|
1
|
Villasís-Keever MÁ, Zurita-Cruz JN, Nava-Sánchez K, Barradas-Vázquez AS, López-Beltrán AL, Espíritu-Díaz ME, Delgadillo-Ruano MA. [Comparison of serum uric acid and liver enzyme levels in adolescents with obesity and with metabolic syndrome]. NUTR HOSP 2024; 41:933-938. [PMID: 38896119 DOI: 10.20960/nh.05137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
Introduction Introduction: a relationship has been observed between elevated levels of liver enzymes and uric acid with the presence of metabolic syndrome (MS) in the pediatric population. Objective: to compare serum liver enzyme and uric acid levels between adolescents with and without MS. Methods: a cross-sectional study was carried out in adolescents with obesity between 10 and 18 years old. Somatometric data, serum insulin, lipid profile, uric acid levels and liver enzymes (aspartate aminotransferase [AST], alanine aminotransferase [ALT] and gamma-glutamyl transferase [GGT]) were analyzed. Statistical analysis: Student's t test or the Chi-square test was used to evaluate differences between groups. Results: a total of 1095 adolescents with obesity were included (444 with MS and 651 without MS). The group with MS had a higher BMI (with MS 2.28 vs without MS 2.11 p < 0.001), with no difference in body fat (42.9 % vs 42.9 %, p = 0.978). The MS group had significantly higher levels of AST (34.4 vs. 29.5, p = 0.013), ALT (42.2 vs. 34.6, p = 0.003), and uric acid (6.17 vs. 5.74, p = 0.002). comparison to the group without MS. The proportion of ALT (40.5 % vs 29.5 %, p = 0.029) and altered uric acid (58.1 % vs. 45.6 %, p = 0.019) was higher in the MS group. Conclusions: serum levels of ALT, AST and uric acid in adolescents with obesity and MS were higher compared to those without MS. Altered ALT was a risk factor for SM.
Collapse
Affiliation(s)
- Miguel Ángel Villasís-Keever
- Unidad de Investigación en Análisis y Síntesis de la Evidencia. Centro Médico Nacional Siglo XXI. Instituto Mexicano del Seguro Social (IMSS)
| | - Jessie Nallely Zurita-Cruz
- Facultad de Medicina. Universidad Nacional Autónoma de México. Hospital Infantil de México Federico Gómez
| | - Karla Nava-Sánchez
- Facultad de Medicina. Universidad Nacional Autónoma de Mexico. Hospital Infantil de Mexico Federico Gómez
| | - Aly Sugei Barradas-Vázquez
- Unidad de Investigación en Análisis y Síntesis de la Evidencia. Centro Médico Nacional Siglo XXI. Instituto Mexicano del Seguro Social
| | - Ana Laura López-Beltrán
- Servicio de Endocrinología Pediátrica, UMAE. Hospital de Pediatría. Centro Médico Nacional de Occidente. Instituto Mexicano del Seguro Social
| | - Mireya Elizabeth Espíritu-Díaz
- Servicio de Endocrinología Pediátrica, UMAE. Hospital de Pediatría. Centro Médico Nacional de Occidente. Instituto Mexicano del Seguro Social
| | - Martha Alicia Delgadillo-Ruano
- Servicio de Endocrinología Pediátrica, UMAE. Hospital de Pediatría. Centro Médico Nacional de Occidente. Instituto Mexicano del Seguro Social
| |
Collapse
|
|
2
|
Fukuda S, Shirase U, Ogimoto S, Nakagawa M, Nakagawa K, Tominaga A, Morioka H. Association between elevated serum transaminase and moderately increased albuminuria: a cross-sectional study in western Tokushima, Japan. BMC Nephrol 2023; 24:358. [PMID: 38053047 PMCID: PMC10696726 DOI: 10.1186/s12882-023-03411-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/24/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND This study aimed to identify the factors relating to moderately increased albuminuria among middle-aged and older individuals in Japan. METHODS We conducted specific health examinations in which we measured albuminuria levels, and administered a questionnaire survey to record participants' lifestyles in western Tokushima Prefecture, Japan. A total of 1,660 people whose albuminuria was less than 300 mg/g creatinine (Cr) were analyzed. We divided participants into two groups-those with normal albuminuria (< 30 mg/gCr) and those with moderately increased albuminuria (≥ 30 mg/gCr, > 300 mg/gCr)-and compared their characteristics. To investigate all relevant factors, we conducted a multivariate logistic regression analysis. RESULTS The moderately increased albuminuria group were significantly older and had, among them, significantly higher percentages of a body mass index (BMI) ≥ 25 kg/m2, diabetes, hypertension, and mild liver disorder (aspartate transaminase ≥ 31 U/L or alanine aminotransferase ≥ 31 U/L or gamma-glutamyl transferase ≥ 51 U/L). (p < 0.01) In a multivariate logistic regression analysis that used microalbuminuria as an independent variable, we found the adjusted odds ratio (AOR) and 95% confidence interval (CI) to be significantly higher among individuals with diabetes (AOR: 2.04, 95% CI: 1.40-2.99); hypertension (AOR: 1.90, 95% CI: 1.36-2.65); BMI ≥ 25 kg/m2 (AOR: 1.76, 95% CI: 1.27-2.44); and mild liver disorder (AOR: 1.54, 95% CI: 1.10-2.18). CONCLUSIONS In addition to diabetes, hypertension, and BMI ≥ 25 kg/m2, this study found that among the middle-aged and older general population living in western Tokushima Prefecture, there were cases of mild liver disorder (elevated serum transaminase), which independently associated with moderately increased albuminuria. Therefore, in health checkups targeting the general population, there is a need to consider measuring albuminuria, even in those who have only mild liver dysfunction (health guidance level). TRIAL REGISTRATION N/A.
Collapse
Affiliation(s)
- Shoichi Fukuda
- Department of Public Health, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15, Kuramoto, Tokushima city, Tokushima, 770-8503, Japan
| | - Ukyo Shirase
- Department of Public Health, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15, Kuramoto, Tokushima city, Tokushima, 770-8503, Japan
| | - Shigeru Ogimoto
- Mima Public Health Centre, 23-23, Myouren, Anabuki, Mima city, Tokushima, 777-0005, Japan
| | - Mai Nakagawa
- Department of Public Health, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15, Kuramoto, Tokushima city, Tokushima, 770-8503, Japan
| | - Kazumi Nakagawa
- Department of Public Health, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15, Kuramoto, Tokushima city, Tokushima, 770-8503, Japan
| | - Ayumu Tominaga
- Department of Public Health, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15, Kuramoto, Tokushima city, Tokushima, 770-8503, Japan
| | - Hisayoshi Morioka
- Department of Public Health, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15, Kuramoto, Tokushima city, Tokushima, 770-8503, Japan.
| |
Collapse
|
|
3
|
Dai H, Zhu L, Pan B, Li H, Dai Z, Su X. The relationship between serum γ-glutamyltransferase (GGT) and diabetic nephropathy in patients with type 2 diabetes mellitus: a cross-sectional study. Clin Exp Med 2023; 23:3619-3630. [PMID: 36630069 DOI: 10.1007/s10238-023-00991-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 01/04/2023] [Indexed: 01/12/2023]
Abstract
The relationship between serum γ-glutamyltransferase (GGT) and renal dysfunction is controversial. In this study, we examined the relationship of serum GGT to diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM). A total of 577 patients with T2DM were enrolled and their basic information and laboratory data were collected and analyzed. The prevalence of DN increased with the elevated serum GGT tertiles. The level of serum GGT in the DN group was higher than in the non-DN groups. Multivariate logistic analysis showed that high GGT was independent risks for DN (OR = 1.041, 95% CIs 1.023-1.059). And the OR of log-transformed serum GGT for DN was 6.190 (95% CIs 4.248-9.021). The OR of DN across increasing tertiles of serum GGT were 1.00, 3.288 (1.851-5.840), and 5.059 (2.620-9.769) (P for trend < 0.001). Stratified receiver operating characteristic (ROC) analysis by gender showed that the area under ROC curve (AUC) value for GGT was 0.781 (0.732-0.825, P < 0.05) in male and was 0.817 (0.761-0.864, P < 0.05) in female. Compared with female, GGT in male showed lower sensitivity (52.86% vs. 82.05%) and higher specificity (90.32% vs. 55.26%). And the AUC value for GGT was greater than creatinine (Cr) and estimated glomerular filtration rate (eGFR) in male and smaller than Cr and eGFR in female, respectively. In Conclusion, there was an independently positive relationship between serum GGT levels and DN, which suggested that elevated GGT was a potential indicator for risk of DN. There were gender differences in the predictive property of GGT for DN.
Collapse
Affiliation(s)
- Huifang Dai
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No.109, Xueyuanxi Road, Wenzhou, 325000, Zhejiang, China
| | - Lielie Zhu
- Department of Rehabilitation, Zhejiang Chinese Medical University Affiliated Wenzhou Hospital of Traditional Chinese Medicine, No.9 Jiaowei Road, Wenzhou, 325000, Zhejiang, China.
| | - Bilin Pan
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No.109, Xueyuanxi Road, Wenzhou, 325000, Zhejiang, China
| | - Hai Li
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No.109, Xueyuanxi Road, Wenzhou, 325000, Zhejiang, China
| | - ZhiJuan Dai
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No.109, Xueyuanxi Road, Wenzhou, 325000, Zhejiang, China
| | - Xiaoyou Su
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No.109, Xueyuanxi Road, Wenzhou, 325000, Zhejiang, China
| |
Collapse
|
|
4
|
Kwak J, Seo IH, Lee YJ. Serum γ-glutamyltransferase level and incidence risk of metabolic syndrome in community dwelling adults: longitudinal findings over 12 years. Diabetol Metab Syndr 2023; 15:29. [PMID: 36823659 PMCID: PMC9948354 DOI: 10.1186/s13098-023-01000-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/17/2023] [Indexed: 02/25/2023] Open
Abstract
PURPOSE Although a recent meta-analysis demonstrated a positive association between serum γ-glutamyltransferase (GGT) and metabolic syndrome (MetS), sex differences in the relationship between GGT levels and MetS risk were not fully considered. We prospectively examined the relationship between serum GGT levels and incidence risk of MetS. METHODS Data were collected from the Korean Genome and Epidemiology Study (KoGES) enrolled in 2001-2002. Among 10,030 total participants, 5960 adults (3130 men and 2830 women) aged 40-69 without MetS were included and divided according to sex-specific quartiles of baseline serum GGT levels and followed up biennially until 2014. The hazard ratios (HRs) with 95% confidence intervals (CIs) for incident MetS were prospectively analyzed using multiple Cox proportional hazards regression analysis models. RESULTS Among 5960 participants, 1215 males (38.8%) and 1263 females (44.6%) developed MetS during 12-year follow up. Higher quartiles of GGT showed significantly higher cumulative incidence of MetS in both sexes (log-rank test P < 0.001). The HRs (95% CIs) for incident type 2 diabetes for the highest quartile versus referent lowest quartile for serum GGT levels were 3.01 (2.35-3.76) for men and 1.83 (1.30-2.57) for women after adjusting for age, smoking status, daily alcohol intake (g/day), regular exercise, family history of diabetes, and log-transformed LDL-cholesterol, creatinine, and aminotransferase levels. CONCLUSION In conclusion, high levels of GGT were found to be associated with increased risk of Mets in both men and women and the positive associations were stronger in men than in women.
Collapse
Affiliation(s)
- Jiwon Kwak
- Department of Family Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-Gu, Seoul, 06273, Republic of Korea
| | - In-Ho Seo
- Department of Family Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-Gu, Seoul, 06273, Republic of Korea
| | - Yong-Jae Lee
- Department of Family Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-Gu, Seoul, 06273, Republic of Korea.
| |
Collapse
|
|
5
|
Sung Y, Lee YJ, Jung DH, Park B. Potential Association of Isolated γ-Glutamyltransferase Elevation with Incident Ischemic Heart Disease in Lean Koreans. J Pers Med 2022; 12:jpm12121966. [PMID: 36556187 PMCID: PMC9785500 DOI: 10.3390/jpm12121966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/17/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022] Open
Abstract
Isolated elevation of γ-glutamyltransferase (GGT), a microsomal membrane-bound protein, is commonly observed in non-obese Koreans without diabetes, and its clinical implications are not well-known. Therefore, we aimed to investigate the longitudinal effect of isolated GGT on the incidence of ischemic heart disease (IHD) risk in a large cohort of lean non-diabetic Koreans. Data were obtained from the Health Risk Assessment Study (HERAS) and Korea Health Insurance Review and Assessment (HIRA) datasets. The participants were divided into four groups according to the GGT quartile after the exclusion of those participants with diabetes, a body mass index (BMI) ≥ 25 kg/m2, alanine aminotransferase (ALT) ≥ 40 IU/L, and aspartate aminotransferase (AST)/ALT > 1.5, as well as those positive for hepatitis B surface antigen or hepatitis C antibody. We prospectively assessed the hazard ratios (HRs) with 95% confidence intervals (CIs) for IHD using multivariate Cox proportional hazard regression models over a 50-month period. During the follow-up period, 183 individuals (1.85%) developed IHD. After setting the lowest GGT quartile as a reference group, the HRs of IHD for GGT quartiles 2−4 were 1.66 (95% CI 0.95−2.89), 1.82 (95% CI 1.05−3.16), and 1.98 (95% CI 1.12−3.50), respectively, after adjusting for age, sex, body mass index, smoking status, alcohol consumption, physical activity, mean arterial blood pressure, fasting plasma glucose, and dyslipidemia. An isolated high GGT may be an additional measure for assessing and managing future IHD risks among lean Koreans without diabetes.
