Elsevier

Atherosclerosis

Volume 189, Issue 1, November 2006, Pages 198-205
Atherosclerosis

Elevated serum levels of alanine aminotransferase and gamma glutamyltransferase are markers of inflammation and oxidative stress independent of the metabolic syndrome

https://doi.org/10.1016/j.atherosclerosis.2005.11.036Get rights and content

Abstract

The present study attempted to establish whether elevated serum levels of alanine aminotransferase (ALT) and gamma glutamyltransferase (GGT) are independent (of each other) markers of systemic inflammation and oxidative stress as assessed by the plasma levels of C-reactive protein (CRP) and lipid peroxides (lipOX), regardless of the presence of underlying metabolic syndrome (as defined by the modified Adult Treatment Panel III (ATPIII) criteria). The plasma levels of CRP and lipOX were determined in 1483 middle-age Japanese men (42 ± 9 years). A general linear model analysis indicated that elevated serum ALT and/or serum GGT (levels in the respective highest quartiles) were significantly related to the logarithms of the plasma levels of CRP (Beta = 0.08 (0.05–0.11) and 0.08 (0.05–0.11), respectively) and the logarithm of the plasma levels of lipOX (Beta = 0.03 (0.01–0.05) and 0.03 (0.01–0.05), respectively), regardless of the presence of underlying metabolic syndrome (MetS) (p < 0.01). In addition, the presence of MetS and elevated serum levels of both of these liver enzymes additively increased the plasma levels of CRP and lipOX. Thus, it is proposed that elevated serum ALT and elevated serum GGT are independent markers of the activation of systemic inflammation and increased oxidative stress, independent of their relationship to MetS, and that the presence of MetS and elevations of both of these liver enzymes may additively worsen the atherogenic state.

Section snippets

Design and subjects

This cross-sectional study was performed on the employees of a single large construction company, all of whom underwent a routine annual health checkup between May and July 2004. In addition to the routine tests, measurements of the plasma levels of CRP and lipOX were also conducted in the subjects enrolled for this study. The routine annual health checkup included evaluation of the atherosclerotic risk factors {body mass index, serum levels of triglycerides (TG), high-density lipoprotein

Results

The quartile ranges for the serum levels of ALT and GGT were as follows—ALT (U/L): 6–16, 17–21, 22–30, and 31–231; GGT (U/L): 6–23, 24–35, 36–58, and 59–266. Table 1 shows the clinical characteristics of the subjects with and without elevated serum ALT and of those with and without elevated serum GGT. Ethnic differences have been reported in relation to the plasma level of CRP [22]. The mean value of CRP in the subjects in this study was consistent with that reported from other studies

Discussion

The present study was the first to examine whether elevated serum ALT and/or serum GGT might be individually related to increased plasma levels of CRP and lipOX, independent of their relationship with the MetS. In the present study, the odds ratios for the presence of elevated serum ALT and/or serum GGT increased as the number of components of the MetS present in the subjects increased. However, a GLM analysis demonstrated that elevated serum ALT and/or elevated serum GGT were individually

Acknowledgement

This study was supported in part by a Grant-in-Aid from the Japanese Atherosclerosis Prevention Fund, awarded to Prof. Akira Yamashina.

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