR、γ-GGT、NT-proBNP升高均为影响急性期NSTEMI患者术后MACE发生的独立危险因素(OR=3.074、2.686、3.340,P均<0.05)。ROC结果显示血清FAR、γ-GGT、NT-proBNP及其联合检测预测急性NSTEMI患者术后MACE发生的曲线下面积(AUC)分别为0.681、0.690、0.733和0.790,联合检测的AUC更高(P<0.05)。结论血清FAR、γ-GGT、NT-proBNP水平升高增加了急性NSTEMI患者PCI术后MACE的发生风险,三者联合检测对患者术后不良预后有一定预测价值。

Gamma-glutamyl Transpeptidase to Platelet Ratio Predicts Liver Injury in Hepatitis B e Antigen-negative Chronic Hepatitis B Patients With Normal Alanine Aminotransferase

Background and Aims:Chronic hepatitis B virus(HBV)infection is a serious health problem worldwide.Evaluating liver injury in patients with hepatitis B e antigen(HBeAg)-negative chronic hepatitis B(CHB)with detectable HBV DNA and normal alanine aminotransferase(ALT)is crucial to guide their clinical management.We aimed to investigate the stages of liver inflammation and fibrosis as well as the predictive accuracy of gamma-glutamyl transpepti-dase-to-platelet ratio(GPR)in these patients.Methods:A total of 184 treatment-naïve HBeAg-negative CHB pa-tients with detectable HBV DNA and normal ALT were enrolled.The Scheuer scoring system was used to classify liver inflammation and fibrosis.Results:The distribution of patients with different liver inflammation grades were as follows:G0,0(0%);G1,97(52.7%);G2,68(37.0%);G3,12(6.5%);and G4,7(3.8%).The distribution of patients with different liver fibrosis stages were as follows:S0,22(12.0%);S1,72(39.1%);S2,42(22.8%);S3,19(10.3%);and S4,29(15.8%).The areas under the re-ceiver operating characteristic(AUROC)curves of GPR in predicting significant inflammation,severe inflammation,and advanced inflammation were 0.723,0.895,and 0.952,respectively.The accuracy of GPR was significantly superior to that of ALT in predicting liver inflammation.The AUROCs of GPR in predicting significant fibrosis,severe fibrosis,and cirrhosis were 0.691,0.780,and 0.803,respectively.The predictive accuracy of GPR was significantly higher than that of aminotransferase-to-platelet ratio index(APRI)and fibrosis index based on four factors(FIB-4)in identifying advanced fibrosis and cirrhosis,and it was superior to FIB-4 but comparable to APRI in identifying significant fibrosis.Conclusions:Nearly half of the HBeAg-negative CHB patients with detectable HBV DNA and normal ALT levels had significant liver inflammation or fibrosis.GPR can serve as an accurate predictor of liver inflammation and fibrosis in these patients.

The clinical implication of gamma-glutamyl transpeptidase in COVID-19

Background and aim:Coronavirus disease 2019(COVID-19)is a life-threatening disease that predomi-nantly causes respiratory failure.The impact of COVID-19 on other organs remains elusive.Herein,we aimed to investigate the effects of COVID-19 on the hepatobiliary system.Methods:In the current study,we obtained the clinical records and laboratory results from 66 laboratory-confirmed patients with COVID-19 at the Wuhan Tongji Hospital between 10 February 2020 and 28 February 2020.The detailed clinical features and laboratory findings were collected for analysis.Bioinformatics analysis was conducted to evaluate the correlation between gamma-glutamyl transferase(GGT)and severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)entry receptor angiotensin-converting enzyme 2(ACE2).Results:In this cohort,30(51.7%)patients had abnormal liver function on admission,which was asso-ciated with disease severity and enriched in the male and diabetic patients.The elevated levels of direct bilirubin(P¼0.029)and GGT(P¼0.004)were common in patients with severe pneumonia when compared with those with mild pneumonia.In addition,elevated levels of GGT(P¼0.003)and aspartate aminotransferase(AST)(P¼0.007)were positively associated with longer hospital stay.The expression of ACE2 was closely associated with GGT in various human tissues because they shared the common transcriptional regulator hepatic nuclear factor-1 b(HNF1B).Conclusions:Increased GGT levels were common in severe cases and elevated GGT levels were positively associated with prolonged hospital stay and disease severity.Due to the consistent expression with ACE2,GGT is a potent biomarker indicating the susceptibility of SARS-CoV-2 infection.