Collapse
Affiliation(s)
- Yumin Sung
- Department of Family Medicine, Yongin Severance Hospital, Yongin-si 16995, Republic of Korea
| | - Yong-Jae Lee
- Department of Family Medicine, Gangnam Severance Hospital, Seoul 06273, Republic of Korea
| | - Dong-Hyuk Jung
- Department of Family Medicine, Yongin Severance Hospital, Yongin-si 16995, Republic of Korea
- Correspondence: (D.-H.J.); (B.P.)
| | - Byoungjin Park
- Department of Family Medicine, Yongin Severance Hospital, Yongin-si 16995, Republic of Korea
- Correspondence: (D.-H.J.); (B.P.)
| |
Collapse
|
|
6
|
Teng F, Ye Y, Wang L, Qin R, Liu X, Geng H, Xu W, Lai P, Liang J. Association between serum gamma glutamyl transferase and fasting blood glucose in Chinese people: A 6-year follow-up study. J Diabetes Investig 2022; 14:339-343. [PMID: 36412546 PMCID: PMC9889614 DOI: 10.1111/jdi.13947] [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: 06/10/2022] [Revised: 10/25/2022] [Accepted: 11/02/2022] [Indexed: 11/23/2022] Open
Abstract
AIMS/INTRODUCTION In this study, we aimed to investigate the relationships between gamma-glutamyl transferase (GGT) and fasting blood glucose (FBG) during a 6-year follow-up study of participants, and to determine whether GGT is a risk factor for FBG. MATERIALS AND METHODS A total of 1,369 individuals from the health examination survey in the urban area of Xuzhou, central China, were followed up for 6 years. The patients were divided into four groups based on their baseline GGT levels (in quartiles). The one-way analysis of variance (anova) method was used to compare the differences between the variables and baseline. The relationship between GGT and FBG levels was investigated using repeated measurements anova. RESULTS The grouping of baseline GGT levels affected the changes in blood glucose during the 6-year follow-up study. In the GGT quartile subgroups, the annual mean increase in FBG levels showed a positive relationship with baseline GGT levels. This trend was even more aggregated in the highest baseline GGT group. Interactions among time course, baseline FBG and GGT groups in different participants together affected the change of FBG levels during the follow-up period. The repeated measures anova suggested that different baseline GGT groups were still significantly associated with increased FBG levels. GGT is a risk factor that affects FBG levels(P < 0.001). CONCLUSIONS The annual mean increase in FBG levels showed a positive relationship with baseline GGT levels. Higher baseline GGT levels resulted in a faster annual mean increase in FBG. Thus, GGT can be used for the early detection of FBG-related disorders of glucose metabolism for clinical application.
Collapse
Affiliation(s)
- Fei Teng
- Present address:
Department of EndocrinologyXuzhou Central HospitalXuzhou, JiangsuChina,Xuzhou Institute of Medical SciencesXuzhou, JiangsuChina
| | - Yan Ye
- Present address:
Department of EndocrinologyXuzhou Central HospitalXuzhou, JiangsuChina,The Xuzhou Clinical College of Xuzhou Medical UniversityXuzhou, JiangsuChina
| | - Liying Wang
- Present address:
Department of EndocrinologyXuzhou Central HospitalXuzhou, JiangsuChina
| | - Ruihao Qin
- Present address:
Department of EndocrinologyXuzhou Central HospitalXuzhou, JiangsuChina,Department of General SurgeryXuzhou Central HospitalXuzhou, JiangsuChina
| | - Xuekui Liu
- Present address:
Department of EndocrinologyXuzhou Central HospitalXuzhou, JiangsuChina,Xuzhou Institute of Medical SciencesXuzhou, JiangsuChina
| | - Houfa Geng
- Present address:
Department of EndocrinologyXuzhou Central HospitalXuzhou, JiangsuChina
| | - Wei Xu
- Present address:
Department of EndocrinologyXuzhou Central HospitalXuzhou, JiangsuChina
| | - Peng Lai
- The Xuzhou Clinical College of Xuzhou Medical UniversityXuzhou, JiangsuChina
| | - Jun Liang
- The Xuzhou Clinical College of Xuzhou Medical UniversityXuzhou, JiangsuChina
| |
Collapse
|
|
7
|
Hu J, Zheng P, Qiu J, Chen Q, Zeng S, Zhang Y, Lin S, Zheng B. High-Amylose Corn Starch Regulated Gut Microbiota and Serum Bile Acids in High-Fat Diet-Induced Obese Mice. Int J Mol Sci 2022; 23:ijms23115905. [PMID: 35682591 PMCID: PMC9180756 DOI: 10.3390/ijms23115905] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 05/22/2022] [Accepted: 05/23/2022] [Indexed: 02/06/2023] Open
Abstract
Simple Summary High-amylose corn starch, as a kind of resistant starch, could profoundly regulate the gut microbiota and exert anti-obesity properties. Since the gut microbiota was found to improve metabolic health by altering circulating bile acids, therefore, here we investigated the association between the gut microbiota and serum bile acids in high fat diet induced obese mice fed with high-amylose corn starch. We found high-amylose corn starch could modulate the gut microbiota composition and partially restore the alternations in circulating bile acid profiles in obese mice. These influences on gut microbiota and circulating bile acids could be the underlying mechanisms of anti-obesity activity of high-amylose corn starch. Abstract High-amylose corn starch is well known for its anti-obesity activity, which is mainly based on the regulatory effects on gut microbiota. Recently, the gut microbiota has been reported to improve metabolic health by altering circulating bile acids. Therefore, in this study, the influence of high-amylose corn starch (HACS) on intestinal microbiota composition and serum bile acids was explored in mice fed with a high fat diet (HFD). The results demonstrated HACS treatment reduced HFD-induced body weight gain, hepatic lipid accumulation, and adipocyte hypertrophy as well as improved blood lipid profiles. Moreover, HACS also greatly impacted the gut microbiota with increased Firmicutes and decreased Bacteroidetes relative abundance being observed. Furthermore, compared to ND-fed mice, the mice with HFD feeding exhibited more obvious changes in serum bile acids profiles than the HFD-fed mice with the HACS intervention, showing HACS might restore HFD-induced alterations to bile acid composition in blood. In summary, our results suggested that the underlying mechanisms of anti-obesity activity of HACS may involve its regulatory effects on gut microbiota and circulating bile acids.
Collapse
Affiliation(s)
- Jiamiao Hu
- Engineering Research Centre of Fujian-Taiwan Special Marine Food Processing and Nutrition, Ministry of Education, Fuzhou 350002, China; (J.H.); (P.Z.); (Q.C.); (S.Z.); (Y.Z.)
| | - Peiying Zheng
- Engineering Research Centre of Fujian-Taiwan Special Marine Food Processing and Nutrition, Ministry of Education, Fuzhou 350002, China; (J.H.); (P.Z.); (Q.C.); (S.Z.); (Y.Z.)
| | - Jinhui Qiu
- Key Laboratory of Marine Biotechnology of Fujian Province, Institute of Oceanology, Fujian Agriculture and Forestry University, Fuzhou 350002, China;
| | - Qingyan Chen
- Engineering Research Centre of Fujian-Taiwan Special Marine Food Processing and Nutrition, Ministry of Education, Fuzhou 350002, China; (J.H.); (P.Z.); (Q.C.); (S.Z.); (Y.Z.)
| | - Shaoxiao Zeng
- Engineering Research Centre of Fujian-Taiwan Special Marine Food Processing and Nutrition, Ministry of Education, Fuzhou 350002, China; (J.H.); (P.Z.); (Q.C.); (S.Z.); (Y.Z.)
| | - Yi Zhang
- Engineering Research Centre of Fujian-Taiwan Special Marine Food Processing and Nutrition, Ministry of Education, Fuzhou 350002, China; (J.H.); (P.Z.); (Q.C.); (S.Z.); (Y.Z.)
| | - Shaoling Lin
- College of Food Science, Fujian Agriculture and Forestry University, Fuzhou 350002, China
- Correspondence: (S.L.); (B.Z.); Tel.: +86-15606025198 (S.L.); +86-13705009016 (B.Z.)
| | - Baodong Zheng
- Engineering Research Centre of Fujian-Taiwan Special Marine Food Processing and Nutrition, Ministry of Education, Fuzhou 350002, China; (J.H.); (P.Z.); (Q.C.); (S.Z.); (Y.Z.)
- Correspondence: (S.L.); (B.Z.); Tel.: +86-15606025198 (S.L.); +86-13705009016 (B.Z.)
| |
Collapse
|
|
8
|
Biomarkers in metabolic syndrome. Adv Clin Chem 2022; 111:101-156. [DOI: 10.1016/bs.acc.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
|
9
|
Durrer C, McKelvey S, Singer J, Batterham AM, Johnson JD, Gudmundson K, Wortman J, Little JP. A randomized controlled trial of pharmacist-led therapeutic carbohydrate and energy restriction in type 2 diabetes. Nat Commun 2021; 12:5367. [PMID: 34508090 PMCID: PMC8433183 DOI: 10.1038/s41467-021-25667-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 08/12/2021] [Indexed: 11/17/2022] Open
Abstract
Type 2 diabetes can be treated, and sometimes reversed, with dietary interventions; however, strategies to implement these interventions while addressing medication changes are lacking. We conducted a 12-week pragmatic, community-based parallel-group randomized controlled trial (ClinicalTrials.gov: NCT03181165) evaluating the effect of a low-carbohydrate (<50 g), energy-restricted diet (~850-1100 kcal/day; Pharm-TCR; n = 98) compared to treatment-as-usual (TAU; n = 90), delivered by community pharmacists, on glucose-lowering medication use, cardiometabolic health, and health-related quality of life. The Pharm-TCR intervention was effective in reducing the need for glucose-lowering medications through complete discontinuation of medications (35.7%; n = 35 vs. 0%; n = 0 in TAU; p < 0.0001) and reduced medication effect score compared to TAU. These reductions occurred concurrently with clinically meaningful improvements in hemoglobin A1C, anthropometrics, blood pressure, and triglycerides (all p < 0.0001). These data indicate community pharmacists are a viable and innovative option for implementing short-term nutritional interventions for people with type 2 diabetes, particularly when medication management is a safety concern. Community pharmacists are accessible healthcare providers with expertise in medication management. Here the authors show that a low-carbohydrate, low-energy diet implemented by community pharmacists reduced diabetes medication use and improved glucose control in people with type 2 diabetes.
Collapse
Affiliation(s)
- Cody Durrer
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | - Sean McKelvey
- Institute for Personalized Therapeutic Nutrition, Vancouver, BC, Canada
| | - Joel Singer
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Alan M Batterham
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - James D Johnson
- Institute for Personalized Therapeutic Nutrition, Vancouver, BC, Canada.,Diabetes Research Group, Life Sciences Institute, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kelsey Gudmundson
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | - Jay Wortman
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jonathan P Little
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada. .,Institute for Personalized Therapeutic Nutrition, Vancouver, BC, Canada.
| |
Collapse
|
|
10
|
Heda R, Yazawa M, Shi M, Bhaskaran M, Aloor FZ, Thuluvath PJ, Satapathy SK. Non-alcoholic fatty liver and chronic kidney disease: Retrospect, introspect, and prospect. World J Gastroenterol 2021; 27:1864-1882. [PMID: 34007127 PMCID: PMC8108029 DOI: 10.3748/wjg.v27.i17.1864] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/07/2021] [Accepted: 04/07/2021] [Indexed: 02/06/2023] Open
Abstract
With the growing prevalence of obesity and diabetes in the United States and across the world, a rise in the overall incidence and prevalence of non-alcoholic fatty liver disease (NAFLD) is expected. The risk factors for NAFLD are also associated with the development of chronic kidney disease (CKD). We review the epidemiology, risk factors, genetics, implications of gut dysbiosis, and specific pathogenic mechanisms linking NAFLD to CKD. Mechanisms such as ectopic lipid accumulation, cellular signaling abnormalities, and the interplay between fructose consumption and uric acid accumulation have led to the emergence of potential therapeutic implications for this patient population. Transplant evaluation in the setting of both NAFLD and CKD is also reviewed. Potential strategies for surveillance and management include the monitoring of comorbidities, the use of non-invasive fibrosis scoring systems, and the measurement of laboratory markers. Lastly, we discuss the management of patients with NAFLD and CKD, from preventative measures to experimental interventions.
