1
|
Chiu KL, Chen YD, Wang ST, Chang TH, Wu JL, Shih CM, Yu CS. Exploring the Potential Performance of Fibroscan for Predicting and Evaluating Metabolic Syndrome using a Feature Selected Strategy of Machine Learning. Metabolites 2023; 13:822. [PMID: 37512529 PMCID: PMC10383149 DOI: 10.3390/metabo13070822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023] Open
Abstract
Metabolic syndrome (MetS) includes several conditions that can increase an individual's predisposition to high-risk cardiovascular events, morbidity, and mortality. Non-alcoholic fatty liver disease (NAFLD) is a predominant cause of cirrhosis, which is a global indicator of liver transplantation and is considered the hepatic manifestation of MetS. FibroScan® provides an accurate and non-invasive method for assessing liver steatosis and fibrosis in patients with NAFLD, via a controlled attenuation parameter (CAP) and liver stiffness measurement (LSM or E) scores and has been widely used in current clinical practice. Several machine learning (ML) models with a recursive feature elimination (RFE) algorithm were applied to evaluate the importance of the CAP score. Analysis by ANOVA revealed that five symptoms at different CAP and E score levels were significant. All eight ML models had accuracy scores > 0.9, while treebags and random forest had the best kappa values (0.6439 and 0.6533, respectively). The CAP score was the most important variable in the seven ML models. Machine learning models with RFE demonstrated that using the CAP score to identify patients with MetS may be feasible. Thus, a combination of CAP scores and other significant biomarkers could be used for early detection in predicting MetS.
Collapse
Affiliation(s)
- Kuan-Lin Chiu
- Department of Family Medicine, Taipei Medical University Hospital, Taipei 110301, Taiwan
| | - Yu-Da Chen
- Department of Family Medicine, Taipei Medical University Hospital, Taipei 110301, Taiwan
| | - Sen-Te Wang
- Department of Family Medicine, Taipei Medical University Hospital, Taipei 110301, Taiwan
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Health Management Center, Taipei Medical University Hospital, Taipei 110301, Taiwan
| | - Tzu-Hao Chang
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 235603, Taiwan
- Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei 110301, Taiwan
| | - Jenny L Wu
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 235603, Taiwan
| | - Chun-Ming Shih
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Cardiovascular Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan
- Taipei Heart Institute, Taipei Medical University, Taipei 11031, Taiwan
| | - Cheng-Sheng Yu
- Graduate Institute of Data Science, College of Management, Taipei Medical University, Taipei 235603, Taiwan
- Clinical Data Center, Office of Data Science, Taipei Medical University, Taipei 106339, Taiwan
| |
Collapse
|
2
|
Wang W, Ren J, Zhou W, Huang J, Wu G, Yang F, Yuan S, Fang J, Liu J, Jin Y, Qi H, Miao Y, Le Y, Ge C, Qiu X, Wang J, Huang P, Liu Z, Wang S. Lean non-alcoholic fatty liver disease (Lean-NAFLD) and the development of metabolic syndrome: a retrospective study. Sci Rep 2022; 12:10977. [PMID: 35768441 PMCID: PMC9243064 DOI: 10.1038/s41598-022-14701-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 06/10/2022] [Indexed: 11/09/2022] Open
Abstract
Lean NAFLD is a special phenotypic closely correlated with metabolic syndrome (MS). The aim of this study is to investigate the MS development and the gender differences in lean NAFLD population. Participants were divided into 4 groups by BMI and NAFLD status. Descriptive analysis was performed to characterize baseline information. A total of 18,395 subjects were participated, and 1524 incident cases of MS were documented. Then, Kaplan–Meier curves were used to present the MS outcomes in different groups, and the NAFLD was found to be a riskier factor than obesity for MS. Subgroup analysis showed significantly higher MS incidence in female than male among lean NAFLD group, which is different from other groups. Although with higher prevalence in male, lean NAFLD seems to be a more harmful phenotype for females according to the TG, ALT and GGT levels. The logistic regressive analysis was performed to show the impact of NAFLD status and BMI changes on MS risk. Lean non-NAFLD subjects merely developed to NAFLD with no BMI status changes exhibited highest MS risk (ORs = 1.879, 95% CI 1.610–2.292) than that with both BMI increase and NAFLD development (ORs = 1.669, 95% CI 1.325–2.104). It also suggests the metabolic specificity of this population.
Collapse
Affiliation(s)
- Wenting Wang
- School of Public Health, Hangzhou Normal University, No.2318 Yuhangtang Road, Hangzhou, 311121, Zhejiang Province, China.,Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No.261 Huansha Road, Hangzhou, 310006, Zhejiang Province, China
| | - Jianping Ren
- School of Public Health, Hangzhou Normal University, No.2318 Yuhangtang Road, Hangzhou, 311121, Zhejiang Province, China.
| | - Wenzhao Zhou
- Zhejiang Laboratory for Systems & Precision Medicine, Zhejiang University Medical Center, 1369 West Wenyi Road, Hangzhou, 311121, Zhejiang Province, China. .,Department of Biology and Chemistry, Zhejiang Institute of Metrology, No.300 Xiasha Road, Hangzhou, 310018, Zhejiang Province, China.
| | - Jinyu Huang
- Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No.261 Huansha Road, Hangzhou, 310006, Zhejiang Province, China
| | - Guomin Wu
- Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No.261 Huansha Road, Hangzhou, 310006, Zhejiang Province, China
| | - Fenfang Yang
- Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No.261 Huansha Road, Hangzhou, 310006, Zhejiang Province, China
| | - Shuang Yuan
- School of Public Health, Hangzhou Normal University, No.2318 Yuhangtang Road, Hangzhou, 311121, Zhejiang Province, China
| | - Juan Fang
- School of Public Health, Hangzhou Normal University, No.2318 Yuhangtang Road, Hangzhou, 311121, Zhejiang Province, China
| | - Jing Liu
- Department of Hepatology, Affiliated Hospital of Hangzhou Normal University, Normal University, HangzhouHangzhou, 310015, Zhejiang Province, China.,Institute of Hepatology and Metabolic Diseases, Hangzhou Normal University, Hangzhou, 311121, Zhejiang Province, China
| | - Yao Jin
- School of Public Health, Hangzhou Normal University, No.2318 Yuhangtang Road, Hangzhou, 311121, Zhejiang Province, China
| | - Haiyang Qi
- Department of Biology and Chemistry, Zhejiang Institute of Metrology, No.300 Xiasha Road, Hangzhou, 310018, Zhejiang Province, China
| | - Yuyang Miao
- Department of Biology and Chemistry, Zhejiang Institute of Metrology, No.300 Xiasha Road, Hangzhou, 310018, Zhejiang Province, China
| | - Yanna Le
- Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No.261 Huansha Road, Hangzhou, 310006, Zhejiang Province, China.,Hangzhou Medical Association, No.70 Kaiyuan Road, Hangzhou, 310006, Zhejiang Province, China
| | - Cenhong Ge
- Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No.261 Huansha Road, Hangzhou, 310006, Zhejiang Province, China
| | - Xiantao Qiu
- School of Public Health, Hangzhou Normal University, No.2318 Yuhangtang Road, Hangzhou, 311121, Zhejiang Province, China
| | - JinJing Wang
- School of Public Health, Hangzhou Normal University, No.2318 Yuhangtang Road, Hangzhou, 311121, Zhejiang Province, China
| | - Ping Huang
- School of Public Health, Hangzhou Normal University, No.2318 Yuhangtang Road, Hangzhou, 311121, Zhejiang Province, China
| | - Zixin Liu
- School of Public Health, Hangzhou Normal University, No.2318 Yuhangtang Road, Hangzhou, 311121, Zhejiang Province, China
| | - Sheng Wang
- School of Nursing, Hangzhou Normal University, No.2318 Yuhangtang Road, Hangzhou, 311121, Zhejiang Province, China.
| |
Collapse
|
3
|
Kathak RR, Sumon AH, Molla NH, Hasan M, Miah R, Tuba HR, Habib A, Ali N. The association between elevated lipid profile and liver enzymes: a study on Bangladeshi adults. Sci Rep 2022; 12:1711. [PMID: 35110625 PMCID: PMC8810783 DOI: 10.1038/s41598-022-05766-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 01/14/2022] [Indexed: 12/14/2022] Open
Abstract
Dyslipidemia, a major contributor to cardiovascular diseases, is rapidly increasing in Asian countries including Bangladesh. In addition to the cardiovascular system, abnormal lipid levels are also known to cause complications in renal and hepatic systems. The data regarding dyslipidemia and its relationship with liver enzymes are scarce for the Bangladeshi population. Therefore, this study was conducted to estimate the prevalence of dyslipidemia and determine the relationship between lipid profile and liver enzymes in Bangladeshi adults. A total of 405 participants (318 males and 87 females) were enrolled in the study. Serum levels of TG, TC, LDL, HDL and liver enzymes including ALT, AST, GGT and ALP were analyzed using standard methods. Dyslipidemia and liver function tests abnormalities were defined according to the international standard guidelines. The association between elevated lipid profile markers and liver enzyme abnormalities was assessed by logistic regression analysis. Overall, the prevalence of elevated TG, TC, LDL and low HDL were 30.9%, 23.7%, 26.2% and 78.8%, respectively. On the other hand, the prevalence of elevated liver enzymes ALT, AST, GGT and ALP were 18.8%, 21.6%, 12.9% and 21.9%, respectively. Dyslipidemia and liver enzyme abnormalities were higher in diabetic and hypertensive participants than in the healthy participants. About 61% of participants with dyslipidemia had at least one or more elevated liver enzymes. In regression analysis, an independent association was observed between serum GGT and all lipid components. In conclusion, a high prevalence of dyslipidemia and liver enzyme abnormalities were observed among the study participants. Of the four liver enzymes, the serum levels of GGT showed an independent association with all lipid components. Moreover, this study indicates that subjects with dyslipidemia often have a higher chance of having liver diseases than subjects with no dyslipidemia. However, large-scale prospective studies are needed to understand the underlying mechanisms of lipid-induced hepatic dysfunction in the Bangladeshi population.
Collapse
Affiliation(s)
- Rahanuma Raihanu Kathak
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh
| | - Abu Hasan Sumon
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh
| | - Noyan Hossain Molla
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh
| | - Mahmudul Hasan
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh
| | - Rakib Miah
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh
| | - Humaira Rashid Tuba
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh
| | - Ahsan Habib
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh
| | - Nurshad Ali
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh.
| |
Collapse
|
4
|
Reimann B, Vrijens K, Roels HA, Wang C, Cosemans C, Van Overmeire I, Nawrot TS, Plusquin M. In utero exposure to parabens and early childhood BMI z-scores - Associations between placental ethyl paraben, longitudinal BMI trajectories and cord blood metabolic biomarkers. ENVIRONMENT INTERNATIONAL 2021; 157:106845. [PMID: 34474324 PMCID: PMC8484768 DOI: 10.1016/j.envint.2021.106845] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/21/2021] [Accepted: 08/20/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND Parabens are used as antimicrobial preservatives in personal care products. Few studies have dealt with adverse health outcomes, transplacental transfer, and obesogenic effects of prenatal exposure to parabens. We examined the association between placental paraben levels and cord blood metabolic biomarkers, considering modulating effects of maternal pre-pregnancy BMI and underlying epigenetic mechanisms, and investigated longitudinal effects of in utero paraben exposure on early childhood trajectories of BMI z-scores. METHODS Placental concentrations of four parabens [methyl (MeP), ethyl (EtP), propyl (PrP), and butyl (BuP)] were measured by ultra-performance liquid chromatography/tandem mass spectrometry in 229 placentas of the ENVIRONAGE birth cohort. The association with cord blood metabolic biomarkers [glucose, insulin, γ-glutamyltransferase (GGT), high-density and low-density lipoprotein (HDL and LDL)] was analyzed in multiple regression models with two different sets of, a priori selected potential confounders, additionally stratified for different maternal BMI groups and assessed by causal mediation analysis. The association between placental paraben concentration and differential DNA methylation of CpGs annotated to GGT and longitudinal measurements of BMI z-scores were investigated with adjusted linear mixed models. RESULTS The geometric means of placental MeP, EtP, PrP, and BuP levels above the limit of detection (LOD) were 4.42, 1.32, 1.51, and 0.35 ng/g respectively, with only EtP showing sufficient (88%) measurements above LOD for further analyses. An interquartile ratio (IQR) increase in placental EtP was associated with an increase of 12.61 % (95% CI: 1.80 24.57) in the geometric mean of cord GGT activity, and with a decrease of -3.64 % (95% CI: -6.80 to -0.39) in the geometric mean of cord glucose. Placental EtP levels were significantly associated with hypermethylation of cg08612779 annotated to GGT7 after correcting for multiple testing (ß = 0.0017, p = 0.049). An interquartile ratio (IQR) increment in placental EtP was associated with a decrease in longitudinal BMI z-score of 0.27 points (95% CI: -0.46 to -0.088). CONCLUSION Prenatal EtP exposure may affect early childhood BMI. The association of placental EtP with cord blood GGT and glucose levels provides a starting point for further research on mechanisms of paraben-related metabolic processes in utero.
