Key result
Patients with non-alcoholic steatohepatitis had significantly impaired flow-mediated dilatation (4.9% vs 9.3%) compared to healthy controls, and serum GGT and ALT concentrations were predictive of this dysfunction.
Why the study?
Do serum GGT and ALT concentrations predict endothelial dysfunction in patients with non-alcoholic steatohepatitis?
Case-Control (n=80)
No
Do serum GGT and ALT concentrations predict endothelial dysfunction in patients with non-alcoholic steatohepatitis?
Absolute Event Rate: 4.9% vs 9.3%
p-value: p=<0.001
In patients with non-alcoholic steatohepatitis, elevated serum GGT and ALT concentrations are associated with impaired flow-mediated dilatation and increased carotid intima-media thickness, suggesting their utility as markers for subclinical endothelial dysfunction.
GGT and ALT may mark endothelial dysfunction in NASH; hypothesis-generating and should not yet change practice.
PURPOSE: Cardiovascular diseases are the leading cause of death in patients with non-alcoholic steatohepatitis (NASH). We aimed to investigate the presence of endothelial dysfunction and whether serum concentrations of liver enzymes may reflect the severity of such an endothelial dysfunction in patients with NASH. METHODS: Fifty patients with NASH diagnosed by liver biopsies and 30 healthy controls were included. Blood samples after fasting were harvested for measurements of glucose, insulin, cholesterol, triglyceride, and liver enzymes. All patients underwent transthoracic echocardiography and brachial and carotid artery Doppler ultrasonography to evaluate flow-mediated dilatation (FMD) and carotid artery intima-media thickness (CIMT). RESULTS: Patients with NASH had impaired FMD (4.9 ± 2.8% to 9.3 ± 4.4%, P < 0.001) and higher CIMT (0.79 ± 0.16 mm to 0.64 ± 0.11 mm, P < 0.001) when compared with healthy controls. Linear regression analyses revealed that serum concentrations of gamma glutamyl transferase (GGT) and alanine transaminase (ALT) were associated with FMD and CIMT. CONCLUSIONS: Patients with NASH have impaired FMD and increased CIMT when compared with healthy controls. In patients with NASH, serum concentrations of GGT and ALT might have a predictive value for FMD and CIMT.
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Arınç et al. (2013) conducted a case-control in Non-alcoholic steatohepatitis (n=80). Non-alcoholic steatohepatitis (NASH) vs. Healthy controls was evaluated on Flow-mediated dilatation (FMD) (p=<0.001). Patients with non-alcoholic steatohepatitis had significantly impaired flow-mediated dilatation (4.9% vs 9.3%) compared to healthy controls, and serum GGT and ALT concentrations were predictive of this dysfunction.
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