Collapse
Affiliation(s)
- Rajiv Heda
- Department of Internal Medicine, Tulane University School of Medicine, New Orleans, LA 70112, United States
| | - Masahiko Yazawa
- Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Michelle Shi
- Department of Internal Medicine, Donald and Barbara Zucker School of Medicine, Northwell Health, Manhasset, NY 11030, United States
| | - Madhu Bhaskaran
- Department of Nephrology, Northwell Health/Zucker School of Medicine at Hosftra, Manhasset, NY 11030, United States
| | - Fuad Zain Aloor
- Department of Internal Medicine, Baylor College of Medicine, Houston, TX 77030, United States
| | - Paul J Thuluvath
- Institute of Digestive Health & Liver Diseases, Mercy Medical Center, Baltimore, MD 21202, United States
| | - Sanjaya K Satapathy
- Department of Internal Medicine, Donald and Barbara Zucker School of Medicine, Northwell Health, Manhasset, NY 11030, United States
| |
Collapse
|
|
11
|
Lee SR, Han KD, Choi EK, Oh S, Lip GYH. Nonalcoholic fatty liver disease and the risk of atrial fibrillation stratified by body mass index: a nationwide population-based study. Sci Rep 2021; 11:3737. [PMID: 33580177 PMCID: PMC7881181 DOI: 10.1038/s41598-021-83367-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 01/04/2021] [Indexed: 02/07/2023] Open
Abstract
We evaluated the association between nonalcoholic fatty liver disease (NAFLD) and incident atrial fibrillation (AF) and analyzed the impact of NAFLD on AF risk in relation to body mass index (BMI). A total of 8,048,055 subjects without significant liver disease who were available fatty liver index (FLI) values were included. Subjects were categorized into 3 groups based on FLI: < 30, 30 to < 60, and ≥ 60. During a median 8-year of follow-up, 534,442 subjects were newly diagnosed as AF (8.27 per 1000 person-years). Higher FLI was associated with an increased risk of AF (hazard ratio [HR] 1.053, 95% confidence interval [CI] 1.046–1.060 in 30 ≤ FLI < 60, and HR 1.115, 95% CI 1.106–1.125 in FLI ≥ 60). In underweight subjects (BMI < 18.5 kg/m2), higher FLI raised the risk of AF (by 1.6-fold in 30 ≤ FLI < 60 and by twofold in FLI ≥ 60). In normal- and overweight subjects, higher FLI was associated with an increased risk of AF, but the HRs were attenuated. In obese subjects, higher FLI was not associated with higher risk of AF. NAFLD as assessed by FLI was independently associated with an increased risk of AF in nonobese subjects with BMI < 25 kg/m2. The impact of NAFLD on AF risk was accentuated in lean subjects with underweight.
Collapse
Affiliation(s)
- So-Ryoung Lee
- Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Kyung-Do Han
- Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Eue-Keun Choi
- Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Seil Oh
- Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Gregory Y H Lip
- Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Chest & Heart Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| |
Collapse
|
|
12
|
Wang Y, Wu T, Zang X, Liu X, Xu W, Lai P, Wang Y, Teng F, Qiu Q, Geng H, Liang J. Relationship Between Serum Gamma-Glutamyl Transferase Level and Impaired Fasting Glucose Among Chinese Community-Dwelling Adults: A Follow-Up Observation of 6 Years. Metab Syndr Relat Disord 2020; 19:100-106. [PMID: 33170087 DOI: 10.1089/met.2020.0032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective: We aimed to investigate the relationship between serum gamma-glutamyl transferase (GGT) and fasting blood glucose (FBG) levels, as well as the cumulative risk of impaired fasting glucose (IFG) regulation in the Chinese adult population after 6 years of follow-up. Methods: A total of 1360 apparently healthy Chinese men and women who completed a community-based health examination survey and did not have IFG in central China in 2010 and 2016 were included in this study. The patients were divided into four groups according to their baseline GGT (in quartiles). The relationship between GGT levels and FBG levels was examined using general linear regression models. The effect of the GGT level on the risk of IFG was analyzed using multivariate logistic regression. The first quartile group of GGT levels was set as the dummy variable in the model, and the odds ratios and 95% confidence intervals of the remaining quartile groups relative to the first quartile group were obtained. Results: After 6 years of follow-up, 16.4% (188/1148) of participants were diagnosed with IFG. The cumulative incidence of IFG in the four groups according to their baseline GGT levels (in quartiles) was 7.7%, 16.1%, 15.8%, and 26.8%, respectively. Based on the Cox multiple regression, the hazard ratio for IFG increased by 28.9% for each unit of increase in the baseline GGT level after adjusting for the confounding factors. The GGT levels of participants in the first quartile were used as the reference group. The relative risks of IFG in the second, third, and fourth quartiles of GGT were 1.70, 1.55, and 2.46, respectively (P = 0.005). Conclusions: GGT was positively associated with the risk of IFG and can be used as an indicator to assess whether a patient may develop prediabetes.
Collapse
Affiliation(s)
- Yun Wang
- The Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Tingting Wu
- The Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xiu Zang
- Department of Endocrinology, Xuzhou Central Hospital; Affiliated Hospital of Medical College of Southeast University; Affiliated Hospital of Nanjing University of Chinese Medicine, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou Clinical School of Nanjing Medical University, Xuzhou, Jiangsu, China
| | - Xuekui Liu
- Department of Endocrinology, Xuzhou Central Hospital; Affiliated Hospital of Medical College of Southeast University; Affiliated Hospital of Nanjing University of Chinese Medicine, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou Clinical School of Nanjing Medical University, Xuzhou, Jiangsu, China
| | - Wei Xu
- Department of Endocrinology, Xuzhou Central Hospital; Affiliated Hospital of Medical College of Southeast University; Affiliated Hospital of Nanjing University of Chinese Medicine, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou Clinical School of Nanjing Medical University, Xuzhou, Jiangsu, China
| | - Peng Lai
- The Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yu Wang
- Department of Endocrinology, Xuzhou Central Hospital; Affiliated Hospital of Medical College of Southeast University; Affiliated Hospital of Nanjing University of Chinese Medicine, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou Clinical School of Nanjing Medical University, Xuzhou, Jiangsu, China
| | - Fei Teng
- Department of Endocrinology, Xuzhou Central Hospital; Affiliated Hospital of Medical College of Southeast University; Affiliated Hospital of Nanjing University of Chinese Medicine, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou Clinical School of Nanjing Medical University, Xuzhou, Jiangsu, China
| | - Qinqin Qiu
- Department of Endocrinology, Xuzhou Central Hospital; Affiliated Hospital of Medical College of Southeast University; Affiliated Hospital of Nanjing University of Chinese Medicine, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou Clinical School of Nanjing Medical University, Xuzhou, Jiangsu, China
| | - Houfa Geng
- Department of Endocrinology, Xuzhou Central Hospital; Affiliated Hospital of Medical College of Southeast University; Affiliated Hospital of Nanjing University of Chinese Medicine, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou Clinical School of Nanjing Medical University, Xuzhou, Jiangsu, China
| | - Jun Liang
- Department of Endocrinology, Xuzhou Central Hospital; Affiliated Hospital of Medical College of Southeast University; Affiliated Hospital of Nanjing University of Chinese Medicine, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou Clinical School of Nanjing Medical University, Xuzhou, Jiangsu, China
| |
Collapse
|
|
13
|
Lee JH, Lee HS, Lee YJ. Serum γ-glutamyltransferase as an independent predictor for incident type 2 diabetes in middle-aged and older adults: Findings from the KoGES over 12 years of follow-up. Nutr Metab Cardiovasc Dis 2020; 30:1484-1491. [PMID: 32600956 DOI: 10.1016/j.numecd.2020.04.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/12/2020] [Accepted: 04/29/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUNDS AND AIMS Limited evidence is available on whether serum γ-glutamyltransferase (GGT) has value as a predictor of type 2 diabetes in East Asian populations. We investigated the causal relationship between serum GGT level and incident type 2 diabetes in Korean adults. METHODS AND RESULTS A total of 7739 nondiabetic adults aged 40-69 years from the Korean Genome and Epidemiology Study were studied. We divided the population into four groups according to sex-specific quartiles by serum GGT levels. Hazard ratios (HRs) with 95% Confidence intervals (CIs) for incident type 2 diabetes were prospectively analyzed using multivariate Cox proportional hazards regression models. A total of 1432 (18.5%) participants developed type 2 diabetes over 12 years of follow-up. The higher the serum GGT group quartile, the higher the cumulative type 2 diabetes incidence over 12 years with significance in both sexes (log-rank test P < 0.001). HRs (95% CIs) for incident type 2 diabetes for the highest quartile versus referent lowest quartile for serum GGT levels were 2.55 (1.86-3.51) for men and 1.90 (1.40-2.58) for women after adjusting for confounding variables. CONCLUSIONS Higher serum GGT levels preceded and positively associated with incident type 2 diabetes among community-dwelling middle-aged and older Korean adults.
Collapse
Affiliation(s)
- Jun-Hyuk Lee
- Department of Family Medicine, Yonsei University College of Medicine, Yong-In Severance Hospital, Yong-In, Republic of Korea; Department of Medicine, Graduate School of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yong-Jae Lee
- Department of Family Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea.
| |
Collapse
|
|
14
|
Pertiwi K, Küpers LK, Geleijnse JM, Zock PL, Wanders AJ, Kruger HS, van Zyl T, Kruger IM, Smuts CM. Associations of linoleic acid with markers of glucose metabolism and liver function in South African adults. Lipids Health Dis 2020; 19:138. [PMID: 32546275 PMCID: PMC7296762 DOI: 10.1186/s12944-020-01318-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/10/2020] [Indexed: 11/17/2022] Open
Abstract
Background The relation between dietary and circulating linoleic acid (18:2 n-6, LA), glucose metabolism and liver function is not yet clear. Associations of dietary and circulating LA with glucose metabolism and liver function markers were investigated. Methods Cross-sectional analyses in 633 black South Africans (aged > 30 years, 62% female, 51% urban) without type 2 diabetes at baseline of the Prospective Urban Rural Epidemiology study. A cultural-sensitive 145-item food-frequency questionnaire was used to collect dietary data, including LA (percentage of energy; en%). Blood samples were collected to measure circulating LA (% total fatty acids (FA); plasma phospholipids), plasma glucose, glycosylated hemoglobin (HbA1c), serum gamma-glutamyl transferase (GGT), alanine (ALT) and aspartate aminotransferase (AST). Associations per 1 standard deviation (SD) and in tertiles were analyzed using multivariable regression. Results Mean (±SD) dietary and circulating LA was 6.8 (±3.1) en% and 16.0 (±3.5) % total FA, respectively. Dietary and circulating LA were not associated with plasma glucose or HbA1c (β per 1 SD: − 0.005 to 0.010, P > 0.20). Higher dietary LA was generally associated with lower serum liver enzymes levels. One SD higher circulating LA was associated with 22% lower serum GGT (β (95% confidence interval): − 0.25 (− 0.31, − 0.18), P < 0.001), but only ≤9% lower for ALT and AST. Circulating LA and serum GGT associations differed by alcohol use and locality. Conclusion Dietary and circulating LA were inversely associated with markers of impaired liver function, but not with glucose metabolism. Alcohol use may play a role in the association between LA and liver function. Trial registration PURE North-West Province South Africa study described in this manuscript is part of the PURE study. The PURE study is registered in ClinicalTrials.gov (Identifier: NCT03225586; URL).
Collapse
Affiliation(s)
- Kamalita Pertiwi
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands.
| | - Leanne K Küpers
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Johanna M Geleijnse
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Peter L Zock
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands.,Unilever R&D, Foods Innovation Centre, Wageningen, the Netherlands
| | - Anne J Wanders
- Unilever R&D, Foods Innovation Centre, Wageningen, the Netherlands
| | - Herculina S Kruger
- Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Tertia van Zyl
- Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Iolanthé M Kruger
- Africa Unit for Transdisciplinary Health Research, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Cornelius M Smuts
- Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| |
Collapse
|
|
15
|
Barretto JR, Boa-Sorte N, Vinhaes CL, Malta-Santos H, Rebouças-Silva J, Ramos CF, Torres-Nascimento MAS, Borges VM, Andrade BB. Heightened Plasma Levels of Transforming Growth Factor Beta (TGF-β) and Increased Degree of Systemic Biochemical Perturbation Characterizes Hepatic Steatosis in Overweight Pediatric Patients: A Cross-Sectional Study. Nutrients 2020; 12:nu12061650. [PMID: 32498337 PMCID: PMC7352859 DOI: 10.3390/nu12061650] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 12/15/2022] Open
Abstract
Nonalcoholic Fatty Liver Disease (NAFLD) is a common cause of chronic liver disease in childhood and strongly associated with obesity. Routine biochemical non-invasive tests remain with low accuracy for diagnosis of NAFLD. We performed a cross-sectional study to examine potential associations between anthropometric and biochemical parameters, specially TGF-β, a prognosis marker for hepatic steatosis (HS). Between May and October 2019, seventy-two overweight adolescents were enrolled, of which 36 had hepatic steatosis. Hepatic, lipidic and glycemic profiles, and levels of vitamin D, ferritin and TGF-β were analyzed. Hierarchical cluster and a discriminant model using canonical correlations were employed to depict the overall expression profile of biochemical markers and the biochemical degree of perturbation. Median values of alanine aminotransferase (ALT), gamma glutamyl transpeptidase (GGT), and TGF-β were higher in the adolescents with HS. Values of body mass index (BMI)/age and ALT, but not of TGF-β, were gradually increased proportionally to augmentation of steatosis severity. In a multivariate analysis, TGF-β plasma concentrations were associated with occurrence of hepatic steatosis independent of other covariates. Discriminant analysis confirmed that TGF-β concentrations can identify HS cases. Our data reveal that HS patients exhibit a distinct biosignature of biochemical parameters and imply TGF-β as an important biomarker to evaluate risk of steatosis development.
Collapse
Affiliation(s)
- Junaura R. Barretto
- Escola Bahiana de Medicina e Saúde Pública, Salvador 41150-100, Brazil; (J.R.B.); (N.B.-S.); (C.F.R.); (M.A.S.T.-N.)
- Fima Lifshitz Metabolic Unit, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador 40170-110, Brazil
| | - Ney Boa-Sorte
- Escola Bahiana de Medicina e Saúde Pública, Salvador 41150-100, Brazil; (J.R.B.); (N.B.-S.); (C.F.R.); (M.A.S.T.-N.)
- Fima Lifshitz Metabolic Unit, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador 40170-110, Brazil
- Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador 48000-000, Brazil
| | - Caian L. Vinhaes
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil; (C.L.V.); (H.M.-S.); (J.R.-S.); (V.M.B.)