Collapse
Affiliation(s)
- Brigitte Reimann
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium
| | - Karen Vrijens
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium
| | - Harry A Roels
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium
| | - Congrong Wang
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium
| | - Charlotte Cosemans
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium
| | - Ilse Van Overmeire
- Sciensano, Chemical and Physical Health Risks, J. Wytsmanstraat 14, 1050 Brussels, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium; Department of Public Health, Environment & Health Unit, Leuven University (KU Leuven), Kapucijnenvoer 35, 3000 Leuven, Belgium
| | - Michelle Plusquin
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium.
| |
Collapse
|
5
|
Assessment of the relationship between serum uric acid levels and liver enzymes activity in Bangladeshi adults. Sci Rep 2021; 11:20114. [PMID: 34635716 PMCID: PMC8505549 DOI: 10.1038/s41598-021-99623-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/27/2021] [Indexed: 11/08/2022] Open
Abstract
Serum uric acid (SUA) level has been suggested to be associated with cardiovascular disease, diabetes and metabolic syndrome. However, little is known about the relationship between SUA and liver enzymes activity in the general population. The present study aimed to assess the relationship between SUA and serum liver enzymes in an adult population in Bangladesh. In this cross-sectional study, a total of 410 blood samples were collected from apparently healthy adults aged > 18 years. SUA, liver enzymes, lipid profile and other biochemical markers were measured in the collected samples by using standard methods. Multinomial logistic regression model was used to assess the relationship between SUA and elevated levels of liver enzymes among the participants. Overall, the prevalence of hyperuricemia was 30.1% with 32.2% in male and 18.6% in female participants. About 33% of the participants had at least one or more elevated levels of liver enzymes. The mean level of SUA was significantly higher in males (389.3 ± 96.9 µmol/L) than in the female (290.4 ± 89.8 µmol/L) subjects (p < 0.001). There was a significant difference in the mean levels of serum ALT and GGT between the male (34.5 ± 16.0 U/L and 26.7 ± 19.5 U/L, respectively) and female (25.0 ± 13.0 U/L and 19.5 ± 13.2 U/L, respectively) participants (p < 0.001 and p < 0.01, respectively). An increasing trend was observed in the mean levels of serum ALT and GGT across the SUA quartile groups (p < 0.001 and p < 0.01, respectively). SUA showed a positive and significant correlation with serum ALT (p < 0.001) and GGT (p < 0.01). In further statistical analysis after adjustment for potential confounders, SUA showed an independent and significant association with serum ALT and GGT in all regression models. In conclusion, SUA was strongly associated with serum levels of ALT and GGT after adjustment for potential confounders. More prospective studies are needed to clarify the complex relationship between SUA and liver enzymes in the general population.
Collapse
|
6
|
Islam S, Rahman S, Haque T, Sumon AH, Ahmed AZM, Ali N. Prevalence of elevated liver enzymes and its association with type 2 diabetes: A cross-sectional study in Bangladeshi adults. Endocrinol Diabetes Metab 2020; 3:e00116. [PMID: 32318634 PMCID: PMC7170449 DOI: 10.1002/edm2.116] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/22/2020] [Accepted: 01/25/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Type 2 diabetes (T2D) is a major public health concern affecting millions of people worldwide. The relationship between liver enzymes and T2D has been reported in limited studies; however, there is still a lack of evidence for the Bangladeshi population. This study aimed to evaluate the prevalence of elevated liver enzymes and examine its association with the prevalence of T2D in Bangladeshi adults. METHODS A total of 270 individuals (110 diabetic and 160 nondiabetic) were enrolled in the study. Alanine and aspartate aminotransferase (ALT, AST), alkaline phosphatase (ALP) and γ-glutamyltransferase (GGT) activities were measured in blood serum collected from them. T2D was defined as fasting blood glucose (FBG) ≥126 mg/dL or self-reported recent use of insulin or antidiabetic medications. Association between liver enzymes and T2D was evaluated by multinomial logistic regression analysis. RESULTS Overall, 61.2% of participants in T2D and 37.1% of participants in the nondiabetes group had at least one or more elevated liver enzymes. The mean concentrations of serum ALT, AST, ALP and GGT were significantly higher in the T2D group compared to the nondiabetes group. The prevalence of elevated liver enzymes was significantly higher in the diabetes group compared to the nondiabetes group (P < .01). In regression analysis, serum GGT activity showed an independent association with the prevalence of T2D. CONCLUSIONS A high prevalence of elevated liver enzymes was observed in subjects having diabetes. Increased serum GGT activity was independently associated with the prevalence of T2D among Bangladeshi adults. More studies of this nature should be carried out in developing countries to get proper insights into the involvement of liver enzymes in T2D.
Collapse
Affiliation(s)
- Shiful Islam
- Department of Biochemistry and Molecular BiologyShahjalal University of Science and TechnologySylhetBangladesh
| | - Sadaqur Rahman
- Department of Biochemistry and Molecular BiologyShahjalal University of Science and TechnologySylhetBangladesh
| | - Tangigul Haque
- Department of Biochemistry and Molecular BiologyShahjalal University of Science and TechnologySylhetBangladesh
| | - Abu Hasan Sumon
- Department of Biochemistry and Molecular BiologyShahjalal University of Science and TechnologySylhetBangladesh
| | | | - Nurshad Ali
- Department of Biochemistry and Molecular BiologyShahjalal University of Science and TechnologySylhetBangladesh
| |
Collapse
|
7
|
Abstract
The mercapturic acid pathway is a major route for the biotransformation of xenobiotic and endobiotic electrophilic compounds and their metabolites. Mercapturic acids (N-acetyl-l-cysteine S-conjugates) are formed by the sequential action of the glutathione transferases, γ-glutamyltransferases, dipeptidases, and cysteine S-conjugate N-acetyltransferase to yield glutathione S-conjugates, l-cysteinylglycine S-conjugates, l-cysteine S-conjugates, and mercapturic acids; these metabolites constitute a "mercapturomic" profile. Aminoacylases catalyze the hydrolysis of mercapturic acids to form cysteine S-conjugates. Several renal transport systems facilitate the urinary elimination of mercapturic acids; urinary mercapturic acids may serve as biomarkers for exposure to chemicals. Although mercapturic acid formation and elimination is a detoxication reaction, l-cysteine S-conjugates may undergo bioactivation by cysteine S-conjugate β-lyase. Moreover, some l-cysteine S-conjugates, particularly l-cysteinyl-leukotrienes, exert significant pathophysiological effects. Finally, some enzymes of the mercapturic acid pathway are described as the so-called "moonlighting proteins," catalytic proteins that exert multiple biochemical or biophysical functions apart from catalysis.
Collapse
Affiliation(s)
- Patrick E Hanna
- Department of Medicinal Chemistry, University of Minnesota, Minneapolis, MN, USA
| | - M W Anders
- Department of Pharmacology and Physiology, University of Rochester Medical Center, Rochester, NY, USA
| |
Collapse
|
8
|
Lee MY, Hyon DS, Huh JH, Kim HK, Han SK, Kim JY, Koh SB. Association between Serum Gamma-Glutamyltransferase and Prevalence of Metabolic Syndrome Using Data from the Korean Genome and Epidemiology Study. Endocrinol Metab (Seoul) 2019; 34:390-397. [PMID: 31884739 PMCID: PMC6935781 DOI: 10.3803/enm.2019.34.4.390] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 09/18/2019] [Accepted: 11/19/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The aim of this study was to determine whether there is a positive correlation between gamma-glutamyltransferase (GGT) levels and the prevalence of metabolic syndrome and whether GGT can be used as an easily checkable metabolic index using data from the large-scale Korean Genome and Epidemiology Study (KoGES). METHODS We obtained data of 211,725 participants of the KoGES. The collected data included age, sex, height, weight, waist circumference, and various biochemical characteristics, including serum GGT levels. The data of study participants who ingested more than 40 g/day of alcohol and who were diagnosed with metabolic syndrome at baseline was excluded. We analyzed the prevalence of metabolic syndrome according to GGT quartiles in both genders. RESULTS The GGT level was significantly higher in subjects with metabolic syndrome compared to normal subjects (37.92±48.20 mg/dL vs. 25.62±33.56 mg/dL). The prevalence of metabolic syndrome showed a stepwise increase with GGT quartiles in both male and female subjects. Compared to the lowest GGT quartile, the odds ratio was 1.534 (95% confidence interval [CI], 1.432 to 1.643), 1.939 (95% CI, 1.811 to 2.076), and 2.754 (95% CI, 2.572 to 2.948) in men and 1.155 (95% CI, 1.094 to 1.218), 1.528 (95% CI, 1.451 to 1.609), and 2.022 (95% CI, 1.921 to 2.218) in women with increasing GGT quartile. The cutoff value of GGT predicting risk of metabolic syndrome was 27 IU/L in men and 17 IU/L in women. CONCLUSION We suggested that GGT could be an easily checkable marker for the prediction of metabolic syndrome.
Collapse
Affiliation(s)
- Mi Young Lee
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dae Sung Hyon
- Department of Preventive Medicine and Institute of Occupational Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Ji Hye Huh
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hae Kyung Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sul Ki Han
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jang Young Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sang Baek Koh
- Department of Preventive Medicine and Institute of Occupational Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, Wonju, Korea
- Center for Global Health and Social Medicine, Institute of Poverty Alleviation and International Development, Yonsei University, Seoul, Korea.
| |
Collapse
|
9
|
Zhao H, Song X, Li Z, Wang X. Risk factors associated with nonalcohol fatty liver disease and fibrosis among patients with type 2 diabetes mellitus. Medicine (Baltimore) 2018; 97:e12356. [PMID: 30212992 PMCID: PMC6156034 DOI: 10.1097/md.0000000000012356] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is closely related to hepatic steatosis and fibrosis. The aim of this study was to analyze the occurrence of hepatic steatosis and fibrosis in patients with T2DM and to explore the risk factors.A total of 629 patients with T2DM were enrolled. Liver stiffness value (LSV) and controlled attenuation parameters (CAP) were measured using Fibroscan. Liver fibrosis was diagnosed when LSV was greater than 7.4 kPa, and advanced liver fibrosis was diagnosed when LSV was greater than 10.6 kPa. Hepatic steatosis diagnosis was made when CAP value was greater than 238 dB/m. Demographic information, physical examination data, and laboratory tests results were collected. The 629 patients were classified into 2 groups by the liver fibrosis and liver steatosis, and then the difference was analyzed.Among patients enrolled, 231 patients were diagnosed as liver fibrosis. The age of the patients in the fibrosis group was significantly greater than that in the non-fibrosis group, and similar trends were observed in the waist-hip ratio (WHR), systolic blood pressure, and diastolic blood pressure. The proportion of smoking and alcoholic consumption was significantly lower in patients with non-fibrosis group. A total of 426 patients were diagnosed with liver steatosis. Body mass index (BMI), WHR, systolic blood pressure, and diastolic blood pressure in patients with steatosis were significantly higher than those in non-steatosis group. We observed that the LSV (P = .042) and CAP value (P < .001) are positively correlated with metabolic syndrome components in T2DM patients. Older age (OR = 1.099, P = .001), high BMI (OR = 1.088, P = .003), low platelet level (OR = 0.996, P = .014), and smoking (OR = 1.653, P = .013) were independent risk factors of liver fibrosis among T2DM patients. High BMI (OR = 1.369, P < .001), high diastolic blood pressure (OR = 1.048, P < .001), and high gamma glutamyl transpeptidase (OR = 1.018, P = .009) were independent risk factors for liver steatosis among T2DM patients.This study suggested risk factors screening of liver fibrosis and steatosis. Timely intervention should be taken into consideration among high risk patients to prevent progress liver diseases.
Collapse
Affiliation(s)
- Hongli Zhao
- Department of Endocrinology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi
| | - Xiangxin Song
- Department of Endocrinology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi
| | - Zhang Li
- Department of Medicine, Xinjiang Altay Region People's Hospital, Altay, Xinjiang, P.R. China
| | - Xinling Wang
- Department of Endocrinology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi
| |
Collapse
|
10
|
Lin CM, Hsieh CH, Lee CH, Pei D, Lin JD, Wu CZ, Liang YJ, Hung YJ, Chen YL. Predictive Value of Serum Gamma-glutamyltranspeptidase for Future Cardiometabolic Dysregulation in Adolescents- a 10-year longitudinal study. Sci Rep 2017; 7:9636. [PMID: 28851958 PMCID: PMC5574888 DOI: 10.1038/s41598-017-09719-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 06/27/2017] [Indexed: 12/29/2022] Open
Abstract
Serum gamma-glutamyltransferase (γ-GT) is implicated in the pathogenesis of atherosclerosis and metabolic syndrome (MetS) in adults. The relationships between γ-GT and cardiometabolic dysregulation remains unclear in adolescents. We enrolled 7,072 Taiwanese adolescents and followed them for a median of 6.8 years. The optimal cut-off values (CoVs) of baseline γ-GT to predict future MetS, hypertension (HTN), and type 2 diabetes (T2DM) were determined by receiving operating characteristic (ROC) curve. Using these CoVs, the participants were divided into normal- and high-level groups. Cox proportional hazard analysis was used to calculate hazard ratios (HRs) for the subjects with a high level of γ-GT for the risk of future cardiometabolic dysregulation. Serum γ-GT was significantly higher in the subjects with MetS than in those without MetS at baseline (p < 0.001). The optimal CoVs of γ-GT were 12 U/L for boys and 11 U/L for girls. In multivariate Cox regression analysis, a higher serum γ-GT level increased the risk of future MetS (HRs 1.98 and 2.85 for boys and girls, respectively, both p < 0.001), but not new onset HTN and T2DM. In conclusion, serum γ-GT levels not only demonstrated an excellent correlation with the presence of MetS and also in predicting future MetS in adolescents.
