1
|
Sun R, Li S, Wei Y, Hu L, Xu Q, Zhan G, Yan X, He Y, Wang Y, Li X, Luo A, Zhou Z. Development of interpretable machine learning models for prediction of acute kidney injury after noncardiac surgery: a retrospective cohort study. Int J Surg 2024; 110:2950-2962. [PMID: 38445452 DOI: 10.1097/js9.0000000000001237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/15/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Early identification of patients at high-risk of postoperative acute kidney injury (AKI) can facilitate the development of preventive approaches. This study aimed to develop prediction models for postoperative AKI in noncardiac surgery using machine learning algorithms. The authors also evaluated the predictive performance of models that included only preoperative variables or only important predictors. MATERIALS AND METHODS Adult patients undergoing noncardiac surgery were retrospectively included in the study (76 457 patients in the discovery cohort and 11 910 patients in the validation cohort). AKI was determined using the KDIGO criteria. The prediction model was developed using 87 variables (56 preoperative variables and 31 intraoperative variables). A variety of machine learning algorithms were employed to develop the model, including logistic regression, random forest, extreme gradient boosting, and gradient boosting decision trees. The performance of different models was compared using the area under the receiver operating characteristic curve (AUROC). Shapley Additive Explanations (SHAP) analysis was employed for model interpretation. RESULTS The patients in the discovery cohort had a median age of 52 years (IQR: 42-61 years), and 1179 patients (1.5%) developed AKI after surgery. The gradient boosting decision trees algorithm showed the best predictive performance using all available variables, or only preoperative variables. The AUROCs were 0.849 (95% CI: 0.835-0.863) and 0.828 (95% CI: 0.813-0.843), respectively. The SHAP analysis showed that age, surgical duration, preoperative serum creatinine, and gamma-glutamyltransferase, as well as American Society of Anesthesiologists physical status III were the most important five features. When gradually reducing the features, the AUROCs decreased from 0.852 (including the top 40 features) to 0.839 (including the top 10 features). In the validation cohort, the authors observed a similar pattern regarding the models' predictive performance. CONCLUSIONS The machine learning models the authors developed had satisfactory predictive performance for identifying high-risk postoperative AKI patients. Furthermore, the authors found that model performance was only slightly affected when only preoperative variables or only the most important predictive features were included.
Collapse
Affiliation(s)
- Rao Sun
- Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia
| | - Shiyong Li
- Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia
| | - Yuna Wei
- Yidu Cloud Technology Inc, Beijing, People's Republic of China
| | - Liu Hu
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Qiaoqiao Xu
- Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia
| | - Gaofeng Zhan
- Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia
| | - Xu Yan
- Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia
| | - Yuqin He
- Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia
| | - Yao Wang
- Yidu Cloud Technology Inc, Beijing, People's Republic of China
| | - Xinhua Li
- Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia
| | - Ailin Luo
- Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia
| | - Zhiqiang Zhou
- Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia
| |
Collapse
|
2
|
Fluorescence Imaging Using Enzyme-Activatable Probes for Detecting Diabetic Kidney Disease and Glomerular Diseases. Int J Mol Sci 2022; 23:ijms23158150. [PMID: 35897725 PMCID: PMC9332157 DOI: 10.3390/ijms23158150] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/22/2022] [Accepted: 07/22/2022] [Indexed: 12/10/2022] Open
Abstract
A clear identification of the etiology of glomerular disease is essential in patients with diabetes. Renal biopsy is the gold standard for assessing the underlying nephrotic pathology; however, it has the risk for potential complications. Here, we aimed to investigate the feasibility of urinary fluorescence imaging using an enzyme-activatable probe for differentiating diabetic kidney disease and the other glomerular diseases. Hydroxymethyl rhodamine green (HMRG)-based fluorescent probes targeting gamma-glutamyl transpeptidase (GGT) and dipeptidyl-peptidase (DPP) were used. Urinary fluorescence was compared between groups which were classified by their histopathological diagnoses (diabetic kidney disease, glomerulonephritis, and nephrosclerosis) as obtained by ultrasound-guided renal biopsy. Urinary fluorescence was significantly stronger in patients with diabetic kidney disease compared to those with glomerulonephritis/nephrosclerosis after DPP-HMRG, whereas it was stronger in patients with nephrosclerosis than in patients with glomerulonephritis after GGT-HMRG. Subgroup analyses of the fluorescence performed for patients with diabetes showed consistent results. Urinary fluorescence imaging using enzyme-activatable fluorescence probes thus represents a potential noninvasive assessment technique for kidney diseases in patients with diabetes.