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador 41810-710, Brazil
- Curso de Medicina, Faculdade de Tecnologia e Ciências, Salvador 45600-080, Brazil
| | - Hayna Malta-Santos
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil; (C.L.V.); (H.M.-S.); (J.R.-S.); (V.M.B.)
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador 40170-110, Brazil
| | - Jessica Rebouças-Silva
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil; (C.L.V.); (H.M.-S.); (J.R.-S.); (V.M.B.)
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador 40170-110, Brazil
| | - Camila F. Ramos
- Escola Bahiana de Medicina e Saúde Pública, Salvador 41150-100, Brazil; (J.R.B.); (N.B.-S.); (C.F.R.); (M.A.S.T.-N.)
| | | | - Valeria M. Borges
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil; (C.L.V.); (H.M.-S.); (J.R.-S.); (V.M.B.)
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador 40170-110, Brazil
| | - Bruno B. Andrade
- Escola Bahiana de Medicina e Saúde Pública, Salvador 41150-100, Brazil; (J.R.B.); (N.B.-S.); (C.F.R.); (M.A.S.T.-N.)
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil; (C.L.V.); (H.M.-S.); (J.R.-S.); (V.M.B.)
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador 41810-710, Brazil
- Curso de Medicina, Faculdade de Tecnologia e Ciências, Salvador 45600-080, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador 40170-110, Brazil
- Curso de Medicina, Universidade Salvador (UNIFACS), Laureate Universities, Salvador 41770-235, Brazil
- Correspondence: ; Tel.: +55-71-3176-2264
| |
Collapse
|
|
16
|
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: 2.3] [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
|
|
17
|
Shin KA. Comparison of the Serum Gamma-Glutamyl Transferase and Serum Uric Acid Levels according to the Obesity Types Based upon on the Body Mass Index in Korean Men. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2019. [DOI: 10.15324/kjcls.2019.51.1.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Kyung A Shin
- Department of Clinical Laboratory Science, Shinsung University, Dangjin, Korea
| |
Collapse
|
|
18
|
Naderpoor N, Mousa A, de Courten M, Scragg R, de Courten B. The relationship between 25-hydroxyvitamin D concentration and liver enzymes in overweight or obese adults: Cross-sectional and interventional outcomes. J Steroid Biochem Mol Biol 2018; 177:193-199. [PMID: 28899715 DOI: 10.1016/j.jsbmb.2017.09.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 08/07/2017] [Accepted: 09/08/2017] [Indexed: 01/10/2023]
Abstract
Vitamin D deficiency is prevalent in individuals with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis. However, there is limited and inconsistent data on the effect of vitamin D supplementation on liver function. Hepatic enzymes have been used as surrogate markers for NAFLD and have been associated with metabolic syndrome. We examined the relationships between 25-hydroxyvitamin D (25(OH)D) and γ-glutamyl transferase (GGT), alanine aminotransferase (ALT), alkaline phosphatase (ALP) in 120 drug-naïve individuals with no history of liver disease. In addition, the effect of vitamin D supplementation (100,000 loading dose of cholecalciferol followed by 4000IU daily for 16 weeks) on hepatic enzymes was investigated in a subgroup of 54 vitamin D-deficient overweight or obese individuals (28 randomised to cholecalciferol and 26 to placebo). Hepatic enzymes, anthropometric parameters, lipid profile, insulin sensitivity (hyperinsulinaemic-euglycaemic clamp, M value) and high sensitivity C-reactive protein (hs-CRP) were measured before and after the intervention. In the cross-sectional study, levels of GGT and ALT were higher in men compared to women (both p=0.001). There were no significant differences in GGT, ALT and ALP between vitamin D categories (25(OH)D<25nmol/L, 25-50nmol/L, and >50nmol/L) and no relationships were found between the three enzymes and 25(OH)D before and after adjustment for age, sex, BMI, WHR, and insulin sensitivity (all p>0.5). In the randomised trial, 25(OH)D concentrations increased in the vitamin D group (mean change 57.0±21.3nmol/L) compared to the placebo group (mean change 1.9±15.1nmol/L). Mean changes in GGT, ALT and ALP were not significantly different between vitamin D and placebo groups (all p>0.2). Change in 25(OH)D concentration was not correlated with changes in GGT, ALT and ALP before and after adjustments for age and sex (all p>0.1). In summary, 25(OH)D concentrations were not related to hepatic enzymes in drug-naive adults with no history of liver disease, and vitamin D supplementation had no effect on the serum levels of hepatic enzymes in vitamin D-deficient and overweight or obese, otherwise healthy individuals. Hence, vitamin D supplementation is unlikely to prevent incident NAFLD.
Collapse
Affiliation(s)
- Negar Naderpoor
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3168, Australia; Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, VIC 3168, Australia
| | - Aya Mousa
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3168, Australia
| | | | - Robert Scragg
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Barbora de Courten
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3168, Australia; Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, VIC 3168, Australia.
| |
Collapse
|
|
19
|
Zhu Y, Hedderson MM, Quesenberry CP, Feng J, Ferrara A. Liver Enzymes in Early to Mid-pregnancy, Insulin Resistance, and Gestational Diabetes Risk: A Longitudinal Analysis. Front Endocrinol (Lausanne) 2018; 9:581. [PMID: 30333792 PMCID: PMC6176077 DOI: 10.3389/fendo.2018.00581] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 09/13/2018] [Indexed: 01/01/2023] Open
Abstract
Background: Liver enzymes may be implicated in glucose homeostasis; liver enzymes progressively change during pregnancy but longitudinal data during pregnancy in relation to insulin resistance and gestational diabetes (GDM) risk are lacking. We investigated longitudinal associations of γ-glutamyl transferase (GGT) and alanine aminotransferase (ALT) with insulin secretion and resistance markers across early to mid-pregnancy and subsequent GDM risk. Methods: Within the prospective Pregnancy Environment and Lifestyle Study cohort, 117 GDM cases were ascertained and matched to 232 non-GDM controls in a nested case-control study. Fasting blood samples were collected at two clinic visits (CV1, gestational weeks 10-13; CV2, gestational weeks 16-19). Linear mixed model and conditional logistic regression were used, adjusting for major risk factors for GDM. Results: In repeated measure analysis, after adjusting for confounders including body mass index and waist-to-hip ratio, GGT per standard deviation increment was associated with elevated fasting glucose and HOMA-IR (% change = 1.51%, 95% CI 0.56-2.46% and 7.43%, 95% CI 1.76-13.11%, respectively) and decreased adiponectin (% change = -2.86%, 95% CI-5.53 to -0.20%) from CV1 to CV2. At CV1 and CV2, GGT levels comparing the highest versus lowest quartile were associated with 3.01-fold (95% CI 1.32-6.85) and 3.51-fold (95% CI 1.37-8.97) increased risk of GDM, respectively. Progressively increased (<median at CV1, ≥median at CV2) and stably high (≥median at both CV1 and CV2) GGT levels were associated with 3.89- and 2.39-fold increased risk of GDM, compared to stably low levels (<median at both CV1 and CV2), respectively (both P < 0.05). Similar but non-significant trends were observed for ALT. Conclusion: Elevated levels of GGT in early and mid-pregnancy, even within the conventional normal range, and its progressive increase from early to mid-pregnancy may be implicated in the pathogenesis of GDM, highlighting its potential to inform early screening or preventive strategies to mitigate subsequent risk of GDM.
Collapse
Affiliation(s)
- Yeyi Zhu
- Women and Children's Health Section, Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
- *Correspondence: Yeyi Zhu
| | - Monique M. Hedderson
- Women and Children's Health Section, Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Charles P. Quesenberry
- Biostatistics Core, Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Juanran Feng
- Women and Children's Health Section, Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
- Biostatistics Core, Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Assiamira Ferrara
- Women and Children's Health Section, Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| |
Collapse
|
|
20
|
Lee SR, Choi EK, Han KD, Cha MJ, Oh S. Association between γ-glutamyltransferase level and incidence of atrial fibrillation: A nationwide population-based study. Int J Cardiol 2017; 245:149-155. [DOI: 10.1016/j.ijcard.2017.07.067] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 06/19/2017] [Accepted: 07/19/2017] [Indexed: 01/29/2023]
|
|
21
|
Shin KA. The Clinical Implications of Hepatic Enzymes in Metabolically Healthy Obese Men. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2017. [DOI: 10.15324/kjcls.2017.49.3.248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Kyung-A Shin
- Department of Clinical Laboratory Science, Shinsung University, Dangjin, Korea
| |
Collapse
|
|
22
|
Momtazi AA, Banach M, Pirro M, Stein EA, Sahebkar A. PCSK9 and diabetes: is there a link? Drug Discov Today 2017; 22:883-895. [DOI: 10.1016/j.drudis.2017.01.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 12/08/2016] [Accepted: 01/10/2017] [Indexed: 12/14/2022]
|
|
23
|
Ejelonu OC, Elekofehinti OO, Adanlawo IG. Tithonia diversifolia saponin-blood lipid interaction and its influence on immune system of normal wistar rats. Biomed Pharmacother 2017; 87:589-595. [DOI: 10.1016/j.biopha.2017.01.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 12/29/2016] [Accepted: 01/02/2017] [Indexed: 12/22/2022] Open
|
|
24
|
Long Y, Jia D, Wei L, Yang Y, Tian H, Chen T. Liver-Specific Overexpression of Gamma-Glutamyltransferase Ameliorates Insulin Sensitivity of Male C57BL/6 Mice. J Diabetes Res 2017; 2017:2654520. [PMID: 28660214 PMCID: PMC5474247 DOI: 10.1155/2017/2654520] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 04/18/2017] [Accepted: 05/04/2017] [Indexed: 02/05/2023] Open
Abstract
In the current study, we developed a liver-specific GGT-overexpressing mice model by rapid injection pLIVE-GGT vector through tail vein and investigated the effects of GGT elevation on glucose metabolism and insulin sensitivity. The serum GGT activity was significantly increased after 7 days of pLIVE-GGT1 vector delivery and lasted for about 3 weeks. GGT overexpression reduced the levels of GSSG and GSH in the liver and serum and had no effects on total antioxidative capacity in the liver, kidney, and skeletal muscle except for the pancreas. Increased GGT activity had no effect on the glucose tolerance but could facilitate blood glucose lowering after intraperitoneal insulin administration. The results of Western blotting showed that increased GGT activity enhanced insulin-induced AKT phosphorylation at Ser473. Furthermore, GGT inhibitor could attenuate the changes of insulin-induced blood glucose uptake and AKT phosphorylation in the liver. In summary, the present study developed a liver-specific GGT-overexpressing mice model and found that GGT elevation in short term had no effects on glucose metabolism but could increase insulin sensitivity through enhancing the activity of insulin signaling pathway.
Collapse
Affiliation(s)
- Yang Long
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu 610041, China
- Laboratory of Endocrinology, Experimental Medicine Center, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - Dan Jia
- Division of General Practice, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Libin Wei
- Department of Stomatology, Hebei Medical University Affiliated North China Petroleum Bureau General Hospital, Renqiu 062552, China
| | - Yumei Yang
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu 610041, China
- Health Examination Management Center, Sichuan Province People's Hospital, Chengdu 610072, China
| | - Haoming Tian
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu 610041, China
- *Haoming Tian: and
| | - Tao Chen
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu 610041, China
- *Tao Chen:
| |
Collapse
|
|
25
|
Iwahashi Y, Hirose S, Nakajima S, Seo A, Takahashi T, Tamori Y. Evaluation of metabolic parameters and body composition in Japanese patients with type 2 diabetes mellitus who were administered tofogliflozin for 48 weeks. Diabetol Int 2016; 8:205-211. [PMID: 30603323 DOI: 10.1007/s13340-016-0295-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 10/26/2016] [Indexed: 01/10/2023]
Abstract
Sodium glucose cotransporter 2 inhibitors are unique antihyperglycemic agents that cause osmotic diuresis and calorie loss to urine. We previously reported that administration of tofogliflozin, a sodium glucose cotransporter 2 inhibitor, for 8 weeks decreased fat-free mass without affecting fat mass. We thus investigated the impact of tofogliflozin on metabolic parameters and body composition for 48 weeks in Japanese patients with type 2 diabetes mellitus. This single-arm open-label study enrolled 20 patients. Patients received tofogliflozin 20 mg once daily for 48 weeks. At week 48, changes in metabolic parameters and body composition from baseline were evaluated. Two patients discontinued administration due to adverse events during the first 8 weeks; however, no other adverse events occurred after that period. Seventeen patients completed the 48 weeks of administration of tofogliflodin. Body weight and body mass index decreased during the treatment period. Hemoglobin A1c decreased from 7.8% to 7.1%. The degree of improvement in hemoglobin A1c was correlated with body mass index, fat mass, and plasma glucose level at baseline. As for body composition, fat mass decreased without any change in fat-free mass (including total body water, extracellular water, and intracellular water). Red blood cell count and hematocrit increased, while the estimated glomerular filtration rate decreased. ALT and γ-GTP decreased and the decrease in γ-GTP was correlated with the loss of fat mass. In conclusion, our study clearly suggests that the body weight reduction caused by tofogliflozin administration for 48 weeks was almost entirely due to fat mass dissipation.
