Serum glutamyl transpeptidase (GGT) is found in kidney, pancreas, liver, intestine, brain, lung, skeletal muscle and myocardium, and in the liver mainly in the hepatocyte plasma and intrahepatic bile duct epithelium.GGT is of clinical value in various hepatobiliary diseases. Its activity is elevated in most hepatobiliary diseases, but the relative proportion of elevation to other serum enzyme activities varies in different hepatobiliary diseases.
Reference value: 4-38u/L
Clinical significance.
Physiological alterations
1, 20-30 years old overload male elevated about 60%. 50-60 years old male and female elevated about 30%. Chronic alcoholism is about 20%-400% higher. 4-10 years old children are about 10% lower.
2, the influence of drugs: taking streptomycin, barbiturates, luminal, anti-epileptic drugs can cause GGT elevation.
3.In recent years, it is found that there are cases of increased GGT without the influence of any drugs or diseases, which may be caused by the increase of liver burden due to excessive consumption of high protein supplements, etc.
Pathological changes
1.In patients with primary or metastatic hepatocellular carcinoma, most of the enzymes are moderately or highly increased, which may be several times or even tens of times greater than normal, while most of the tumors in other systems are normal.
2.When intrahepatic or extrahepatic bile duct obstruction occurs, GGT excretion is obstructed and flow back into blood with bile, resulting in an increase in serum GGT.
3.In acute viral hepatitis, the enzyme synthesis of the hepatocytes adjacent to the necrotic area is hyperactive, causing an increase in serum GGT.
4.In chronic active hepatitis, GGT is often 1-2 times higher than normal, and if it is elevated for a long time, there may be a tendency of necrosis.
5.Serum GGT changes in cirrhosis depend on the activity of intrahepatic lesions and their degree.
6.GGT is also often elevated in patients with fatty liver, but in general, most of the serum GGT activity in nutritional fatty liver does not exceed 2 times the normal value.
7.Alcoholic hepatitis and alcoholic cirrhosis patients almost all have elevated GGT, which becomes an important feature of alcoholic liver disease.
8.Acute myocardial infarction, hyperlipidemia, diabetes mellitus, rheumatoid arthritis, infectious mononucleosis, etc. may also have increased serum GGT.
Clinical significance of reference values
1.200u/L or more Usually liver and biliary disease
2.50U/L or more Biological variation including pharmacological causes should be investigated.
3. Below 25U/L Both pathological and biological variants can be excluded.