Collapse
|
3
|
Selen T, Akoglu H, Agbaht K. Relationship between liver function tests & cardiovascular risk factors in stage 3-5 pre-dialysis chronic kidney disease. Indian J Med Res 2022; 155:397-402. [DOI: 10.4103/ijmr.ijmr_1777_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
4
|
Irshaid Ir F, Mohammad K S, Mohummad A A, Saad Abood A. Effects of Smoking and Body Mass Index on Serum Liver Enzyme Levels in Chronic Kidney Disease Patients on Hemodialysis. JOURNAL OF MEDICAL SCIENCES 2018. [DOI: 10.3923/jms.2018.114.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
5
|
Zhou X, Wang L, Wang G, Cheng X, Hu S, Ke W, Li M, Zhang Y, Song Z, Zheng Q. A new plasma biomarker enhance the clinical prediction of postoperative acute kidney injury in patients with hepatocellular carcinoma. Clin Chim Acta 2017; 475:128-136. [PMID: 29031454 DOI: 10.1016/j.cca.2017.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Revised: 09/07/2017] [Accepted: 10/10/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND The ratio of serum γ-glutamyl transferase (GGT) to alanine aminotransferase (ALT) (GGT/ALT) is a marker for evaluating effects to antivirotic treatment and a helpful predictive factor for the prognosis of Child-Pugh A hepatocellular carcinoma (HCC) patients after surgery. The relationship between the incidence of postoperative acute kidney injury (AKI) and preoperative GGT/ALT is studied in hepatectomized hepatitis B- or C- associated HCC patients. METHODS A total of 253 hepatitis B or C virus-related HCC patients undergoing hepatectomy between September 2012 and August 2016 at our hospital were included in the retrospective study. Serum ALT and GGT value were recorded, and the GGT/ALT was computed. AKI was defined that based on the "Kidney Disease Improving Global Outcomes (KDIGO) criteria". RESULTS AKI was observed in 22 (8.7%) patients. Mean GGT/ALT of patients with AKI was significantly higher than in those without it (6.0 vs 2.1, P<0.001). Multivariate analysis revealed an increase in GGT/ALT as an independent risk factor for AKI in hepatitis B- or C- associated HCC patients, particularly in patients with Barcelona Clinic Liver Cancer (BCLC) stage 0 or A staged HCC (odds ratio (OR) 1.400, P<0.001). Multivariate analysis showed that ALT (OR 0.966, P=0.044) was somewhat inversely associated with the incidence of AKI in hepatitis B- or C- associated HCC patients. The best cutoff point of GGT/ALT was 2.92. Multivariate analysis showed that preoperative GGT/ALT ≥2.92 predicted poor prognosis of postoperative AKI in patients with HCC after hepatectomy (odds ratio 17.697, P<0.001). After propensity score matching, preoperative GGT/ALT ≥2.92 remained an independent risk factor for AKI in HCC patients (OR 13.947, P=0.003). CONCLUSIONS The GGT/ALT of patients with AKI was significantly higher than those without it. Evaluation of GGT/ALT before surgery can be a helpful predictive tool for postoperative AKI in hepatitis B- or C- associated HCC patients undergoing hepatectomy, particularly in patients with BCLC stage 0 or A staged HCC. Hepatitis B- or C- associated HCC patients with low ALT especially within the normal range may have a high risk of AKI. However, the reason remains to be elucidated.
