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BackgroundAlcohol use disorder (AUD) is a common chronic and relapsing psychiatric disorders. Identifying severe AUD early and intervening promptly is crucial to prevent irreversible harm. Currently, the assessment of AUD severity primarily relies on psychiatric examination by clinicians, and there is limited research on the factors influencing AUD severity and the development of prediction models. ObjectiveTo analyze the factors influencing AUD severity, and construct a risk prediction model to aid in the assessment of disease progression in AUD patients. MethodsA retrospective analysis was conducted on 1 358 first-time hospitalized patients admitted to Nanning Fifth People's Hospital from January 1, 2017 to December 31, 2022. These patients met the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) criteria for AUD. Basic patient data was collected, and the patients were divided into two groups based on disease severity: mild-moderate group (n=330) and severe group (n=1 028). The patients were randomly divided into training and test sets in a 7∶3 ratio. A Logistic regression model was constructed in the training set, and the predictive ability of the model for disease severity was evaluated using the receiver operating characteristic (ROC) curve in the test set. ResultsCompared with the mild-moderate group, the severe group had a higher proportion of patients living in urban areas (χ2=7.804), were farmers (χ2=17.991), had a higher frequency of alcohol consumption (more than 1 to 2 drinks/day) (χ2=35.267), had a higher age at first drinking (t=-3.858), had a greater number of comorbid somatic disorders (Z=-22.782), and had higher proportions of γ-Glutamyl transpeptidase (χ2=259.940) and total bilirubin abnormalities (χ2=148.552) (P<0.01). Logistic analysis conducted in the training set showed that being a farmer (OR=2.024, 95% CI: 1.352~3.029), having an older age at first drinking (OR=1.075, 95% CI: 1.025~1.129), drinking outside of mealtimes (OR=3.988, 95% CI: 2.408~6.606), having total bilirubin abnormalities (OR=1.034, 95% CI: 1.000~1.069), and having more comorbid somatic diseases (OR=4.386, 95% CI: 2.636~7.298) were identified as risk factors for disease severity in AUD patients. The area under curve (AUC) for this model in the test set was 0.906. ConclusionIn psychiatric hospitals, being a farmer, having an older age at first drinking, drinking outside of mealtimes, having abnormal total bilirubin levels, and having comorbidities with somatic illnesses may be risk factors for severe AUD.
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Objective:To explore the association between glutamyl transpeptidase (GGT) trajectories and new-onset metabolic syndrome to provide insights for the prevention and treatment of metabolic syndrome.Methods:A total of 3 209 subjects who met the inclusion criteria were enrolled in the study cohort of physical examination population. The GGT levels before follow-up were classified by R LCTMtools program into 3 GGT trajectory groups: low-stable group, medium-stable group and high-stable group. Cox proportional hazards regression model was used to analyze the correlation between different GGT trajectories and new-onset metabolic syndrome.Results:At the end of follow-up in 2020, the cumulative incidence of metabolic syndrome was 7.0%, and the incidence of metabolic syndrome in the low-stable group, medium-stable group and high-stable group were 3.9%, 11.4%, and 15.0%, respectively, showing a growth trend ( P<0.001). After adjusting for multiple confounding factors by Cox proportional hazards regression model, the risk of metabolic syndrome in medium-stable group and high-stable group increased in the total population. The hazard ratios (95% CI)for the high stable group in males and the medium-stable group in females were 1.67(1.07-2.60) and 3.29(1.14-9.53), respectively, compared with their respective low-stable group. Conclusion:Elevated longitudinal trajectory of GGT is a risk factor for new-onset metabolic syndrome, the risk of metabolic syndrome in the total population increased with the increase of long-term GGT level. It is recommended to maintain the long-term level of GGT at about 28 U/L in males and 14 U/L in females, respectively, to achieve the goal of early prevention of metabolic syndrome.
