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Zheng K, Li X, Rong Y, Wang X, Hou L, Gu W, Hou X, Guan Y, Liu L, Geng J, Song G. Serum Gamma Glutamyltransferase: A Biomarker for Identifying Postprandial Hypertriglyceridemia. Diabetes Metab Syndr Obes 2024; 17:2273-2281. [PMID: 38859995 PMCID: PMC11164083 DOI: 10.2147/dmso.s461876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/28/2024] [Indexed: 06/12/2024] Open
Abstract
Purpose Elevated serum gamma-glutamyltranspeptidase (GGT) is an independent marker of the activation of systemic inflammation, while conditions associated with elevated triglyceride (TG) levels, such as type 2 diabetes, non-alcoholic fatty liver disease, obesity, and metabolic syndrome, are associated with an increased inflammatory burden. Moreover, serum liver enzymes (GGT, alanine aminotransferase [ALT], aspartate aminotransferase [AST], and alkaline phosphatase [ALP]) are associated with metabolic syndrome and its components, including hypertriglyceridemia. However, the relationship between liver enzymes and postprandial hypertriglyceridemia (PHTG) remains unclear. Therefore, in this study we conducted oral fat tolerance tests (OFTTs) to understand the differences in serum liver enzyme levels among individuals with different lipid tolerance levels and their correlation with PHTG. Patients and Methods For the OFTT, we enrolled 202 non-diabetic volunteers whose fasting triglyceride (TG) levels were less than 1.7 mmol/L in this case-control study. The participants were categorized into two groups according to the TG levels at the 0- and 4-h OFTT: a postprandial normal TG (PNTG) group and a PHTG group. Routine fasting serum biochemical indices, liver enzyme (GGT, ALT, AST, and ALP) levels, and 0- and 4-h OFTT lipid levels were assessed. Results The PHTG group had significantly higher serum GGT and ALT levels and a lower AST/ALT ratio than those in the PNTG group. However, no significant difference was observed in AST and ALP levels compared with the PNTG group. After adjusting for major confounders, logistic regression analysis indicated a significant correlation between serum GGT and PHTG (odds ratio = 1.168, P < 0.001), but not with ALT level, AST level, AST/ALT ratio, and ALP level. The receiver operating characteristic curve analysis demonstrated that the serum GGT level was an effective predictor of PHTG. Conclusion Serum GGT levels are significantly associated with PHTG risk and serve as an effective biomarker for early identification.
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Affiliation(s)
- Kunjie Zheng
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, Hengshui People’s Hospital, Hengshui, Hebei, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Xiaolong Li
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, Hengshui People’s Hospital, Hengshui, Hebei, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Yihua Rong
- Department of Endocrinology, Hengshui People’s Hospital, Hengshui, Hebei, People’s Republic of China
| | - Xuejing Wang
- Hengshui People’s Hospital Statistical Office, Hengshui, Hebei, People’s Republic of China
| | - Liping Hou
- Department of Endocrinology, Hengshui People’s Hospital, Hengshui, Hebei, People’s Republic of China
| | - Wei Gu
- Department of Endocrinology, Hengshui People’s Hospital, Hengshui, Hebei, People’s Republic of China
| | - Xiaoyu Hou
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Yunpeng Guan
- Department of Endocrinology, Shijiazhuang People’s Hospital, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Lifang Liu
- Department of Endocrinology, Baoding First Central Hospital, Baoding, Hebei, People’s Republic of China
| | - Jianlin Geng
- Department of Endocrinology, Hengshui People’s Hospital, Hengshui, Hebei, People’s Republic of China
| | - Guangyao Song
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