Collapse
Affiliation(s)
- Yasuyuki Iwahashi
- 1Division of Diabetes and Endocrinology, Department of Internal Medicine, Chibune General Hospital, 2-2-45, Tsukuda, Nishiyodogawa-ku, Osaka, 555-0001 Japan
| | - Sachie Hirose
- 1Division of Diabetes and Endocrinology, Department of Internal Medicine, Chibune General Hospital, 2-2-45, Tsukuda, Nishiyodogawa-ku, Osaka, 555-0001 Japan.,Present Address: Division of Endocrinology, Department of Internal Medicine, Osaka Gyomeikan Hospital, 5-4-8, Nishikujyo, Konohana-ku, Osaka, 554-0012 Japan
| | - Shinsuke Nakajima
- 2Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
| | - Akane Seo
- 1Division of Diabetes and Endocrinology, Department of Internal Medicine, Chibune General Hospital, 2-2-45, Tsukuda, Nishiyodogawa-ku, Osaka, 555-0001 Japan
| | - Tetsuya Takahashi
- 1Division of Diabetes and Endocrinology, Department of Internal Medicine, Chibune General Hospital, 2-2-45, Tsukuda, Nishiyodogawa-ku, Osaka, 555-0001 Japan
| | - Yoshikazu Tamori
- 1Division of Diabetes and Endocrinology, Department of Internal Medicine, Chibune General Hospital, 2-2-45, Tsukuda, Nishiyodogawa-ku, Osaka, 555-0001 Japan.,2Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
| |
Collapse
|
|
26
|
Association between serum γ-glutamyltransferase and chronic kidney disease in urban Han Chinese: a prospective cohort study. Int Urol Nephrol 2016; 49:303-312. [DOI: 10.1007/s11255-016-1429-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 09/21/2016] [Indexed: 01/09/2023]
|
|
27
|
Popov VB, Thompson CC, Kumar N, Ciarleglio MM, Deng Y, Laine L. Effect of Intragastric Balloons on Liver Enzymes: A Systematic Review and Meta-Analysis. Dig Dis Sci 2016; 61:2477-87. [PMID: 27207181 DOI: 10.1007/s10620-016-4178-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 04/20/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Intragastric balloons (IGBs) are safe and effective in inducing weight loss in obese patients. The objective of this study was to review and analyze the available data of the effect of IGB on markers of nonalcoholic fatty liver disease (NAFLD) and liver enzymes. METHODS Searches were performed of MEDLINE and Embase databases from inception through January 2016. Study inclusion criteria were the following: ≥5 overweight or obese adult patients undergoing intragastric balloon placement, with liver tests [alanine aminotransferase (ALT) or gamma-glutamyl transpeptidase (GGT)] or markers of NAFLD (e.g., imaging, biopsy) reported before balloon insertion and after balloon removal at 6 months. RESULTS Nine observational studies and one randomized trial were identified. ALT decreased by -10.02 U/l (95 % CI, -13.2, -6.8), GGT decreased by -9.82 U/l (95 % CI, -12.9, -6.8), and BMI decreased by -4.98 kg/m(2) (-5.6, -4.4) with IGB therapy. Hepatic steatosis improved from baseline after 6 months of balloon therapy by magnetic resonance imaging (fat fraction, 16.7 ± 10.9-7.6 ± 9.8, p = 0.003), ultrasound (severe liver steatosis, 52-4 %, p < 0.0001). Histological NAFLD activity score was lower after 6 months of IGB versus control with sham endoscopy and diet (2 ± 0.75 vs. 4 ± 2.25, p = 0.03). CONCLUSION The use of intragastric balloon decreases liver enzymes and is potentially an effective short-term treatment for NAFLD as part of a multidisciplinary approach. Larger, more rigorous trials are needed to confirm the effect of IGBs on NAFLD.
Collapse
Affiliation(s)
- Violeta B Popov
- NYU Langone Medical Center and VA NY Harbor Healthcare System, 423 East 23rd Street, 11 North, New York, NY, 10010, USA.
| | - Christopher C Thompson
- Division of Gastroenterology and Hepatology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Thorne 14, Boston, MA, USA
| | - Nitin Kumar
- Division of Gastroenterology and Hepatology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Thorne 14, Boston, MA, USA.,Bariatric Endoscopy Institute Gastroenterology Weight Management, Addison, IL, 60101, USA
| | - Maria M Ciarleglio
- Department of Biostatistics, Yale School of Public Health, 60 College Street, New Haven, CT, 06520, USA
| | - Yanhong Deng
- Yale Center for Analytical Sciences, Yale University, 300 George Street, Suite 555, New Haven, CT, 06515, USA
| | - Loren Laine
- Yale School of Medicine and VA Connecticut Healthcare System, PO Box 208019, New Haven, CT, 06520, USA
| |
Collapse
|
|
28
|
Lee YS, Cho Y, Burgess S, Davey Smith G, Relton CL, Shin SY, Shin MJ. Serum gamma-glutamyl transferase and risk of type 2 diabetes in the general Korean population: a Mendelian randomization study. Hum Mol Genet 2016; 25:3877-3886. [PMID: 27466193 DOI: 10.1093/hmg/ddw226] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 06/01/2016] [Accepted: 07/08/2016] [Indexed: 01/09/2023] Open
Abstract
Elevated gamma-glutamyl transferase (GGT) levels are associated with higher risk of type 2 diabetes in observational studies, but the underlying causal relationship is still unclear. Here, we tested a hypothesis that GGT levels have a causal effect on type 2 diabetes risk using Mendelian randomization. Data were collected from 7640 participants in a South Korean population. In a single instrumental variable (IV) analysis using two stage least squares regression with the rs4820599 in the GGT1 gene region as an instrument, one unit of GGT levels (IU/L) was associated with 11% higher risk of type 2 diabetes (odds ratio (OR) = 1.11, 95% confidence interval (CI): 1.04 to 1.19). In a multiple IV analysis using seven genetic variants that have previously been demonstrated to be associated with GGT at a genome-wide level of significance, the corresponding estimate suggested a 2.6% increase in risk (OR = 1.026, 95% CI: 1.001 to 1.052). In a two-sample Mendelian randomization analysis using genetic associations with type 2 diabetes taken from a trans-ethnic GWAS study of 110 452 independent samples, the single IV analysis confirmed an association between the rs4820599 and type 2 diabetes risk (P-value = 0.04); however, the estimate from the multiple IV analysis was compatible with the null (OR = 1.007, 95% CI: 0.993 to 1.022) with considerable heterogeneity between the causal effects estimated using different genetic variants. Overall, there is weak genetic evidence that GGT levels may have a causal role in the development of type 2 diabetes.
Collapse
Affiliation(s)
- Youn Sue Lee
- Department of Public Health Sciences, BK21PLUS Program in Embodiment: Health-Society Interaction, Graduate School, Korea University, Seoul 02841, Republic of Korea.,Department of Public Health Sciences, BK21PLUS Program in Embodiment: Health-Society Interaction, Graduate School, Korea University, Seoul 02841, Republic of Korea
| | - Yoonsu Cho
- Department of Public Health Sciences, BK21PLUS Program in Embodiment: Health-Society Interaction, Graduate School, Korea University, Seoul 02841, Republic of Korea
| | - Stephen Burgess
- KoNECT, Korea National Enterprise For Clinical Trials, Seoul 04143, Republic of Korea.,MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - George Davey Smith
- KoNECT, Korea National Enterprise For Clinical Trials, Seoul 04143, Republic of Korea
| | - Caroline L Relton
- KoNECT, Korea National Enterprise For Clinical Trials, Seoul 04143, Republic of Korea.,Cardiovascular Epidemiology Unit, University of Cambridge, Strangeways Research Laboratory, Wort's Causeway, Cambridge CB1 8RN, UK
| | - So-Youn Shin
- KoNECT, Korea National Enterprise For Clinical Trials, Seoul 04143, Republic of Korea
| | - Min-Jeong Shin
- Department of Public Health Sciences, BK21PLUS Program in Embodiment: Health-Society Interaction, Graduate School, Korea University, Seoul 02841, Republic of Korea .,Institute of Genetic Medicine, Newcastle University, Central Pkwy, Newcastle Upon Tyne NE1 3BZ, UK and
| |
Collapse
|
|
29
|
Pershadsingh HA. Dual Peroxisome Proliferator-Activated Receptor-alpha/gamma Agonists : In the Treatment of Type 2 Diabetes Mellitus and the Metabolic Syndrome. ACTA ACUST UNITED AC 2016; 5:89-99. [PMID: 16542049 DOI: 10.2165/00024677-200605020-00003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The metabolic syndrome consists of a combination of cardiovascular risk factors that include hyperglycemia with or without type 2 diabetes mellitus, visceral obesity, elevated blood pressure, and atherogenic dyslipidemia. These interrelated disorders and their associated lipotoxicity, oxidative stress, and inflammatory state predispose to a constellation of cardiovascular conditions leading to high risk of heart attack, stroke, renal failure, blindness, and lower extremity amputation. Visceral obesity, a prime risk factor for type 2 diabetes and a major component of the metabolic syndrome, potentiates atherogenesis, atherosclerosis, organ lipotoxicity, and oxidative tissue damage.Peroxisome proliferator-activated receptors (PPARs) are relatively recently discovered nuclear transcription factors that are modulated by dietary fatty acids, including the essential polyunsaturated fatty acids, arachidonic acid and its metabolites, and are essential to the control of energy metabolism. Of the three PPAR isoforms (alpha, gamma, and delta), synthetic pharmaceutical ligands that activate PPARalpha (the antidyslipidemic fibric acid derivatives ['fibrates']) and PPARgamma (the antidiabetic thiazolidinediones) have been studied extensively. Recently developed dual PPARalpha/gamma agonists may combine the therapeutic effects of these drugs, creating the expectation of greater efficacy, and perhaps other advantages in the treatment of type 2 diabetes and the metabolic syndrome. However, thiazolidinediones are hampered by adverse effects related to increased weight gain and fluid overload. It remains to be seen whether the dual PPARalpha/gamma agonists currently under development have similar limitations. Nevertheless, existing clinical data imply that the combined effects of thiazolidinediones and fibrates are likely to be emulated by dual PPARalpha/gamma agonists, providing superior efficacy to these classes for the treatment of type 2 diabetes, the metabolic syndrome, and their cardiovascular and other end-organ complications.
Collapse
|
|
30
|
Oliveira LPM, de Jesus RP, Boulhosa RSSB, Onofre T, Mendes CMC, Vinhas L, Waitzberg DL, Lemaire DC, Cavalcante LN, Lyra AC, Lyra LGC. Factors Associated with Insulin Resistance in Patients with Chronic HCV Genotype 1 Infection without Obesity or Type 2 Diabetes. J Am Coll Nutr 2016; 35:436-42. [PMID: 26933768 DOI: 10.1080/07315724.2015.1072756] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To investigate the prevalence of insulin resistance (IR) and its association with clinical parameters in patients with hepatitis C virus (HCV) genotype 1 without obesity or type 2 diabetes. METHODS One hundred and twenty-seven HCV-infected patients admitted to the Nutrition and Hepatology Clinic were included. Statistical analysis was performed using the Mann-Whitney test, Fisher's exact test, and Poisson regression analysis. RESULTS The prevalence of IR (homeostasis model assessment [HOMA]-IR ≥ 3.0) was 37.0%. The independent predictors for IR included the following: aspartate aminotransferase (AST) and alanine aminotransferase (ALT) 1.5 times the upper normal limit (odds ratio [PR] = 2.06, 95% CI, 1.16-3.66; PR = 2.32, 95% CI, 1.26-4.49, respectively); gamma glutamyl transferase (γGT) ≥ 85 U/L (PR = 2.09, 95% CI, 1.12-4.12); increased waist circumference (PR = 2.24, 95% CI, 1.25-4.17); increased waist : hip ratio (PR = 2.24, 95% CI, 1.11-5.17); increased body fat percentage (PR = 2.21, 95% CI, 1.01-5.79); overweight (PR = 2.54, 95% CI, 1.40-4.82); and metabolic syndrome (PR = 3.05, 95% CI, 1.69-5.44). High ALT levels and anthropometric parameters remained in the model of multivariate regression analysis. CONCLUSIONS Our findings showed a significantly high prevalence of insulin resistance in nondiabetic, nonobese patients with hepatitis C genotype 1. High ALT levels and anthropometric parameters were significantly associated with IR after multivariate regression analysis. Our data show the importance of monitoring IR, weight, and body composition in patients with chronic hepatitis C. Nutritional management seems to be important in the control of comorbidities related to excess weight and the enhancement of therapeutic responses.
