Expression and alterations of different molecular form γ-glutamyl transferase and total RNA concentration during the carcinogenesis of rat hepatoma

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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.

Gamma-glutamyl transferase and cardiovascular risk in nonalcoholic fatty liver disease:The Gut and Obesity Asia initiative

BACKGROUND Gamma-glutamyl transferase(GGT)is associated with the risk of cardiovascular disease(CVD)in the general population.AIM To identify the association of baseline GGT level and QRISK2 score among patients with biopsy-proven nonalcoholic fatty liver disease(NAFLD).METHODS This was a retrospective study involving 1535 biopsy-proven NAFLD patients from 10 Asian centers in 8 countries using data collected by the Gut and Obesity in Asia(referred to as“GO ASIA”)workgroup.All patients with available baseline GGT levels and all 16 variables for the QRISK2 calculation(QRISK2-2017;developed by researchers at the United Kingdom National Health Service;https://qrisk.org/2017/;10-year cardiovascular risk estimation)were included and compared to healthy controls with the same age,sex,and ethnicity.Relative risk was reported.QRISK2 score>10%was defined as the high-CVD-risk group.Fibrosis stages 3 and 4(F3 and F4)were considered advanced fibrosis.RESULTS A total of 1122 patients(73%)had complete data and were included in the final analysis;314(28%)had advanced fibrosis.The median age(interquartile range[IQR])of the study population was 53(44-60)years,532(47.4%)were females,and 492(43.9%)were of Chinese ethnicity.The median 10-year CVD risk(IQR)was 5.9%(2.6-10.9),and the median relative risk of CVD over 10 years(IQR)was 1.65(1.13-2.2)compared to healthy individuals with the same age,sex,and ethnicity.The high-CVD-risk group was significantly older than the low-risk group(median[IQR]:63[59-67]vs 49[41-55]years;P<0.001).Higher fibrosis stages in biopsy-proven NAFLD patients brought a significantly higher CVD risk(P<0.001).Median GGT level was not different between the two groups(GGT[U/L]:Median[IQR],high risk 60[37-113]vs low risk 66[38-103],P=0.56).There was no correlation between baseline GGT level and 10-year CVD risk based on the QRISK2 score(r=0.02).CONCLUSION The CVD risk of NAFLD patients is higher than that of healthy individuals.Baseline GGT level cannot predict CVD risk in NAFLD patients.However,advanced fibrosis is a predictor of a high CVD risk.

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.

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.

Associations between y-glutamyl transferase, metabolic abnormalities and inflammation in healthy subjects from a population-based cohort: A possible implication for oxidative stress

AIM: To examine the relationships between γ -glutamyltransferase (GGT), alanine-aminotransferase (ALT),aspartate-aminotransferase (AST) and various metabolic parameters, C-reactive protein (CRP) and an oxidative stress marker (nitrotyrosine, NT) in subjects without any metabolic abnormalities from a population-based sample.METHODS: Two hundred and five subjects with normal body mass index (BMI), glucose tolerance, and without any metabolic abnormality were studied out of 1339subjects, without known liver diseases, alcohol abuse or use of hepatotoxic drugs, who are representative of the 45-64 aged population of Asti (north-western Italy).RESULTS: In all patients metabolic parameters and hs-CRP levels linearly increase from the lowest to the highest ALT and GGT tertiles, while in subjects without metabolic abnormalities, there is a significant association between fasting glucose, uric acid, waist circumference,hs-CRP, triglyceride values, and GGT levels. In these subjects, male sex, higher hs-CRP and glucose levels are associated with GGT levels in a multiple regression model, after adjustments for multiple confounders.In the same model, median NT levels are significantly associated with the increasing GGT tertile (β = 1.06;95%CI 0.67-1.45), but not with the AST and ALT tertiles.In a multiple regression model, after adjusting for age,sex, BMI, waist, smoking, and alcohol consumption, both NT (β = 0.05; 95%CI 0.02-0.08) and hs-CRP levels (β =0.09; 95%CI 0.03-0.15) are significantly associated with fasting glycemia.CONCLUSION: GGT, an easy, universally standardized and available measurement, could represent an early marker of sub-clinical inflammation and oxidative stress in otherwise healthy individuals. Prospective studies are needed to establish if GGT could predict future diabetes in these subjects.

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.

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.

