Estimation of gamma-glutamyl transferase as a suitable simple biomarker of the cardiovascular risk in children with non-alcoholic fatty liver disease

Bobrus-Chociej, Anna; Flisiak-Jackiewicz, Marta; Daniluk, Urszula; Wojtkowska, Małgorzata; Oksiuta, Monika Kłusek; Tarasów, Eugeniusz; Lebensztejn, Dariusz Marek

doi:10.18388/abp.2018_2611

Cited by 8 publications

(9 citation statements)

References 21 publications

(27 reference statements)

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“…Elevated liver enzymes, in particular ALT, exceeding two-fold the upper limit of normal values may be used as surrogate for “mild NAFLD” [ 6 , 27 ]. An earlier study performed in the Polish pediatric population showed that in obese children, with ultrasonography confirmed NAFLD, fasting levels of ALT were in the range of 51–95 U/L and those of GGT were in the range of 22–45 U/L [ 28 ]. On one hand, occurrence of NAFLD in our MetS(+) group seems to be unlikely because the single highest level of fasting ALT was 27 U/L at TG level of 188 mg/dL, and the single highest fasting GGT level was 38 U/L at TG 111 mg/dL.…”

Section: Discussionmentioning

confidence: 99%

Association between Fasting and Postprandial Levels of Liver Enzymes with Metabolic Syndrome and Suspected Prediabetes in Prepubertal Children

Bergmann

Stefańska

Krintus

et al. 2023

IJMS

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Elevated liver enzyme activity may be associated with metabolic syndrome (MetS); however, it is not included in the MetS definition for children. Postprandial changes in the levels of biochemistry tests are related to manifestations of metabolic abnormalities. We assessed the association between fasting and postprandial liver enzymes levels with MetS and elevated hemoglobin A1c (HbA1c) in children aged 9–11. The study included 51 girls and 48 boys, all presumably healthy. In all participants’ anthropometric indices, fasting glucose, insulin, lipid profile and HbA1c were measured. Enzymes, including alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT), were assayed in fasting and postprandial states. Individuals were divided into subgroups: with (MetS(+): n = 26); without MetS (MetS(−): n = 73); with HbA1c levels ≤ 5.3% (n = 39); and ≥5.7% (n = 11). Elevated fasting GGT levels were found in 23% of MetS(+) children and rarely in MetS(−) children; increased postprandial GGT was noted in 35% of MetS(+) individuals. Postprandial GGT changes tend to predict MetS (OR = 1.16; p = 0.092). Increased fasting ALT was found rarely in MetS(+) children, but did not occur in MetS(−) children. HbA1c ≥ 5.7% occurred rarely and neither fasting ALT nor GGT were related to elevated HbA1c. However, postprandial change of ALT was a good positive predictor of increased HbA1c (OR = 1.33; p = 0.021). Postprandial GGT performs better as an indicator of metabolic syndrome occurrence, and instead postprandial ALT may predict prediabetes in prepubertal children.

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Section: Discussionmentioning

confidence: 99%

Association between Fasting and Postprandial Levels of Liver Enzymes with Metabolic Syndrome and Suspected Prediabetes in Prepubertal Children

Bergmann

Stefańska

Krintus

et al. 2023

IJMS

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“…44 Moreover, a study on children with NAFLD confirmed that GGT might be a potentially reliable, simple, and non‐invasive biochemical marker for the estimation of cardiovascular risk in obese children with NAFLD. 6 , 45 …”

Section: Discussionmentioning

confidence: 99%

Ectopic pancreatic fat as a risk factor for hypertension in children and adolescents with nonalcoholic fatty liver disease