Collapse
Affiliation(s)
- Chien-Ming Lin
- Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chang-Hsun Hsieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chien-Hsing Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Dee Pei
- Department of Internal Medicine, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Jiunn-Diann Lin
- Division of Endocrinology, Department of Internal Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, Republic of China.,Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China
| | - Chung-Ze Wu
- Division of Endocrinology, Department of Internal Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, Republic of China.,Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China
| | - Yao-Jen Liang
- Department of Life Science, Graduate Institute of Applied Science and Engineering, College of Science and Engineering, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Yi-Jen Hung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
| | - Yen-Lin Chen
- Department of Pathology, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.
| |
Collapse
|
11
|
Vinodhini R, Kebede L, Teka G, Asana B, Abel T. Prevalence of Prediabetes and its Risk Factors among the Employees of Ambo University, Oromia Region, Ethiopia. RESEARCH IN MOLECULAR MEDICINE 2017. [DOI: 10.29252/rmm.5.3.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
|
12
|
Choi YJ, Lee DH, Han KD, Yoon H, Shin CM, Park YS, Kim N. Elevated serum gamma-glutamyltransferase is associated with an increased risk of oesophageal carcinoma in a cohort of 8,388,256 Korean subjects. PLoS One 2017; 12:e0177053. [PMID: 28475598 PMCID: PMC5419599 DOI: 10.1371/journal.pone.0177053] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 04/21/2017] [Indexed: 12/18/2022] Open
Abstract
Gamma-glutamyltransferase (GGT) is a marker for hepatic injury and alcohol consumption. However, the association of GGT with the risk of oesophageal carcinoma (OC) has not been fully recognized to date. Therefore, this study aimed to determine the association between elevated GGT and OC, by also considering the body mass index (BMI) of the subjects. Clinical data from 8,388,256 Korean individuals, who were aged 40 years and over and who received healthcare check-ups arranged by the national insurance program in 2007 and 2008, were analysed. Newly diagnosed OC was identified using claims data during a median follow-up duration of 8.72 years. During the study period, 6,863 individuals (0.08%) developed OC. We found that there was an increased risk of OC in subjects with serum GGT values >18 IU/L. Furthermore, a BMI <18.5 kg/m2 (underweight) was associated with increased OC risk, while a BMI ≥23.0 kg/m2 was associated with a reduced OC risk. Individuals who were both underweight and in the highest GGT quartile (≥40 IU/L) had a far greater risk of OC compared to other individuals (hazard ratio: 3.65, 95% confidence interval: 3.10–4.30). In conclusion, increased serum GGT was associated with an increased risk of developing OC in the general Korean population, regardless of age, sex, smoker status, or alcohol consumption.
Collapse
Affiliation(s)
- Yoon Jin Choi
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea
| | - Dong Ho Lee
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
- * E-mail:
| | - Kyung-Do Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hyuk Yoon
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea
| | - Cheol Min Shin
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea
| | - Young Soo Park
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Nayoung Kim
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| |
Collapse
|
13
|
Wang J, Zhang D, Huang R, Li X, Huang W. Gamma-glutamyltransferase and risk of cardiovascular mortality: A dose-response meta-analysis of prospective cohort studies. PLoS One 2017; 12:e0172631. [PMID: 28231268 PMCID: PMC5322906 DOI: 10.1371/journal.pone.0172631] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 02/07/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Serum gamma-glutamyltransferase (GGT) elevation likely contributes to cardiovascular (CV) mortality, however it has remained unknown whether a dose-response relationship exists between serum GGT and CV mortality. METHODS We searched the PubMed, EMBASE, and Cochrane library databases for prospective cohort studies published up to October 2, 2016. Summary hazard ratios (HRs) with their corresponding 95% confidence intervals (CIs) were calculated using a fixed effects model. FINDINGS Nine prospective studies, including 527,589 participants and more than 7,011 cases, were included in this meta-analysis. For the moderate, high, and highest levels of GGT, the pooled HRs of CV mortality were 1.11 (95% CI = 1.04-1.19), 1.29 (95% CI = 1.21-1.38) and 1.59 (95% CI = 1.47-1.72), respectively (all p < 0.05 as compared to the lowest levels of GGT). Additionally, the HR per incremental increase of GGT by 10 U/L was 1.10 (95% CI = 1.08-1.11). Evidence of a positive relationship with nonlinear trend for GGT elevation with CV mortality in females was found (P = 0.04 for nonlinearity). However, a linear model was better fit to illustrate the GGT-CV mortality among males (P = 0.304 for nonlinearity). CONCLUSIONS These findings indicate that serum GGT activity within the reference interval is positively associated with increased risk of CV mortality in a dose-response manner.
Collapse
Affiliation(s)
- Junna Wang
- Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dandan Zhang
- Department of Gerontology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Rongzhong Huang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xingsheng Li
- Department of Gerontology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- * E-mail: (XSL); (WXH)
| | - Wenxiang Huang
- Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- * E-mail: (XSL); (WXH)
| |
Collapse
|
14
|
Treeprasertsuk S, Romero-Corral A, Somers VK, Sierra-Johnson J, Lindor KD, Angulo P, Lopez-Jimenez F. Association of adiposity, measures of metabolic dysregulation, and elevated alanine aminotransferase in subjects with normal body mass index. ASIAN BIOMED 2017. [DOI: 10.5372/1905-7415.0805.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Abstract
Background: Differences in body fat (BF) distribution in patients with normal body mass index (BMI) with elevated alanine aminotransferase (ALT) remains poorly described.
Objective: To determine the relationship between total BF, waist circumference (WC), insulin resistance (IR), and cardiometabolic risk profile in subjects with elevated ALT and normal BMI.
Methods: We analyzed cross-sectional data from 4,914 US participants in the third National Health and Nutrition Examination Survey database, who were ≥20 years of age, had normal BMI, and had body composition assessed by bioimpedance.
Results: Mean ± SD age was 41.4 ± 0.3 years, and 58% participants were women. BF was 20 ± 0.1% in men and 29.9 ± 0.1% in women. As total BF increased by tertiles, there was a tendency towards a higher prevalence of nonalcoholic fatty liver disease in men (6.1%, 6.5%, 9.5%, P = 0.13), but not in women (8.7%, 8.2%, 10.7%, P = 0.71). As WC increased by tertiles, there was a higher prevalence of elevated ALT in men (2.6%, 8.6%, 6.6%, P < 0.0001), but not in women. As ALT increased, men had significantly higher levels of nonhigh density lipoprotein cholesterol (HDL-C), increased apolipoprotein B, increased IR, and lower levels of C-reactive protein, whereas, women had higher levels of non-HDL-C and increased IR.
Conclusion: In subjects with normal BMI, increased WC is associated with a higher prevalence of elevated ALT in men, but not in women. Higher levels of ALT correlated with a poor cardiometabolic risk profile.
Collapse
Affiliation(s)
- Sombat Treeprasertsuk
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Mayo Foundation Rochester, Minnesota 55902, USA Thailand
- Correspondence: MD, PhD, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Abel Romero-Corral
- Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Mayo Foundation Rochester, MN, Minnesota 55902, USA United States of America
- Department of Internal Medicine, Albert Einstein Medical Center, Philadelphia 19141, United States of America
| | - Virend K. Somers
- Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Mayo Foundation Rochester, MN, Minnesota 55902, United States of America
| | - Justo Sierra-Johnson
- Department of Medicine, Atherosclerosis Research Unit, Karolinska Institute, SE-171 76 Stockholm, Sweden
| | - Keith D. Lindor
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Mayo Foundation Rochester, Minnesota 55902, United States of America
| | - Paul Angulo
- Division of Gastroenterology, University of Kentucky Chandler Medical Center, Lexington, Kentucky 40536-0509, United States of America
| | - Francisco Lopez-Jimenez
- Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Mayo Foundation Rochester, MN, Minnesota 55902, United States of America
| |
Collapse
|
15
|
Ko SH, Baeg MK, Han KD, Ko SY, Shin SB, Ko SH, Ahn YB. Association between gamma-glutamyltransferase and albuminuria in nondiabetic adults with normal renal function. Clin Exp Nephrol 2016; 21:835-841. [PMID: 27933415 DOI: 10.1007/s10157-016-1356-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 11/01/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND Serum gamma-glutamyltransferase (GGT) has been associated with albuminuria in diabetes patients, but it has not been investigated in the general population. We aimed to investigate the association between serum GGT and albuminuria in the nondiabetic Korean population with normal kidney function. METHODS Study participants (3948; 1549 men and 2399 women) with an estimated glomerular filtration rate ≥60 mL/min/1.73 m2 were analyzed from the fifth Korean National Health and Nutrition Examination Survey (2011). Albuminuria was defined as an albumin-creatinine ratio >30 mg/g. Serum GGT was analyzed by dividing into quartiles. Multiple logistic models were used to analyze the associations between GGT and albuminuria. RESULTS The prevalence of albuminuria was 5.1% and increased linearly according to increasing GGT quartiles (P for trend = 0.005). A linear regression analysis revealed that GGT was positively related with albuminuria (P = 0.008). After adjusting for confounding factors, the odds ratio for albuminuria was 1.80 (95% CI 1.079-3.010, P for trend = 0.029) for the highest quartile group compared with those observed in the lowest quartile of GGT. In addition, this independent relationship did not change when the cut-off value of GGT (30 IU/L) was applied to this analysis. Compared with GGT value ≤30 IU/L, the adjusted odds ratio of albuminuria in participants with GGT >30 IU/L was 1.96 (95% CI 1.319-2.906, P < 0.001). CONCLUSION Higher serum GGT levels within the reference range were significantly associated with albuminuria in nondiabetic Koreans with preserved kidney function, independently of traditional cardio-renal risk factors.
Collapse
Affiliation(s)
- Sun-Hye Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, 137-701, Seoul, Republic of Korea
| | - Myong Ki Baeg
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung-Do Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seung-Yeon Ko
- Department of General Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sae-Bom Shin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, 137-701, Seoul, Republic of Korea
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, 137-701, Seoul, Republic of Korea
| | - Yu-Bae Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, 137-701, Seoul, Republic of Korea.
| |
Collapse
|
16
|
Yu JH, Kim JS, Lee MR, Yoon SY, Cho SY, Yoo SH, Kim BI. Risks of borderline liver enzyme abnormalities to the incidence of impaired fasting glucose and diabetes mellitus: a 7 year follow up study of workers. Ann Occup Environ Med 2016; 28:18. [PMID: 27057316 PMCID: PMC4823863 DOI: 10.1186/s40557-016-0105-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 03/28/2016] [Indexed: 01/14/2023] Open
Abstract
Background The aim of this study was to identify the relationships between borderline serum liver enzyme abnormalities and the incidence of impaired fasting glucose (IFG) and diabetes mellitus (DM) during a 7-year follow-up of workers, and to evaluate the quantitative level of risks. Methods A total of 749 workers in an electronics manufacturing company were divided into the normal fasting blood glucose (n = 633), IFG (n = 98), and DM (n = 18) groups, according to the results of their health checkup in 2006. Among 633 workers in the normal group, excluding 55 workers who were impossible to follow, incidence rate and relative risks of 578 workers to the IFG or DM in 2013 according to the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyltransferase (γ-GTP) were investigated. The liver enzyme levels were categorized as A (normal), B (borderline elevation), and R (definite elevation) following the standard of the National Health Insurance Service of Korea. Results The incidence rate of IFG or DM based on ALT level was 9.7 % for the A, 30.0 % for B, and 15.4 % for R. According to γ-GTP, the incidence rate was 9.8 % for A, 34.5 % for B, and 25.0 % for R. The relative risk(RR) to the incidence of IFG or DM depending on the level of ALT were 3.09 in B and 1.59 in R compared to A. According to γ-GTP, RR was 3.52 in B and 2.55 in R compared to A. AST level was not related to the incidence of IFG or DM. A multiple logistic regression analysis with the incidence of IFG or DM as a dependent variable resulted in an odds ratio of 2.664(1.214–5.849) for B level ALT, 3.685(1.405–9.667) for B level of γ-GTP even after adjustment for other variables such as age, sex, body mass index, AUDIT score, systolic blood pressure, and triglyceride. Conclusions Even borderline elevations of ALT and γ-GTP, but not AST, increased the incidence and risk of IFG or DM after 7 years. Borderline elevation of ALT and γ-GTP was identified as an independent risk factor of IFG or DM.
