ナカイ　ヨウスケ   NAKAI Yousuke
  中井　陽介
   所属   医学部 医学科（東京女子医科大学病院）
   職種   教授・基幹分野長
Article types Original article
Language English
Peer review Non peer reviewed
Title Importance of gamma-glutamyl transferase elevation in patients with Fontan-associated liver disease
Journal Formal name：Hepatology research
Abbreviation：Hepatol Res
ISSN code：13866346/13866346
Domestic / ForeginDomestic
Volume, Issue, Page 54(12),pp.1205-1214
Author and coauthor KOGISO Tomomi†, OGASAWARA Yuri, TANIAI Makiko, SHIMADA Eriko, INAI Kei, TOKUSHIGE Katsutoshi, NAKAI Yosuke
Authorship Last author
Publication date 2024/12
Summary AIM:In patients with Fontan-associated liver disease (FALD), gamma-glutamyl transferase (GGT) levels are often elevated, however, its clinical importance is unclear. We investigated the relationship between the clinical course of FALD and GGT levels.METHODS:We enrolled 145 patients with FALD who underwent right-heart catheterization (RHC) and visited our department. Ursodeoxycholic acid (UDCA) was administered to 62 of the patients. Patients with GGT levels <50 and ≥50 U/L were compared. Follow-up RHC was undertaken in 76 patients. Cases in which GGT levels decreased by ≥10% or <50 U/L were defined as improved (n = 33).RESULTS:Patients with GGT levels ≥50 U/L had significantly lower levels of albumin and higher levels of alanine transaminase (ALT) but no significant differences in RHC factors. Over a 4.6-year period, 43.4% showed improvement in GGT levels. Improved cases had significantly lower total bilirubin (1.1 vs. 1.6 mg/dL), AST (22 vs. 28 U/L), and ALT (18 vs. 27 U/L) levels than nonimproved cases (n = 29, p < 0.05), and the change in platelet count (-0.5 vs. -3.0 × 10-4/μL) was significantly lower in the latter (p = 0.03). The improvement rate was significantly higher in UDCA-treated cases (55.2%) with GGT levels ≥50 U/L compared to cases not treated with UDCA (18.2%, p = 0.04).CONCLUSION:In cases of FALD with no improvement in GGT level, the platelet count decreased over time, suggesting progression of fibrosis. Physicians should be aware of the importance of a high GGT level in patients with FALD.
DOI 10.1111/hepr.14093
PMID 38985389