Background & Aims: Four gamma-gultamyltransferases (GGT) f.actions (b-, m-, s-, and f.GGT) have been identified in human plasma and their concentrations and ratios vary in different pathological conditions. To assess the behaviour of f.actional GGT in cirrhotic patients evaluated f.r liver transplantation. Methods: This was a single-centre, cross-sectional study; GGT f.actions were determined by gel-filtration chromatography. Results: 264 cirrhotic patients (215 males; median age 54.5 years) were included and compared against a group of 200 healthy individuals (100 males; median age 41.5). Median (25th-75th percentile) total and f.actional GGT were higher in cirrhotics, with s-GGT showing the greatest increase [36.6 U/L (21.0-81.4) vs. 5.6 U/L (3.2-10.2), P < 0.0001], while the median b-GGT/s-GGT ratio was lower in cirrhotics than in healthy controls [0.06 (0.04-0.10)] vs. 0.28 (0.20-0.40), P < 0.0001]. The ratio showed higher diagnostic accuracy (ROC-AUC, 95% CI: 0.951, 0.927-0.969) then either s-GGT (0.924, 0.897-0.947; P < 0.05) or total GGT (0.900, 0.869-0.925; P < 0.001). The diagnostic accuracy of the ratio was maintained (0.940, 0.907-0.963) in cirrhotic patients (n = 113) with total GGT values within the reference range. The s-GGT f.action consisted of two components, with one (s2-GGT) showing a significant positive correlation with serum aspartate aminotransferases, alanine aminotransferase, lactate dehydrogenases (LDH), alkaline phosphatases and bilirubin, and negative with albumin. The b-GGT f.action showed a positive correlation with albumin, f.brinogen, and platelet counts, and negative with international normalized ratio, bilirubin and LDH. Conclusions: The ratio performs as a sensitive biomarker of the liver parenchymal rearrangement, irrespective of aetiology of cirrhosis and presence of hepatocellular carcinoma, even in patients with total GGT values within the reference range. © 2014 John Wiley & Sons A/S.
|Autori:||Hassan A. Elawdi; Maria Franzini; Aldo Paolicchi; Michele Emdin; Irene Fornaciari; Vanna Fierabracci; Paolo De Simone; Paola Carrai; Franco Filipponi|
|Titolo:||Circulating gamma-glutamyltransferase fractions in cirrhosis|
|Anno del prodotto:||2014|
|Digital Object Identifier (DOI):||10.1111/liv.12455|
|Appare nelle tipologie:||1.1 Articolo in rivista|