Collapse
Affiliation(s)
- Jin-Hyun Yu
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, Gongdan 1-dong, Gumi-si, Gyeongbuk, 730-706 South Korea
| | - Jin-Seok Kim
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, Gongdan 1-dong, Gumi-si, Gyeongbuk, 730-706 South Korea
| | - Mee-Ra Lee
- LIGnex1 Gumi company, 133, Gongdan 1-dong, Gumi-si, Gyeongbuk, 730-703 South Korea
| | - Seong-Yong Yoon
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, Gongdan 1-dong, Gumi-si, Gyeongbuk, 730-706 South Korea
| | - Seong-Yong Cho
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, Gongdan 1-dong, Gumi-si, Gyeongbuk, 730-706 South Korea
| | - Seung-Hyun Yoo
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, Gongdan 1-dong, Gumi-si, Gyeongbuk, 730-706 South Korea
| | - Boo-Il Kim
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, Gongdan 1-dong, Gumi-si, Gyeongbuk, 730-706 South Korea
| |
Collapse
|
17
|
Mok Y, Son DK, Yun YD, Jee SH, Samet JM. γ-Glutamyltransferase and cancer risk: The Korean cancer prevention study. Int J Cancer 2015; 138:311-9. [PMID: 26111622 DOI: 10.1002/ijc.29659] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 05/28/2015] [Accepted: 06/02/2015] [Indexed: 01/08/2023]
Abstract
Elevated serum γ-glutamyltransferase (GGT) is a marker of hepatic injury and is associated with risk of chronic disease. However, the value of GGT as a biomarker for cancer risk remains unclear. Therefore, we evaluated the association of serum GGT with cancer incidence among more than 1.6 million Koreans. We included 1,662,087 Koreans (1,108,121 men and 553,966 women aged 20-95 years) who received health insurance from the National Health Insurance Service and had a biennial medical evaluation between 1995 and 1998. Follow-up was through December 2012. Using Cox proportional hazards models, we adjusted for age, smoking status, alcohol consumption, exercise and body mass index after exclusion of early cases (cancer diagnosis or death within 5 years of starting follow-up) and estimated hazard ratios (HRs) of overall and organ-specific cancer incidence by GGT quintiles. During the 17-year follow-up, 129,087 new cancer cases occurred among the participants. Across levels of GGT, there was a positive gradient of HR and the highest quintile of GGT (≥ 60 IU/L) had the highest HR for all cancers in both men and women. By cancer site, the association was strongest for liver cancer, comparing the highest and lowest strata in men [HR, 6.67; 95% confidence interval (95%CI), 5.88-7.57] and in women (HR, 7.57; 95%CI, 6.41-8.94). Significant associations were also observed for cancers of the esophagus, larynx, stomach, colorectal, bile duct and lung in men and of the bile duct in women. Increased serum GGT level is independently associated with risk of cancer.
Collapse
Affiliation(s)
- Yejin Mok
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Dong-Koog Son
- National Health Insurance Service, Seoul, Republic of Korea
| | - Young Duk Yun
- National Health Insurance Service, Seoul, Republic of Korea
| | - Sun Ha Jee
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Jonathan M Samet
- Department of Preventive Medicine, Keck School of Medicine, and Institute for Global Health, University of Southern California, Los Angeles, CA
| |
Collapse
|
18
|
Bulusu S, Sharma M. What does serum γ-glutamyltransferase tell us as a cardiometabolic risk marker? Ann Clin Biochem 2015; 53:312-32. [PMID: 26139450 DOI: 10.1177/0004563215597010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2015] [Indexed: 01/18/2023]
Abstract
γ-glutamyltransferase plays a key role in the synthesis and metabolism of extracellular glutathione, a major antioxidant in several defence mechanisms in the body. γ-glutamyltransferase is affected by environmental and genetic factors, and is raised when there is depletion of glutathione. Hence, it is a marker of oxidative stress. There is robust evidence that γ-glutamyltransferase even when values are within the reference interval is associated with increased cardiovascular and all-cause mortality in both sexes, in normal subjects and subjects with coronary artery disease, in the middle-aged and the elderly after adjusting for confounding factors. γ-glutamyltransferase even within the reference interval is associated with future presentation of type 2 diabetes, and the longitudinal increase in γ-glutamyltransferase activity is associated with increased risk of type 2 diabetes and cardiovascular mortality. γ-glutamyltransferase is associated with cardiovascular risk factors and metabolic syndrome. It has a prognostic value after a previous acute myocardial infarction and may be an indicator of adverse outcome in acute coronary syndromes and other chronic cardiac disorders. There is limited data about γ-glutamyltransferase and any association with peripheral arterial disease and also whether knowing γ-glutamyltransferase activity improves cardiovascular risk prediction beyond conventional risk factors. γ-glutamyltransferase is present in atherosclerotic lesions in the coronary and carotid arteries, and has a prooxidant role leading to the production of reactive oxygen species and atherosclerosis. Current reference intervals for γ-glutamyltransferase are inappropriate and need to be addressed. Some laboratories still use non- International Federation of Clinical Chemistry methods for estimation of γ-glutamyltransferase which are associated with lower results. Such laboratories should review their method and consider changing to the International Federation of Clinical Chemistry method.
Collapse
Affiliation(s)
- Sudha Bulusu
- Department of Clinical Biochemistry, Homerton Hospital, London, UK
| | - Manisha Sharma
- Department of Clinical Biochemistry, Homerton Hospital, London, UK
| |
Collapse
|
19
|
Staudigl C, Concin N, Grimm C, Pfeiler G, Nehoda R, Singer CF, Polterauer S. Prognostic relevance of pretherapeutic gamma-glutamyltransferase in patients with primary metastatic breast cancer. PLoS One 2015; 10:e0125317. [PMID: 25915044 PMCID: PMC4411095 DOI: 10.1371/journal.pone.0125317] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 03/17/2015] [Indexed: 12/30/2022] Open
Abstract
Background Gamma-glutamyltransferase (GGT) is a known marker for apoptotic balance and cell detoxification. Recently, an association of baseline GGT levels and breast cancer incidence, tumor progression and chemotherapy resistance was shown. The purpose of this study was to evaluate the association of pre-therapeutic GGT levels, clinical-pathological parameters and survival in patients with primary metastatic breast cancer (PMBC). Methods In this multicenter analysis, pre-therapeutic GGT levels and clinical-pathological parameters of 114 patients diagnosed with PMBC between 1996 and 2012 were evaluated. The association between GGT levels and clinical-pathological parameters were analysed. Patients were stratified into four GGT risk-groups (GGT < 18.00 U/L: normal low, 18.00 to 35.99 U/L: normal high, 36.00 to 71.99 U/L: elevated and ≥ 72.00 U/L: highly elevated) and survival analyses were performed. Findings Patients in the high risk GGT group had a poorer overall survival, when compared to the low risk group with five-year overall survival rates of 39.5% and 53.7% (p = 0.04), respectively. Patients with larger breast tumors had a trend towards higher GGT levels (p = 0.053). Pre-therapeutic GGT levels were not associated with indicators of aggressive tumor biology such as HER2-status, triple negative histology, or poorly differentiated cancers. Conclusion Pre-therapeutic GGT serum level might serve as a novel prognostic factor for overall-survival in patients with PMBC.
Collapse
Affiliation(s)
- Christine Staudigl
- Department of General Gynecology and Gynecologic Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Nicole Concin
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Grimm
- Department of General Gynecology and Gynecologic Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Georg Pfeiler
- Department of General Gynecology and Gynecologic Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Regina Nehoda
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian F. Singer
- Department of General Gynecology and Gynecologic Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Stephan Polterauer
- Department of General Gynecology and Gynecologic Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- * E-mail:
| |
Collapse
|
20
|
Yoon SR, Lee JH, Na GY, Seo YJ, Han S, Shin MJ, Kim OY. Glycated Hemoglobin is a Better Predictor than Fasting Glucose for Cardiometabolic Risk in Non-diabetic Korean Women. Clin Nutr Res 2015; 4:97-103. [PMID: 25954730 PMCID: PMC4418421 DOI: 10.7762/cnr.2015.4.2.97] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Revised: 04/09/2015] [Accepted: 04/10/2015] [Indexed: 12/17/2022] Open
Abstract
This study aimed to investigate if glycated hemoglobin (HgbA1C) as compared to fasting blood glucose is better for reflecting cardiometabolic risk in non-diabetic Korean women. Fasting glucose, HgbA1C and lipid profiles were measured in non-diabetic women without disease (n = 91). The relationships of fasting glucose or HgbA1C with anthropometric parameters, lipid profiles, and liver and kidney functions were analyzed. Both fasting glucose and HgbA1C were negatively correlated with HDL-cholesterol (r = -0.287, p = 0.006; r = -0.261, p = 0.012), and positively correlated with age (r = 0.202, p = 0.008; r = 0.221, p = 0.035), waist circumference (r = 0.296, p = 0.005; r = 0.304, p = 0.004), diastolic blood pressure (DBP) (r = 0.206, p = 0.050; r = 0.225, p = 0.032), aspartate transaminase (AST) (r = 0.237, p = 0.024; r = 0.368, p < 0.0001), alanine transaminase (ALT) (r = 0.296, p = 0.004; r = 0.356, p = 0.001), lipid profiles including triglyceride (r = 0.372, p < 0.001; r = 0.208, p = 0.008), LDL-cholesterol (r = 0.315, p = 0.002; r = 0.373, p < 0.0001) and total cholesterol (r = 0.310, p = 0.003; r = 0.284, p = 0.006). When adjusted for age and body mass index, significant relationships of DBP (r = 0.190, p = 0.049), AST (r = 0.262, p = 0.018), ALT (r = 0.277, p = 0.012), and HDL-cholesterol (r = -0.202, p = 0.049) with HgbA1C were still retained, but those with fasting glucose disappeared. In addition, the adjusted relationships of LDL-cholesterol and total cholesterol with HgbA1C were much greater than those with fasting glucose. These results suggest that glycated hemoglobin may be a better predictor than fasting glucose for cardiometabolic risk in non-diabetic Korean women.
Collapse
Affiliation(s)
- So Ra Yoon
- Department of Food Science and Nutrition, Dong-A University, Brain Busan 21 Project, Busan 604-714, Korea
| | - Jae Hyang Lee
- Department of Food Science and Nutrition, Dong-A University, Brain Busan 21 Project, Busan 604-714, Korea
| | - Ga Yoon Na
- Department of Food Science and Nutrition, Dong-A University, Brain Busan 21 Project, Busan 604-714, Korea
| | - Yu Jeong Seo
- Department of Food Science and Nutrition, Dong-A University, Brain Busan 21 Project, Busan 604-714, Korea
| | - Seongho Han
- Department of Family Medicine, Dong-A University, College of Medicine, Busan 602-714, Korea
| | - Min-Jeong Shin
- Department of Food and Nutrition, Korea University, Seoul 136-701, Korea
| | - Oh Yoen Kim
- Department of Food Science and Nutrition, Dong-A University, Brain Busan 21 Project, Busan 604-714, Korea
| |
Collapse
|
21
|
Fisher L, Srikusalanukul W, Fisher A, Smith P. Liver function parameters in hip fracture patients: relations to age, adipokines, comorbidities and outcomes. Int J Med Sci 2015; 12:100-15. [PMID: 25589886 PMCID: PMC4293175 DOI: 10.7150/ijms.10696] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 04/11/2014] [Indexed: 02/07/2023] Open
Abstract
AIM To asses liver markers in older patients with hip fracture (HF) in relation to age, comorbidities, metabolic characteristics and short-term outcomes. METHODS In 294 patients with HF (mean age 82.0±7.9 years, 72.1% women) serum alanine aminotransferase (ALT), gammaglutamyltransferase (GGT), alkaline phosphatase (ALP), albumin, bilirubin, 25(OH)vitaminD, PTH, calcium, phosphate, magnesium, adiponectin, leptin, resistin, thyroid function and cardiac troponin I were measured. RESULTS Elevated ALT, GGT, ALP or bilirubin levels on admission were observed in 1.7%-9.9% of patients. With age GGT, ALT and leptin decrease, while PTH and adiponectin concentrations increase. Higher GGT (>30 U/L, median level) was associated with coronary artery disease (CAD), diabetes mellitus (DM), and alcohol overuse; lower ALT (≤20 U/L, median level) with dementia; total bilirubin>20 μmol/L with CAD and alcohol overuse; and albumin>33 g/L with CAD. Multivariate adjusted regression analyses revealed ALT, ALP, adiponectin, alcohol overuse and DM as independent and significant determinants of GGT (as continuous or categorical variable); GGT for each other liver marker; and PTH for adiponectin. The risk of prolonged hospital stay (>20 days) was about two times higher in patients with GGT>30 U/L or adiponectin>17.14 ng/L (median level) and 4.7 times higher if both conditions coexisted. The risk of in-hospital death was 3 times higher if albumin was <33 g/L. CONCLUSIONS In older HF patients liver markers even within the normal range are associated with age-related disorders and outcomes. Adiponectin (but not 25(OH)vitaminD, PTH, leptin or resistin) is an independent contributor to higher GGT. Serum GGT and albumin predict prolonged hospital stay and in-hospital death, respectively. A unifying hypothesis of the findings presented.