Collapse
Affiliation(s)
- Xing Zhou
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Liyu Wang
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Guoliang Wang
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Xiang Cheng
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Shaobo Hu
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Wenbo Ke
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Min Li
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yong Zhang
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Zifang Song
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Qichang Zheng
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| |
Collapse
|
6
|
Caravaca-Fontán F, Azevedo L, Bayo MÁ, Gonzales-Candia B, Luna E, Caravaca F. Niveles séricos elevados de gamma-glutamil transferasa y fosfatasa alcalina son predictores independientes de mortalidad en la enfermedad renal crónica estadio 4-5. Nefrologia 2017. [DOI: 10.1016/j.nefro.2016.11.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
|
7
|
Perrin-Sarrado C, Pongas M, Dahboul F, Leroy P, Pompella A, Lartaud I. Reduced Activity of the Aortic Gamma-Glutamyltransferase Does Not Decrease S-Nitrosoglutathione Induced Vasorelaxation of Rat Aortic Rings. Front Physiol 2017; 7:630. [PMID: 28066263 PMCID: PMC5168561 DOI: 10.3389/fphys.2016.00630] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 12/05/2016] [Indexed: 12/28/2022] Open
Abstract
Aims: Gamma-glutamyl transferase (GGT), an enzyme present on the endothelium, is involved in the release of nitric oxide (NO) from S-nitrosoglutathione (GSNO) and in the GSNO-induced vasodilation. Endogenous GSNO is a physiological storage form of NO in tissues while exogenous GSNO is an interesting candidate for compensating for the decreased NO bioavailability occurring during cardiovascular diseases. We investigated in a rat model of human hypertension, the spontaneous hypertensive rat (SHR), submitted or not to high salt diet, whether a decreased vascular GGT activity modifies the vasorelaxant effect of GSNO. Methods: Thoracic aortic rings isolated from male SHR and Wistar Kyoto rats (WKY) aged 20–22 weeks—submitted or not for 8 weeks to a high salt diet (1% w/v NaCl in drinking water) were pre-constricted with phenylephrine then submitted to concentration-vasorelaxant response curves (maximal response: Emax; pD2) to carbachol or sodium nitroprusside to evaluate endothelial dependent or independent NO-induced vasodilation, or GSNO (exogenous NO vasodilation depending from the endothelial GGT activity). GGT activity was measured using a chromogenic substrate in aortic homogenates. Its role in GSNO-induced relaxation was assessed following inhibition of the enzyme activity (serine-borate complex). That of protein disulfide isomerase (PDI), another redox sensitive enzyme involved in GSNO metabolism, was assessed following inhibition with bacitracin. Results: Aortic GGT activity (18–23 μmol/min/mg of tissue in adult WKY) decreased by 33% in SHR and 45% in SHR with high salt diet. Emax and pD2 for sodium nitroprusside were similar in all groups. Emax for carbachol decreased by −14%, reflecting slight endothelial NO-dependent dysfunction. The GSNO curve was slightly shifted to the left in SHR and in SHR with high salt diet, showing a small enhanced sensitivity to GSNO. Involvements of GGT, as that of PDI, in the GSNO effects were similar in all groups (pD2 for GSNO −0.5 to −1.5 following enzymatic inhibition). Conclusion: Hypertension is associated with a decreased aortic GGT activity without decreasing the vasorelaxant effects of GSNO, whose bioactivity may be supplemented through the alternative enzymatic activity of PDI.
Collapse
Affiliation(s)
- Caroline Perrin-Sarrado
- EA3452 CITHEFOR "Drug Targets, Formulation and Preclinical Assessment", Faculté de Pharmacie, Université de Lorraine Nancy, France
| | - Marios Pongas
- EA3452 CITHEFOR "Drug Targets, Formulation and Preclinical Assessment", Faculté de Pharmacie, Université de Lorraine Nancy, France