原发性高血压患者血清谷氨酰转肽酶水平与左心房内径的相关性研究

目的探讨原发性高血压患者左心房内径与血清谷氨酰转肽酶(GGT)水平的关系及临床意义。方法从赣州市人民医院选取资料完整的原发性高血压患者320例,根据经胸超声心动图检查结果分为左心房增大组及左心房正常组;测量患者肝肾功能、血脂、血压、血糖等指标并进行统计分析。结果在原发性高血压患者当中,左心房增大组血清GGT水平[(24.78±10.93)U/L]明显低于左心房正常组[(35.23±12.46)U/L],且差异具有统计学意义(P=0.004),线性回归显示血清GGT水平与左心房内径呈负相关(P=0.032),多因素Logistic回归显示血清GGT水平是左心房增大的保护因素(OR=0.424,P=0.026)。结论原发性高血压患者血清GGT水平与左心房大小呈负相关关系,监测血清肝酶变化可能对早期发现心房增大有一定意义。

血清PLD、LXA4及γ-GGT水平在2型糖尿病周围神经病变中的影响和相关性分析

目的探讨血清PLD、LXA4及γ-GGT水平与2型糖尿病周围神经病变的相关性。方法在2016年1月至2017年6月期间,选取我院内分泌科收治的单纯2型糖尿病(T2DM)患者60例作为T2DM组,选取2型糖尿病周围神经病变(DPN)患者60例作为DPN组,选取同期进行体检的健康人50例作为对照组。比较三组研究对象的基本资料及生化指标,并进行Pearson相关性和Logistic多元回归分析。结果三组研究对象的年龄、BMI、SBP、DBP、TC、TG、LDL-C、HDL-C、FPG差异均无统计学意义(P>0.05),相比于对照组,T2DM组与DPN组的HbA1c、γ-GGT均显著高于对照组,PLD、LXA4显著低于对照组(P <0.05);DPN组的病程、HbA1c、γ-GGT均显著高于T2DM组,PLD、LXA4显著低于T2DM组(P <0.05)。经过Pearson相关性分析,病程、HbA1c、γ-GGT与DPN神经传导速度呈正相关,PLD、LXA4与DPN神经传导速度呈负相关。以逐步回归法进行Logistic多元回归分析,结果表明病程、HbA1c、PLD、LXA4及γ-GGT均是DPN的独立影响因素。结论血清PLD、LXA4及γ-GGT与DPN的发生均有一定相关性,γ-GGT可能是其危险因素,PLD、LXA4可能是其保护因素。

血清酶学指标检测在髓系白血病的意义

[目的]观察急、慢性髓系白血病血清肿瘤标志酶在各个时期的水平差异,并分析其临床意义。[方法]将化疗前后的白血病分为慢性粒细胞性白血病(CGL)组、急性非淋巴细胞性白血病(ANLL)组,对比两组化疗前后、初发、复发、缓解期血清乳酸脱氢酶(LDH)、γ-谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、α-羟丁酸脱氢酶(HBDH)的水平差异,并与正常对照组进行对比。[结果]CGL组化疗前的4种肿瘤标志酶均明显高于ANLL及对照组穴P<0.05雪,在化疗后LDH明显降低(P<0.05);ANLL组化疗前的LDH、ALP、HBDH水平也高于正常对照组穴P<0.05雪,化疗后HBDH的减低较为明显(P<0.05);ANLL复发时的LDH、HBDH明显升高(P<0.01),而CGL的LDH水平由初发到缓解随着白细胞数的减低而逐渐降低。[结论]在白血病患者中多见LDH、GGT、ALP、HBDH升高,这种改变在CGL和ANLL复发病例中更为严重;而随着化疗的进行,LDH、HBDH逐渐降低;在复发后,LDH、HBDH随着白细胞的升高而再度上升,高LDH、HBDH血症可能是CGL与ANLL复发病例的一个独立危险因素。

慢性酒精中毒性肝病干预治疗CDT及血清酶学临床分析

目的探讨酒精性肝病患者干预治疗前后血清CDT及生化指标变化情况。方法对106例酒精性肝病患者戒酒前和戒酒2、4周时糖CDT、GGT、ALT和AST水平及糖缺失转铁蛋白百分比(CDT%),对结果进行统计学分析。结果随着患者干预治疗时间的延长,血清CDT、CDT%、GGT水平下降(P<0.05)。与戒酒前相比,戒酒2周和戒酒4周血清酶学水平降低(P<0.05)。结论长期饮酒者血清GGT、CDT、CDT%水平随戒酒时间延长降低,GGT水平易受其他因素影响。因此,血清CDT及CDT%水平可用于酒精性肝病患者干预治疗情况的长期监控。