肝功能相关指标联合胆囊收缩率在诊断胆道闭锁中的应用价值

目的探讨γ-谷氨酰转移酶(gamma-glutamyl transferase,GGT)、直接胆红素(direct bilirubin,DBil)与胆囊收缩率在诊断胆道闭锁(biliary atresia,BA)中的应用价值。方法收集2017年9月至2021年9月在西安交通大学附属儿童医院及西安市中心医院儿科住院治疗的185例胆汁淤积性肝病患儿为研究对象,根据剖腹探查或术中胆道造影和随访情况,将患儿分为BA组(70例)和肝内胆汁淤积(intrahepatic cholestasis,IHC)组(115例)。比较两组患儿的一般临床资料、实验室检查指标[包括总胆红素(total bilirubin,TBil)、DBil、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、GGT、碱性磷酸酶(alkaline phosphatase,ALP)、总胆汁酸(total bile acid,TBA)]及腹部超声检查资料。将有统计学意义的指标纳入受试者工作特征(receiver operator characteristic,ROC)曲线分析,计算ROC曲线下面积、最佳诊断界值和OR值;应用MedCalc软件进行ROC曲线下面积对比,分析各指标对诊断BA的价值。结果BA组和IHC组患儿的性别(男/女:31例/39例比78例/37例)、就诊年龄(中位数:52.0 d比58.0 d)、肝脏肋下大小(中位数:4.0 cm比2.0 cm)、脾大比例[40%(28/70)比18.3%(21/115)]、大便颜色、TBil(中位数:204.35μmol/L比138.30μmol/L)、DBil(中位数:125.70μmol/L比80.00μmol/L)、ALT(中位数:112.00 U/L比71.00 U/L)、AST(中位数:175.00 U/L比120.00 U/L)、GGT(中位数:440.75 U/L比94.50 U/L)、餐后1 h胆囊收缩率(无收缩/有收缩且<50%/有收缩且>50%:52.9%/41.4%/5.7%比7.0%/27.8%/65.2%)差异有统计学意义(P均<0.05)。两组患儿ALP(中位数526.00 U/L比548.00 U/L)、TBA(中位数:143.45μmol/L比161.90μmol/L)和25羟维生素D(中位数:8.00 ng/ml比8.13 ng/ml)水平差异无统计学意义(P均>0.05)。多因素Logistic回归分析表明,DBil(OR=1.031,95%CI:1.015~1.047,P<0.001)、GGT(OR=1.007,95%CI:1.004~1.011,P<0.001)、餐后1 h胆囊无收缩(OR=57.493,95%CI:9.577~345.133,P<0.001)和胆囊收缩率<50%(OR=9.907,95%CI:1.828~53.710,P=0.008)均为BA的危险因素。TBil、DBil、ALT、AST、GGT、GGT+DBil、GGT+DBil+胆囊收缩率诊断BA的ROC曲线下面积分别为0.797、0.820、0.614、0.658、0.890、0.932和0.963。单项指标中GGT的ROC曲线下面积最大,当GGT超过界值173.20 U/L时诊断BA的敏感度、特异度、阳性似然比、阴性似然比和诊断比值比分别为84.3%、78.3%、3.885、0.201和19.328。GGT+DBil+胆囊收缩率联合对BA的诊断价值最高,ROC曲线下面积显著高于GGT+DBil(z=2.303,P=0.021),其诊断BA的敏感度、特异度、阳性似然比、阴性似然比和诊断比值比分别为90.0%、90.4%、9.375、0.111和84.459。结论GGT、DBil与胆囊收缩率联合对BA有较高的诊断价值,当GGT超过界值173.20 U/L、DBil超过界值97.05μmol/L且超声提示胆囊收缩不良时需高度警惕BA。