| | - Fatima Dahboul
- EA3452 CITHEFOR "Drug Targets, Formulation and Preclinical Assessment", Faculté de Pharmacie, Université de Lorraine Nancy, France
| | - Pierre Leroy
- EA3452 CITHEFOR "Drug Targets, Formulation and Preclinical Assessment", Faculté de Pharmacie, Université de Lorraine Nancy, France
| | - Alfonso Pompella
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa Medical School Pisa, Italy
| | - Isabelle Lartaud
- EA3452 CITHEFOR "Drug Targets, Formulation and Preclinical Assessment", Faculté de Pharmacie, Université de Lorraine Nancy, France
| |
Collapse
|
8
|
Association between serum γ-glutamyltransferase and chronic kidney disease in urban Han Chinese: a prospective cohort study. Int Urol Nephrol 2016; 49:303-312. [DOI: 10.1007/s11255-016-1429-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 09/21/2016] [Indexed: 01/09/2023]
|
9
|
Wang X, Chen LL, Zhang Q. Increased Serum Level of Growth Differentiation Factor 15 (GDF-15) is Associated with Coronary Artery Disease. Cardiovasc Ther 2016; 34:138-43. [PMID: 26996787 DOI: 10.1111/1755-5922.12184] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Xia Wang
- Department of Clinical laboratory; Huai'an First People's Hospital; Nanjing Medical University; Huai'an China
| | - Lei-Lei Chen
- Department of Cardiology; The First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Qing Zhang
- Department of Cardiology; Huai'an First People's Hospital; Nanjing Medical University; Huai'an China
| |
Collapse
|
10
|
Oksuz F, Yarlioglues M, Cay S, Celik IE, Mendi MA, Kurtul A, Cankurt T, Kuyumcu S, Canpolat U, Turak O. Predictive Value of Gamma-Glutamyl Transferase Levels for Contrast-Induced Nephropathy in Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention. Am J Cardiol 2015; 116:711-6. [PMID: 26116992 DOI: 10.1016/j.amjcard.2015.05.042] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 05/23/2015] [Accepted: 05/23/2015] [Indexed: 11/19/2022]
Abstract
Contrast-induced nephropathy (CIN) after primary percutaneous coronary intervention (PPCI) is associated with adverse short- and long-term outcomes. The aim of this study was to evaluate the predictive value of gamma-glutamyl transferase (GGT) for risk of CIN in patients with ST-segment elevation myocardial infarction who underwent PPCI. A total of 473 patients were enrolled in the study. A relative increase in serum creatinine ≥25%, or an absolute increase ≥0.5 mg/dl, from the baseline within 72 hours of contrast exposure was defined as CIN. Patients were divided into 3 groups according to GGT tertiles (tertile 1, GGT <19 U/L; tertile 2, GGT 19 to 33 U/L; and tertile 3, GGT >33 U/L) on admission. Demographics, clinical risk factors, laboratory parameters, CIN incidence, and other inhospital clinical outcomes were compared among GGT tertiles. CIN incidence was significantly higher in tertile 3 (29%) compared with tertiles 1 (11%) and 2 (11%, p <0.001). Inhospital death incidence was significantly increased across tertiles (from tertile 1 to tertiles 2 and 3, 1%, 4%, and 5%, respectively, p <0.05). In receiver operating characteristic analysis, a threshold value of GGT >26.5 U/L had 70% sensitivity and 60% specificity for CIN. After including variables found significant in univariate analysis, the presence of diabetes mellitus (odds ratio [OR] 1.71, 95% confidence interval [CI] 1.22 to 2.31, p <0.001), C-reactive protein (for each 1 mg/L increase; OR 1.01, 95% CI 1.00 to 1.02, p = 0.007), contrast volume (for each 1-ml increase; OR 1.01, 95% CI 1.00 to 1.02, p = 0.012), and GGT >26.5 U/L (OR 2.59, 95% CI 1.48 to 4.53, p <0.001) were found as independent associates of CIN in multivariate regression analysis. Each 1 U/L increase in GGT was also associated with CIN risk (OR 1.04, 95% CI 1.03 to 1.06, p <0.001). In conclusion, GGT on admission was a significant and independent predictor of CIN after PPCI in patients with ST-segment elevation myocardial infarction.
