Role of Enzyme Gamma Glutamyl Transferase in Diagnosis of Metabolic Syndrome in Subjects with Normal Liver Function

Introduction: Recently Liver enzymes have gained popularityamong researchers regarding their potential role in the fieldof diagnosis of metabolic disorders including type 2 diabetesand cardiovascular diseases. Studies done in past havedocumented the presence of GGT in atheromatous plaquesof established cases of coronary artery diseases. Also GGTlevels are put to assess the prognosis of patients suffering fromcardiovascular events like myocardial infarction, stroke, etc.Scientific community lacks sufficient data on levels of GGT atthe stage of primordial and primary prevention. The study wasconducted with an aim to establish an association betweenGGT levels and metabolic syndrome in subjects havingnormal liver function. Also, the study has evaluated the role ofGGT as a diagnostic biomarker of metabolic syndrome.Material and methods: In the present study, 120 subjects wereenrolled out of which 60 were having metabolic syndrome and60 were normal individuals. We have measured the levels ofGGT in subjects of metabolic syndrome and compared themwith normal individuals.All the subjects enrolled in the studyhad normal liver function test.Results: We found a significant difference in levels of SerumGGT in subjects with and without metabolic syndrome (p-value<0.001).On ROC analysis, Among other liver enzymes, GGTshowed the maximum area under the curve, and a sensitivityof 61.1%, a specificity of 69.8% in the diagnosis of metabolicsyndrome.Conclusion: Liver enzymes assay is simple yet sensitiveand cheap test to diagnose the cases of Metabolic Syndrome,more than that their role in development and progression ofatherosclerosis, make GGT, a potential biomarker for riskstratification of subjects for cardiovascular diseases.

Impedance cardiography for monitoring changes in cardiac output.

Impedance Cardiography (ICG) is a non invasive method useful for continuous monitoring of cardiac output but, it still has not found wide usage for measuring cardiac output in clinics and research. Most studies focused on comparing the cardiac output measured at rest with reference methods. In the present study we evaluated the validity of ICG against Doppler Echocardiography (DE) in measuring cardiac output changes that occur during static exercise. Cardiac output of 30 healthy males between 18-26 yrs of age was measured during supine rest, during and 5 min after completion of 3 minute static exercise by ICG and DE. The increase in cardiac output during exercise measured with ICG and DE does not differ significantly (1.04±0.72 L/min and 1.05±1.24 L/min respectively) and has significantly high correlation (r=0.76, P<0.001). The bias and limits of agreement are (–0.01±0.83) in acceptable limits. The pooled means of cardiac output measured by ICG and DE do not differ significantly and bears a significant correlation (r=0.812, P<0.001). The bias (d±s) calculated is 0.15±0.64 L/min. ICG could provide valid information regarding the relative changes in cardiac output.

Oral contraceptive pills decrease pulmonary airway resistance in healthy north Indian women.

Objectives: Oral contraceptive pills (OCPs) are hormonal pills used by females to prevent conception; they are a combination of estrogen and progestin. There is, however, compelling evidence that throughout the reproductive life of a woman, her airways are subject to the influence of the cyclical variations in sex hormones which occur in relation to circadian rhythms. The present study has been designed to investigate the effects of OCPs on airway resistance in terms of spirometric parameters in OCP users and nonusers. Materials and Methods: A total of 100 women (age: 20-40 years) ware selected for the present study. The subjects were provided with a one-month supply of OCPs. The constituents per tablet of MALA-N used were levonorgestrel 0.15 mg and ethinylestradiol 0.03 mg. Peak expiratory flow rate (PEFR), forced expiratory flow in expiring 25-75% air (FEF 25-75), forced expiratory volume percentage in one second (FEV1% or FEV1/FVC), forced vital capacity (FVC), and forced expiratory volume in one second (FEV1) were recorded. Results: In our study, the FEF 25-75and PEFR increased significantly in OCP users, showing that these hormone pills decrease the resistance offered by small bronchioles.