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Zhao Y, Xin X, Luo XP. The relationship between the ratio of gamma-glutamyltransferase to high-density lipoprotein cholesterol and the risk of diabetes mellitus using publicly available data: a secondary analysis based on a longitudinal study in Japan. Lipids Health Dis 2023; 22:7. [PMID: 36650520 PMCID: PMC9843936 DOI: 10.1186/s12944-023-01772-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 01/02/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The ratio of gamma-glutamyltransferase to high-density lipoprotein cholesterol (GGT/HDL-C) has been highlighted in nonalcoholic fatty liver disease (NAFLD) by previous studies. However, there have been fewer investigations into the correlation between the GGT/HDL-C ratio and type 2 diabetes mellitus (T2DM) incidence. Our secondary analysis used published data from a Japanese population and aimed to investigate the role of the GGT/HDL-C ratio in the incidence of T2DM. METHODS The research was a longitudinal cohort study completed by Okamura, Takuro et al. We obtained the data from the DATADRYAD website and used it for secondary analysis only. The participants recruited from a medical program called the NAGALA database received regular medical examinations and standardized questionnaires to obtain the baseline variables. Abdominal ultrasound was used to diagnose fatty liver disease. The participants were followed up, and the duration and occurrence of T2DM were documented. The GGT/HDL-C ratio evaluated at baseline served as the independent variable, while the occurrence of diabetes served as the dependent variable. RESULTS A total of 15,453 cases (8,419 men and 7,034 women) were included in our study. After adjusting for age, sex, BMI, DBP, SBP, ALT, AST, TG, TC, HbA1C, FPG, drinking status, smoking status, exercise status, and fatty liver, we observed that the GGT/HDL-C ratio was positively associated with the incidence of T2DM (hazard ratio = 1.005, 95% confidence interval: 1.000 to 1.010, P = 0.0667). The results were consistent when the GGT/HDL-C quartile was used as a categorical variable (P for trend < 0.00396). A curvilinear relationship with a threshold effect was identified between the GGT/HDL-C ratio and the risk of incident T2DM. On the left of the point, a one-unit increase in the GGT/HDL-C ratio was associated with a 1.5-fold increase in the risk of incident T2DM (hazard ratio 2.57, 95% confidence interval 1.20 to 5.49). On the right of the point, when GGT/HDL-C was greater than 6.53, their relationship became saturated. CONCLUSION The GGT/HDL-C ratio correlated with the incidence of T2DM in a curvilinear form with a threshold effect. Their positive relationship could be observed when GGT/HDL-C was less than 6.53.
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Affiliation(s)
- Yue Zhao
- grid.412793.a0000 0004 1799 5032Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xing Xin
- grid.412793.a0000 0004 1799 5032Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao-ping Luo
- grid.412793.a0000 0004 1799 5032Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Chu LM, Karunanayake C, Aich P, Hecker M, Pahwa P. Association between liver enzymes and metabolic syndrome in Canadian adults: results from the Canadian health measures survey - cycles 3 &4. J Diabetes Metab Disord 2022; 21:1699-1708. [PMID: 36404860 PMCID: PMC9672191 DOI: 10.1007/s40200-022-01124-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/06/2022] [Indexed: 10/14/2022]
Abstract
Background The relationship between liver enzymes and Metabolic Syndrome (MetS) in different populations, including Canadians, is not consistent and well understood. We used the Canadian Health Measures Survey data (Cycles 3 and 4) to examine the cross-sectional relationships between select liver biomarkers and MetS in the adult Canadian population. The biomarkers selected were gamma-glutamyl transferase (GGT), aspartate aminotransferase (AST), and alkaline phosphatase (ALKP). Methods Fasting blood samples (FBS) were collected from adults above the age of 20 years for Cycle 3 and Cycle 4 (n = 3003). MetS was diagnosed if the subjects had three or more risk determinants according to the Joint Interim Statement criteria. Primary risk factors included quartile cut-offs for each of the biomarkers ALKP, AST, GGT for males and females separately. A multivariable logistic regression technique based on a maximum likelihood approach was used to evaluate the association between quartiles of ALKP, AST, and GGT, other individual and contextual factors, and the prevalence of MetS. Results MetS was prevalent in 32.3% of subjects. BMI was an effect modifier in the relationship between GGT and MetS prevalence, while sex was an effect modifier in the relationship between ALKP and MetS prevalence; and age was an effect modifier in the relationship between AST and MetS prevalence. Conclusions Since the mechanisms to underpin the associations between the liver enzymes activity and MetS are unknown, further epidemiologic investigations using longitudinal designs are necessary to understand these associations.