Collapse
Affiliation(s)
- Fatih Oksuz
- Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
| | - Mikail Yarlioglues
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Serkan Cay
- Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Ibrahim Ethem Celik
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Mehmet Ali Mendi
- Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Alparslan Kurtul
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Tayyar Cankurt
- Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Serdar Kuyumcu
- Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Uğur Canpolat
- Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Osman Turak
- Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| |
Collapse
|
11
|
Sun K, Li F, Lin D, Qi Y, Xu M, Li N, Huang C, Ren M, Li Y, Yan L. Serum gamma - glutamyltransferase is associated with albuminuria: a population-based study. PLoS One 2014; 9:e114970. [PMID: 25500578 PMCID: PMC4263709 DOI: 10.1371/journal.pone.0114970] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 11/17/2014] [Indexed: 01/18/2023] Open
Abstract
Background Serum γ - glutamyltransferase (GGT) is implicated in the pathogenesis of endothelial dysfunction and atherosclerosis. Albuminuria is a marker of endothelial damage and correlated with structural and functional integrity of the vasculature. Our objective was to evaluate the association between serum GGT level and prevalence of albuminuria in a Chinese population. Materials and Methods We conducted a population-based cross-sectional study in 9,702 subjects aged 40 years or older. Increased urinary albumin excretion was defined according to the urinary albumin-to-creatinine ratio (ACR) ranges greater or equal than 30 mg/g. Low-grade albuminuria was defined according to the highest quartile of ACR in participants without increased urinary albumin excretion. Results The prevalence of low-grade albuminuria and increased urinary albumin excretion were respectively 23.4% and 6.6% in this population and gradually increased across the sex-specific serum GGT quartiles (all P for trend <0.05). In logistic regression analysis, compared with subjects in the lowest quartile of serum GGT level, the adjusted odds ratios (ORs) in the highest quartile was 1.22 [95% confidence interval (CI), 1.04–1.43] for low-grade albuminuria and 1.55 (95% CI, 1.18–2.04) for increased urinary albumin excretion. In subgroup analysis, significant relationship of serum GGT level with both low-grade albuminuria and increased urinary albumin excretion were detected in women, younger subjects, overweight subjects and in those with hypertension or glomerular filtration rate greater than 90 (all P <0.05). Conclusion Serum GGT level is associated with urinary albumin excretion in middle-aged and elderly Chinese.
Collapse
Affiliation(s)
- Kan Sun
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People' s Republic of China
| | - Feng Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People' s Republic of China
| | - Diaozhu Lin
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People' s Republic of China
| | - Yiqin Qi
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People' s Republic of China
| | - Mingtong Xu
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People' s Republic of China
| | - Na Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People' s Republic of China
| | - Chulin Huang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People' s Republic of China
| | - Meng Ren
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People' s Republic of China
| | - Yan Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People' s Republic of China
- * E-mail: (LY); (YL)
| | - Li Yan
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People' s Republic of China
- * E-mail: (LY); (YL)
| |
Collapse
|
12
|
Taşolar H, Taşolar S, Kurtuluş D, Altun B, Bayramoğlu A, Otlu YÖ, Ballı M, Çetin M, Altunışık N, Kapıcıoğlu Y, Pekdemir H. Increased epicardial adipose tissue thickness on transthoracic echocardiography in patients with Behçet disease. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:1393-1400. [PMID: 25063404 DOI: 10.7863/ultra.33.8.1393] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES Owing to the fact that the potential frequency of endothelial dysfunction and early atherosclerosis might be higher in Behçet disease, characterized by acute and chronic inflammatory attacks, it may lead to impairment in flow-mediated dilatation and an increase in epicardial adipose tissue thickness. Therefore, we aimed to evaluate whether epicardial adipose tissue thickness and brachial artery flow-mediated dilatation as markers of early atherosclerosis and endothelial dysfunction were associated with Behçet disease. METHODS Thirty-five patients with Behçet disease and 35 healthy volunteers were included in this study. Epicardial adipose tissue was identified as an anechoic space between epicardial layers on 2-dimensional images, and its thickness was measured on the free wall of the right ventricle. Right brachial artery flow-mediated dilatation was assessed according to recent guidelines. RESULTS Serum γ-glutamyl transferase (GGT) levels and epicardial adipose tissue thickness were significantly higher (P = .001; P < .001 respectively), whereas flow-mediated, endothelium-dependent dilatation was significantly lower in the Behçet disease group than controls (P < .001). There was a significant negative association between epicardial adipose tissue thickness and flow-mediated dilatation (P < .001). Epicardial adipose tissue thickness was also positively correlated with Behçet disease activity (P< .001), Behçet disease duration (P< .001), and waist circumference (P< .001). Flow-mediated dilatation was negatively correlated with GGT (P< .001), Behçet disease activity (P< .001), and age (P< .001). There was also a significant association between GGT and Behçet disease activity (P < .001). CONCLUSIONS We found that epicardial adipose tissue thickness was significantly higher and flow-mediated dilatation was significantly lower in patients with Behçet disease than in controls. We suggest that identification of increased epicardial adipose tissue might aid in the diagnosis and treatment of possible coronary artery disease in patients with Behçet disease.