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Objective: To explore the application value of shear wave elastography (SWE) and γ-glutamyl transpeptidase/platelet ratio (GPR) in diagnosis of liver fibrosis in chronic hepatitis B (CHB) patients. Methods: A total of 116 patients with CHB were collected. SWE examinations and blood routine and liver function tests were performed before liver biopsy. Liver hardness measurement (LSM) was recorded, and GPR was calculated. According to the Metavir scoring system, liver fibrosis was classified as F0, F1, F2, F3 and F4 in the pathologic examinations. The correlations of SWE, GPR and liver fibrosis stages were analyzed. Receiver operating characteristic curve (ROC) was drawn, and Elast PQ and GPR for diagnosis of liver fibrosis in patients with CHB were compared. The diagnostic value of Elast PQ of liver fibrosis in patients with ALT below 2 times of the upper limit of normal (ULN) value was analyzed. Results: Elast PQ and GPR were all positively correlated with liver fibrosis staging (r=0.94, P<0.01; r=0.92, P<0.01). The diagnostic efficiency of Elast PQ was superior to that of GPR for F1-F3 fibrosis stages (Z=2.21, P=0.03; Z=2.16, P=0.03; Z=2.27, P=0.02), of Elast PQ in patients with ALT≤1×ULN was better than that in patients with 1×ULN
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Objective: To investigate the diagnostic efficiency of γ-glutamyl transpeptidase to platelet ratio (GPR) for detecting liver fibrosis in chronic hepatitis B patients, and to compare its efficiency with those of liver stiffness measurement (LSM) value, asperate aminotransferase to platelet ratio index (APRI) and fibrosis-4 index (FIB-4). Methods: We retrospectively included patients with chronic hepatitis B who had undergone surgery or liver biopsy in our hospital from May 2015 to Sep. 2015. All patients had undergone transient elastography to record LSM value and serological examination to calculate GPR, APRI and FIB-4 before surgery or liver biopsy. The diagnostic efficiency of each index was evaluated by receiver operating characteristic (ROC) curve and the area under ROC curve was compared. Results: Totally 260 patients were eventually enrolled in the present study, including 213 males and 47 females, with the average age being (53.49±9.78) years and the average BMI being (23.36±3.06) kg/m2. GPR, LSM value, APRI and FIB-4 were moderately correlated with S≥2 and S4 liver fibrosis (all P0.05). Conclusion: It has been indicated that GPR, LSM value, APRI and FIB-4 have diagnostic accuracy for S≥2 and S4 liver fibrosis. The diagnostic accuracy of LSM value and GPR for S≥2 and S4 liver fibrosis is better than that of FIB-4, and that of LSM value for S4 liver fibrosis is better than that of APRI. Therefore, GPR and LSM value may serve as the optimal indexes for noninvasively evaluating liver fibrosis in chronic hepatitis B patients.
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γ-glutamyl transpeptidase (GGT) is an important index of cholestasis.Most patients with cholestasis liver diseases have high GGT level,but some of the patients are characterized by low GGT level.This paper summarizes the progress of cholestasis liver diseases with low GGT level in order to improve the understanding of these diseases.
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γ-glutamyl transpeptidase(GGT) is an important index of cholestasis.Most patients with cholestasis liver diseases have high GGT level, but some of the patients are characterized by low GGT level.This paper summarizes the progress of cholestasis liver diseases with low GGT level in order to improve the understanding of these diseases.