Collapse
Affiliation(s)
- Leon Fisher
- 1. Department of Gastroenterology, The Canberra Hospital, Canberra, ACT, Australia
| | - Wichat Srikusalanukul
- 2. Department of Geriatric Medicine, The Canberra Hospital, Canberra, ACT, Australia
| | - Alexander Fisher
- 2. Department of Geriatric Medicine, The Canberra Hospital, Canberra, ACT, Australia ; 4. Australian National University Medical School, Canberra, ACT, Australia
| | - Paul Smith
- 3. Department of Orthopaedic Surgery, The Canberra Hospital, Canberra, ACT, Australia ; 4. Australian National University Medical School, Canberra, ACT, Australia
| |
Collapse
|
22
|
Gamma-glutamyl transferase levels in patients with acute ischemic stroke. Cardiovasc Psychiatry Neurol 2014; 2014:170626. [PMID: 25202453 PMCID: PMC4151543 DOI: 10.1155/2014/170626] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 08/04/2014] [Accepted: 08/08/2014] [Indexed: 12/31/2022] Open
Abstract
Objective. The aim of this study was to investigate the relationship between gamma-glutamyl transferase (GGT) levels, cerebrovascular risk factors, and distribution of cerebral infarct areas in patients with acute ischemic stroke (AIS). Patients and Methods. Sixty patients with AIS and 44 controls who had not cerebrovascular disease were included in the study. The patients were divided into four groups according to the location of the infarct area and evaluated as for GGT levels and the presence of diabetes mellitus (DM), hypertension (HT), and hyperlipidemia (HL). Results. The frequency of DM, HT, and HL and gender distributions were similar. The mean GGT levels were significantly higher in patients with AIS and those with relatively larger areas of infarction (P < 0.05). Increased mean GGT levels were found in the subgroup with hypertension, higher LDL-cholesterol, and triglyceride levels among cases with AIS (P < 0.05). Conclusion. Higher GGT levels in AIS patients reinforce the relationship of GGT with inflammation and oxidative stress. The observation of higher GGT levels in patients with relatively larger areas of infarction is indicative of a positive correlation between increases in infarct areas and elevated GGT levels.
Collapse
|
23
|
Lee K, Han J, Kim SG. Increasing risk of diabetes mellitus according to liver function alterations in electronic workers. J Diabetes Investig 2014; 5:671-6. [PMID: 25422767 PMCID: PMC4234230 DOI: 10.1111/jdi.12202] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 12/25/2013] [Accepted: 12/26/2013] [Indexed: 12/20/2022] Open
Abstract
Aims/Introduction We sought to determine the association between change in fasting plasma glucose (FPG) and levels of liver enzymes, such as aspartate transaminase, alanine transaminase and gamma-glutamyltransferase, from health examinations. Materials and Methods A total of 9,393 health screen examinees with no evidence of viral hepatitis, liver diseases, abnormal liver function and diabetes in their past disease history were enrolled in the present study. All the participants underwent three health examinations. Group 1 and 4 were stationary groups of those with normal liver enzyme levels in the first and second health examinations (G1), and abnormal liver enzyme levels in the first and second health check-up (G4). Groups 2 and 3 were altered groups of those with abnormal liver enzyme levels in the first health examination, which became normal in the second health examination (G2), and from a normal liver enzymes level to an abnormal liver enzymes level (G3). Results FPG levels were elevated in male participants (P < 0.01), and were related to old age (P < 0.01), drinking (P < 0.01), smoking (P < 0.01) and so on. There was a strong relationship between FPG levels in the last health examination and altered liver function enzyme levels from the first health examination to the second check-up. In other words, group 4 had the highest level of FPG compared with the other groups (G1 < G2 < G3). Conclusions An association was observed between FPG levels and abnormal liver function in manufacturing workers. Abnormal liver function can be closely associated with the development of diabetes.
Collapse
Affiliation(s)
- Kyoungho Lee
- Samsung Health Research Institute, Samsung Electronics Yongin-City, Korea
| | - Joohee Han
- Samsung Health Research Institute, Samsung Electronics Yongin-City, Korea
| | - Soo-Geun Kim
- Department of Occupational Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Seoul, Korea
| |
Collapse
|
24
|
Akgul O, Uyarel H. G-glutamyl transferase: a novel prognostic marker for cardiovascular disease. J Crit Care 2013; 29:167-8. [PMID: 24331949 DOI: 10.1016/j.jcrc.2013.10.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 10/24/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Ozgur Akgul
- Clinic of Cardiology, İstanbul Mehmet Akif Ersoy Thoracic, Cardiovascular Surgery Education and Research Hospital, İstanbul, Turkey
| | - Huseyin Uyarel
- Clinic of Cardiology, İstanbul Mehmet Akif Ersoy Thoracic, Cardiovascular Surgery Education and Research Hospital, İstanbul, Turkey
| |
Collapse
|
25
|
Plasma gamma-glutamyltransferase is strongly determined by acylation stimulating protein levels independent of insulin resistance in patients with acute coronary syndrome. DISEASE MARKERS 2013; 35:155-61. [PMID: 24167361 PMCID: PMC3774975 DOI: 10.1155/2013/914748] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 07/28/2013] [Accepted: 07/28/2013] [Indexed: 01/14/2023]
Abstract
Background. Steatosis is a manifestation of the metabolic syndrome often associated with release of liver enzymes and inflammatory adipocytokines linked to cardiovascular risk. Gamma-glutamyltransferase (GGT) is one sensitive liver marker recently identified as an independent cardiovascular risk factor. Mechanisms involved in enhanced hepatic lipogenesis causing steatosis are not yet identified and are usually linked to insulin resistance (IR). Acylation stimulating protein (ASP), a potent lipogenic factor, was recently shown to increase in patients with steatosis and was implicated in its pathogenesis. Aim. To investigate the association of plasma ASP levels with liver and metabolic risk markers in acute coronary syndrome (ACS) patients. Methods. 28 patients and 30 healthy controls were recruited. Their anthropometrics, lipid profile, liver markers, insulin, and ASP levels were measured. Results. In the patients, ASP, liver, and metabolic risk markers were markedly higher than in the controls. ASP strongly predicted GGT levels (B = 0.75, P < 0.0001), followed by triglycerides (B = 0.403, P = 0.017), together determining 57.6% variation in GGT levels. Insulin and IR correlated with metabolic risk components but not with liver enzymes. Conclusion. The strong association of ASP with GGT in ACS patients suggests that ASP, independent of IR, may contribute to a vicious cycle of hepatic lipogenic stimulation and GGT release promoting atherogenesis.
Collapse
|
26
|
Enooku K, Kato R, Ikeda H, Kurano M, Kume Y, Yoshida H, Ono T, Aizawa K, Suzuki T, Yamazaki T, Yatomi Y. Inverse correlations between serum ADAMTS13 levels and systolic blood pressure, pulse pressure, and serum C-reactive protein levels observed at a general health examination in a Japanese population: a cross-sectional study. Clin Chim Acta 2013; 421:147-51. [PMID: 23523588 DOI: 10.1016/j.cca.2013.03.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 03/05/2013] [Accepted: 03/12/2013] [Indexed: 02/08/2023]
Abstract
BACKGROUND Although a defect in ADAMTS13 activity is known to cause platelet thrombosis resulting in thrombotic thrombocytopenic purpura (TTP), recent evidence has revealed that low plasma ADAMTS13 concentrations may increase the risk of ischemic vascular diseases. Furthermore, reduced plasma ADAMTS13 activity has been reported in acute systemic inflammation or sepsis. These findings prompted us to examine whether ADAMTS13 may play a role in more diverse diseases, not limited to TTP. METHODS A cross-sectional study was conducted to examine ADAMTS13 concentrations in blood samples from 432 subjects who had undergone a general health examination. RESULTS Serum ADAMTS 13 concentrations were lower in men than in women and in older age, as previously reported. Of note, the serum ADAMTS13 concentration was significantly and inversely correlated with the systolic blood pressure, pulse pressure, and serum C reactive protein concentration in both men and women and with the serum γ-glutamyltransferase concentration in men only. In 88 subjects, who underwent a carotid artery evaluation, serum ADAMTS13 concentrations were significantly lower in the subjects with a thicker carotid intima-media. CONCLUSIONS ADAMTS13 may play a role in not only TTP, but also inflammation, oxidative stress, and atherosclerosis. The potentially diverse clinical significance of ADAMTS13 should be prospectively elucidated in a larger cohort.
Collapse
Affiliation(s)
- Kenichiro Enooku
- Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Serum levels of choline-containing compounds are associated with aerobic fitness level: the HUNT-study. PLoS One 2012; 7:e42330. [PMID: 22860113 PMCID: PMC3408491 DOI: 10.1371/journal.pone.0042330] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 07/03/2012] [Indexed: 11/29/2022] Open
Abstract
Background Cardiovascular disease (CVD) is a leading cause of death worldwide, and the number of people at risk is continuously growing. New methods for early risk prediction are therefore needed to actuate prevention strategies before the individuals are diagnosed with CVD. Several studies report that aerobic fitness level, measured as maximal oxygen uptake (VO2max), is the single best predictor of future CVD mortality in healthy people. Based on this, we wanted to study differences between healthy individuals with a large difference in VO2max-level to identify new biomarkers of low aerobic fitness that may also have potential as early biomarkers of CVD risk. Methodology/Principal Findings Serum samples from 218 healthy individuals with a low VO2max (n = 108, 63 women) or high VO2max (n = 110, 64 women) were analysed with MR metabolomics. In addition, standard clinical-chemical analyses for glucose, lipids, liver enzymes, micro-CRP, and colorimetric analysis on circulating choline were performed. Individuals in the low VO2max-group had increased serum levels of free choline, decreased phosphatidylcholine, increased glucosę and decreased unsaturated fatty acids compared to the individuals in the high VO2max–group. Conclusions/Significance Aerobic fitness dependent differences in serum levels of free choline and phosphatidylcholine are observed. They should be further studied as potential early markers of CVD risk.
Collapse
|
28
|
Suh BS. The Association between Serum Gamma-Glutamyltransferase within Normal Levels and Metabolic Syndrome in Office Workers: A 4-Year Follow-up Study. Korean J Fam Med 2012; 33:51-8. [PMID: 22745888 PMCID: PMC3383242 DOI: 10.4082/kjfm.2012.33.1.51] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 01/17/2012] [Indexed: 01/14/2023] Open
Abstract
Background Serum gamma-glutamyltransferase (GGT) has been suggested as a predictor for development of the metabolic syndrome in non-Korean population, but studies in Korean population are scarce. Therefore, we examined the association between serum GGT levels and the incidence of the metabolic syndrome in Korean male office workers. Methods The study population consisted of 32,692 office workers who underwent health checkups in both 2005 and 2009. A total of 17,583 with elevated GGT levels, the presence of metabolic syndrome, medication history at baseline, and female office workers were excluded. Finally, 15,109 subjects were included in the final analysis. We measured serum GGT levels and individual metabolic components. Results As a quartile of serum GGT increased, 4-year follow-up incidence of the metabolic syndrome increased. After adjustment for age, alcohol drinking status and smoking status in 2005, logistic regression analysis showed that the odds ratios (95% confidence interval) for incident metabolic syndrome in 2009 compared to the lowest quartile and upper quartiles were 1.00 (reference), 1.57 (1.24-2.00), 2.73 (2.17-3.43), 3.78 (3.02-4.74), and statistically significant (P < 0.001), respectively. Conclusion These results showed that the higher serum GGT predicted the future development of metabolic syndrome. In Korean male office workers without the metabolic syndrome, the serum GGT levels despite normal levels were associated with an increased risk of incident metabolic syndrome.
Collapse
Affiliation(s)
- Byung-Seong Suh
- Department of Occupational Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
29
|
Xu Y, Xu M, Huang Y, Wang T, Li M, Wu Y, Song A, Li X, Bi Y, Ning G. Elevated serum γ-glutamyltransferase predicts the development of impaired glucose metabolism in middle-aged and elderly Chinese. Endocrine 2011; 40:265-72. [PMID: 21523521 DOI: 10.1007/s12020-011-9468-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 03/29/2011] [Indexed: 01/03/2023]
Abstract
The aim of this article is to prospectively investigate the association of the liver enzyme γ-glutamyltransferase (GGT) with the development of diabetes and impaired glucose regulation (IGR) in a Chinese population. Seven hundred and sixty normoglycaemic subjects aged 40 years or older randomly selected from an urban community of Shanghai received a baseline investigation in May 2005. The participants were invited to receive a standard 75-g oral glucose tolerance test (OGTT) in November 2008. Incident diabetes and IGR were determined according to the 1999 WHO criteria. Serum GGT levels were significantly associated with incident diabetes or combined diabetes and IGR prospectively. After extensive adjustment, the diabetes risk was significantly increased with incrementing serum GGT quartiles (P value for trend = 0.0027). As compared with the lowest quartile of GGT, the highest quartile had an adjusted hazard ratio of 1.30 (95% CI 1.03-1.65) for developing combined diabetes and IGR. Furthermore, a high serum GGT level at baseline was independently associated with an increase in the index of homeostasis model assessment of insulin resistance (HOMA-IR) at follow-up. Serum GGT concentration, even within its normal range, is a risk marker for developing impaired glucose metabolism in middle-aged and elderly Chinese.