血清镁离子浓度与直肠癌患者谷氨酰转肽酶的关系

直肠癌患者血清镁离子(Mg^(2+))浓度对γ-谷氨酰转肽酶(γ-GT)的影响尚不明确,收集分析临床数据,Mg^(2+)浓度不呈正态分布(D=0.737,P<0.05),按照中位数分组,比较不同组间临床病理特征的差异,用局部加权散点平滑(LOWESS)、分段线性回归方法,拟合血清Mg^(2+)浓度与γ-GT的关系。结果发现,与Mg^(2+)浓度小于0.92 mmol/L组的直肠癌患者比较,Mg^(2+)浓度≥0.92 mmol/L组的γ-GT和血清总胆固醇较高(P均<0.05)。LOWESS的结果表明,原始数据中血清Mg^(2+)浓度的两个变化点分别为0.92 mmol/L和0.99 mmol/L,自然对数转换的数据中血清Mg^(2+)浓度的另外两个变化点分别为-0.167和-0.01。利用原始数据建立的两段线性回归模型表明,血清Mg^(2+)浓度的变化点为0.98 mmol/L,Mg^(2+)浓度<0.98 mmol/L对γ-GT有正向影响,Mg^(2+)≥0.98 mmol/L时有负向影响。另一个使用自然对数转换数据的两段线性回归模型显示,血清Mg^(2+)浓度的变化点为0.01,其中Mg^(2+)浓度的自然对数<0.01对γ-GT有正向影响,当Mg^(2+)浓度的自然对数≥0.01时则有负向影响。用原始数据LOWESS回归的2个拐点,即0.92 mmol/L和0.99 mmol/L的Mg^(2+)浓度,进行三段线性回归分析,结果显示,<0.980 mmol/L的Mg^(2+)浓度,对γ-GT的影响是正向的,且与<0.929 mmol/L的Mg^(2+)浓度区间的系数不同,影响程度不同,而在≥0.980 mmol/L的Mg^(2+)浓度区间,对γ-GT的影响是负向的,此外,用对数转换数据LOWESS的2个拐点进行的三段线性回归,也显示Mg^(2+)浓度的自然对数以-0.020为分界点时,对γ-GT的影响方向是相反的,但三段线性回归模型均没有统计学意义,总之,具有较高Mg^(2+)浓度的直肠癌患者,其γ-GT的水平也较高,Mg^(2+)浓度对γ-GT的影响存在拐点效应,为γ-GT的关联因素研究提供了基础。

甘油三酯-葡萄糖指数与γ-谷氨酰基转移酶在中青年代谢综合征诊断中的临床应用

目的探讨甘油三酯-葡萄糖(TyG)指数与γ-谷氨酰基转移酶(GGT)预测中青年代谢综合征(MS)的临床价值。方法选取2022年12月至2023年9月在首都医科大学附属北京世纪坛医院肥胖与代谢中心住院治疗的151例中青年MS患者作为研究对象(MS组),另选取同期在医院进行健康体检者130例作为对照组,分别测定两组的代谢及炎症指标。MS组根据MS组分数目分为MS3组(101例)、MS4组(32例)及MS5组(18例),比较三组TyG指数、GGT水平。采用Pearson相关检验分析TyG指数、GGT与MS诊断指标的相关性。通过多因素logistic回归分析MS发生的危险因素。使用受试者操作特征(ROC)曲线评估TyG指数、GGT预测MS的价值。结果MS组患者TyG指数、GGT显著高于对照组,MS5组TyG指数、GGT显著高于MS3组和MS4组,差异均有统计学意义(P<0.05)。Pearson相关分析显示,TyG指数、GGT水平与体重指数、舒张压、收缩压、空腹血糖、甘油三酯呈正相关(P<0.05),与高密度脂蛋白胆固醇呈负相关(P<0.05)。Logistic回归分析显示,TyG指数、GGT均为MS的危险因素。ROC曲线分析显示,TyG指数、GGT预测MS的曲线下面积(AUC)分别为0.72(95%CI 0.66~0.781)、0.675(95%CI 0.612~0.739)结论中青年MS患者TyG指数、GGT表达明显增高,二者均与MS的发生密切相关。