血清肝酶与2型糖尿病及空腹血糖受损的相关性研究

目的探讨血清肝酶与2型糖尿病及空腹血糖受损的相关性。方法选取初诊2型糖尿病患者(T2DM组)及空腹血糖受损患者(IFG组)各300例,检测血清天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、谷氨酰转肽酶(GGT)、空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)水平。结果 T2DM组ALT、AST、GGT、FBG、TG、LDL-C水平明显高于IFG组(P<0.05);AST、ALT、GGT三分位分为高水平、中水平、低水平组,高水平组年龄、舒张压、FBG、TG、LDL-C水平与低水平组比较,差异有显著性(P<0.05),Pearson相关分析AST、ALT、GGT均与FBG、TG、LDL-C间具有正相关性(P<0.05);多元线性逐步回归分析FBG、TG、LDL-C水平与ALT水平呈正相关(P<0.05)。结论血清肝酶AST、ALT、GGT升高与T2DM、IFG关系密切,FBG、TG、LDL-C水平与ALT水平间呈正相关,提示ALT升高与T2DM、IFG关系最为密切。

血清AFP、GGT、SF联合检测在原发性肝癌诊断中的价值

目的探讨联合检测血清甲胎蛋白(AFP)、γ-谷氨酰基转移酶(GGT)、铁蛋白(SF)在原发性肝癌诊断中的价值。方法检测61例原发性肝癌患者、64例肝炎/肝硬化患者和55例健康对照组血清AFP、GGT、SF的含量。结果AFP和SF检测的阳性率在原发性肝癌组与肝炎/肝硬化组比较差异具有统计学显著意义(P<0.05),肝癌组的阳性率高于肝炎/肝硬化组,GGT检测的阳性率在两组比较差异无统计学意义(P>0.05);AFP、GGT和SF三项联合检测原发性肝癌的阳性率可提高到96.7%,与单项检测比较差异均具有统计学显著意义(P<0.05)。结论血清AFP、GGT、SF联合检测可明显提高对原发性肝癌的阳性检出率。

非酒 精性脂肪肝患者血清铁蛋白与γ-谷氨酰转肽酶、脂肪肝指数的相关性研究

目的探讨非酒精性脂肪肝(NAFLD)患者血清铁蛋白(SF)与谷氨酰转肽酶(γ-GT)、脂肪肝指数(FLI)的相关性。方法选择2016年8月~2018年4月于我科就诊的患者861例,根据SF水平分为正常组(SF≤320 ng/ml,624例)和高SF组(SF>320 ng/ml,237例),收集其一般资料(性别、年龄、身高、体重、腰围、BMI、NAFLD患病率)、实验室检查结果及FLI并进行比较。采用Pearson相关分析探讨SF与各代谢指标的相关性。采用多因素logistic回归分析探讨SF与NAFLD患病率、FLI、γ-GT的关系。结果高SF组患者腰围、BMI、NAFLD患病率、ALT、AST、γ-GT、FLI、白蛋白(Alb)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(HbAlc)、血红蛋白(Hb)、PLT计数、SF均明显高于正常组(P<0.05)。SF与腰围、BMI、ALT、AST、γ-GT、Alb、TG、TC、低密度脂蛋白胆固醇(LDL-C)、Hb、FLI均呈正相关,与年龄、HDL-C、PLT计数均呈负相关;将所有患者根据SF水平从低到高四等分为Q1~Q4组,随着SF水平升高,NAFLD患病率逐渐增加(趋势P<0.05)。再将NAFLD患者根据SF水平从低到高四等分为N1~N4组,随着SF水平升高,γ-GT异常和FLI>60的风险均增加(趋势P<0.05)。结论高SF水平与NAFLD患病率明显相关,NAFLD患者SF与γ-GT、FLI显著相关,SF可作为NAFLD早期诊断的指标。