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Affiliation(s)
- Luan Manh Chu
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
| | - Chandima Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
| | - Palok Aich
- School of Biological Sciences, National Institute of Science Education and Research (NISER), HBNI, PO Jatni, Khurda, Odisha 752050 India
| | - Markus Hecker
- School of Environment & Sustainability & Toxicology Centre, University of Saskatchewan, Saskatoon, Canada
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada
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Can Gamma-glutamyl Transferase Predict Unhealthy Metabolic Phenotypes Among Healthcare Workers in Azar Cohort Study? HEPATITIS MONTHLY 2022. [DOI: 10.5812/hepatmon-121021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Background: Although various studies have assessed the correlation between gamma-glutamyl transferase (GGT) and cardiometabolic risk factors in obesity, no research has differentiated among metabolically-healthy obese (MHO) and metabolically unhealthy obese (MUHO), metabolically-healthy lean (MHL), and metabolically-unhealthy lean (MUHL). Objectives: Accordingly, this study evaluated the correlation between GGT and cardiometabolic phenotypes among healthcare workers. Methods: In this study, there were anthropometric measurements as well as the measurements of fasting blood sugar (FBS), GGT, cholesterol, triglyceride (TG), high lipoprotein density (HDL), and blood pressure in 1458 healthcare workers enrolled in the Azar Cohort Study. Metabolic syndrome (MetS) was defined according to the National Cholesterol Education Program Adult Treatment Panel III (ATP III). Accordingly, the participants were divided into four cardiometabolic phenotypes. Results: In this cross-sectional study, there was a significant difference in the prevalence of cardiometabolic phenotypes regarding the GGT tertiles (P ≤ 0.001). The highest prevalence of MHO was observed in the third GGT tertile. The mean waist circumference, TG, FBS, HDL, and systolic and diastolic blood pressure levels increased in the MHO, MUHO, and MHL groups in a dose dependent manner with an increase in the GGT tertiles (P < 0.05). In comparing the highest and lowest GGT tertile, the risk of MHO and MUHO increased by 2.84 (95%CI 2.01 - 4.01) and 9.12 (95%CI 5.54 - 15), respectively. However, the correlation between the GGT tertile and MUHL did not reveal a similar trend. The ROC curve shows the cutoff value of 18.5 U/L for GGT, which allowed us to distinguish between the MUHO and MHO individuals. Conclusions: The findings revealed that GGT can indicate the risk of MetS as such, it can be used to detect at-risk MHO individuals and administer proper interventions.
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Toda-Oti KS, Stefano JT, Cavaleiro AM, Carrilho FJ, Correa-Gianella ML, Oliveira CPMDSD. Association of UCP3 Polymorphisms with Nonalcoholic Steatohepatitis and Metabolic Syndrome in Nonalcoholic Fatty Liver Disease Brazilian Patients. Metab Syndr Relat Disord 2022; 20:114-123. [PMID: 35020496 DOI: 10.1089/met.2020.0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: We investigated the possible association of uncoupling protein 3 gene (UCP3) single nucleotide polymorphisms (SNPs) with nonalcoholic steatohepatitis (NASH) and metabolic syndrome (MetS) in nonalcoholic fatty liver disease (NAFLD) Brazilian patients. Methods: UCP3 SNPs rs1726745, rs3781907, and rs11235972 were genotyped in 158 biopsy-proven NAFLD Brazilian patients. Statistics was performed with JMP, R, and SHEsis softwares. Results: The TT genotype of rs1726745 was associated with less occurrence of MetS (P = 0.006) and with lower body mass index (BMI) in the entire NAFLD sample (P = 0.01) and in the NASH group (P = 0.02). The rs1726745-T was associated with lower values of AST (P = 0.001), ALT (P = 0.0002), triglycerides (P = 0.01), and total cholesterol (P = 0.02) in the entire NAFLD sample. Between groups, there were lower values of aminotransferases strictly in individuals with NASH (AST, P = 0.002; ALT, P = 0.0007) and with MetS (AST, P = 0.002; ALT, P = 0.001). The rs3781907-G was associated with lower GGT elevation values in the entire NAFLD sample (P = 0.002), in the NASH group (P = 0.004), and with MetS group (P = 0.003) and with protection for advanced fibrosis (P = 0.01). The rs11235972-A was associated with lower GGT values in the entire NAFLD sample (P = 0.006) and in the NASH group (P = 0.01) and with MetS group (P = 0.005), with fibrosis absence (P = 0.01) and protection for advanced fibrosis (P = 0.01). The TAA haplotype was protective for NASH (P = 0.002), and TGG haplotype was protective for MetS (P = 0.01). Conclusion: UCP3 gene variants were associated with protection against NASH and MetS, in addition to lower values of liver enzymes, lipid profile, BMI and, lesser fibrosis severity in the studied population.
