A STUDY OF GAMMA GLUTAMYL TRANSFERASE AS A DIAGNOSTIC MARKER IN METABOLIC SYNDROME.

Dr. Harini G.L. and Dr. Raveendra K.R. MD

ABSTRACT

Introduction: Metabolic syndrome or syndrome X is a cluster of risk factors (diabetes, prediabetes, abdominal obesity, hypertension and dyslipidemias) for the development of cardiovascular disease. The prevalence of Metabolic Syndrome worldwide is 20-25%. Although GGT is a less specific marker of liver function, higher GGT levels have also been linked with obesity, physical inactivity, hypertension, dyslipidemias, and hyperinsulinemia, implying that elevated GGT belongs in the cluster of the metabolic syndrome. And it has been shown that risk for the individual metabolic syndrome components increased as the baseline GGT levels increased. It has been clearly demonstrated that serum GGT levels elevated even within normal range are associated with some atherosclerotic risk factors. Although the exact mechanism responsible for this association is unknown, several possible mechanisms have been proposed for the role of serum GGT in increasing cardiovascular risk. The most widely accepted mechanism is oxidative stress, followed by hepatic insulin resistance and subclinical inflammation.Raised liver enzymes, as relatively sensitive and easily obtained markers of non alcoholic fatty liver disease, reflect chronic ectopic fat deposition in the liver that may be useful in diagnosis of metabolic syndrome. High liver function tests, especially GGT levels, are associated with prevalent metabolic syndrome and in this aspect they may have a predictive value in diagnosis of metabolic syndrome. Objectives 1. To study the association of gamma glutamyl Transferase with metabolic syndrome. 2. To assess the sensitivity and specificity of GGT in the diagnosis of metabolic syndrome. Methods: In a cross sectional study of 100 subjects, 50 were taken as cases and 50 as controls, after fulfilling necessary inclusion and exclusion criteria and relevant investigations were done including estimation of gamma glutamyl transferase in all.Results A total of 100 subjects were chosen in the study with 50 as study population and the other 50 as controls, investigations were done as mentioned and their gamma glutamyl transferase levels were assessed.The estimated GGT values were high in 35(70%) of cases showing moderate elevation and7(14%) cases showing severe elevation. The mean GGT among the cases is 48.18±14.68 and that among controls is 30.96±10.06 with a very significant p value of <0.001.The sensitivity and specificity of gamma glutamyl transferase in diagnosis of metabolic syndrome was found to be 92% and 88% respectively. Conclusion: Elevated levels of GGT were found to be associated with metabolic syndrome. GGT was found to be more specific than the other liver enzymes which are also raised in metabolic syndrome. Sensitivity of 92% and specificity of 88% makes gamma glutamyl transferase a good marker for diagnosis of metabolic syndrome.

Keywords: metabolic syndrome, gamma glutamyl transferase.