Collapse
Affiliation(s)
- Yu Xu
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrinology and Metabolism, The State Key Laboratory of Medical Genomics, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Park YJ, Lim JH, Kwon ER, Kim HK, Jung MC, Seol KH, Noh WY, Kim NE. Development and validation of a simple index system to predict nonalcoholic fatty liver disease. THE KOREAN JOURNAL OF HEPATOLOGY 2011; 17:19-26. [PMID: 21494074 PMCID: PMC3304618 DOI: 10.3350/kjhep.2011.17.1.19] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background/Aims Abdominal ultrasonography is useful for the detection and diagnosis of nonalcoholic fatty liver disease (NAFLD). The aims of this study were to establish a predictive model for the selection of subjects for abdominal ultrasonography for the diagnosis of NAFLD and to assess validity of the model. Methods The subjects included 901 people who visited the health examination center of the Busan Medical Center. We conducted multiple logistic regression analyses of potential risk factors to identify independent risk factors for NAFLD, and developed an index system. Results Four independent risk factors were identified. The index system was developed by assigning 1 clinical scoring point to approximately 0.7 logistic regression coefficients to each factor as follows: alanine aminotransferase/aspartate aminotransferase ratio >1.5 (odds ratio [OR], 2.22; 95% confidence interval [CI], 1.21-4.07; P=0.010), 1 point; γ-glutamyl transpeptidase >50 (OR, 2.15; 95% CI, 1.13-4.07; P=0.019), 1 point; triglyceride >150 mg/dL (OR, 1.92; 95% CI, 1.14-3.24; P=0.015), 1 point; 23 kg/m2≤BMI<25 kg/m2 (OR, 3.68; 95% CI, 2.05-6.63; P<0.001), 2 points; and BMI 25 kg/m2 (OR, 7.65; 95% CI, 4.29-13.62; P<0.001), 3 points. The area under the receiver operating characteristics curve was 0.797 (95% CI, 0.751-0.842), and when 3 points was used as a cut-off value, the sensitivity and specificity were 71.7% and 75.9%, respectively. Conclusions NAFLD can be predicted through the clinical application of the index system established herein. If abdominal ultrasonography is used for high-risk patients, NAFLD will be diagnosed and managed in its early stage.
Collapse
Affiliation(s)
- Young Jin Park
- Department of Family Medicine, Busan Medical Center, Busan, Korea
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Oh HJ, Kim TH, Sohn YW, Kim YS, Oh YR, Cho EY, Shim SY, Shin SR, Han AL, Yoon SJ, Kim HC. Association of serum alanine aminotransferase and γ-glutamyltransferase levels within the reference range with metabolic syndrome and nonalcoholic fatty liver disease. THE KOREAN JOURNAL OF HEPATOLOGY 2011; 17:27-36. [PMID: 21494075 PMCID: PMC3304617 DOI: 10.3350/kjhep.2011.17.1.27] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND/AIMS Nonalcoholic fatty liver disease (NAFLD) has recently been found to be a novel component of metabolic syndrome (MS), which is one of the leading causes of chronic liver disease. The serum alanine aminotransferase (ALT) and ⟨-glutamyltransferase (GGT) levels are suggested to affect liver fat accumulation and insulin resistance. We assessed the associations of serum ALT and GGT concentrations within the reference ranges with MS and NAFLD. METHODS In total, 1,069 subjects enrolled at the health promotion center of Wonkwang University Hospital were divided into 4 groups according to serum ALT and GGT concentrations levels within the reference ranges. We performed biochemical tests, including liver function tests and lipid profiles, and diagnosed fatty liver by ultrasonography. Associations of ALT and GGT concentrationgrading within the reference range with fatty liver and/or MS were investigated. RESULTS The presence of MS, its components, and the number of metabolic abnormalities [except for high-density lipoprotein-cholesterol (HDL-C) and fasting blood glucose] increased with the ALT level, while the presence of MS, its components, and the number of metabolic abnormalities (except for HDL-C) increased with the GGT level. The odds ratios for fatty liver and MS increased with the ALT level (P⟨0.001 and P=0.049, respectively) and the GGT level (P=0.044 and P=0.039, respectively). CONCLUSIONS Serum ALT and GGT concentrations within the reference ranges correlated with the incidence of NAFLD and MS in a dose-dependent manner. There associations need to be confirmed in large, prospective studies.
Collapse
Affiliation(s)
- Hyo Jeong Oh
- Department of Internal Medicine, Sanbon Medical Center, Wonkwang University College of Medicine, Gunpo, Korea
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Lioudaki E, Vrentzos GE, Mavrogeni H, Zeniodi MH, Ganotakis ES, Mikhailidis DP, Papadakis JA. Prevalence of Metabolic Syndrome According to Different Definitions in a Hypertensive Population. Angiology 2011; 63:39-47. [DOI: 10.1177/0003319711407303] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Aims: The metabolic syndrome (MetS) is associated with increased risk of cardiovascular disease (CVD) and diabetes mellitus (DM). Several definitions of MetS have been proposed. The aim of the present study was to estimate and compare the prevalence of MetS according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), American Heart Association-National Heart Lung and Blood Institute (AHA-NHLBI), International Diabetes Federation (IDF) and the more recent Joint Interim Statement (JIS) definitions in patients attending a hypertension clinic. Methods: The records of patients referred to the hypertension clinic at the University Hospital (Heraklion, Crete) from January 2001 to June 2009 were screened retrospectively. A total 384 patients (146 men) were included in the study. Results: The prevalence of MetS according to the IDF and JIS definitions was significantly higher compared with that of the NCEP ATP III in both genders (IDF: P = .009 and P = .002, JIS: P = .002 and P = 0.001 for men and women, respectively); this was the case for the AHA-NHLBI definition only among women ( P = .03). All MetS components differed significantly ( P from < .0001 to .02) between patients with and without MetS for all definitions. Conclusions: The prevalence of MetS varies considerably depending on the definition used in a hypertensive population in a Mediterranean country. These differences will influence risk assessment.
Collapse
Affiliation(s)
- Eirini Lioudaki
- Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London, UK
- Department of Internal Medicine, University of Crete and School of Medicine, Heraklion, Crete, Greece
| | - George E. Vrentzos
- Department of Internal Medicine, University of Crete and School of Medicine, Heraklion, Crete, Greece
| | - Helen Mavrogeni
- Department of Internal Medicine, University of Crete and School of Medicine, Heraklion, Crete, Greece
| | - Maria-Helen Zeniodi
- Department of Internal Medicine, University of Crete and School of Medicine, Heraklion, Crete, Greece
| | - Emmanuel S. Ganotakis
- Department of Internal Medicine, University of Crete and School of Medicine, Heraklion, Crete, Greece
| | - Dimitri P. Mikhailidis
- Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London, UK
| | - John A. Papadakis
- Department of Internal Medicine, University of Crete and School of Medicine, Heraklion, Crete, Greece
| |
Collapse
|
33
|
Xu Y, Bi YF, Xu M, Huang Y, Lu WY, Gu YF, Ning G, Li XY. Cross-sectional and longitudinal association of serum alanine aminotransaminase and γ-glutamyltransferase with metabolic syndrome in middle-aged and elderly Chinese people. J Diabetes 2011; 3:38-47. [PMID: 21199427 DOI: 10.1111/j.1753-0407.2010.00111.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Although associations of the liver enzymes alanine aminotransaminase (ALT) and γ-glutamyltransferase (GGT) with metabolic syndrome (MetS) are well recognized, whether they are independent of insulin resistance and which enzyme is more effective are yet to be clarified. METHODS A total of 5404 subjects aged ≥ 40 years were recruited from two urban communities in Shanghai for cross-sectional analyses. A subgroup of 681 participants without MetS at baseline was included in the longitudinal analyses. Insulin resistance was measured using the homeostasis model assessment of insulin resistance (HOMA-IR), and the modified National Cholesterol Education Program Adult Treatment Panel III criteria were adopted to diagnose MetS. RESULTS Both GGT and ALT were strongly and positively associated with MetS risks in simple and multivariate analyses. Further adjustment for HOMA-IR and ALT did not change the association of GGT and MetS materially, whereas adjustment for HOMA-IR and GGT substantially attenuated the ALT-MetS association. In longitudinal analyses, risks of developing MetS were increased across GGT quartiles in a dose-dependent manner after extensive adjustments (odds ratios were 1.00, 1.38, 1.62, and 2.29 for GGT, quartile 1 through quartile 4; P for trend = 0.01). In contrast, ALT was no longer associated with MetS development after final adjustment for GGT (P for trend = 0.09). CONCLUSIONS Our study confirmed significant and independent associations of GGT and ALT with MetS in adult Chinese people. Moreover, GGT might be more effective for indicating the future development of MetS.
Collapse
Affiliation(s)
- Yu Xu
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrinology and Metabolism, The State Key Laboratory of Medical Genomics, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | | | | | | | | | | | | | | |
Collapse
|
34
|
Shin JY, Hwang JH, Jeong JY, Kim SH, Moon JD, Roh SC, Kim YW, Kim Y, Leem JH, Ju YS, Hong YS, Ha EH, Lee YH, Lee DH, Kim DH. [The association of central obesity with type 2 diabetes among Koreans according to the serum gamma-glutamyltransferase level: Korean genome and epidemiology study]. J Prev Med Public Health 2011; 42:386-91. [PMID: 20009485 DOI: 10.3961/jpmph.2009.42.6.386] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES This cross-sectional study was performed to examine if the serum gamma-glutamyltransferase (GGT) level that is within its normal range is associated with the risk of type 2 diabetes and if the association between the waist hip ratio (WHR) and type 2 diabetes is different depending on the serum GGT levels. METHODS The study subjects were 23,436 persons aged 40 years or older and who participated in regular health check-ups at 11 hospitals (males: 5,821, females: 17,615). The gender-specific quintiles of the serum GGT and WHR were used to examine the associations with type 2 diabetes. RESULTS The serum GGT levels within their normal range were positively associated with type 2 diabetes only in women. The adjusted odds ratios (ORs) were 1.0, 1.0, 1.4, 2.1, and 2.5 according to the quintiles of the serum GGT (p(trend)<0.01). The WHR was more strongly associated with the prevalence of diabetes among the women with a high-normal serum GGT level as compared with those with a low-normal serum GGT level (p for interaction=0.02). For example, the adjusted ORs for women with a low normal serum GGT level were 1.0, 1.2, 1.5, 2.2, and 2.4 according to the quintiles of the WHR, while those figures were 1.0, 2.4, 3.6, 5.0, and 8.3 among the women with a high normal serum GGT level. However, in men, the serum GGT was very weakly associated with type 2 diabetes and the association between the WHR and type 2 diabetes was not different depending on the serum GGT level. CONCLUSIONS Serum GGT within its normal range was positively associated with type 2 diabetes, and central obesity was more strongly associated with the prevalence of type 2 diabetes when the serum GGT level was high-normal. However, these associations were observed only in women, which is different from the previous findings. The stronger relation between central obesity and type 2 diabetes among women with a high-normal serum GGT level can be useful for selecting a group that is at high risk for type 2 diabetes irregardless of whatever the underlying mechanism is.
Collapse
Affiliation(s)
- Ji-Yeon Shin
- Department of Preventive Medicine, Kyungpook National University School of Medicine, Korea
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Pacifico L, Poggiogalle E, Cantisani V, Menichini G, Ricci P, Ferraro F, Chiesa C. Pediatric nonalcoholic fatty liver disease: A clinical and laboratory challenge. World J Hepatol 2010; 2:275-88. [PMID: 21161009 PMCID: PMC2998974 DOI: 10.4254/wjh.v2.i7.275] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Revised: 07/06/2010] [Accepted: 07/13/2010] [Indexed: 02/06/2023] Open
Abstract
The true prevalence of pediatric nonalcoholic fatty liver disease (NAFLD) is unknown. Challenges in determining the population prevalence of NAFLD include the type of test (and the reference intervals used to define normal and abnormal), the type of population (general population, hospital series), the demographic characteristics of the population sampled, and the nature of the study design. The natural history of pediatric NAFLD remains uncertain. The issue of when to perform a liver biopsy in children with suspected NAFLD remains controversial. Children with NAFLD but normal alanine aminotransferase are rarely investigated. However, evidence of alterations in glucose metabolism parameters should prompt a better understanding of the natural history of pediatric NAFLD not only in terms of the progression of liver disease but also regarding its potential relationship with other health outcomes such as type 2 diabetes mellitus and cardiovascular disease. This evidence could make liver biopsy mandatory in the majority of cases at risk of progressive and severe hepatic and extrahepatic disease. This conclusion, however, raises the question of the feasibility of liver biopsy assessment in an extremely large at risk population, and of the cost/effectiveness of this policy. There is a considerable, continuous interest in reliable, noninvasive alternatives that will allow the prognosis of pediatric NAFLD to be followed in large community or population-based studies.