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Affiliation(s)
- Karla Sawada Toda-Oti
- Departamento de Gastroenterologia, Faculdade de Medicina da, Universidade de São Paulo, São Paulo, Brazil
| | - José Tadeu Stefano
- Laboratório de Gastroenterologia Clínica e Experimental (LIM-07), Departamento de Gastroenterologia e Hepatologia, Faculdade de Medicina, Hospital das Clínicas HC-FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Ana Mercedes Cavaleiro
- Laboratório de Carboidratos e Radioimunensaio (LIM-18), Hospital das Clínicas HC-FMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Flair José Carrilho
- Departamento de Gastroenterologia, Faculdade de Medicina da, Universidade de São Paulo, São Paulo, Brazil.,Laboratório de Gastroenterologia Clínica e Experimental (LIM-07), Departamento de Gastroenterologia e Hepatologia, Faculdade de Medicina, Hospital das Clínicas HC-FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Maria Lúcia Correa-Gianella
- Laboratório de Carboidratos e Radioimunensaio (LIM-18), Hospital das Clínicas HC-FMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.,Programa de Pós-graduação em Medicina, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | - Cláudia Pinto Marques de Souza de Oliveira
- Departamento de Gastroenterologia, Faculdade de Medicina da, Universidade de São Paulo, São Paulo, Brazil.,Laboratório de Gastroenterologia Clínica e Experimental (LIM-07), Departamento de Gastroenterologia e Hepatologia, Faculdade de Medicina, Hospital das Clínicas HC-FMUSP, Universidade de São Paulo, São Paulo, Brazil
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Ferraris C, Turner A, Scarlett CJ, Veysey M, Lucock M, Bucher T, Beckett EL. Sour Taste SNP KCNJ2-rs236514 and Differences in Nutrient Intakes and Metabolic Health Markers in the Elderly. Front Nutr 2021; 8:701588. [PMID: 34485363 PMCID: PMC8415820 DOI: 10.3389/fnut.2021.701588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/23/2021] [Indexed: 12/29/2022] Open
Abstract
Single nucleotide polymorphisms (SNPs) in taste receptors influence dietary choices that contribute to health and quality of life. Individual differences in sour taste perception and preference have been linked to heritable genetics, yet the impact of sour taste receptor SNPs on sour taste is under-researched, and studies on sour taste SNP associations to diet and health are lacking. Therefore, this study explored the relationships between the sour taste SNP KCNJ2-rs236514 and estimated macronutrient, vitamin and mineral intakes, and markers of metabolic health. Associations were explored in 523 participants aged 65 years and older with data analysed using standard least squares and nominal logistic regression modelling with post hoc student's t-tests and Tukey's HSD. Associations were found between the presence of the KCNJ2-rs236514 variant allele (A) and lower intakes of energy, total fat, monounsaturated fat and saturated fat. The lower fat intakes were significant in female carriers of the variant allele (A), along with lower water intake. Lower retinol, riboflavin, folate, calcium and sodium intakes were found in the KCNJ2-A allele carriers. In females, the variant allele was associated with lower sodium intake before and after Bonferroni adjustment. Higher body mass index, waist and waist-to-hip ratio measures were found in males carrying the variant allele. Lower levels of liver function biomarkers were associated with the presence of the KCNJ2-A allele. Overall and in males, the variant's association to lower gamma-glutamyl transferase (GGT) levels remained significant after Bonferroni adjustments. These novel findings suggest the sour taste SNP, KCNJ2-rs236514, may be modifying macronutrient, vitamin and mineral intakes, and markers of metabolic health. Research on the extra-oral functions of this SNP may improve health outcomes for those with overweight, obesity and liver disease.