健康体检者血尿酸和γ-谷氨酰转肽酶水平与代谢综合征的关联性分析

目的:分析血尿酸(SUA)和γ-谷氨酰转肽酶(γ-GGT)水平与代谢综合征(MS)患病的关联性,探讨SUA与γ-GGT在MS中的交互作用,为MS的风险预测和早期干预提供依据。方法:采用整群抽样方法共抽取延边朝鲜族自治州安图县医院体检中心20~79岁健康体检者7 560名,按照MS诊断标准分为MS及其相关代谢指标异常组和MS及其相关代谢指标正常组,收集各组研究对象的性别、年龄、身高、体质量、收缩压(SBP)和舒张压(DBP)以及血清空腹血糖(FBG)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-c)、SUA和γ-GGT等指标,Logistic回归分析法分析不同代谢异常患者患病风险,并分析各组患者各种代谢指标异常患病的交互作用。结果:MS及其相关代谢指标异常组研究对象的高尿酸血症(HUA)和γ-GGT水平升高患病风险均高于MS及其相关代谢指标正常组,随着SUA和γ-GGT水平升高,MS及其相关代谢异常患病风险逐渐升高。MS及其相关代谢指标异常组研究对象的HUA和γ-GGT水平升高患病风险是MS及其相关代谢指标正常组的4.660倍(95%CI:3.571~6.085)和5.260倍(95%CI:4.009~6.897),随着代谢异常程度增加,HUA和γ-GGT水平升高患病风险逐渐升高。SUA和γ-GGT水平均升高组研究对象的肥胖、高血压、血脂异常、高血糖和MS患病风险分别是SUA和γ-GGT水平均正常组的1.930倍(95%CI:1.617~2.304)、 1.618倍(95%CI:1.352~1.935)、 4.011倍(95%CI:3.245~4.958)、 1.890倍(95%CI:1.654~2.393)和2.695倍(95%CI:2.248~3.230)。SUA和γ-GGT水平升高对血脂异常患病存在相加交互作用,其交互效应指数(S)和归因交互效应百分比分别为1.17和10.9%。结论:SUA和γ-GGT水平与MS及其相关各种代谢指标异常患病风险有密切关联,SUA和γ-GGT水平升高与代谢异常程度有关联。HUA并发γ-GGT水平升高明显增加高血压、血脂异常和MS的患病风险,且SUA和γ-GGT水平升高对血脂异常患病具有相加交互作用。

老年冠心病患者血清尿酸、Cys C及γ-GGT的水平及其与冠状动脉病变程度的相关性探究

目的分析老年冠状动脉粥样硬化心脏病(简称冠心病)患者血清尿酸、胱抑素C(Cys C)及γ-谷氨酰转肽酶(γ-GGT)的水平及临床意义。方法选择该院收治的132例冠心病患者和52例体检健康者,比较各组血清尿酸、Cys C及γ-GGT水平。结果冠心病稳定型心绞痛(SAP)组、不稳定型心绞痛(UAP)组、急性心肌梗死(AMI)组血清尿酸、Cys C及γ-GGT均高于健康对照组,且AMI组血清尿酸、Cys C及γ-GGT高于SAP组及UAP组(P<0.05)。多支病变组血清尿酸、Cys C及γ-GGT高于双支病变组及单支病变组(P<0.05)。重度狭窄组血清尿酸、Cys C及γ-GGT高于轻度狭窄组(P<0.05)。冠心病患者血清尿酸、Cys C及γ-GGT与Gensini积分均呈正相关(r=0.531、0.598、0.485,均P<0.05)。结论血清尿酸、Cys C及γ-GGT有利于冠心病临床分型的鉴别,且和冠状动脉病变支数和狭窄程度密切相关。

血清γ-谷氨酰转肽酶与糖尿病肾病的相关性分析

目的:探讨血清γ-谷氨酰转肽酶(GGT)与糖尿病肾病的关系。方法:选取2型糖尿病患者345例作为研究对象,根据24 h尿微量白蛋白水平(UMA)分为无糖尿病肾病组(N组)、早期糖尿病肾病组(EDN组)及临床糖尿病肾病组(CDN组);收集所有患者一般临床资料及生化指标,比较三组临床及生化指标的差异,分析糖尿病肾病的危险因素。结果:(1)EDN、CDN组血清GGT水平明显高于N组,比较差异有统计学意义(P<0.01或P<0.05),EDN组与CDN组血清GGT水平比较差异无统计学意义(P>0.05);(2)Pearson相关分析显示:UMA与病程、收缩压、舒张压、BMI、GGT、血尿酸、血肌酐、甘油三酯、总胆固醇、低密度脂蛋白、C反应蛋白、血浆纤维蛋白原均呈正相关(P<0.01或P<0.05);(3)二元Logistic回归分析显示:血清GGT、收缩压、TC、Scr是糖尿病肾病的独立危险因素(P<0.05)。结论:血清GGT可作为早期预测糖尿病肾病的重要指标。

病毒性肝炎患者血清γ-谷氨酰转肽酶水平与预后的关系

目的 探讨γ -谷氨酰转肽酶 (γ -GT)检测对判定病毒性肝炎预后的临床意义。方法 选择 2 0 0 0- 1 2～ 2 0 0 3- 0 1间收治 1 31例各型病毒性肝炎 ,每 5d检测γ -GT。结果 急性肝炎γ -GT明显升高 ,慢性肝炎次之 ,而重型肝炎γ -GT不升高或呈下降趋势。结论 γ -GT系肝功能指标之一 。