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Objective To compare the diagnostic values of γ-glutamyl transpeptidase-to-platelet ratio index (GPRI) ,aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis index based on the four factors (Fib-4) for chronic hepatitis B (CHB) fibrosis and cirrhosis .Methods According to the Metavir score ,262 CHB patients were divided into F0 — F1 group (n= 131) ,F2 — F3 group (n= 102) and F4 group (n = 29 ) . The age , gender , alanine aminotransferase (ALT ) , aspartate aminotransferase (AST ) ,γ-glutamyl transpeptidas (γ-GT ) and platelet count were recorded .GPRI ,APRI ,Fib-4 scores were calculated separately .Statistical analysis was performed by t test ,Kruskal-Wallis H test ,and χ2 test .The correlations between serum models and liver fibrosis stages were analyzed using the Spearman test .Results The scores of GPRI in F0 — F1 group ,F2 — F3 group and F4 group were 0 .39 (0 .21 , 0 .95) ,1 .05 (0 .38 ,2 .39) and 2 .11 (1 .12 ,3 .33) ,respectively .The difference was statistically significant (χ2 = 40 .645 ,P< 0 .01) .APRI scores in the three groups were 0 .49 (0 .32 ,0 .97) ,0 .77 (0 .52 ,1 .52) and 1 .12 (0 .77 ,2 .50) ,respectively .The difference was statistically significant (χ2 = 32 .636 , P < 0 .01) . Fib-4 scores in the three groups were 1 .36 (0 .92 ,2 .05) ,2 .34 (1 .28 ,4 .35) and 3 .86 (3 .03 ,8 .99) , respectively .The difference was statistically significant (χ2 = 48 .943 , P< 0 .01) .Age ,γ-GT ,AST and liver fibrosis were all positively correlated with liver fibrosis (r = 0 .322 ,0 .301 and 0 .199 ,respectively , all P< 0 .05) .Platelet was negatively correlated with liver fibrosis (r = — 0 .455 , P< 0 .05) ,while ALT was not significantly associated with hepatic fibrosis (r= 0 .111 ,P= 0 .073) .GPRI ,APRI and Fib-4 were positively correlated with liver fibrosis (r = 0 .625 ,0 .417 and 0 .399 ,respectively ,all P < 0 .05) .The areas under the operating characteristic curve of GPRI for significant hepatic fibrosis , advanced liver fibrosis and cirrhosis were 0 .818 ,0 .864 and 0 .837 ,respectively .APRI for significant hepatic fibrosis , advanced liver fibrosis and cirrhosis were 0 .694 ,0 .766 and 0 .722 ,respectively ,while Fib-4 were 0 .696 , 0 .770 and 0 .724 ,respectively .The low cutoff values of GPRI for various stages of liver fibrosis were 0 .99 ,1 .04 and 1 .06 ,respectively ,and the sensitivity ,specificity ,positive predictive value (PPV ) and negative predictive value (NPV) were all higher than those of APRI and Fib-4 .The high cutoff values of GPRI for liver fibrosis at each stage were 2 .49 ,3 .69 and 6 .77 , respectively , and the sensitivity , specificity ,PPV and NPV of the diagnosis were all higher than those of APRI and Fib-4 .Conclusion The diagnostic value of GPRI for CHB liver fibrosis is higher than those of APRI and Fib-4 .
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Objective To analyze the association of serum γ-glutamyl transpeptidase(γ-GT)level with carotid intima media thickness(IMT) in essential hypertension.Methods All the 300 essential hypertension patients and 70 healthy controls were from Ganzhou People′s Hospital.They were divided into healthy control group(70 cases),hypertension with out arteriosclerosis group(141 cases) and hypertension with arteriosclerosis group(159 cases) based on carotid IMT.Fasting blood glucose,serum lipid,routine laboratory tests,hepatic and renal function were detected by routine methods.The one-way analysis of variance and χ2-test were used to compared among the three groups,and the relationship of γ-GT with IMT was assessed by using the Spearman correlation coefficient,multiple linear regressions and Logistic regression analysis.Results The diastolic blood pressure,body mass index,fasting blood glucose,glomerular filtration rate and glycosylated hemoglobin had no differences among the three groups(P>0.05),but systolic pressure,triacylglycerol,total cholesterol,high density lipoprotein cholesterol,aspartate transaminase(AST),low density lipoprotein cholesterol alanine,transaminase(ALT) and γ-GT had significant differences among the three groups(P<0.05).Multiple linear regression analysis showed that the serum γ-GT(β=-0.345,95%CI was-0.005——0.511,P=0.036) was also negatively correlated with IMT,and Logistic regression analysis showed that γ-GT(OR=0.569,95%CI was 0.237-0.867,P=0.029)was a protective factor for atherosclerosis.Conclusion Our study demonstrated the level of γ-GT is negative with IMT among essential hypertension patients,and monitoring the changes of serum liver enzyme might has significant effect on the early detection of arteriosclerosis.