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Affiliation(s)
- Celeste Ferraris
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, NSW, Australia
| | - Alexandria Turner
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, NSW, Australia
| | - Christopher J Scarlett
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, NSW, Australia
| | - Martin Veysey
- School of Medicine & Public Health, The University of Newcastle, Gosford, NSW, Australia.,Hull York Medical School, University of Hull, Cottingham, United Kingdom
| | - Mark Lucock
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, NSW, Australia
| | - Tamara Bucher
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, NSW, Australia.,Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Emma L Beckett
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, NSW, Australia.,Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia
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Chen LW, Huang MS, Shyu YC, Chien RN. Gamma-glutamyl transpeptidase elevation is associated with metabolic syndrome, hepatic steatosis, and fibrosis in patients with nonalcoholic fatty liver disease: A community-based cross-sectional study. Kaohsiung J Med Sci 2021; 37:819-827. [PMID: 34002481 DOI: 10.1002/kjm2.12395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/28/2021] [Accepted: 05/03/2021] [Indexed: 01/14/2023] Open
Abstract
This study aimed to analyze the association between elevated gamma-glutamyl transpeptidase (GGT) and metabolic syndrome (MetS), hepatic steatosis, and fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). From August 2013 to August 2018, a community-based study was conducted in the northeastern part of Taiwan. Patients who underwent abdominal ultrasonography (US) and had no history of alcoholic liver disease were included. According to a US examination showing fatty liver degree, 1566 patients with NAFLD were divided into four groups: normal GGT, isolated GGT elevation, isolated alanine aminotransferase (ALT) elevation, and both GGT and ALT elevation groups. Further 1147 participants with normal serum ALT, GGT, and the abdominal US were included as the control group. GGT levels were associated with high sensitivity C-reactive protein, lower adiponectin, diabetes mellitus, and chronic kidney disease. A stepwise increase in odds ratio (OR) for MetS was found in the normal GGT group (OR = 1.71), isolated GGT elevation group (OR = 3.06), isolated ALT elevation (OR = 4.00), and both GGT + ALT elevation group (OR = 4.17) than the control group. Linear regression analysis revealed a positive association between GGT/ALT value and hepatic steatosis degree, GGT value, and degree of hepatic fibrosis. Hence, GGT elevation is associated with MetS, hepatic steatosis, and fibrosis in patients with NAFLD.
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Affiliation(s)
- Li-Wei Chen
- Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital and University at Keelung, Keelung, Taiwan.,Community Medicine Research Center, Chang-Gung Memorial Hospital, Keelung, Taiwan
| | - Mi-Sio Huang
- Community Medicine Research Center, Chang-Gung Memorial Hospital, Keelung, Taiwan
| | - Yu-Chiau Shyu
- Community Medicine Research Center, Chang-Gung Memorial Hospital, Keelung, Taiwan
| | - Rong-Nan Chien
- Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital and University at Keelung, Keelung, Taiwan.,Community Medicine Research Center, Chang-Gung Memorial Hospital, Keelung, Taiwan
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Shiraishi M, Tanaka M, Okada H, Hashimoto Y, Nakagawa S, Kumagai M, Yamamoto T, Nishimura H, Oda Y, Fukui M. Potential impact of the joint association of total bilirubin and gamma-glutamyltransferase with metabolic syndrome. Diabetol Metab Syndr 2019; 11:12. [PMID: 30740147 PMCID: PMC6360758 DOI: 10.1186/s13098-019-0408-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 01/31/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Metabolic syndrome is characterized by the clustering of different metabolic abnormalities. Total bilirubin and gamma-glutamyltransferase (GGT) levels have been reported to be associated with this condition. However, the extent to which the interaction between these parameters affects metabolic syndrome is unknown. Therefore, we examined the association of total bilirubin and GGT levels with metabolic syndrome, and investigated the combined effect of the two parameters. METHODS In this retrospective cohort study, we analyzed 8992 middle-aged Japanese subjects (4586 men, 4406 women; mean age, 44.8 ± 9.3 years) without metabolic syndrome from a cohort of employees undergoing annual health examinations. They were divided into four groups according to median total bilirubin and GGT levels: both-low, GGT-high, total bilirubin-high, and both-high. The incident of metabolic syndrome was evaluated during a follow-up of 2.8 ± 1.2 years. RESULTS The incident rate of metabolic syndrome during the follow-up was 4.6% in the both-low group, 12.1% in the GGT-high group, 2.7% in the total bilirubin-high group, and 10.6% in the both-high group. Total bilirubin and GGT have an interaction effect on the risk of incident metabolic syndrome (p = 0.0222). The both-low [hazard ratio (HR), 1.37; 95% confidence interval (CI) 1.002-1.89], GGT-high (HR, 1.88; 95% CI 1.42-2.52), and both-high (HR, 2.07; 95% CI 1.56-2.80) groups showed an increased adjusted HR for incident metabolic syndrome after adjusting for covariates compared with the total bilirubin-high group. CONCLUSIONS The simultaneous presence of high total bilirubin and low GGT levels may be associated with a lower incidence of metabolic syndrome.