γ-谷氨酰转移酶/血小板在乙肝肝硬化失代偿期患者中的表达及临床意义

目的观察γ-谷氨酰转移酶(GGT)/血小板(PLT)在乙肝肝硬化失代偿期患者中的表达。方法回顾性分析,收集2019年1月至2023年1月商丘市中心医院收治的65例乙肝肝硬化失代偿期患者的临床资料。所有患者均完成入院时相关检查,包括Child-Pugh分级评估、血清GGT、PLT、GGT/PLT检测;均接受对症综合治疗并完成6个月随访。比较不同Child-Pugh分级乙肝肝硬化失代偿期患者血清GGT、PLT、GGT/PLT水平,探究血清GGT、PLT、GGT/PLT水平与Child-Pugh分级的相关性。绘制受试者工作特征(ROC)曲线分析血清GGT、PLT、GGT/PLT对乙肝肝硬化失代偿期患者短期预后的预测价值。结果65例乙肝肝硬化失代偿期患者中Child-Pugh B级38例,Child-Pugh C级27例,患者随访期间存活42例,病死23例。Child-Pugh C级患者GGT、GGT/PLT高于Child-Pugh B级患者,PLT低于Child-Pugh B级患者(P<0.05)。经Kendall’s tau-b相关系数检验显示,GGT、GGT/PLT与Child-Pugh分级呈正相关(r>0,P<0.05),PLT与患者Child-Pugh分级呈负相关(r<0,P<0.05)。病死患者入院时GGT、GGT/PLT高于存活患者,PLT低于存活患者(P<0.05)。绘制ROC曲线,结果显示,血清GGT、PLT、GGT/PLT预测乙肝肝硬化失代偿期患者近期预后的AUC均≥0.7,均有一定的预测价值。结论GGT/PLT与乙肝肝硬化失代偿期患者Child-Pugh分级呈正相关,且早期检测患者GGT/PLT水平可用于预测患者短期不良预后风险。

血清胆碱酯酶、谷氨酰转移酶水平与病毒性肝炎患者肝功能的相关性

目的:分析血清胆碱酯酶(CHE)、谷氨酰转移酶(GGT)水平与病毒性肝炎患者肝功能的相关性。方法:回顾性分析2021年1月至2022年8月该院收治的100例病毒性肝炎患者的临床资料作为研究组,另选取同期该院100名健康体检者的临床资料作为对照组。检测两组血清CHE、GGT水平,并采用Child-Pugh分级评估病毒性肝炎患者的肝功能,比较两组及不同Child-Pugh分级病毒性肝炎患者的血清CHE、GGT水平,采用Kendall’s tau-b相关系数分析血清CHE、GGT水平与病毒性肝炎患者肝功能的相关性。结果:研究组血清GGT水平高于对照组,CHE水平低于对照组,差异有统计学意义(P<0.05);Child-Pugh分级C级病毒性肝炎患者血清GGT水平高于Child-Pugh分级A、B级患者,且B级患者高于A级患者,Child-Pugh分级C级病毒性肝炎患者血清CHE水平低于Child-Pugh分级A、B级患者,且B级患者低于A级患者,差异有统计学意义(P<0.05);Kendall’s tau-b相关系数分析结果显示,血清CHE水平与病毒性肝炎患者肝功能呈正相关(r>0,P<0.05),血清GGT水平与病毒性肝炎患者肝功能呈负相关(r<0,P<0.05)。结论:血清CHE水平与病毒性肝炎患者肝功能呈正相关,血清GGT水平与病毒性肝炎患者肝功能呈负相关。

超声内镜联合ALP、GGT在诊断胆总管结石自发排石中的应用研究

目的探讨超声内镜(EUS)联合血清碱性磷酸酶(ALP)和y谷氨酰转移酶(GGT)在诊断胆总管结石自发排石中的价值。方法回顾性分析安徽医科大学第--附属医院2017年9月~2021年7月收治住院的诊断胆总管结石患者97例,所有患者均通过影像学等检查首诊为胆总管结石,入院拟接受内镜逆行胰胆管造影(ERCP)手术。入院时采集人选者空腹静脉血,测定ALP、GCT水平,并在术前复查此两项指标并行EUS检查。患者经ERCP治疗明确取出结石判定为阳性胆总管结石;EUS诊断为胆总管结石但ERCP未发现结石,EUS检查未发现结石,并且随访期间无胆道症状、复查影像学未发现结石均判定为自发排石。观察患者EUS、ALP和GGT结果,评估EUS、ALP和GGT诊断胆总管结石自发排石的灵敏度和特异度。结果ROC曲线分析显示,ALP和GGT检测诊断胆总管结石的ROC曲线下的面积分别为0.790和0.756,ALP灵敏度和特异度分别为50%和93.3%,GGT为90.38%和62.22%,EUS为96.1%和86.7%。结论ALP、GGT检测可以预测患者可能出现排石,而EUS检查可以较准确判定自发排石,三者联合可以更好的判断胆总管结石自发排石的发生,避免了临床不必要的有创手术,减少了患者的身体创伤及医疗费用。

