Serum
a-Glutathione
S-Transferase as a Sensitive Marker of Hepatocellular Damage in
Patients with Cystic Fibrosis
K. ŠÍDLOVÁ1,2,
V. SKALICKÁ1, K. KOTAŠKA2, M. PECHOVÁ2,
M. CHADA2, J. BARTOŠOVÁ3, Z. HŘÍBAL4,
J. NEVORAL1, V. VÁVROVÁ3, R. PRŮŠA2
1First Department of Pediatrics, 2Department
of Clinical Biochemistry and Pathobiochemistry, 3Second
Department of Pediatrics, 4Department of
Radiodiagnostics, Charles University, Second Faculty of
Medicine and Faculty Hospital Motol, Prague, Czech
Republic
Received
March 18, 2002
Accepted July 23, 2002
Summary
The aim of the
study was to evaluate serum
a-glutathione
S-transferase (s-GSTA) levels in patients with cystic fibrosis (CF)
and to compare s-GSTA with other liver function tests and with a
hepatic ultrasound scan (US). The cytosolic enzyme,
a-glutathione
S-transferase is predominantly found in the liver and is
distributed uniformly in the liver tissue. In our study s-GSTA
levels were measured in 37 CF patients aged 1 to 28 years (mean
age 10.4 years, 24 males). The control group consisted of 27
patients aged 2 to 17 years (mean age 8.5 years, 18 males). The
presence of hepatobiliary abnormalities was assessed by clinical
examination, ultrasound scan, s-GSTA, and conventional liver
enzymes: alanine aminotransferase (ALT), alkaline phosphatase
(ALP), aspartate aminotransferase (AST) and
g-glutamyl
transferase (GMT). The calculated 5-95 % range of s-GSTA
for the control group was 0.098-2.54
mg/l,
for the CF group 0.43-9.76
mg/l.
Mean s-GSTA level in the control group was 1.55
mg/l
(S.D.=1.57), and 2.05 mg/l
(S.D.=2.60) in the CF group. In the group of CF patients, the
serum levels were significantly higher than in the control group
(P<0.01). No significant correlation existed in the CF group
between s-GSTA and conventional liver tests (ALT, AST, ALP and
GMT). Four patients in the CF group had hepatobiliary
abnormalities detectable by conventional liver tests, s-GSTA and
US. Four patients had abnormal s-GSTA, while conventional liver
tests and US were normal. One other patient had abnormal hepatic
US, but normal standard liver tests and s-GSTA. The study has
suggested that a raised s-GSTA level might be a marker of
possible pathological changes of the hepatobiliar system
in CF patients. Serum GSTA seems to be a more sensitive
marker than transaminases for the monitoring of hepatocellular
integrity and as an early predictor of hepatic damage.
Key
words
Cystic
fibrosis-related liver disease
·
Liver tests ·
a-glutathione
S-transferase
Reprint
requests
MUDr. Kateřina Šídlová, First Department of Pediatrics, Faculty
Hospital Motol, V úvalu 84, 150 06 Prague 5 - Motol,
Czech Republic, e-mail:
katerina.sidlova@email.cz
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