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Affiliation(s)
- Makoto Shiraishi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566 Japan
| | - Muhei Tanaka
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566 Japan
| | - Hiroshi Okada
- Department of Internal Medicine, Matsushita Memorial Hospital, Osaka, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566 Japan
| | | | - Muneaki Kumagai
- Medical Corporation Soukenkai, Nishimura Clinic, Kyoto, Japan
| | | | | | - Yohei Oda
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566 Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566 Japan
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Association between plasma gamma-glutamyltransferase fractions and metabolic syndrome among hypertensive patients. Sci Rep 2017; 7:12003. [PMID: 28931896 PMCID: PMC5607275 DOI: 10.1038/s41598-017-12356-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 09/05/2017] [Indexed: 12/15/2022] Open
Abstract
Among the risk factors associated to metabolic syndrome (MetS), hypertension shows the highest prevalence in Italy. We investigated the relationship between the newly identified serum γ-glutamyltransferase (GGT) fractions, b- s- m- f-GGT, and risk factors associated to MetS in hypertensive patients. A total of ninety-five consecutive hypertensive patients were enrolled. GGT fractions were analysed by gel-filtration chromatography, and hepatic steatosis was evaluated by ultrasound. MetS was diagnosed in 36% of patients. Considering the whole group, b- and f-GGT showed the highest positive correlation with BMI, glucose, triglycerides and insulin, and the highest negative correlation with HDL cholesterol. While both serum triglycerides and insulin were independently associated with b-GGT levels, only triglycerides were independently associated with f-GGT. The values of b-GGT activity increased with steatosis grade (g0 = 1.19; g2 = 3.29; ratio g2/g0 = 2.75, p < 0.0001 linear trend). Patients with MetS showed higher levels of b-GGT, m-GGT and f-GGT [median (25th-75th) U/L: 3.19 (1.50-6.59); 0.55 (0.26-0.81); 10.3 (9.1-13.6); respectively] as compared to subjects presenting with one or two MetS criteria [1.75 (0.95-2.85), p < 0.001; 0.33 (0.19-0.60), p < 0.05; 8.8 (7.0-10.6), p < 0.001]. Our data point to a potential role for b- and f-GGT fractions in identifying MetS patients among hypertensive subjects, thus providing a minimally invasive blood-based tool for MetS diagnosis.
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'Aussie normals': an a priori study to develop clinical chemistry reference intervals in a healthy Australian population. Pathology 2015; 47:138-44. [PMID: 25551303 DOI: 10.1097/pat.0000000000000227] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Development of reference intervals is difficult, time consuming, expensive and beyond the scope of most laboratories. The Aussie Normals study is a direct a priori study to determine reference intervals in healthy Australian adults. All volunteers completed a health and lifestyle questionnaire and exclusion was based on conditions such as pregnancy, diabetes, renal or cardiovascular disease. Up to 91 biochemical analyses were undertaken on a variety of analytical platforms using serum samples collected from 1856 volunteers. We report on our findings for 40 of these analytes and two calculated parameters performed on the Abbott ARCHITECTci8200/ci16200 analysers. Not all samples were analysed for all assays due to volume requirements or assay/instrument availability. Results with elevated interference indices and those deemed unsuitable after clinical evaluation were removed from the database. Reference intervals were partitioned based on the method of Harris and Boyd into three scenarios, combined gender, males and females and age and gender. We have performed a detailed reference interval study on a healthy Australian population considering the effects of sex, age and body mass. These reference intervals may be adapted to other manufacturer's analytical methods using method transference.