急性冠状动脉综合征冠状动脉严重程度的影响因素与γ-GGT及Hcy的相关性分析

目的探讨急性冠状动脉综合征(ACS)冠状动脉严重程度的影响因素及与谷氨酰转移酶(γ-GGT)、同型半胱氨酸(Hcy)的相关性分析。方法选择连云港市第二人民医院2019年1月~2021年12月收治的ACS患者110例,采用Gensini评分对患者冠状动脉严重程度进行评估,根据评估结果分为轻度组(0~30分)和中/重度组(>30分)。采用全自动生化分析仪检测γ-GGT及Hcy水平,并与冠状动脉严重程度进行相关分析。结果年龄、cTnI、CK-MB、FPG、LDL-C、hs-CRP、γ-GGT、Hcy均为ACS的危险因素(P<0.05)。ACS患者Gensini评分与γ-GGT、Hcy水平呈正相关性(r=0.573、0.435,P<0.05)。结论急性冠状动脉综合征患者冠状动脉相对严重,但受到的影响因素较多,且与γ-GGT及Hcy水平存在强相关性,应根据可能的影响因素进行干预,以改善患者预后。

老年急性呼吸衰竭患者血清hs-CRP、 GGT、CysC水平及其与心肌损伤的相关性

目的探究老年急性呼吸衰竭患者血清超敏C反应蛋白(hs-CRP)、γ-谷氨酰转移酶(GGT)、胱抑素C(CysC)水平及其与心肌损伤的相关性。方法回顾性收集2019年9月至2022年9月成都市第三人民医院收治的老年急性呼吸衰竭患者106例临床资料,按心肌损伤情况分为心肌损伤组37例和非心肌损伤组69例。比较两组患者的一般资料、血清hs-CRP、GGT、CysC水平,分析血清hs-CRP、GGT、CysC水平与心肌损伤的相关性,以及老年急性呼吸衰竭患者出现心肌损伤的危险因素。结果两组患者在年龄、性别、体重指数、原发疾病、合并糖尿病、合并高脂血症、呼吸衰竭类型、动脉血二氧化碳分压(PaCO_(2))等方面比较,差异均无统计学意义(P>0.05),心肌损伤组合并高血压病率高于非心肌损伤组,1秒用力呼气量/用力肺活量(FEV1/FVC)、动脉血氧分压(PaO_(2))均低于非心肌损伤组,差异均有统计学意义(P<0.05)。心肌损伤组血清N末端脑钠肽前体(NT-pro BNP)、肌钙蛋白I(cTnI)、肌酸激酶同工酶MB(CK-MB)水平为(359.32±54.89)mg/L、(1.31±0.17)U/L、(28.46±2.86)mg/L,均高于非心肌损伤组[(271.44±45.35)mg/L、(0.08±0.01)U/L、(17.10±2.52)mg/L],血清hs-CRP、GGT、CysC水平为(53.97±9.80)mg/L、(29.49±5.08)U/L、(1.49±0.22)mg/L,均高于非心肌损伤组[(45.52±7.39)mg/L、(25.14±4.56)U/L、(1.31±0.18)mg/L],差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,血清hs-CRP、GGT、CysC水平与老年急性呼吸衰竭患者心肌损伤呈正相关(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,血清hs-CRP、GGT、CysC的曲线下面积分别为0.780、0.754和0.750,截断值分别为50.635 mg/L、25.415 U/L和1.515 mg/L;Logistics回归分析结果显示,合并高血压病、hs-CRP>50.635 mg/L、GGT>25.415 U/L、CysC>1.515 mg/L与老年急性呼吸衰竭患者心肌损伤相关(P<0.05)。结论血清hs-CRP、GGT、CysC水平与老年急性呼吸衰竭患者发生心肌损伤相关,可用于临床参考。