Nonalcoholic steatohepatitis in nonalcoholic fatty liver disease patients of Bangladesh

AIM: To explore the prevalence and risk factors for nonalcoholic steatohepatitis (NASH) in nonalcoholic fatty liver disease (NAFLD) patients. METHODS: We have included 493 patients with sonographic evidence of a fatty change, and 177 of these individuals were evaluated and confirmed after liver biopsy. The exclusion criteria consisted of significant alcohol abuse (【 20 g daily), evidence of hepatitis B and C, evidence of drug-induced fatty liver disease and other specific liver diseases such as hemochromatosis, Wilson’s disease or autoimmune liver disease. The patients were assessed for metabolic syndrome, and biochemical, anthropometric and histopathological evaluations were carried out. The degree of disease activity in the NAFLD patients was evaluated using the NAFLD Activity Score. The data were analyzed by SPSS, version 16.0. RESULTS: Females predominated among the study participants (250, 57.0%), and the mean age was 40.8 ± 10.2 years. The numbers of overweight, obeseⅠ and obese Ⅱ patients were 58 (13.2%), 237 (53.9%) and 93 (21.2%), respectively. However, there were 422 (96.2%) centrally obese patients. NASH was absent in 10 (5.6%) cases, borderline in 92 (52.6%) cases and present in 75 (42.4%) cases. The presence of diabetes could significantly (P = 0.001) differentiate NASH from simple steatosis. The following parameters did not influence the development of NASH: age, sex, basal metabolic index, waist circumference, serum high-density lipoprotein, triglyceride, insulin resistance index, hypertension and metabolic syndrome. The serum gammaglutamyl transpeptidase (GGT) level was significantly higher (P = 0.05, 51.7 ± 32.8 and 40.4 ± 22.6 U/L) in the NASH patients, with a sensitivity of 45% and a specificity of only 68%. The serum alanine aminotransferase and aspartate aminotransferase levels were not able to predict NASH. CONCLUSION: Females were the predominant sufferers of NAFLD in Bangladesh. The prevalence of NASH was high. Diabetes was found to be the main culprit in developing NASH. GGT was the only biochemical marker of NASH. We recommend liver biopsy in NAFLD patients who have diabetes and elevated GGT.

Relationship between alcohol consumption and clinical manifestation of patients with fatty liver:a single-center study

BACKGROUND:Fatty liver is a common chronic liver disease worldwide.It is associated with an increasing morbidity in China in recent years.The aim of this study was to analyze the effect of drinking alcohol on the hemoglobin and biochemical values of patients with fatty liver.METHODS:We investigated the clinical and laboratory data of 669 patients with fatty liver.Of the 669 patients,166 consumed alcohol more than 60 g per week for at least 2 years,and 503 did not have a history of long-term alcohol consumption.We further analyzed the relationship between alcohol consumption and clinical characteristics of these patients.RESULTS:The values of aspartate transaminase (AST),gammaglutamyl transpeptidase (GGT),and hemoglobin in the long-term consumption group were significantly higher than those in the non long-term consumption group (P<0.05).In the patients without long-term alcohol consumption,the values of GGT and hemoglobin in patients with light alcohol consumption were significantly higher than those in non alcohol consumers (P<0.05).CONCLUSION:Alcohol consumption is associated with significantly increased values of AST,GGT,and hemoglobin in patients with fatty liver,suggesting their potential roles in hepatic steatosis.

Silymarin in non alcoholic fatty liver disease

AIM: This study was undertaken to evaluate the hepatic effects of silybum marianum on non alcoholic fatty liver disease (NAFLD). METHODS: In 72 patients affected by NAFLD, main metabolic, hepatic and anti-inflammatory parameters were assayed after 3 mo of a restricted diet and before silymarin treatment (twice a day orally). The brightness of liver echography texture (hepatorenal ratio brightness) was also defined at same time. These evaluations were repeated after 6 mo of treatment. RESULTS: Serum levels of some metabolic and anti-inflammatory data nonsignificantly lowered after 6 mo of silymarin. On the contrary, Steato test, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transpeptidase were significantly (P < 0.001) reduced. Instead, the AST/ALT ratio unchanged. Finally, the hepatorenal brightness ratio, as an index of hepatic steatosis, significantly (P < 0.05) dropped. CONCLUSION: The obtained results indicate that silymarin appears to be effective to reduce the biochemical, inflammatory and ultrasonic indices of hepatic steatosis. Some parameters indicative of early stage of atherosclerosis were also lowered.