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Lonardo A, Ballestri S, Marchesini G, Angulo P, Loria P. Nonalcoholic fatty liver disease: a precursor of the metabolic syndrome. Dig Liver Dis 2015; 47:181-90. [PMID: 25739820 DOI: 10.1016/j.dld.2014.09.020] [Citation(s) in RCA: 476] [Impact Index Per Article: 52.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 09/19/2014] [Accepted: 09/21/2014] [Indexed: 02/07/2023]
Abstract
The conventional paradigm of nonalcoholic fatty liver disease representing the "hepatic manifestation of the metabolic syndrome" is outdated. We identified and summarized longitudinal studies that, supporting the association of nonalcoholic fatty liver disease with either type 2 diabetes mellitus or metabolic syndrome, suggest that nonalcoholic fatty liver disease precedes the development of both conditions. Online Medical databases were searched, relevant articles were identified, their references were further assessed and tabulated data were checked. Although several cross-sectional studies linked nonalcoholic fatty liver disease to either diabetes and other components of the metabolic syndrome, we focused on 28 longitudinal studies which provided evidence for nonalcoholic fatty liver disease as a risk factor for the future development of diabetes. Moreover, additional 19 longitudinal reported that nonalcoholic fatty liver disease precedes and is a risk factor for the future development of the metabolic syndrome. Finally, molecular and genetic studies are discussed supporting the view that aetiology of steatosis and lipid intra-hepatocytic compartmentation are a major determinant of whether fatty liver is/is not associated with insulin resistance and metabolic syndrome. Data support the novel paradigm of nonalcoholic fatty liver disease as a strong determinant for the development of the metabolic syndrome, which has potentially relevant clinical implications for diagnosing, preventing and treating metabolic syndrome.
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Affiliation(s)
- Amedeo Lonardo
- AUSL Modena and University of Modena and Reggio Emilia, Department of Biomedical, Metabolic and Neural Sciences, Division of Internal Medicine, NOCSAE - Baggiovara, Modena, Italy.
| | - Stefano Ballestri
- AUSL Modena, Department of Internal Medicine, Division of Internal Medicine, Hospital of Pavullo, Pavullo nel Frignano, Italy
| | - Giulio Marchesini
- "Alma Mater Studiorum" University, Unit of Metabolic Diseases and Clinical Dietetics, Bologna, Italy
| | - Paul Angulo
- University of Kentucky, Division of Digestive Diseases & Nutrition, Section of Hepatology, Medical Center, Lexington, KY, USA
| | - Paola Loria
- AUSL Modena and University of Modena and Reggio Emilia, Department of Biomedical, Metabolic and Neural Sciences, Division of Internal Medicine, NOCSAE - Baggiovara, Modena, Italy
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Pei D, Hsia TL, Chao TT, Lin JD, Hsu CH, Wu CZ, Hsieh CH, Liang YJ, Chen YL. γ-glutamyl transpeptidase in men and alanine aminotransferase in women are the most suitable parameters among liver function tests for the prediction of metabolic syndrome in nonviral hepatitis and nonfatty liver in the elderly. Saudi J Gastroenterol 2015; 21:158-64. [PMID: 26021775 PMCID: PMC4455146 DOI: 10.4103/1319-3767.157564] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND/AIMS Nonalchoholic fatty liver disease (NAFLD) has been reported as a hepatic manifestation of metabolic syndrome (MetS); it is common and accounts for 80% of the cases with abnormal liver function tests (LFTs). In addition, several studies have proved that there is a correlation between abnormal LFTs and MetS. Therefore, LFTs may represent the abnormal metabolic status of livers in the patients with MetS. To identify the early state of metabolic dysfunction, we investigate the value of LFTs for the future MetS development in the relatively healthy (non-NAFLD) elderly. PATIENTS AND METHODS A total of 16,912 subjects met the criteria for analysis. In the first stage of this study, subjects were enrolled in the cross-sectional study in order to find out the optimal cutoff value in different LFTs with higher chances to have MetS. In the second stage of the present study, subjects with MetS at baseline were excluded from the same study group, and a median 5.6-year longitudinal study was conducted on the rest of the group. RESULTS Among all LFTs, only aspartate aminotransferase in both genders and the α-fetal protein in women failed to show the significance in distinguishing subjects with MetS by the receiver