Collapse
Affiliation(s)
- Hakan Taşolar
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey.
| | - Sevgi Taşolar
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Duygu Kurtuluş
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Burak Altun
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Adil Bayramoğlu
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Yılmaz Ömür Otlu
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Mehmet Ballı
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Mustafa Çetin
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Nihal Altunışık
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Yelda Kapıcıoğlu
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Hasan Pekdemir
- Departments of Cardiology (H.T., M.B., M.Ç.) and Radiology (S.T.), Adiyaman University Training and Research Hospital, Adiyaman, Turkey; Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey (D.K.); Department of Cardiology, Faculty of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey (B.A.); and Departments of Cardiology (A.B., Y.Ö.O., H.P.) and Dermatology (N.A., Y.K.), Faculty of Medicine, Inonu University, Malatya, Turkey
| |
Collapse
|
13
|
Mao Y, Qi X, Xu W, Song H, Xu M, Ma W, Zhou L. Serum gamma-glutamyl transferase: a novel biomarker for coronary artery disease. Med Sci Monit 2014; 20:706-10. [PMID: 24780890 PMCID: PMC4010599 DOI: 10.12659/msm.890245] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Atherosclerosis is a chronic inflammatory process, in which oxidative stress is the key event. Gamma-glutamyl transferase (GGT) is a cellular production of oxidants. We aimed to elucidate the relationship of serum GGT levels and coronary artery disease (CAD) in a Chinese population. MATERIAL AND METHODS A total of 513 adult subjects who had undergone coronary angiography were enrolled in the study. Clinical characteristics, coronary angiography, and serum samples were collected from all the patients and analyzed for the serum GGT, blood lipids, and cardiovascular risk factors. RESULTS Subjects with CAD had significantly increased activity of serum GGT (p=0.003). Serum GGT levels exhibited positive correlations with alcohol intake (β=0.177, p<0.001), coronary complexity (β=0.068, p<0.001), and triacylglycerol (β=0.058, p<0.001). High-density lipoprotein cholesterol levels (β=0.157, p=0.008) and age (β=0.004, p=0.002) were negatively correlated with serum GGT in the CAD group. The coronary complexity presented a negative correlation with Ig-apolipoprotein AI (β=-2.517, p=0.001) and positive correlations with smoking (β=0.640, p<0.001), Ig-GGT (β=0.613, p=0.004), Ig high sensitivity-C reactive protein (β=0.320, p<0.001), and hypertension (β=0.286, p<0.026). CONCLUSIONS The study showed a positive correlation between serum GGT and CAD in a Chinese population. Serum GGT levels may be a potential biomarker for CAD.
Collapse
Affiliation(s)
- Yu Mao
- Division of Cardiology, Shanghai Tongji Hospital, Shanghai, China (mainland)
| | - Xiaolong Qi
- Institute of Digestive Disease, Shanghai Tongji Hospital, Shanghai, China (mainland)
| | - Wenjun Xu
- Division of Cardiology, Shanghai Tongji Hospital, Shanghai, China (mainland)
| | - Haoming Song
- Division of Cardiology, Shanghai Tongji Hospital, Shanghai, China (mainland)
| | - Mingxin Xu
- Institute of Digestive Disease, Shanghai Tongji Hospital, Shanghai, China (mainland)
| | - Wanrong Ma
- Institute of Digestive Disease, Shanghai Tongji Hospital, Shanghai, China (mainland)
| | - Lin Zhou
- Division of Cardiology, Shanghai Tongji Hospital, Shanghai, China (mainland)
| |
Collapse
|
14
|
Yamazaki J, Mochizuki K, Miyauchi R, Ichikawa Y, Goda T. Circulating interleukin-1β concentrations are independently-positively associated with γ-glutamyltransferase activity within the normal range in middle-aged apparently healthy Japanese women. J Nutr Sci Vitaminol (Tokyo) 2014; 59:526-32. [PMID: 24477249 DOI: 10.3177/jnsv.59.526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We previously demonstrated that the circulating concentrations of interleukin (IL)-1β, which is known to induce the development and progression of type 2 diabetes and its complications, were positively associated with γ-glutamyltransferase (γ-GTP) activity in middle-aged apparently healthy Japanese men. It was still unknown if the association between IL-1β concentrations and γ-GTP activity is within the normal range in apparently healthy Japanese women. In this study, we conducted a cross-sectional study of 824 apparently healthy women aged 40-64 y [mean±standard deviation age, 53.1±7.1 y; body mass index (BMI), 22.0±3.1 kg/m(2)] who participated in health checkups in Japan, and whose γ-GTP activity was within the normal range (<38 U/L). Associations of γ-GTP with IL-1β and other clinical or lifestyle factors were determined using analysis of variance (ANOVA) and one-way analysis of covariance (ANCOVA) followed by Tukey's multiple-range test. Multivariate logistic regression analyses (MLRA) were performed with γ-GTP activity as the dependent variable; independent variables included IL-1β plus clinical and lifestyle factors. ANOVA and ANCOVA indicated that IL-1β concentrations were positively associated with γ-GTP activity. MLRA showed that γ-GTP activity showed trends for higher IL-1β concentrations after adjusting for age, BMI, energy intake, alcohol intake, and smoking status. Together, IL-1β concentrations are positively associated with γ-GTP activity within the normal range in middle-aged apparently healthy Japanese women. Our results suggest that γ-GTP activity would be useful for assessing inflammation from the healthy state in Japanese women.