Collapse
Affiliation(s)
- Lucia Pacifico
- Lucia Pacifico, Eleonora Poggiogalle, Flavia Ferraro, Claudio Chiesa, Departments of 1 Pediatrics, Sapienza University of Rome, Rome 00161, Italy
| | | | | | | | | | | | | |
Collapse
|
36
|
Filippatos TD, Elisaf MS. Combination drug treatment in patients with non-alcoholic fatty liver disease. World J Hepatol 2010; 2:139-42. [PMID: 21160985 PMCID: PMC2999276 DOI: 10.4254/wjh.v2.i4.139] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Revised: 03/24/2010] [Accepted: 03/31/2010] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) includes simple steatosis, a benign condition, and non-alcoholic steatohepatitis, a condition that beyond TG accumulation also includes necroinflammation and fibrosis. An association between NAFLD and cardiovascular disease (CVD) has been recently suggested. NAFLD patients usually have an increased CVD risk profile. NAFLD is also associated with metabolic syndrome (MetS) and is considered as the hepatic component of MetS by some authors. Currently, the only established treatment of NAFLD is gradual weight loss. However, multifactorial treatment of NAFLD risk factors may be needed to reduce the increased CVD risk of NALFD patients. Drug combinations that include antiobesity drugs (such as orlistat and sibutramine) and target CVD risk factors may be a good approach to NAFLD patients. Our group has investigated the orlistat-fenofibrate combination treatment in obese patients with MetS and the orlistat-ezetimibe and sibutramine-antihypertensive combination treatment in obese patients with hyperlipidaemia with promising results in CVD risk factor reduction and improvement of liver function tests. Small studies give promising results but double-blind, randomized trials examining the effects of such multifactorial treatment in hard CVD endpoints in NAFLD patients are missing.
Collapse
Affiliation(s)
- Theodosios D Filippatos
- Theodosios D Filippatos, Moses S Elisaf, Department of Internal Medicine, University of Ioannina, Ioannina 45110, Greece
| | | |
Collapse
|
37
|
Xia C, Tong Q, Wang Q, Tang Z, Qi L, Chi S, Zhang M, Wang X, Li H, Xu G. Application of five frozen human-pooled serum samples assigned by the International Federation of Clinical Chemistry and Laboratory Medicine reference procedure in a traceability investigation of γ-glutamyltransferase catalytic concentration measurements in China. Ann Clin Biochem 2010; 47:189-94. [PMID: 20392748 DOI: 10.1258/acb.2009.009210] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background The in vitro directive of the European Union requires traceability to the international recommended reference procedures. The application of the reference procedures is necessary in order to evaluate the accuracy of γ-glutamyltransferase (GGT) assays of routine measurement systems in China. Methods Five frozen patient-pooled serum samples were assigned values by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) reference procedure in order to evaluate the traceability of the results of GGT catalytic activity from six homogeneous systems. One of the serum samples was used to calibrate seven non-homogeneous systems. Results All of the homogeneous systems, except the Dade system (Dade Bering Inc, IL, USA), achieved traceability within the measurement range. The Roche and Hitachi systems were better than the other systems. After calibration, the variance of the non-homogeneous systems decreased dramatically from between 14.50% and 25.23% to between 1.25% and 3.09% and the bias decreased from between −11.4% and −4.1% to between 0.5% and 3.5%. Conclusion Manufacturers in China should ensure that their calibration systems correspond to the IFCC reference procedures. Fresh frozen pooled patient serum assigned by reference laboratories can be used to calibrate non-homogeneous systems in order to achieve traceability.
Collapse
Affiliation(s)
- Changyu Xia
- Clinical Laboratory Department, Peking University First Hospital
| | - Qing Tong
- Clinical Laboratory Department, Beijing Chaoyang Hospital, Beijing
| | - Qingtao Wang
- Clinical Laboratory Department, Beijing Chaoyang Hospital, Beijing
| | - Zhuling Tang
- Clinical Laboratory Department, The Affiliated Hospital of Guiyang Medical College, Guizhou
| | - Lili Qi
- Biosino Bio-technology and Science Inc
| | - Shan Chi
- Clinical Laboratory Department, Beijing Shijitan Hospital, Beijing, China
| | - Man Zhang
- Clinical Laboratory Department, Beijing Shijitan Hospital, Beijing, China
| | - Xuejing Wang
- Clinical Laboratory Department, Peking University First Hospital
| | - Haixia Li
- Clinical Laboratory Department, Peking University First Hospital
| | - Guobin Xu
- Clinical Laboratory Department, Peking University First Hospital
| |
Collapse
|
38
|
Bianchi C, Penno G, Crisci I, Daniele G, Agostini A, Del Prato S, Miccoli R. Serum gamma-glutamyltransferase levels are related to insulin sensitivity and secretion in subjects with abnormal glucose regulation. Diabetes Metab Res Rev 2010; 26:181-6. [PMID: 20186999 DOI: 10.1002/dmrr.1069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND To test the association between gamma-glutamyltransferase level and glucose regulation. METHODS We performed a cross-sectional analysis of 500 subjects [199 men/301 women, age 47 +/- 11 years, body mass index (BMI) 28.6 +/- 5.5 kg/m(2)] referred to Diabetes Clinics because of potential risk of type 2 diabetes mellitus (T2DM). RESULTS The prevalence of all glucose intolerance categories was higher in the top quartile of gamma-glutamyltransferase than in the first. Subjects with normal glucose tolerance showed lower gamma-glutamyltransferase levels compared with those with impaired glucose tolerance (IGT), impaired fasting glucose (IFG)+ IGT and T2DM (ANOVA, p < 0.0001), but not those with IFG. Homeostasis model assessment-insulin resistance (HOMA-IR) increased with increasing levels of gamma-glutamyltransferase, while the insulinogenic index/HOMA-IR ratio decreased. In an age- and sex-adjusted analysis, the top gamma-glutamyltransferase quartile was independently associated with IFG + IGT [odds ratio (OR) 2.41; 95% confidence interval (CI): 1.13-5.15] and T2DM (OR 2.77; 95% CI: 1.47-5.22). After further adjustment for BMI, alcohol intake, family history of diabetes, cigarette smoking and physical activity, the top quartile of gamma-glutamyltransferase remained an independent predictor of IFG + IGT (OR 2.62; 95% CI: 1.13-6.07) and T2DM (OR 2.39; 95% CI: 1.20-4.76). Only when transaminases and HOMA-IR have been added to the model, the top quartile of gamma-glutamyltransferase resulted no more independently associated to IFG + IGT or T2DM. CONCLUSIONS Gamma-glutamyltransferase is closely related to insulin resistance, reduced beta-cell function and deterioration of glucose tolerance.
Collapse
Affiliation(s)
- Cristina Bianchi
- Department of Endocrinology and Metabolism, University of Pisa, Pisa, Italy
| | | | | | | | | | | | | |
Collapse
|
39
|
Nakao H, Yoneda M. The intertwisted correlations among non-alcoholic fatty liver disease, atherosclerosis, and metabolic syndrome. J Gastroenterol 2010; 44:1162-4. [PMID: 19802516 DOI: 10.1007/s00535-009-0140-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
40
|
Clinical risk factors for osteoporotic fracture: a population-based prospective cohort study in Korea. J Bone Miner Res 2010; 25:369-78. [PMID: 19594298 DOI: 10.1359/jbmr.090722] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Clinical risk factors (CRFs), either alone or in combination with bone mineral density, are used to determine the fracture risk for clinical assessment and to determine intervention thresholds. Because fracture risk is strongly affected by ethnicity and population-specific differences, we sought to identify Korean-specific CRFs for fracture, in combination with quantitative ultrasound (qUS) measurements of the radius and tibia. A total of 9351 subjects (4732 men and 4619 women) aged 40 to 69 years were followed for a mean of 46.3 +/- 2.2 months. We obtained CRF information using a standardized questionnaire and measured anthropometric variables. Speed of sound at the radius (SoSR) and tibia (SoST) were measured by qUS. Fracture events were recorded using a questionnaire, and a height-loss threshold was used as an indicator of vertebral fracture. Relative risks were calculated by Cox regression analysis. A total of 195 subjects (61 men and 134 women) suffered low-trauma fractures. Older age, lower body mass index (BMI), and previous fracture history were positively associated with fracture risk in both sexes. Decreased hip circumference, lack of regular exercise, higher alcohol intake, menopause, and osteoarthritis history were further independent CRFs for fracture in women. However, neither SoSR nor SoST was independently associated with fracture risk. In this study, we identified the major Korean-specific CRFs for fracture and found that smaller hip circumference was a novel risk factor. This information will allow optimal risk-assessment targeting Koreans for whom treatment would provide the greatest benefit.
