A Lower Serum Gamma-Glutamyltransferase Level Does Not Predict a Sustained Virological Response in Patients with Chronic Hepatitis C Genotype 1

BACKGROUND/AIMS: Low gamma-glutamyltransferase (GGT) level was shown to be an independent predictor of a sustained virological response (SVR) in chronic hepatitis C. We aimed to determine factors associated with high GGT level, and to evaluate whether low GGT level is an independent predictor of a SVR in chronic hepatitis C genotype 1. METHODS: We retrospectively reviewed our data of patients with chronic hepatitis C genotype 1 treated with pegylated interferon-alpha and ribavirin. Baseline features were compared between patients with normal and high GGT levels. Factors associated with high GGT level and those associated with a SVR were determined by univariate and multivariate analysis. RESULTS: This study included 57 patients. Mean age was 52.28+/-9.35 years. GGT levels was elevated in 27 patients (47.4%). GGT levels were normal in 63.3% of the patients who achieved a SVR and in 40.7% of those who did not achieve a SVR (p>0.05). By multivariate logistic regression analysis, the presence of cirrhosis (odds ratio [OR], 9.41; 95% confidence interval [CI], 1.08 to 102.61) and female gender (OR, 6.77; 95% CI, 1.23 to 37.20) were significantly associated with high GGT level, and only rapid virological response was associated with a SVR (OR, 8.369; 95% CI, 1.82 to 38.48). CONCLUSIONS: Low GGT level does not predict a SVR; however, it may be a predictor of high fibrosis scores.

Red Cell Distribution Width: A Novel Marker of Activity in Inflammatory Bowel Disease

BACKGROUND/AIMS: Studies concerning red cell distribution width (RDW) for use in the assessment of inflammatory bowel disease (IBD) activity are limited. We investigated whether RDW is a marker of active disease in patients with IBD. METHODS: In total, 61 patients with ulcerative colitis (UC) and 56 patients with Crohn's disease (CD) were enrolled in the study group, and 44 age- and-sex-matched healthy volunteers were included as the control group. A CD activity index >150 in patients with CD indicated active disease. Patients with moderate and severe disease based on the Truelove-Witts criteria were considered to have active UC. In addition to RDW, serum C-reactive protein levels, erythrocyte sedimentation rates, and platelet counts were measured. RESULTS: Twenty-nine (51.7%) patients with CD and 35 (57.4%) patients with UC had active disease. The RDW was significantly higher in patients with CD and UC than in controls (p<0.001 and p<0.001, respectively). A subgroup analysis indicated that for a RDW cut-off of 14%, the sensitivity for detecting active CD was 79%, and the specicity was 93% (area under curve [AUC], 0.935; p<0.001). RDW was the most sensitive and specific marker for active CD. However, it was not valid for UC, as the ESR at a cutoff of 15.5 mm/hr showed a sensitivity of 83% and a specicity of 76% (AUC, 0.817; p<0.001), whereas the RDW at a cutoff of 14% showed 17% sensitivity and 84% specicity for detecting active UC. CONCLUSIONS: RDW was elevated in IBD in comparison with healthy controls and increased markedly in active disease. RDW may be a sensitive and specific marker for determining active CD, whereas ESR is an important marker of active UC.