operating characteristic curve. In the Kaplan-Meier plot, only γ-glutamyl transpeptidase (γ-GT) in men and the alanine aminotransferase (ALT) in women could be used to successfully separate subjects with higher risk of developing the MetS from those with lower risk. Finally, in the multivariant Cox regression model, similar results were identified. Still, the hazard ratio (HR) to have future MetS, γ-GT in men, and ALT in women showed significance (HR = 1.511 in men and 1.504 in women). CONCLUSION Among all the different LFTs, γ-GT (>16 U/L) in male and ALT (>21 U/L) in female were the best predictors for the development of MetS in healthy elderly. These two liver markers could be an ancillary test in predicting future MetS development/diagnosis. Elevation of the LFTs without underlying liver diseases should be treated as a warning sign of the possible MetS development in the elderly.
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Affiliation(s)
- Dee Pei
- Department of Internal Medicine, Cardinal Tien Hospital, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Te-Lin Hsia
- Department of Internal Medicine, Cardinal Tien Hospital, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Ting-Ting Chao
- Medical Research Center, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Jiunn-Diann Lin
- Division of Endocrinology and Metabolism, Department of Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chun-Hsien Hsu
- Department of Family Medicine, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Chung-Ze Wu
- Division of Endocrinology and Metabolism, Department of Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chang-Hsun Hsieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC, Taiwan
| | - Yao-Jen Liang
- Department of Life-Science, Fu-Jen Catholic University, Taipei, Taiwan
| | - Yen-Lin Chen
- Department of Pathology, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan,Address for correspondence: Dr. Yen-Lin Chen, Department of Pathology, Cardinal Tien Hospital, No. 362, Zhongzheng Road, Xindian District, New Taipei City 231, Taiwan. E-mail:
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Chen X, Chen Q, Chen L, Zhang P, Xiao J, Wang S. Description and prediction of the development of metabolic syndrome in Dongying City: a longitudinal analysis using the Markov model. BMC Public Health 2014; 14:1033. [PMID: 25280459 PMCID: PMC4209018 DOI: 10.1186/1471-2458-14-1033] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 09/29/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Metabolic Syndrome (MS) is increasingly becoming a major worldwide clinical and public health issue. Thus it is extremely important to study the history of MS and search for the most likely component contributing to start the cascade of confusions of MS. METHODS A longitudinal cohort was involved which included the data of 7510 individuals who had at least two routine health check-ups in a six-year follow-up. Based on the data, a Markov model with each chain containing seven states (no component state, four isolated states, 2-component state, and MS state) was built. Annual transition probability was the mean of five probabilities for the transition between the given states between each pair of consecutive years. RESULTS The transition probabilities from the no component state to MS were higher in men than that in women in four age groups. In the young people (men <60 years and women <50 years), the probabilities to the overweight or obesity state and dyslipidemia state were the first two biggest probabilities in transition from no component to the rest six states. However, in the elderly population, the probabilities to hypertension state and 2-component state increased, even surpassed the above two states. The individuals initiating with 2-component states and the isolated hyperglycemia state were more likely to develop MS than the others. CONCLUSIONS The Markov model was able to give a better description of the evolutionary history of MS, and to predict the future course based on past evidence. The occurrence of the MS process mostly began with overweight or obesity and dyslipidemia in young people. In the elderly population, many individuals initiating with hypertension or 2 components besides the above two states. Individuals with the isolated hyperglycemia had greater chances to develop MS than other isolated MS' components.
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Affiliation(s)
| | | | | | | | | | - Shumei Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China.
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