Collapse
|
41
|
Shimizu Y, Imano H, Ohira T, Kitamura A, Kiyama M, Okada T, Sato S, Shimamoto T, Yamagishi K, Tanigawa T, Iso H. γ-Glutamyltranspeptidase and Incident Stroke Among Japanese Men and Women. Stroke 2010; 41:385-8. [DOI: 10.1161/strokeaha.109.569061] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Yuji Shimizu
- From Public Health (Y.S., T. Ohira, H. Iso), Department of Social and Environmental Medicine, Osaka University, Osaka, Japan; Osaka Medical Center for Health Science and Promotion (Y.S., H. Imano, T. Ohira, A.K., M.K., T. Okada, S.S., T.S.), Osaka, Japan; Chiba Prefectural Institute of Public Health (S.S.), Chiba, Japan; the Department of Public Health Medicine (K.Y.), University of Tsukuba, Tsukuba, Japan; and the Department of Public Health (T.T.), Social Medicine and Medical Informatics, Ehime
| | - Hironori Imano
- From Public Health (Y.S., T. Ohira, H. Iso), Department of Social and Environmental Medicine, Osaka University, Osaka, Japan; Osaka Medical Center for Health Science and Promotion (Y.S., H. Imano, T. Ohira, A.K., M.K., T. Okada, S.S., T.S.), Osaka, Japan; Chiba Prefectural Institute of Public Health (S.S.), Chiba, Japan; the Department of Public Health Medicine (K.Y.), University of Tsukuba, Tsukuba, Japan; and the Department of Public Health (T.T.), Social Medicine and Medical Informatics, Ehime
| | - Tetsuya Ohira
- From Public Health (Y.S., T. Ohira, H. Iso), Department of Social and Environmental Medicine, Osaka University, Osaka, Japan; Osaka Medical Center for Health Science and Promotion (Y.S., H. Imano, T. Ohira, A.K., M.K., T. Okada, S.S., T.S.), Osaka, Japan; Chiba Prefectural Institute of Public Health (S.S.), Chiba, Japan; the Department of Public Health Medicine (K.Y.), University of Tsukuba, Tsukuba, Japan; and the Department of Public Health (T.T.), Social Medicine and Medical Informatics, Ehime
| | - Akihiko Kitamura
- From Public Health (Y.S., T. Ohira, H. Iso), Department of Social and Environmental Medicine, Osaka University, Osaka, Japan; Osaka Medical Center for Health Science and Promotion (Y.S., H. Imano, T. Ohira, A.K., M.K., T. Okada, S.S., T.S.), Osaka, Japan; Chiba Prefectural Institute of Public Health (S.S.), Chiba, Japan; the Department of Public Health Medicine (K.Y.), University of Tsukuba, Tsukuba, Japan; and the Department of Public Health (T.T.), Social Medicine and Medical Informatics, Ehime
| | - Masahiko Kiyama
- From Public Health (Y.S., T. Ohira, H. Iso), Department of Social and Environmental Medicine, Osaka University, Osaka, Japan; Osaka Medical Center for Health Science and Promotion (Y.S., H. Imano, T. Ohira, A.K., M.K., T. Okada, S.S., T.S.), Osaka, Japan; Chiba Prefectural Institute of Public Health (S.S.), Chiba, Japan; the Department of Public Health Medicine (K.Y.), University of Tsukuba, Tsukuba, Japan; and the Department of Public Health (T.T.), Social Medicine and Medical Informatics, Ehime
| | - Takeo Okada
- From Public Health (Y.S., T. Ohira, H. Iso), Department of Social and Environmental Medicine, Osaka University, Osaka, Japan; Osaka Medical Center for Health Science and Promotion (Y.S., H. Imano, T. Ohira, A.K., M.K., T. Okada, S.S., T.S.), Osaka, Japan; Chiba Prefectural Institute of Public Health (S.S.), Chiba, Japan; the Department of Public Health Medicine (K.Y.), University of Tsukuba, Tsukuba, Japan; and the Department of Public Health (T.T.), Social Medicine and Medical Informatics, Ehime
| | - Shinichi Sato
- From Public Health (Y.S., T. Ohira, H. Iso), Department of Social and Environmental Medicine, Osaka University, Osaka, Japan; Osaka Medical Center for Health Science and Promotion (Y.S., H. Imano, T. Ohira, A.K., M.K., T. Okada, S.S., T.S.), Osaka, Japan; Chiba Prefectural Institute of Public Health (S.S.), Chiba, Japan; the Department of Public Health Medicine (K.Y.), University of Tsukuba, Tsukuba, Japan; and the Department of Public Health (T.T.), Social Medicine and Medical Informatics, Ehime
| | - Takashi Shimamoto
- From Public Health (Y.S., T. Ohira, H. Iso), Department of Social and Environmental Medicine, Osaka University, Osaka, Japan; Osaka Medical Center for Health Science and Promotion (Y.S., H. Imano, T. Ohira, A.K., M.K., T. Okada, S.S., T.S.), Osaka, Japan; Chiba Prefectural Institute of Public Health (S.S.), Chiba, Japan; the Department of Public Health Medicine (K.Y.), University of Tsukuba, Tsukuba, Japan; and the Department of Public Health (T.T.), Social Medicine and Medical Informatics, Ehime
| | - Kazumasa Yamagishi
- From Public Health (Y.S., T. Ohira, H. Iso), Department of Social and Environmental Medicine, Osaka University, Osaka, Japan; Osaka Medical Center for Health Science and Promotion (Y.S., H. Imano, T. Ohira, A.K., M.K., T. Okada, S.S., T.S.), Osaka, Japan; Chiba Prefectural Institute of Public Health (S.S.), Chiba, Japan; the Department of Public Health Medicine (K.Y.), University of Tsukuba, Tsukuba, Japan; and the Department of Public Health (T.T.), Social Medicine and Medical Informatics, Ehime
| | - Takeshi Tanigawa
- From Public Health (Y.S., T. Ohira, H. Iso), Department of Social and Environmental Medicine, Osaka University, Osaka, Japan; Osaka Medical Center for Health Science and Promotion (Y.S., H. Imano, T. Ohira, A.K., M.K., T. Okada, S.S., T.S.), Osaka, Japan; Chiba Prefectural Institute of Public Health (S.S.), Chiba, Japan; the Department of Public Health Medicine (K.Y.), University of Tsukuba, Tsukuba, Japan; and the Department of Public Health (T.T.), Social Medicine and Medical Informatics, Ehime
| | - Hiroyasu Iso
- From Public Health (Y.S., T. Ohira, H. Iso), Department of Social and Environmental Medicine, Osaka University, Osaka, Japan; Osaka Medical Center for Health Science and Promotion (Y.S., H. Imano, T. Ohira, A.K., M.K., T. Okada, S.S., T.S.), Osaka, Japan; Chiba Prefectural Institute of Public Health (S.S.), Chiba, Japan; the Department of Public Health Medicine (K.Y.), University of Tsukuba, Tsukuba, Japan; and the Department of Public Health (T.T.), Social Medicine and Medical Informatics, Ehime
| |
Collapse
|
42
|
Hwang JH, Shin JY, Chun BY, Lee DH, Kim KY, Park WH, Chae SC. Association Between Gamma-Glutamyltransferase and Hypertension Incidence in Rural Prehypertensive Adults. J Prev Med Public Health 2010; 43:18-25. [DOI: 10.3961/jpmph.2010.43.1.18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Jun-Hyun Hwang
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Korea
| | - Ji-Yeon Shin
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Korea
| | - Byung-yeol Chun
- Health Promotion Research Center, Kyungpook National University, Korea
| | - Duk-Hee Lee
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Korea
| | - Keon-Yeop Kim
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Korea
| | - Wee-hyun Park
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Korea
| | - Shung-chull Chae
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Korea
| |
Collapse
|
43
|
Jimba S, Nakagami T, Oya J, Wasada T, Endo Y, Iwamoto Y. Increase in gamma-glutamyltransferase level and development of established cardiovascular risk factors and diabetes in Japanese adults. Metab Syndr Relat Disord 2009; 7:411-8. [PMID: 19419267 DOI: 10.1089/met.2008.0082] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We investigated the predictive value of changes in serum gamma-glutamyltransferase (GGT) for the development of cardiovascular disease (CVD) risk factors in Japanese. METHODS A total of 1514 adult participants in a general health examination program were followed for 3 years until January, 2006. The subjects were divided into two groups according to whether their serum GGT level had decreased (< or =0 U/L) or increased (> or =1 U/L) from the baseline level of GGT during the study period. The logistic regression model was used to analyze the relationship between increases in GGT levels and the incidence of diabetes (DM), impaired fasting glucose (IFG), dyslipidemia, and hypertension (HT). RESULTS The mean value of GGT level was significantly higher at baseline than the 3-year follow-up point (47 +/- 41 versus 41 +/- 51, P < 0.0001), and the average 3-year GGT change was -5.7 +/- 32.3 U/L. The subjects with an increased GGT over the 3 years had an increased risk of developing DM, IFG, high triglyceride (TG) levels, and HT, in comparison with that of the subjects with a decreased GGT level, with an odds ratios (OR) of 6.13 (95% confidence interval [CI], 2.83-13.25), 2.70 (1.68-4.34), 2.65 (1.76-3.99), and 1.54 (1.12-2.13), respectively, after adjusting for age, sex, and alcohol habits. Further adjustments for baseline GGT, alanine aminotransferase (ALT), body mass index (BMI), and 3-year changes in BMI did not alter these associations. CONCLUSIONS The increased change in GGT over 3 years was a significant and an independent risk factor for the development of high TG, HT, IFG, and DM in Japanese.
Collapse
Affiliation(s)
- Sachiyo Jimba
- Diabetes Center, Tokyo Women's Medical University, Tokyo 162-8666, Japan.
| | | | | | | | | | | |
Collapse
|
44
|
Filippatos TD, Derdemezis CS, Elisaf MS. Effects of orlistat, alone or combined with hypolipidemic drugs, on cardiovascular risk factors. ACTA ACUST UNITED AC 2009. [DOI: 10.2217/clp.09.25] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
45
|
Association of γ-Glutamyltransferase with Cardiovascular Risk: A Prognostic Outlook. Arch Med Res 2009; 40:318-20. [DOI: 10.1016/j.arcmed.2009.04.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2009] [Accepted: 03/30/2009] [Indexed: 12/12/2022]
|
46
|
Bianchi C, Penno G, Del Prato S, Miccoli R. Serum gamma-glutamyltransferase is not associated to peripheral arterial disease in type 2 diabetic patients: Cross-sectional findings. Atherosclerosis 2009; 203:49-50. [DOI: 10.1016/j.atherosclerosis.2008.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2008] [Revised: 07/02/2008] [Accepted: 07/04/2008] [Indexed: 11/29/2022]
|
47
|
Ruhl CE, Everhart JE. Elevated serum alanine aminotransferase and gamma-glutamyltransferase and mortality in the United States population. Gastroenterology 2009; 136:477-85.e11. [PMID: 19100265 DOI: 10.1053/j.gastro.2008.10.052] [Citation(s) in RCA: 259] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2008] [Revised: 09/18/2008] [Accepted: 10/09/2008] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Elevated serum alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) activities are markers of liver injury, but may also be associated with other diseases and death. In a prospective, national, population-based sample, we examined whether elevated ALT and GGT were associated with increased risk of all-cause and disease-specific mortality. METHODS Death certificate-based 12-year mortality was analyzed among 14,950 adult participants in the third US National Health and Nutrition Examination Survey, 1988-1994, who were negative for markers of viral hepatitis B and C. Abnormal ALT was defined as >30 U/L in men or >19 U/L in women, and abnormal GGT as >51 U/L in men or >33 U/L in women. RESULTS Cumulative mortality was 13.9% from all causes, including 4.2% from cardiovascular disease, 4.2% from neoplasms, 0.44% from diabetes, and 0.13% from liver disease. In multivariate-adjusted analyses, elevated ALT was not associated with all-cause mortality (hazard ratio [HR], 1.2; 95% confidence interval [CI], 0.88-1.6). ALT elevation was associated with deaths from liver disease (HR, 8.2; 95% CI, 2.1-31.9), but not from cardiovascular disease (HR, 0.90; 95% CI, 0.56-1.4), neoplasms (HR, 1.0; 95% CI, 0.65-1.5), or diabetes (HR, 2.4; 95% CI, 0.65-9.1). All-cause mortality increased with elevated GGT (HR, 1.5; 95% CI, 1.2-1.8), as did mortality from liver disease (HR, 13.0; 95% CI, 2.4-71.5), neoplasms (HR, 1.5; 95% CI, 1.01-2.2), and diabetes (HR, 3.3; 95% CI, 1.4-7.6), but not from cardiovascular disease (HR, 1.3; 95% CI, 0.80-2.0). CONCLUSIONS In the US population, elevated GGT was associated with mortality from all causes, liver disease, cancer, and diabetes, while ALT was associated only with liver disease mortality.
Collapse
Affiliation(s)
- Constance E Ruhl
- Social & Scientific Systems, Inc, Silver Spring, Maryland 20910, USA.
| | | |
Collapse
|
48
|
Vergauwen B, Dudycz LW, Dansercoer A, Devreese B. A direct spectrophotometric gamma-glutamyltransferase inhibitor screening assay targeting the hydrolysis-only mode. Biochem Biophys Res Commun 2009; 380:591-6. [PMID: 19285006 DOI: 10.1016/j.bbrc.2009.01.129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2009] [Accepted: 01/23/2009] [Indexed: 10/21/2022]
Abstract
Gamma-glutamyltransferase (GGT, E.C. 2.3.2.2) catalyzes the hydrolysis and transpeptidation of extracellular glutathione. Due to its central role in maintaining mammalian glutathione homeostasis, GGT is now believed to be a valuable drug target for a variety of life-threatening diseases, such as cancer. Unfortunately, however, effective tools for screening GGT inhibitors are still lacking. We report here the synthesis and evaluation of an alpha-phenylthio-containing glutathione peptide mimic that eliminates thiophenol upon GGT-catalyzed hydrolysis of the gamma-glutamyl peptide bond. The concurrent, real-time spectrophotometric quantification of the released thiophenol using Ellman's reagent creates a GGT assay format that is simple, robust, and highly sensitive. The versatility of the assay has been demonstrated by its application to the kinetic characterization of equine kidney GGT, and enzyme inhibition assays. The ability of the glutathione mimic to behave as an excellent donor substrate (exhibiting Michaelis-Menten kinetics with a K(m) of 11.3+/-0.5 microM and a k(cat) of 90.1+/-0.8 nmol mg(-1)min(-1)), coupled to the assay's ability to study the hydrolysis-only mode of the GGT-catalyzed reaction, make our approach amenable to high-throughput drug screening platforms.
Collapse
Affiliation(s)
- Bjorn Vergauwen
- Laboratory for Protein Biochemistry and Biomolecular Engineering, Ghent University, 9000 Ghent, Belgium.
| | | | | | | |
Collapse
|
49
|
Kim TY, Kim DH, Park CH, Cho KH, Lee SH, Ga H, Kim HC. The Effect of Gamma-Glutamyltransferase on Impaired Fasting Glucose or Type 2 Diabetes in Korean Men. KOREAN DIABETES JOURNAL 2009. [DOI: 10.4093/kdj.2009.33.3.215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Tae-Yeon Kim
- Department of Radiology, Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Do-Hoon Kim
- Department of Family Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Chang-Hae Park
- Department of Family Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Kyung-Hwan Cho
- Department of Family Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seung-Hwan Lee
- Department of Family Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hyuk Ga
- Institute of Geriatric Medicine, Eun-Hye Hospital, Korea
| | - Hwan-cheol Kim
- Department of Occupational Medicine, Anam Hospital, Inha University College of Medicine, Incheon, Korea
| |
Collapse
|
50
|
Lim JS, Choi YH, Jeong JY, Jang SN, Moon YS, Kim JH, Kwak ES, Choi MG, Hong KS, Kim DH. Association of Serum Gamma Glutamyltransferase and Fasting Blood Glucose among Middle Aged and Elderly in Chuncheon: Hallym Aging Study. Korean J Fam Med 2009. [DOI: 10.4082/kjfm.2009.30.1.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Jung Su Lim
- Department of Family Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Young Ho Choi
- Department of Family Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Jin Young Jeong
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea
- Hallym Research Institute of Clinical Epidemiology, Chuncheon, Korea
| | - Soong Nang Jang
- Deptartment of Society, Human Development and Health, Harvard School of Public Health, Boston, USA
| | - Yoo Sun Moon
- Department of Family Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Jung Hun Kim
- Department of Family Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Eun Shin Kwak
- Department of Family Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Moon Gi Choi
- Department of Endocrinology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Kyung Soon Hong
- Department of Cardiology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Dong Hyun Kim
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea
- Hallym Research Institute of Clinical Epidemiology, Chuncheon, Korea
| |
Collapse
|