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Liver Enzymes- Biomarkers of Alcohol Intake. By Husham Syed -Mohammed Richard Grucza, Andrew Plunk, Laura Bierut, Pamela Hipp. Liver Enzymes. GGT is a glycoprotein enzyme involved in counteracting oxidative stress Increase in serum levels with repeated excessive alcohol consumption
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Liver Enzymes- Biomarkers of Alcohol Intake By Husham Syed-Mohammed Richard Grucza, Andrew Plunk, Laura Bierut, Pamela Hipp
Liver Enzymes • GGT is a glycoprotein enzyme involved in counteracting oxidative stress • Increase in serum levels with repeated excessive alcohol consumption • Asparate and AlanineAminotransferase are liver enzymes involved in amino acid metabolism. • Used clinically as indicators of liver cell injury • Commonly tested in clinical settings in liver panel tests
GGT Morbidity and Mortality • Studies have linked high GGT levels in risk prediction of type 2 diabetes, cardiovascular events, chronic kidney disease, and cancer • Numerous studies have associated GGT with all-cause mortality independent of alcohol use
Significance EtOH GGT GGT Mortality ? EtOH GGT Mortality
Research • Is GGT a more sensitive indicator of alcohol drinking patterns than ALT or AST? • Do drinking patterns impact GGT levels over and above total alcohol intake? • How are alcohol drinking behaviors associated with all-cause mortality? • How does GGT influence mortality at different levels of drinking?
NHANES • National Health and Nutritional Examination Survey • Designed to assess the health and nutritional status of adults and children in the United States • Began in early 1960’s and data is still being currently collected • Combines interviews, physical examinations, and lab tests
Demographics • N=16,811 • Data from five administrations of NHANES (1999-2008) • All past-year drinkers 21 years and older • Drinkers were described as those having at least 12 drinks in the past year • Whites, Hispanics, and Blacks
GGT, AST, ALT Association with Drinking Behaviors • Compared the association of binge-drinking and non binge-drinking behaviors with GGT, AST, and ALT serum levels • Binge-drinking was described as having five or more drinks per drinking episode • “Moderate-drinking” was described as having four or less drinks per drinking episode
Association of GGT with Binge-Drinking Behaviors • Compared association of serum GGT levels with different drinking patterns in different categories of total alcohol consumption • This was to test our hypothesis if drinking patterns impact GGT levels over and above total alcohol intake?
Mortality Study • N=6,834 • Used the same inclusion criteria as previous study • Survival Analysis: Mortality predicted from alcohol drinking patterns • Survival Analysis: Mortality predicted from GGT serum levels in different binge-drinking categories
Conclusions • GGT serum levels are the most sensitive liver enzyme associated with alcohol consumption • Both the amount of drinking and the pattern of drinking effects GGT levels • Binge-drinking behaviors strongly predict mortality, while moderate-drinking behaviors do not seem to have an effect • The association between GGT and mortality may be stronger in heavier drinkers
Thank You • Thank you everyone who helped with the research this summer: • ARTSS Internship program • Richard Grucza • Pamela Hipp • Andrew Plunk • Laura Bierut