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Objective To analyze the expression of IFIT4,PRKR and investigate the clinical and immunology features of different types of liver involvement in patients with systemic lupus erythematosus (SLE).Methods Clinical data of 62 cases of SLE with liver damage and 62 cases of SLE without liver damage were collected.Peripheral venous blood samples were obtained and total RNA were extracted and transcribed into cDNA.Sybr green dye based real-time quantitative PCR method was used to compare the expression levels of IFIT4,PRKR in patients with SLE.Clinical parameters were analyzed by ANOVA,Chi-square test,Pearson's or Spearman's test.Results ① The increase of γ-GT or ALP was correlated with rash and oral ulcer (x2=5.625,P=0.018),lupus nephritis (x2=5.631,P=0.019),anemia,thrombocytopenia (99±21,P=0.028; 81±45,P=0.004,),CRP (33±43,P=0.004).The positive rate of nRNP (x2=4.862,P=0.027 ) and SSA (x2=8.087,P=0.004) was higher in patients with liver damage than other groups; ② The positive rate of anti-Rib antibody in SLE with liver damage was significantly higher than SLE without liver damage (x2=19.542,P=0.000); ③ There was no difference in the expression of IFIT4 among these groups,but higher expression of PRKR was detected in the group of patients with increased γ-glutamyl transpeptidase (γ-GT) or ALP(F=3.54,P=0.018).Conclusion The different types of liver damage in SLE patients have different clinical and immunology characteristics.The expression of PRKR is higher in patients with increased γ-GT or ALP.
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Objective To investigate the serum alkaline phosphatase (ALP) and γ-glutamyl transpeptidase (GGT) levels in patients with neuromyelitis optica (NMO) and multiple sclerosis (MS).Methods Serum ALP and GGT levels in patients with NMO and MS from the database of demyelinating diseases in our hospital were analyzed.Eighty-five healthy controls were chosen.The differences of serum ALP and GGT levels in patient groups and controls were compared, and the correlations between clinical features (age of the subjects, course of disease, times of relapse and scores of EDSS) and both ALP and GGT levels were analyzed. Results The serum ALP and GGT levels in patients with NMO were significantly higher than those in patients with MS and the controls (P<0.05).Patients with NMO still had significantly higher serum ALP level in acute phase than patients with MS,and the serum ALP levels in male patients with NMO and the serum GGT levels in female patients with NMO were, respectively,statistically higher than that of male patients with MS and female patients with MS (P<0.05). In patients with NMO, significantly positive correlations between serum GGT level and both age and times of relapse were noted (P<0.05). Conclusion Serum ALP and GGT levels differ in patients with NMO and MS, indicating their differential diagnostic value in NMO and MS to certain extent.
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Short term effects of ovulen-50, a combination type oral contraceptive agent and phenobarbital—an established hepatic tumour promoter, were examined in the livers of diethylnitrosamine-initiated and uninitiated female rats. Liver mitotic activity as judged by liver weight, [3H] thymidine incorporation into DNA and levels of DNA, RNA and protein were measured in non-regenerating and regenerating liver. Hepatic γ-glutamyl transpeptidase activity and hepatocyte agglutination with concanavalin A were examined in diethylnitrosamine- and/or phenobarbital-treated rats. The results indicate that diethylnitrosamine or ovulen-50 individually are mitoinhibitory in regenerating liver. Phenobarbital alone has a slight mitostimulatory effects in nonregenerating liver, but no effect on liver regeneration. Administration of ovulen-50 and phenobarbital to diethylnitrosamine initiated rats mitigated the mitoinhibition during regeneration. Contrary to the earlier observation with ovulen-50, neither phenobarbital nor diethylnitrosamine induced hepatocyte agglutination in the presence of concanavalin A. Like ovulen-50, diethylnitrosamine also increased the level of hepatic γ-glutamyl transpeptidase. Phenobarbital produced only insignificant rise and did not substantially exacerbate the effect diethylnitrosamine. The data show that though some of the effects of ovulen-50 resemble those of diethylnitrosamine or phenobarbital, the changes observed may not be related to the neoplastic phenomenon since they were not seen in an initiator-promoter combination regimen.
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Measurements have been made of the enzymes associated with γ - glutamyl cycle viz, γ-glutamyl transpeptidase, γ-glutamyl cysteine synthetase, and 5-oxoprolinase in human fetal brain, liver and kidney over 12-36 weeks of gestation. γ-Glutamyl transpeptidase activity increases gradually with age. γ-Glutamyl cysteine synthetase and 5-oxoprolinase show biphasic pattern of development in human fetal brain. The data presented in this communication may indicate a relationship between γ-glutamyl cycle and amino acid transport.