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Accuracy of b‐ GGT fraction for the diagnosis of non‐alcoholic fatty liver disease
Author(s) -
Franzini Maria,
Fornaciari Irene,
Fierabracci Vanna,
Elawadi Hassan Aziz,
Bolognesi Valeria,
Maltinti Simona,
Ricchiuti Angelo,
Bortoli Nicola,
Marchi Santino,
Pompella Alfonso,
Passino Claudio,
Emdin Michele,
Paolicchi Aldo
Publication year - 2012
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2011.02673.x
Subject(s) - fatty liver , alcoholic liver disease , fraction (chemistry) , disease , medicine , gastroenterology , chemistry , chromatography , cirrhosis
Background Serum gamma‐glutamyltransferase ( GGT ) activity is a sensitive but non‐specific marker of non‐alcoholic fatty liver disease ( NAFLD ). Recently, four GGT fractions (big‐, medium‐, small‐, free‐ GGT ) were described in humans. Aim We aimed to investigate whether a specific GGT fraction pattern is associated with NAFLD . Methods Gamma‐glutamyltransferase fractions were determined in patients with NAFLD ( n = 90), and compared with those in control subjects ( n = 70), and chronic hepatitis C ( CHC , n = 45) age and gender matched. Results Total GGT was elevated in NAFLD as compared to controls (median, 25°–75°percentile: 39.4, 20.0–82.0 U/L vs. 18.4, 13.2–24.9 U/L respectively, P < 0.001). All fractions were higher in NAFLD than in controls ( P < 0.001). The b‐ GGT showed the highest diagnostic accuracy for NAFLD diagnosis [area under ROC curve ( ROC ‐ AUC ): 0.85; cut‐off 2.6 U/L, sensitivity 74%, specificity 81%]. Also subjects with CHC showed increased GGT (41.5, 21.9–84.5 U/L, P < 0.001 vs. controls, P = n.s. vs. NAFLD ), as well as m‐, s‐, and f‐ GGT , while b‐ GGT did not show any significant increase ( P = n.s. vs. HS , P < 0.001 vs. NAFLD ). In subjects with CHC , s‐ GGT showed the best diagnostic value ( ROC ‐ AUC : 0.853; cut‐off 14.1 U/L, sensitivity 73%, specificity 90%). Serum GGT did not show any value in the differential diagnosis between NAFLD and CHC ( ROC ‐ AUC 0.507, P = n.s.), while b‐ GGT /s‐ GGT ratio showed the highest diagnostic accuracy for distinguishing NAFLD and CHC ( ROC ‐ AUC : 0.93; cut‐off value 0.16, sensitivity 82%, specificity 90%). Conclusions b‐ GGT increases in NAFLD , but not in CHC . GGT fraction analysis might help in improving the sensitivity and specificity of the diagnosis of NAFLD and other liver dysfunctions.