Collapse
Affiliation(s)
| | | | | | - Thiago Onofre
- a Nutrition Science Department.,b Member of Group of Study of the Liver
| | | | | | - Dan Linetzky Waitzberg
- g Federal University of Bahia, Salvador, BRAZIL; Departamento de Gastroenterologia da Faculdade de Medicina da Universidade de São Paulo , São Paulo , BRAZIL
| | - Denise Carneiro Lemaire
- b Member of Group of Study of the Liver.,e Laboratory of Immunology, Health Science Institute
| | | | - Andre Castro Lyra
- b Member of Group of Study of the Liver.,f Department of Medicine , Division of Gastroenterology and Hepatology.,h Gastro-hepatology Unit, Hospital São Rafael , Salvador , BRAZIL
| | - Luiz Guilherme C Lyra
- b Member of Group of Study of the Liver.,f Department of Medicine , Division of Gastroenterology and Hepatology.,h Gastro-hepatology Unit, Hospital São Rafael , Salvador , BRAZIL
| |
Collapse
|
|
31
|
Jacobs S, Jäger S, Jansen E, Peter A, Stefan N, Boeing H, Schulze MB, Kröger J. Associations of Erythrocyte Fatty Acids in the De Novo Lipogenesis Pathway with Proxies of Liver Fat Accumulation in the EPIC-Potsdam Study. PLoS One 2015; 10:e0127368. [PMID: 25984792 PMCID: PMC4435749 DOI: 10.1371/journal.pone.0127368] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 04/14/2015] [Indexed: 01/22/2023] Open
Abstract
Background Biomarker fatty acids (FAs) reflecting de novo lipogenesis (DNL) are strongly linked to the risk of cardiometabolic diseases. Liver fat accumulation could mediate this relation. There is very limited data from human population-based studies that have examined this relation. Objective The aim of this study was to investigate the relation between specific FAs in the DNL pathway and liver fat accumulation in a large population-based study. Methods We conducted a cross-sectional analysis of a subsample (n = 1,562) of the EPIC-Potsdam study, which involves 27,548 middle-aged men and women. Baseline blood samples have been analyzed for proportions of 32 FAs in erythrocyte membranes (determined by gas chromatography) and biomarker concentrations in plasma. As indicators for DNL, the DNL-index (16:0 / 18:2n-6) and proportions of individual blood FAs in the DNL pathway were used. Plasma parameters associated with liver fat content (fetuin-A, ALT, and GGT) and the algorithm-based fatty liver index (FLI) were used to reflect liver fat accumulation. Results The DNL-index tended to be positively associated with the FLI and was positively associated with GGT activity in men (p for trend: 0.12 and 0.003). Proportions of 14:0 and 16:0 in erythrocytes were positively associated with fetuin-A, whereas 16:1n-7 were positively associated with the FLI and GGT activity (all p for trends in both sexes at least 0.004). Furthermore, the proportion of 16:1n-7 was positively related to fetuin-A in women and ALT activity in men (all p for trend at least 0.03). The proportion of 16:1n-9 showed positive associations with the FLI and GGT activity in men and fetuin-A in both sexes, whereas 18:1n-7 was positively associated with GGT activity in men (all p for trend at least 0.048). Conclusion Findings from this large epidemiological study suggest that liver fat accumulation could link erythrocyte FAs in the DNL pathway to the risk of cardiometabolic diseases.
Collapse
Affiliation(s)
- Simone Jacobs
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Germany
| | - Susanne Jäger
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Germany
| | - Eugene Jansen
- Center for Health Protection, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Andreas Peter
- German Center for Diabetes Research (DZD), Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology, Nephrology, Vascular Disease, and Clinical Chemistry, University Hospital of the Eberhard Karls University, Tübingen, Germany
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen (IDM), Tübingen, Germany
| | - Norbert Stefan
- German Center for Diabetes Research (DZD), Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology, Nephrology, Vascular Disease, and Clinical Chemistry, University Hospital of the Eberhard Karls University, Tübingen, Germany
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen (IDM), Tübingen, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Germany
| | - Janine Kröger
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Germany
- * E-mail:
| |
Collapse
|
|
32
|
Serum alanine aminotransferase independently correlates with intrahepatic triglyceride contents in obese subjects. Dig Dis Sci 2014; 59:2470-6. [PMID: 24861033 DOI: 10.1007/s10620-014-3214-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 05/12/2014] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND AIM Liver enzymes including serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltransferase (GGT) are well recognized as surrogate makers reflecting non-alcoholic fatty liver disease (NAFLD). However, the associations of serum ALT, AST and GGT with hepatic lipid contents are not well established. The aim of this study was to investigate the relationship between liver enzymes and intrahepatic triglyceride (IHTG) contents, and explore the feasibility in using liver enzymes to reflect accumulation of IHTG in obese subjects. METHODS A cross-sectional analysis was conducted in 475 obese adults aged 40-65 years. Anthropometric parameters and blood biochemical indexes including liver enzymes, glucose and lipid profiles were measured. The liver triglyceride contents of subjects were determined by (1)H-MRS. RESULTS Serum ALT, AST and GGT were positively correlated with IHTG contents (p < 0.01). Serum ALT, AST and GGT levels at the highest quartile of IHTG contents were significantly elevated as compared with those in the lowest quartile (p < 0.01). Multivariate linear regression analysis demonstrated that serum ALT, but not AST or GGT was independently associated with IHTG contents. By logistic regression analysis, the odds ratio for higher IHTG contents was increased by 1.464 times/1 SD increase in serum ALT level after adjusting for multiple confounding factors [OR (95% CI) 2.464 (1.584-3.834)]. However, these relationships could not be observed between serum AST or GGT with IHTG contents. CONCLUSIONS Serum ALT level is independently correlated with the hepatic triglyceride contents in obese subjects and more appropriate to be used as a predictor for the degree of NAFLD rather than AST and GGT.
Collapse
|
|
33
|
Milić S, Lulić D, Štimac D. Non-alcoholic fatty liver disease and obesity: Biochemical, metabolic and clinical presentations. World J Gastroenterol 2014; 20:9330-9337. [PMID: 25071327 PMCID: PMC4110564 DOI: 10.3748/wjg.v20.i28.9330] [Citation(s) in RCA: 252] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 01/26/2014] [Accepted: 03/19/2014] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in the world. Presentation of the disease ranges from simple steatosis to non-alcoholic steatohepatitis (NASH). NAFLD is a hepatic manifestation of metabolic syndrome that includes central abdominal obesity along with other components. Up to 80% of patients with NAFLD are obese, defined as a body mass index (BMI) > 30 kg/m2. However, the distribution of fat tissue plays a greater role in insulin resistance than the BMI. The large amount of visceral adipose tissue (VAT) in morbidly obese (BMI > 40 kg/m2) individuals contributes to a high prevalence of NAFLD. Free fatty acids derived from VAT tissue, as well as from dietary sources and de novo lipogenesis, are released to the portal venous system. Excess free fatty acids and chronic low-grade inflammation from VAT are considered to be two of the most important factors contributing to liver injury progression in NAFLD. In addition, secretion of adipokines from VAT as well as lipid accumulation in the liver further promotes inflammation through nuclear factor kappa B signaling pathways, which are also activated by free fatty acids, and contribute to insulin resistance. Most NAFLD patients are asymptomatic on clinical presentation, even though some may present with fatigue, dyspepsia, dull pain in the liver and hepatosplenomegaly. Treatment for NAFLD and NASH involves weight reduction through lifestyle modifications, anti-obesity medication and bariatric surgery. This article reviews the available information on the biochemical and metabolic phenotypes associated with obesity and fatty liver disease. The relative contribution of visceral and liver fat to insulin resistance is discussed, and recommendations for clinical evaluation of affected individuals is provided.
Collapse
|
|
34
|
Liu X, Hamnvik OPR, Chamberland JP, Petrou M, Gong H, Christophi CA, Christiani DC, Kales SN, Mantzoros CS. Circulating alanine transaminase (ALT) and γ-glutamyl transferase (GGT), but not fetuin-A, are associated with metabolic risk factors, at baseline and at two-year follow-up: the prospective Cyprus Metabolism Study. Metabolism 2014; 63:773-82. [PMID: 24726813 PMCID: PMC4104665 DOI: 10.1016/j.metabol.2014.03.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 03/10/2014] [Accepted: 03/13/2014] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To comparatively evaluate traditional liver tests and fetuin A as predictors of cardiometabolic risk, we studied associations between serum alanine transaminase (ALT), γ-glutamyl transferase (GGT), aspartate aminotransferase (AST) and fetuin-A and anthropometric, metabolic, and cardiovascular parameters cross-sectionally at baseline, and prospectively, after 2-years of follow-up. RESEARCH DESIGN AND METHODS 616 randomly enrolled young healthy participants in the Cyprus Metabolism Study, including all 93 subjects who participated in the follow-up study 2 years after baseline assessment, were included in this study. RESULTS In the cross-sectional study, serum ALT and GGT were strongly correlated with anthropometric, cardiovascular, and metabolic variables, while serum AST was only correlated with waist circumference and waist-to-hip ratio. Fetuin-A was correlated with anthropometric variables, systolic blood pressure (SBP), insulin, and homeostasis model of assessment-insulin resistance (HOMA-IR) in the unadjusted model. In the fully adjusted model, both serum ALT and GGT levels remained positively correlated with total and low-density lipoprotein (LDL) cholesterol. GGT levels also remained correlated with triglycerides. ALT levels remained strongly positively correlated with insulin (r=0.17, p<.0001) and HOMA-IR (r=0.16, p=0.0001). Serum fetuin-A levels were no longer significantly correlated with any variables. Prospectively, ALT and GGT were predictors of anthropometric variables and LDL cholesterol, while baseline levels of AST and fetuin-A were not predictors of any variables at 2-year follow-up. CONCLUSIONS We confirmed associations of ALT and GGT levels but failed to demonstrate an independent association between fetuin-A and cardiometabolic risk factors in young healthy men. Traditional liver tests (LFTs) are thus better than fetuin-A predictors of metabolic risk factors cross-sectionally and prospectively in young healthy adults.
Collapse
Affiliation(s)
- Xiaowen Liu
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Ole-Petter R Hamnvik
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - John P Chamberland
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; Section of Endocrinology, Boston VA Healthcare System, Boston, MA
| | - Michael Petrou
- Cyprus International Institute for Environmental and Public Health in association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Huizhi Gong
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Costas A Christophi
- Cyprus International Institute for Environmental and Public Health in association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus; Department of Environmental Health, Harvard School of Public Health, Boston, MA
| | - David C Christiani
- Department of Environmental Health, Harvard School of Public Health, Boston, MA
| | - Stefanos N Kales
- Department of Environmental Health, Harvard School of Public Health, Boston, MA.
| | - Christos S Mantzoros
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Environmental Health, Harvard School of Public Health, Boston, MA; Section of Endocrinology, Boston VA Healthcare System, Boston, MA
| |
Collapse
|
|
35
|
Hepatic glucose uptake is increased in association with elevated serum γ-glutamyl transpeptidase and triglyceride. Dig Dis Sci 2014; 59:607-13. [PMID: 24326630 DOI: 10.1007/s10620-013-2957-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 11/13/2013] [Indexed: 12/30/2022]
Abstract
BACKGROUND Subjects with fatty liver disease (FLD) can show increased hepatic 2-deoxy-2-((18)F)fluoro-D-glucose (FDG) uptake, but the role of hepatic inflammation has not been explored. AIMS We investigated whether hepatic inflammatory response, as implicated by elevated serum markers, is associated with increased liver FDG uptake in FLD. METHODS Liver sonography and FDG positron emission tomography was performed in 331 asymptomatic men with nonalcoholic FLD (NAFLD), 122 with alcoholic FLD (AFLD), and 349 controls. Mean standard uptake value (SUV) of liver FDG uptake was compared to cardiac risk factors and serum markers of liver injury. RESULTS Hepatic FDG mean SUV was increased in NAFLD (2.40 ± 0.25) and AFLD groups (2.44 ± 0.25) compared to controls (2.28 ± 0.26; both P < 0.001). Both FLD groups also had higher serum γ-glutamylranspeptidase (GGT), triglyceride (TG), hepatic transaminases, and LDL. High GGT and TG levels were independent determinants of increased FDG uptake for both FLD groups. Hepatic mean SUV significantly increased with high compared to low GGT for NAFLD (2.48 ± 0.28 vs. 2.37 ± 0.24), AFLD (2.51 ± 0.27 vs. 2.39 ± 0.23), and control groups (2.39 ± 0.22 vs. 2.26 ± 0.26). High TG increased hepatic mean SUV in AFLD and control groups. Furthermore, serum GGT and TG levels significantly correlated to hepatic mean SUV in all three groups. CONCLUSIONS Hepatic FDG uptake is closely associated with elevated TG and GGT regardless of the presence of FLD. Thus, inflammation response may play a major role in increased hepatic glucose uptake.