Lee

Kim

Yang

2021

J of Clinical Hypertension

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Although nonalcoholic fatty liver disease (NAFLD) is known to be a risk factor for cardiovascular diseases, few studies have reported an association between ectopic fat deposition and metabolic complications, including hypertension, in children with NAFLD. The present study evaluated the risk factors for hypertension in children with NAFLD from the aspect of ectopic fat. This cross‐sectional retrospective study investigated 65 children with NAFLD (49 boys, mean age 13.0 ± 3.2 years, mean body mass index z‐score [BMI‐z] 2.5 ± 1.2), who underwent liver biopsy and magnetic resonance imaging‐based fat fraction measurement for ectopic hepatic and pancreatic fats, as well as anthropometry, blood pressure, laboratory tests, and body composition analysis. A logistic regression model was used to identify the risk factors for hypertension. Through a simple logistic regression analysis, age (OR 1.392), BMI‐z (OR 3.971), waist circumference‐to‐height ratio (OR 1.136), fat‐free mass index (OR 1.444), γ‐glutamyl transferase (OR 1.021), quantitative insulin sensitivity check index (OR 0.743), dyslipidemia (OR 5.357), and pancreatic fat fraction (PFF) (OR 1.205) were associated with hypertension. The optimal cut‐off of PFF to divide children with NAFLD into two groups with and without hypertension was 4.39% (area under the curve 0.754, p = .001, sensitivity 82.4%, specificity 73.9%). Multiple logistic regression analysis in the fully adjusted model revealed both BMI‐z (OR 4.912, 95% CI, 1.463–16.497) and PFF (OR 1.279, 95% CI, 1.007–1.624) were independent risk factors for hypertension. In conclusions, in addition to BMI‐z, ectopic pancreatic fat is an important risk factor for hypertension in children with NAFLD.

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“…26 Many studies have shown that GGT is correlated with traditional risk factors for CVD, such as TC, LDL-C, glucose, insulin, BMI, etc. [27][28][29][30][31][32] Further studies showed that higher GGT may increase cardiovascular mortality, [33][34][35][36][37][38] and is an independent predictor for future cardiovascular mortality. 39,40 Even within the normal range, higher GGT is associated with CVD risk factors, [41][42][43][44] suggesting GGT as a superior marker for predicting CVD risk.…”

Section: Discussionmentioning

confidence: 99%

Association of LDLR rs1433099 with the Risk of NAFLD and CVD in Chinese Han Population

Han

Zhang

Liu

et al. 2021

Journal of Clinical and Translational Hepatology

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Background and Aims: Recent genome-wide association studies have shown that low-density lipoprotein receptor (LDLR) rs1433099 polymorphism is associated with cardiovascular disease (CVD) risk in many countries. However, the association of LDLR rs1433099 with CVD in China has not been reported yet. There are no studies on LDLR rs1433099 and non-alcoholic fatty liver disease (NAFLD) as well. The purpose of this study was to investigate whether LDLR rs1433099 is related to CVD or NAFLD in the Chinese population. Methods: LDLR rs1433099 polymorphism was genotyped in 507 individuals, including 140 healthy controls, 79 NAFLD patients, 185 CVD patients, and 103 patients with NAFLD combined with CVD. The expression of LDLR was tested by the sequence detection system, and clinical parameters were assessed by biochemical tests and physical examination. Results: The genotype distribution of LDLR rs1433099 was not statistically different among the NAFLD group, the CVD group, the combined group, and the healthy control group (p>0.05). There was no significant correlation of LDLR rs1433099 genotypic distribution or allele frequency and the risk of NAFLD, CVD or NAFLD combined with CVD (p>0.05). In the CVD group, T allele carriers had higher alkaline phosphatase and gamma-glutamyl transpeptidase than non-carriers (p<0.05). Conclusions: Our study demonstrated that the LDLR rs1433099 polymorphism is not a risk factor of NAFLD. The LDLR rs1433099 polymorphism may increase the risk of CVD through a mechanism involving alkaline phosphatase and gamma-glutamyl transpeptidase.

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Estimation of gamma-glutamyl transferase as a suitable simple biomarker of the cardiovascular risk in children with non-alcoholic fatty liver disease

Cited by 8 publications

References 21 publications

Association between Fasting and Postprandial Levels of Liver Enzymes with Metabolic Syndrome and Suspected Prediabetes in Prepubertal Children

Association between Fasting and Postprandial Levels of Liver Enzymes with Metabolic Syndrome and Suspected Prediabetes in Prepubertal Children

Ectopic pancreatic fat as a risk factor for hypertension in children and adolescents with nonalcoholic fatty liver disease

Association of LDLR rs1433099 with the Risk of NAFLD and CVD in Chinese Han Population

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