Frequently abnormal serum gamma-glutamyl transferase activity is associated with future development of fatty liver: a retrospective cohort study

Abstract

BackgroundNonalcoholic fatty liver disease is characterized by excessive hepatic fat accumulation. Some individuals frequently present elevated gamma-glutamyl transferase (GGT) levels without fatty liver ultrasound images and other abnormal liver enzymes levels. However, whether these individuals are at an elevated risk for developing fatty liver is unclear. We compared fatty liver change rates and risk factors between individuals with frequently elevated GGT levels and those with normal levels.MethodsWe designed a retrospective cohort study on the basis of complete medical checkup records. One group of individuals had presented normal serum GGT levels during the observation period (Normal-GGT group, n = 2713). Another group had had abnormal elevated serum GGT levels frequently (Abnormal-GGT group, n = 264). We determined the fatty liver change incident rates before and after propensity score matching. We explored confounding factors affecting fatty changes in each group using univariate and multivariate Cox models.ResultsThe change incidence rates were 5.80/1000 and 10.02/1000 person-years in the Normal-GGT and Abnormal-GGT groups, respectively. After propensity score matching, the incidence rates were 3.08/1000 and 10.18/1000 person-years in the Normal-GGT and Abnormal-GGT groups, respectively (p = 0.026). The factors associated with fatty liver changes in the Normal-GGT group included body mass index (BMI), hemoglobin, alanine aminotransferase (ALT), albumin, triglyceride (TG), fasting blood sugar, and high-density lipoprotein levels. Those in the Abnormal-GGT group were platelet counts and TG. In our multivariable analysis, BMI, ALT, albumin, and TG levels were independent predictors of fatty changes in the Normal-GGT group, and high TG level was the only independent predictor in the Abnormal-GGT group.ConclusionsThe incidence rate of fatty liver change in the Abnormal-GGT group was higher than that in the Normal-GGT group. Consecutive elevated GGT levels increase the risk for fatty liver, and high TG levels in those individuals further independently increase the risk.

Efficacy and safety of apararenone (MT‐3995) in patients with nonalcoholic steatohepatitis: A randomized controlled study

“…In a subsequent multivariate analysis, body weight was no longer found to be a significant factor and, instead, total bilirubin, GGT, and ELF score were shown to be factors that contributed significantly to an improvement in the FIB‐4 index ( p < 0.0001). These factors have previously been reported to be related to the pathophysiology of NAFLD and NASH 24,28,36,37 ; GGT is known to be an oxidative stress marker, and the inhibition of oxidative stress is also known to contribute to the improvement of fibrosis 36,38,39 . However, further investigation is necessary to confirm the findings from our post hoc analyses.…”

MOTS‐c promotes phosphorodiamidate morpholino oligomer uptake and efficacy in dystrophic mice

“…Importantly, significantly decreased numbers of centrally nucleated fibers (CNFs), indicative of muscle regeneration (van Putten et al , 2012), and less variable cross‐sectional area were found in peripheral muscles of PMO‐M‐treated mdx mice compared to PMO‐treated mdx mice (Fig 5D and E), indicating that PMO‐M effectively prevents muscle pathological progression. Levels of circulatory aspartate transaminase (AST) and alanine aminotransferase (ALT), which rise in DMD patients (McMillan et al , 2011), were significantly decreased in mdx mice treated with PMO‐M, whereas there was no significant change in levels of serum liver enzyme gamma‐glutamyl transferase (GGT) (Fujii et al , 2020; Fig 6A), creatinine (CREA) and blood urea nitrogen (BUN) (Fig 6B), markers for kidney function (Uchino et al , 2012), in mdx mice treated with PMO‐M compared to PMO alone and untreated mdx controls. Consistently, no morphological abnormality was found in kidney and liver (Fig 6C), indicating that PMO‐M does not cause any detectable toxicity.…”

Association between ectopic pancreatic and hepatic fat and metabolic risk factors in children with non‐alcoholic fatty liver disease

“…30 Another retrospective cohort study observed that consecutively elevated GGT levels predisposed patients to fatty liver. 31 Recent research has shown that android fat was positively associated and skeletal muscle was inversely associated with the risk of NAFLD in adults. 32 A study performed in adolescents observed that body fat distribution was significantly associated with liver fat content in youth with NAFLD.…”