Collapse
|
|
36
|
Gohel MG, Chacko AN. Serum GGT activity and hsCRP level in patients with type 2 diabetes mellitus with good and poor glycemic control: An evidence linking oxidative stress, inflammation and glycemic control. J Diabetes Metab Disord 2013; 12:56. [PMID: 24360326 PMCID: PMC7962520 DOI: 10.1186/2251-6581-12-56] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Accepted: 10/15/2013] [Indexed: 01/14/2023]
Abstract
Background Diabetes is undoubtedly one of the most challenging health problems in 21st century. Understanding the pathogenesis and preventing long term complications have been major goals of research in diabetes mellitus (DM). Research in the past few years has linked oxidative stress and inflammation to beta cell dysfunction. Aim of this study is to evaluate serum gamma-glutamyl transferase (GGT) activity (marker of oxidative stress) and high sensitivity C reactive protein (hsCRP) level (an inflammatory marker) in type 2 DM subjects with good and poor glycemic control. Further, we investigated correlation between serum GGT and hsCRP level with glycemic control (FBS, PP2BS, HbA1c) in subjects. Methods A cross sectional study consists of 150 patients out of them 50 patients having type 2 DM with good control (Group II), 50 patients with type 2 DM with poor control (Group III) and 50 normal healthy control (Group I) were selected. Serum GGT, serum hsCRP, FBS, PP2BS, HbA1c, and other biochemical investigations include serum liver enzymes and lipids were measured. Results Mean serum GGT and hsCRP concentration were statistically significantly higher in group III patients compared to group I and group II subjects as well as increased in group II compared to group I (p < 0.001). Further significant positive correlation was observed between GGT and hsCRP concentration as well as both with HbA1c, FBS, and PP2BS. Conclusions Oxidative stress and inflammation appears to be a key component and also associated with poor glycemic control and further pathogenesis of diabetes and its complications. All our finding suggesting a link between oxidative stress, inflammation and glycemic control in patient with type 2 diabetes mellitus. Electronic supplementary material The online version of this article (doi:10.1186/2251-6581-12-56) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Mukesh G Gohel
- Department of Biochemistry, B. J. Medical College & Civil Hospital, Ahmedabad, India
| | - Anusha N Chacko
- Department of Biochemistry, GDERS Dental College, Siddhapur, India
| |
Collapse
|
|
37
|
Dimitrijevic-Sreckovic V, Soldatovic I, Culafic D, Sreckovic B, Popovic S, Djordjevic P, Ille T. Liver function test changes in centrally obese youth with metabolic syndrome in a Serbian population. Metab Syndr Relat Disord 2013; 11:427-33. [PMID: 23931675 DOI: 10.1089/met.2012.0154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the association between metabolic syndrome and liver enzymes in overweight and obese adolescents and young adults. METHODS A total of 126 overweight and obese adolescents and young adults (age, 15-26 years), 55 (43.6%) with metabolic syndrome and 71 (56.4%) without metabolic syndrome, were studied. RESULTS Patients with metabolic syndrome had significantly higher alanine aminotransferase (ALT), γ-glutamyl transpeptidase (GGT), and alkaline phosphatase (ALP) levels compared to patients without metabolic syndrome [36.5±22.2 vs. 29.4±17.8 IU/L (P=0.043), 33.8±17.8 vs. 26.9±18.4 IU/L (P=0.002), and 84.3±32.2 vs. 75.7±29.5 IU/L (P=0.063)]. Aspartate aminotransferase (AST) levels were similar in both groups (24.1±9.8 vs. 23.3±9.0 IU/L, P=0.674). Elevated AST, ALT, GGT, and ALP levels were observed in 6, 15, 18, and 5 patients (11%, 27%, 14%, and 9%) with metabolic syndrome compared to 6, 17, 6, and 4 (8%, 24%, 8% and 5%) patients without metabolic syndrome (P=0.872, P=0.826, P<0.001, and P=0.035). In multivariate regression models adjusted for age and gender, metabolic syndrome was not a significant predictor of ALT (P=0.967), GGT (P=0.526), and ALP levels (P=0.221), but insulin resistance was a significant predictor for ALT and GGT levels (P=0.001, P=0.028). CONCLUSION Changes in liver function tests were observed in obese patients with metabolic syndrome, compared to patients without metabolic syndrome, especially in ALT and GGT levels. Insulin resistance is an independent pathogenic mechanism in liver function test changes regardless of metabolic syndrome in nondiabetic centrally obese youth.
Collapse
|
|
38
|
Tarantino G, Finelli C. What about non-alcoholic fatty liver disease as a new criterion to define metabolic syndrome? World J Gastroenterol 2013; 19:3375-3384. [PMID: 23801829 PMCID: PMC3683675 DOI: 10.3748/wjg.v19.i22.3375] [Citation(s) in RCA: 134] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 01/16/2013] [Accepted: 01/23/2013] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is currently not a component of the diagnostic criteria for metabolic syndrome (MetS); however, the development of NAFLD has some common mechanisms with the development of MetS, as they share the pathophysiologic basis of insulin resistance. It is also recognized that NAFLD is the hepatic manifestation of MetS. To define MetS, the presence of at least three of the proposed criteria is required, and sometimes it is sufficient to have only one laboratory value, modified by diet or drugs, for the classification of MetS. Ultrasonographically-detected NAFLD (US-NAFLD) is more stable, only changing during the middle- to long-term. Although controversies over MetS continue, and considering that abdominal ultrasonography for diagnosing NAFLD has high specificity and guidelines to modify the natural course of NAFLD by diet composition or lifestyle have not yet been established, why should we not introduce US-NAFLD as a new criterion to define MetS?
Collapse
|
|
39
|
Ruiz JR, Ortega FB, Labayen I. A weight loss diet intervention has a similar beneficial effect on both metabolically abnormal obese and metabolically healthy but obese premenopausal women. ANNALS OF NUTRITION AND METABOLISM 2013; 62:223-30. [PMID: 23571719 DOI: 10.1159/000345026] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 10/10/2012] [Indexed: 12/30/2022]
Abstract
BACKGROUND/AIMS We studied the effect of a 12-week energy-restricted diet intervention on cardiometabolic risk in two groups of nonmorbid obese premenopausal Caucasian women, i.e. a metabolically abnormal obese (MAO) and a metabolically healthy but obese (MHO) group. METHODS The participants were 53 MAO and 25 MHO women (age range 19-49 years; body mass index inclusion criterion: 30-39.9). We assessed changes in body weight and composition, blood lipids, insulin resistance, hepatic enzymes, inflammatory markers and adipocytokines. RESULTS Overall, many of the study outcomes improved with the intervention in both MAO and MHO participants, but there was no difference in the magnitude of change between the groups. Body weight, waist circumference and total fat mass decreased significantly in response to the intervention in both MAO and MHO women (all p < 0.001). Fasting insulin, insulin resistance (homeostasis model assessment), hepatic enzymes (alanine aminotransferase and γ-glutamyltransferase), fatty liver index and leptin levels also decreased in both groups after the intervention (all p < 0.001), whereas total cholesterol, triglycerides and C-reactive protein decreased significantly only in MAO women (all p < 0.001). CONCLUSION These findings reinforce the idea that MHO women would also benefit from a lifestyle weight reduction intervention.
Collapse
Affiliation(s)
- Jonatan R Ruiz
- Department of Physical Education, School of Sport Sciences, University of Granada, Granada, Spain
| | | | | |
Collapse
|
|
40
|
Wu J, Qiu L, Yan WH, Cheng XQ, Wu W, Guo XZ, Ding HT, Han HJ, Han SM, Zhu GJ. Serum γ-glutamyltransferase and uric acid levels are associated with impaired fasting glucose in adults from Inner Mongolia, China. BMC Public Health 2013; 13:294. [PMID: 23552170 PMCID: PMC3622625 DOI: 10.1186/1471-2458-13-294] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 03/26/2013] [Indexed: 01/09/2023] Open
Abstract
Background Serum γ-glutamyltransferase (GGT) and uric acid (UA) levels are elevated in patients with diabetes or cardiovascular disease. Prediabetes, characterized by impaired glucose tolerance, is an important risk factor for overt diabetes as well as cardiovascular disease. Therefore, the aim of this study was to explore the relationship between GGT, UA and prediabetes in a Chinese population, and provide a scientific basis for the early prevention and treatment of diabetes. Methods We performed a cross-sectional population-based study in a cohort of 2694 subjects (1211 men and 1483 women, aged 35–86 years). Questionnaires and physical examinations were performed using standardized procedures. Fasting blood was collected to measure glucose and other biochemical parameters. The subjects were divided into two groups with either normal fasting glucose (NFG) or impaired fasting glucose (IFG), according to international diagnostic criteria. Logistic regression analysis was performed to estimate odds ratios (OR) and 95% confidence intervals. Results Compared with the NFG group, the IFG group had significantly higher blood pressure but lower high-density lipoprotein–cholesterol in women. Body mass index, waist circumference, triglyceride, glucose, GGT, and UA levels were significantly higher in males and females in the IFG group than those in the NFG group. Logistic regression analysis revealed that the OR for prediabetes increased with increasing serum GGT quartiles and UA quartiles. GGT and UA were positively associated with prediabetes in men and women, independent of age, ethnicity, smoking, alcohol consumption, blood pressure, physical labor, and other confounders. Conclusions We found that serum GGT and UA levels were positively associated with prediabetes in men and women living in areas inhabited by Chinese ethnic minorities. As elevated GGT and UA levels were associated with significantly increased risk of prediabetes, they may be used as sensitive biological markers of prediabetes.
Collapse
Affiliation(s)
| | - Ling Qiu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
| | | | | | | | | | | | | | | | | |
Collapse
|
|
41
|
Barsalani R, Riesco E, Lavoie JM, Dionne IJ. Effect of exercise training and isoflavones on hepatic steatosis in overweight postmenopausal women. Climacteric 2013; 16:88-95. [PMID: 22530610 DOI: 10.3109/13697137.2012.662251] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Postmenopausal women are particularly inclined to an increased risk of developing non-alcoholic hepatic steatosis. The purpose of this study was to investigate whether adding isoflavone supplementation to exercise training could reduce the risk. METHODS In a 6-month, double-blind, randomized, controlled trial, 54 healthy overweight-to-obese (body mass index 28-40 kg/m2) postmenopausal women were randomly assigned to one of the following groups: (1) exercise and isoflavones (Ex-Iso; n = 26), (2) exercise and placebo (Ex-Pla; n = 28). Exercise training consisted of three weekly sessions of mixed training. We examined the plasma level of specific hepatic enzymes (alanine aminotransferase, aspartate aminotransferase, γ-glutamyltransferase, and alkaline phosphatase) as a reflection of fatty liver along with the calculation of the fatty liver index. All measures were obtained at baseline and after the 6-month intervention. RESULTS Following the intervention, a lower fatty liver index (p <0.01; 29% in Ex-Iso, 18% in Ex-Pla) and plasma γ-glutamyltransferase (p <0.01; 22% in Ex-Iso, 16% in Ex-Pla) were observed in both groups, with a higher reduction in the Ex-Iso group. On the other hand, for all other hepatic enzymes, there was no change. CONCLUSIONS Our results show that exercise training appears to bring favorable changes in the plasma level of hepatic enzymes, possibly due to the lowering of liver fat content. While postmenopausal women can benefit from this intervention to decrease the risk of developing non-alcoholic hepatic steatosis, it seems that the addition of isoflavones to exercise training provides some additional effects to those provided by exercise alone.
Collapse
Affiliation(s)
- R Barsalani
- Faculty of Physical Education and Sports, University of Sherbrooke, Sherbrooke, Québec
| | | | | | | |
Collapse
|
|
42
|
Gómez-Sámano MÁ, Cuevas-Ramos D, Mehta R, Brau-Figueroa H, Meza-Arana CE, Gulias-Herrero A. Association of Alanine Aminotransferase Levels (ALT) with the Hepatic Insulin Resistance Index (HIRI): a cross-sectional study. BMC Endocr Disord 2012; 12:16. [PMID: 22947097 PMCID: PMC3515498 DOI: 10.1186/1472-6823-12-16] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Accepted: 08/09/2012] [Indexed: 01/01/2023] Open
Abstract
UNLABELLED BACKGROUND The association between serum alanine aminotransferase (ALT) levels and hepatic insulin resistance (IR) has been evaluated with the hyperinsulinemic-euglycemic clamp. However, there is no information about the association of ALT with the Hepatic Insulin Resistance Index (HIRI). The aim of this study was to evaluate the association between serum ALT levels and HIRI in subjects with differing degrees of impaired glucose metabolism. METHODS This cross-sectional study included subjects that had an indication for testing for type 2 diabetes mellitus (T2DM) with an oral glucose tolerance test (OGTT). Clinical and biochemical evaluations were carried out including serum ALT level quantification. HIRI was calculated for each participant. Correlation analyses and lineal regression models were used to evaluate the association between ALT levels and HIRI. RESULTS A total of 324 subjects (37.6% male) were included. The mean age was 40.4 ± 14.3 years and the mean body mass index (BMI) was 32.0 ± 7.3 kg/m2. Individuals were divided into 1 of 5 groups: without metabolic abnormalities (n = 113, 34.8%); with the metabolic syndrome (MetS, n = 179, 55.2%), impaired fasting glucose (IFG, n = 85, 26.2%); impaired glucose tolerance (IGT, n = 91, 28.0%), and T2DM (n = 23, 7.0%). The ALT (p < 0.001) and HOMA2-IR (p < 0.001) values progressively increased with HIRI quartiles, while ISI-Matsuda (p < 0.001) progressively decreased. After adjustment for sex, age, and BMI, we identified a significant correlation between HIRI and ALT in persons with the MetS (r = 0.22, p = 0.003), IFG (r = 0.33, p < 0.001), IGT (r = 0.37, p < 0.001), and T2DM (r = 0.72, p < 0.001). Lineal regression analysis adjusting for age, HDL-C, TG and waist circumference (WC) showed an independent association between ALT and HIRI in subjects with the MetS (beta = 0.07, p = 0.01), IFG (beta = 0.10, p = 0.02), IGT (beta = 0.09, p = 0.007), and T2DM (beta = 0.31, p = 0.003). This association was not identified in subjects without metabolic abnormalities. CONCLUSIONS ALT levels are independently associated with HIRI in subjects with the MetS, IFG, IGT, and T2DM. The ALT value in these subjects may be an indirect parameter to evaluate hepatic IR.