Collapse
Affiliation(s)
- Junpei Yamazaki
- Laboratory of Nutritional Physiology, University of Shizuoka, Graduate School of Nutritional and Environmental Sciences
| | | | | | | | | |
Collapse
|
15
|
Noborisaka Y, Ishizaki M, Yamazaki M, Honda R, Yamada Y. Elevated Serum Gamma-Glutamyltransferase (GGT) Activity and the Development of Chronic Kidney Disease (CKD) in Cigarette Smokers. Nephrourol Mon 2013; 5:967-73. [PMID: 24693503 PMCID: PMC3955288 DOI: 10.5812/numonthly.13652] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 07/24/2013] [Accepted: 08/03/2013] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Elevated serum gamma-glutamyltransferase (GGT) is predictive of various cardiovascular (CV) risk factors including chronic kidney disease (CKD). Elevated serum GGT has been recognized in smokers who are likely to develop CKD, but no study has focused on serum GGT and CKD in smokers. OBJECTIVES The aim of this study was to clarify the associations between cigarette consumption, elevation of serum GGT and the development of proteinuria and CKD. PATIENTS AND METHODS A retrospective 6-year observational study was conducted on 2,603 male workers aged between 40 and 64 years. Incidences of proteinuria detected by dipstick and CKD defined by proteinuria and/or reduced estimated glomerular filtration rate (eGFR) measured in health check-ups were determined 6 years later for those who had been free of them at baseline. RESULTS Higher means of serum GGT in smokers than in nonsmokers at baseline, and a higher incidence of elevated serum GGT in smokers than in nonsmokers during the 6-year period were recognized only for alcohol consumers. Incidences of proteinuria and moderate or severe CKD which has a high risk of future renal failure or CV disease were higher in the subjects with greater cigarette consumption or a higher serum GGT level. Multiple logistic regression analyses adjusting for major CV risk factors showed a significant interactive effect between smoking and elevated serum GGT on the development of proteinuria and an additive effect of smoking and serum GGT on the development of high-risk CKD. CONCLUSIONS Elevation of serum GGT in smokers, to a large extent, depends on the associated alcohol consumption. Elevated GGT in smokers plays at least a partial role in the development of CKD, mainly proteinuria, and the underlying mechanisms remain to be elucidated.
Collapse
Affiliation(s)
- Yuka Noborisaka
- Department of Social and Environmental Medicine, Kanazawa Medical University School of Medicine, Ishikawa, Japan
- Corresponding author: Yuka Noborisaka, Department of Social and Environmental Medicine, Kanazawa Medical University School of Medicine, 1-1 Uchinada, Ishikawa 920-0293 Japan. Tel: +81-762188101, Fax: +81-762869723, E-mail:
| | - Masao Ishizaki
- Department of Social and Environmental Medicine, Kanazawa Medical University School of Medicine, Ishikawa, Japan
| | - Michiko Yamazaki
- Department of Social and Environmental Medicine, Kanazawa Medical University School of Medicine, Ishikawa, Japan
| | - Ryumon Honda
- Department of Social and Environmental Medicine, Kanazawa Medical University School of Medicine, Ishikawa, Japan
| | - Yuichi Yamada
- Department of Social and Environmental Medicine, Kanazawa Medical University School of Medicine, Ishikawa, Japan
| |
Collapse
|