Published online Dec 28, 2016. doi: 10.4254/wjh.v8.i36.1610
Peer-review started: June 23, 2016
First decision: August 10, 2016
Revised: September 13, 2016
Accepted: November 1, 2016
Article in press: November 2, 2016
Published online: December 28, 2016
To assess how serum gamma-glutamyltransferase (GGT) fractions vary in patients with alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD).
Serum samples were obtained from 14 patients with biopsy-proven alcoholic liver diseases and 9 patients with biopsy proven non-alcoholic fatty liver disease. In addition to these biopsy-proven cases, 16 obese (body mass index > 25) patients without any history of alcohol consumption but with a fatty liver on ultrasound examination and with elevated GGT were included for an additional analysis. Serum GGT fractionation was conducted by high-performance gel filtration liquid chromatography and was separated into the four fractions, big-GGT, medium-GGT, small-GGT (s-GGT), and free-GGT (f-GGT).
The results were expressed as a ratio of each fraction including the total GGT (t-GGT). The s-GGT/t-GGT ratios were lowest for the control group and highest for the ALD group. The differences between the control and NAFLD groups and also between the NAFLD and ALD groups were statistically significant. In contrast, the f-GGT/t-GGT ratios were highest in the control group and lowest in the ALD group, with the differences being statistically significant. As a result, the s-GGT/f-GGT ratios were markedly increased in the NAFLD group as compared with the control group. The increase of the s-GGT/t-GGT ratios, the decrease of the f-GGT/t-GGT ratios, and the increase of s-GGT/F-GGT ratios as compared with the control group subjects were also found in obese patients with clinically diagnosed fatty change of the liver.
Serum GGT fractionation by high-performance gel filtration liquid chromatography is potentially useful for the differential diagnosis of ALD and NAFLD.
Core tip: The aim of this study was to assess whether fractionation of serum gamma-glutamyltransferase (GGT) into four fractions by high-performance gel filtration chromatography is useful for the differential diagnosis of alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD). In patients with ALD, small-GGT (s-GGT)/total GGT (t-GGT) ratios were significantly higher and free-GGT (f-GGT)/t-GGT ratios were lower than in those in NAFLD. Consequently, there were marked differences in the s-GGT/f-GGT ratio between ALD and NAFLD. These preliminary results indicate that a large-scale study to clarify the diagnostic values of serum GGT fractionation in the differential diagnosis of ALD and NAFLD is warranted.