Collapse
Affiliation(s)
- Miguel Ángel Gómez-Sámano
- Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Vasco de Quiroga # 15, Sección XVI Tlalpan, 14000 Mexico City, Mexico
| | - Daniel Cuevas-Ramos
- Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Mexico City, Mexico
| | - Roopa Mehta
- Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Mexico City, Mexico
| | - Hasan Brau-Figueroa
- Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Vasco de Quiroga # 15, Sección XVI Tlalpan, 14000 Mexico City, Mexico
| | - Clara Elena Meza-Arana
- Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Vasco de Quiroga # 15, Sección XVI Tlalpan, 14000 Mexico City, Mexico
| | - Alfonso Gulias-Herrero
- Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Vasco de Quiroga # 15, Sección XVI Tlalpan, 14000 Mexico City, Mexico
| |
Collapse
|
|
43
|
Consumption of fructose- but not glucose-sweetened beverages for 10 weeks increases circulating concentrations of uric acid, retinol binding protein-4, and gamma-glutamyl transferase activity in overweight/obese humans. Nutr Metab (Lond) 2012; 9:68. [PMID: 22828276 PMCID: PMC3463498 DOI: 10.1186/1743-7075-9-68] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Accepted: 07/24/2012] [Indexed: 12/19/2022] Open
Abstract
Background Prospective studies in humans examining the effects of fructose consumption on biological markers associated with the development of metabolic syndrome are lacking. Therefore we investigated the relative effects of 10 wks of fructose or glucose consumption on plasma uric acid and RBP-4 concentrations, as well as liver enzyme (AST, ALT, and GGT) activities in men and women. Methods As part of a parallel arm study, older (age 40–72), overweight and obese male and female subjects (BMI 25–35 kg/m2) consumed glucose- or fructose-sweetened beverages providing 25% of energy requirements for 10 wks. Fasting and 24-h blood collections were performed at baseline and following 10 wks of intervention and plasma concentrations of uric acid, RBP-4 and liver enzyme activities were measured. Results Consumption of fructose, but not glucose, led to significant increases of 24-h uric acid profiles (P < 0.0001) and RBP-4 concentrations (P = 0.012), as well as plasma GGT activity (P = 0.04). Fasting plasma uric acid concentrations increased in both groups; however, the response was significantly greater in subjects consuming fructose (P = 0.002 for effect of sugar). Within the fructose group male subjects exhibited larger increases of RBP-4 levels than women (P = 0.024). Conclusions These findings suggest that consumption of fructose at 25% of energy requirements for 10 wks, compared with isocaloric consumption of glucose, may contribute to the development of components of the metabolic syndrome by increasing circulating uric acid, GGT activity, suggesting alteration of hepatic function, and the production of RBP-4.
Collapse
|
|
44
|
Liu CF, Zhou WN, Fang NY. Gamma-glutamyltransferase levels and risk of metabolic syndrome: a meta-analysis of prospective cohort studies. Int J Clin Pract 2012; 66:692-8. [PMID: 22698421 DOI: 10.1111/j.1742-1241.2012.02959.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
AIMS Several epidemiological studies suggested that gamma-glutamyltransferase (GGT) levels may be associated with risk of Metabolic Syndrome (MetS). However, the exact association between them is still not fully clear. We therefore conducted a meta-analysis of prospective cohort studies to comprehensively evaluate the exact association between GGT and risk of MetS. METHODS The Pubmed, Embase, Science Citation Index (ISI Web of Science) databases were searched to collect all prospective cohort studies on the association between GGT and MetS. Then, the association between GGT and MetS was analysed in qualitative and quantitative manners. RESULTS Nine prospective cohort studies involving 47,499 participants and 5009 cases of MetS were included. When comparing the risk of MetS between the highest versus the lowest category of GGT levels, the pooled RR of MetS was 1.63 (95% CI: 1.43-1.82; p < 0.000). The second dose-response analysis of GGT levels per 5 U/l increment with risk of MetS showed that the summary RR of MetS was 1.09 (95% CI: 1.06-1.13; p < 0.000). Subgroup analysis suggested that number of adjusted confounding factors may be a potential source of heterogeneity. Sensitivity analyses showed that no single study significantly influenced the pooled RRs. CONCLUSIONS Our results show that GGT levels are positively associated with risk of MetS independently of alcohol intake. GGT may be a promising marker for predicting MetS. Further studies are needed to confirm our findings and elucidate the underlying mechanisms in future.
Collapse
Affiliation(s)
- C-F Liu
- Department of Geriatrics, RenJi Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200001, China
| | | | | |
Collapse
|
|
45
|
Hamaguchi M, Takeda N, Kojima T, Ohbora A, Kato T, Sarui H, Fukui M, Nagata C, Takeda J. Identification of individuals with non-alcoholic fatty liver disease by the diagnostic criteria for the metabolic syndrome. World J Gastroenterol 2012; 18:1508-16. [PMID: 22509083 PMCID: PMC3319947 DOI: 10.3748/wjg.v18.i13.1508] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 01/06/2012] [Accepted: 01/18/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To clarify the efficiency of the criterion of metabolic syndrome to detecting non-alcoholic fatty liver disease (NAFLD).
METHODS: Authors performed a cross-sectional study involving participants of a medical health checkup program including abdominal ultrasonography. This study involved 11 714 apparently healthy Japanese men and women, 18 to 83 years of age. NAFLD was defined by abdominal ultrasonography without an alcohol intake of more than 20 g/d, known liver disease, or current use of medication. The revised criteria of the National Cholesterol Education Program Adult Treatment Panel III were used to characterize the metabolic syndrome.
RESULTS: NAFLD was detected in 32.2% (95% CI: 31.0%-33.5%) of men (n = 1874 of 5811) and in 8.7% (95% CI: 8.0%-9.5%) of women (n = 514 of 5903). Among obese people, the prevalence of NAFLD was as high as 67.3% (95% CI: 64.8%-69.7%) in men and 45.8% (95% CI: 41.7%-50.0%) in women. Although NAFLD was thought of as being the liver phenotype of metabolic syndrome, the prevalence of the metabolic syndrome among subjects with NAFLD was low both in men and women. 66.8% of men and 70.4% of women with NAFLD were not diagnosed with the metabolic syndrome. 48.2% of men with NAFLD and 49.8% of women with NAFLD weren’t overweight [body mass index (BMI) ≥ 25 kg/m2]. In the same way, 68.6% of men with NAFLD and 37.9% of women with NAFLD weren’t satisfied with abdominal classification (≥ 90 cm for men and ≥ 80 cm for women). Next, authors defined it as positive at screening for NAFLD when participants satisfied at least one criterion of metabolic syndrome. The sensitivity of the definition “at least 1 criterion” was as good as 84.8% in men and 86.6% in women. Separating subjects by BMI, the sensitivity was higher in obese men and women than in non-obese men and women (92.3% vs 76.8% in men, 96.1% vs 77.0% in women, respectively).
CONCLUSION: Authors could determine NAFLD effectively in epidemiological study by modifying the usage of the criteria for metabolic syndrome.
Collapse
|
|
46
|
Qin X, Tang G, Qiu L, Xu T, Cheng X, Han S, Zhu G, Liu Y. Association between γ-glutamyltransferase and prehypertension. Mol Med Rep 2012; 5:1092-8. [PMID: 22266633 PMCID: PMC3493114 DOI: 10.3892/mmr.2012.761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2011] [Accepted: 01/03/2012] [Indexed: 11/22/2022] Open
Abstract
Researchers have identified an association between baseline γ-glutamyltransferase (GGT) and prehypertension. However, data from China are limited. A cross-sectional study was performed among 2,205 subjects from Heilongjiang Province in China. Multiple logistic regression analyses revealed a significant association between baseline GGT and prehypertension [1.59, 95% confidence interval (CI), 1.18–2.16], comparing quartile 4 to quartile 1. Subgroup analyses showed a stronger association between GGT and prehypertension in Koreans; men, current alcohol drinkers and subjects with pre-diabetes. Receiver operating characteristics (ROC) analysis demonstrated that when GGT was higher than 20 U/l, the risk of developing prehypertension increased. Serum GGT is used as a biochemical liver test, but our findings suggest that baseline values may also predict prehypertension in Chinese.
Collapse
Affiliation(s)
- Xuzhen Qin
- Department of Clinical Laboratory, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, PR China
| | | | | | | | | | | | | | | |
Collapse
|
|
47
|
Oliveira LPM, Jesus RPD, Boulhosa RSSB, Mendes CMC, Lyra AC, Lyra LGC. Metabolic syndrome in patients with chronic hepatitis C virus genotype 1 infection who do not have obesity or type 2 diabetes. Clinics (Sao Paulo) 2012; 67:219-23. [PMID: 22473401 PMCID: PMC3297029 DOI: 10.6061/clinics/2012(03)03] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Revised: 10/19/2011] [Accepted: 10/26/2011] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The individual components of metabolic syndrome may be independent predictors of mortality in patients with liver disease. We aimed to evaluate the prevalence of metabolic syndrome and its related components in hepatitis C virus-infected patients who are not obese and do not have type 2 diabetes. METHODS This cross-sectional study included 125 patients infected with hepatitis C virus genotype 1. Metabolic syndrome was defined according to the International Diabetes Federation. Anthropometric data were measured according to standardized procedures. Bioimpedance analysis was performed on all patients. RESULTS Metabolic syndrome was diagnosed in 21.6% of patients. Of the subjects with metabolic syndrome, 59.3% had hypertension, 77.8% had insulin resistance, 85.2% were overweight, 48.1% had a high waist circumference, 85.2% had an increased body fat percentage, and 92.3% had an elevated waist:hip ratio. In the bivariate analysis, female sex (OR 2.58; 95% CI: 1.09-6.25), elevated gamma-glutamyl transferase (γGT) (OR 2.63; 95% CI: 1.04-7.29), elevated fasting glucose (OR 8.05; 95% CI: 3.17-21.32), low HDL cholesterol (OR 2.80; 95% CI: 1.07-7.16), hypertriglyceridemia (OR 7.91; 95% CI: 2.88-22.71), elevated waist circumference (OR 10.33; 95% CI: 3.72-30.67), overweight (OR 11.33; 95% CI: 3.97-41.07), and increased body fat percentage (OR 8.34; 95% CI: 2.94-30.08) were independent determinants of metabolic syndrome. Using the final multivariate regression model, similar results were observed for abdominal fat (OR 9.98; 95% CI: 2.63-44.41) and total body fat percentage (OR 8.73; 95% CI: 2.33-42.34). However, metabolic syndrome risk was also high for those with blood glucose >5.55 mmol/L or HDL cholesterol <0.9 mmol/L (OR 16.69; 95% CI: 4.64-76.35; OR 7.23; 95% CI: 1.86-32.63, respectively). CONCLUSION Metabolic syndrome is highly prevalent among hepatitis C virus-infected patients without type 2 diabetes or obesity. Metabolic syndrome was significantly associated with hypertension, insulin resistance, increased abdominal fat, and overweight.
Collapse
|
|
48
|
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
|
|
49
|
Liuwei dihuang lowers body weight and improves insulin and leptin sensitivity in obese rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 2012:847167. [PMID: 21904565 PMCID: PMC3166779 DOI: 10.1155/2012/847167] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2011] [Revised: 06/14/2011] [Accepted: 06/23/2011] [Indexed: 12/23/2022]
Abstract
The present study was aimed at investigating the efficacy and mechanism(s) of action of a Chinese herbal formulation, Liuwei Dihuang (LWDH), as a prospective natural weight-lowering product. Following a 2-week acclimation period, 48 obesity-prone (OP-CD) rats were divided into 4 groups (n = 12 each). One group served as a positive control for obesity (OP), while the other 3 were challenged twice daily by oral gavage with total daily dosages of 500, 1500, or 3500 mg/kg BW LWDH, respectively, for 10 weeks. One group (n = 12) of obesity-resistant (OR-CD) rats served as the normal control group. All rats were fed the same AIN-93G diet modified to contain 60% energy from fat. The highest LWDH dose significantly reduced body weight during the last 4 weeks of treatment. Food intake was reduced beginning in week 2. The high LWDH dose lowered serum triglyceride (TG) and nonesterified fatty acid (NEFA) levels and body fat. Both the high and medium doses also lowered serum leptin and insulin levels. Liver function testing revealed no adverse side effects under the current experimental conditions. The results of the present study suggest that LWDH has potential as a preventive or therapeutic natural product against overweight and obesity.
Collapse
|
|
50
|
Bryhni B, Arnesen E, Jenssen TG. Associations of age with serum insulin, proinsulin and the proinsulin-to-insulin ratio: a cross-sectional study. BMC Endocr Disord 2010; 10:21. [PMID: 21162746 PMCID: PMC3020169 DOI: 10.1186/1472-6823-10-21] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Accepted: 12/16/2010] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Insulin responses and insulin levels seem to decline with age. However, the question of beta cell impairment attributable to ageing has been sparsely addressed in population-based studies. Non-fasting insulin levels are determined by the ambient degree of insulin resistance together with the capacity of beta cells to compensate by insulin secretion to prevent hyperglycaemia. A raised proinsulin-to-insulin ratio (proinsulin/insulin) due to impaired processing of proinsulin is an early marker of beta cell dysfunction. We hypothesised that in a general population, signs of beta cell failure with advancing age manifest not only by decreases in random insulin, but also with a corresponding increase in its precursor proinsulin. METHODS In the Tromsø Study 1994-95 we measured insulin and proinsulin concentrations in random blood samples from 6212 persons without self-reported diabetes mellitus and plotted the levels as percentiles according to age. In regression analyses we assessed the relationships between age and insulin, proinsulin, and proinsulin/insulin, while adjusting for the concomitant measurements of glucose and other metabolic variables, and the time since the last meal. RESULTS Median insulin concentrations declined significantly with advancing age group in men, but not in women. Proinsulin levels and proinsulin/insulin increased across age groups in both genders. After adjustment, greater age was associated with lower log10(insulin) and higher log10(proinsulin) and log10(proinsulin/insulin) (p = 0.0001 for all). CONCLUSIONS Negative associations of age with random insulin levels, together with positive associations of age with proinsulin and proinsulin/insulin, point towards a loss of beta cell function inherent in the ageing process.
Collapse
Affiliation(s)
- Bente Bryhni
- Department of Cardiology, University Hospital of Tromsø, Tromsø, Norway
- Department of Clinical Medicine, University of Tromsø, Tromsø, Norway
| | - Egil Arnesen
- Institute of Community Medicine, University of Tromsø, Tromsø, Norway
| | - Trond G Jenssen
- Department of Clinical Medicine, University of Tromsø, Tromsø, Norway
- Department of Nephrology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| |
Collapse
|