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。

兰州市中老年居民的血清肝酶与2型糖尿病发病的相关性分析

目的探讨兰州市中老年居民的丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)和γ-谷氨酰转肽酶(GGT)与2型糖尿病(T2DM)发病的关系。方法于2011年,整群随机抽样兰州市3个社区40~75岁居民5135名,剔除符合排除标准的居民,最终纳入3832名。根据ALT、AST和GGT四分位数分为四组(Q1~Q4组)。非干预性随访≥3年的T2DM发病事件。logistic回归分析血清肝酶与T2DM发病的相关性。绘制受试者操作特征(ROC)曲线分析血清肝酶对T2DM发病的预测价值。结果非干预性随访≥3年,T2DM发病率为6.99%(268/3832)。T2DM组空腹血糖、餐后2 h血糖、糖化血红蛋白、ALT、GGT、甘油三酯和脂肪肝比例均高于非T2DM组,差异有统计学意义(P<0.05);高密度脂蛋白胆固醇低于非T2DM组,差异有统计学意义(P<0.05)。ALT的Q4组T2DM发病率高于ALT的Q1和Q2组,差异有统计学意义(P<0.05);GGT的Q3、Q4组T2DM发病率高于GGT的Q1和Q2组,差异有统计学意义(P<0.05)。logistic回归分析显示,ALT、GGT升高是T2DM发病的独立危险因素(OR>1,P<0.05)。ROC曲线显示,ALT预测T2DM的临界值、曲线下面积、灵敏度和特异度分别为18.5 U/L、0.593、0.519和0.634,GGT分别为20.5 U/L、0.614、0.616和0.572。结论兰州市中老年居民ALT、GGT升高可能与T2DM发病相关。

血清甲胎蛋白、γ-谷氨酰转肽酶对肝细胞癌发生微血管侵犯的临床应用价值

目的:基于放射学特征和临床实验室数据构建肝细胞癌(hepatocellular carcinoma,HCC)患者发生微血管侵犯(microvascular invasion,MVI)的预测模型,探讨HCC患者术前甲胎蛋白(alpha-fetoprotein,AFP)和γ-谷氨酰转肽酶(gamma-glutamyl transferase,GGT)的临床应用价值。方法:回顾性地收集南京医科大学第一附属医院479例HCC手术切除患者的临床数据,使用Logistics回归分析确定与MVI显著相关的变量,建立模型并绘制列线图。使用受试者工作特征曲线下面积(area under curve,AUC)、校准曲线和决策曲线分析(decision curve analysis,DCA)来评估模型的预测性能。通过灵敏度、特异度和准确度分析对模型预测性能进行比较。应用Kaplan-Meier曲线来评估患者的生存概率。结果:在多因素分析中,肿瘤大小、肿瘤边界不清楚、肿瘤外生性生长、AFP和GGT是HCC患者发生MVI的独立危险因素,用于构建模型。有AFP和GGT的模型A比没有AFP和GGT的模型B表现出更好的预测性能,AUC分别为0.902(0.872~0.932)和0.876(0.842~0.909)。分析评估模型临床净收益的DCA显示出模型A略好于模型B,都具有良好的临床应用价值。模型在队列中显示出良好的识别能力,预测的概率与实际观测值具有较好的一致性。在生存分析中发现,AFP和GGT升高的患者预后明显差于未升高的患者。结论:建立了HCC患者发生MVI的预测模型,研究证实了血清AFP和GGT的临床应用价值。

血清PTX-3、γ-GGT与冠心病及冠脉狭窄程度的相关性分析

目的探讨正五聚蛋白3(pentraxin,PTX-3)和γ-谷氨酰转肽酶(gamma-glutamyl transferase,γ-GGT)在评估冠心病(Coronary Heart Disease,CHD)及冠状动脉狭窄程度的潜在价值,评估两者联合检测对CHD早期诊断的临床意义.方法通过冠状动脉造影(CAG)定量测量Gensini(GS)评分方法评价冠脉狭窄程度.选取75例首次行CAG确诊为CHD的患者为试验组(CHD组),同时选取30例CAG结果阴性的患者为对照组,其中试验组根据GS评分系统依次分为低分组(24例)、中分组(24例)及高分组(27例).入院后采取酶联免疫吸附法(ELISA法)测定PTX-3水平,应用全自动生化分析仪检测所有纳入研究患者的血清γ-GGT水平,比较各组血清PTX-3、γ-GGT水平差异及两者联合检测对CHD早期诊断和冠脉狭窄程度的价值.结果随着CHD冠脉狭窄程度的增高,血清PTX-3、γ-GGT水平依次升高,即高分组>中分组>低分组>对照组(P<0.001).结论PTX-3、γ-GGT在CHD患者血清中显著升高,且与GS评分呈显著正相关关系;PTX-3、γ-GGT联合检测有可能成为冠心病早期诊断和危险分度的血清学标志物.