Relationship Between Serum GGT Levels and Liver Fibrosis in Chronic Hepatitis B Patients

Yıl 2010, Cilt: 15 Sayı: 2, 74 - 78, 01.04.2010

Cem Aygün Nevzat Gözel Ulvi Demirel Mehmet Yalnız İbrahim Hanifi Özercan İbrahim Halil Bahcecioğlu

Öz

Objective: The aim of this study was to evaluate the relationship between serum GGT levels and liver fibrosis among patients with chronic hepatitis B in Fırat University Medical School. Materials and Methods: In Gastroenterology Clinics of Fırat University Medical School, data regarding 140 chronic hepatitis B patients and laboratory results were analysed retrospectively. All patients had undergone liver biopsies and according to histopathological stages of fibrosis (Knodell's classification), they were classified as mild (stage 0-2) and severe (stage 3-4) fibrosis groups. The groups were compared to each other in terms of serum GGT levels. Results: When compared to severe fibrosis group, mild fibrosis group had no statistical difference in terms of serum fasting glucose, bilirubin, ALP, T.protein, PT, Hb, HBsAg titer and HBV DNA levels. On the other hand there were statistically significant differences between groups in terms of age, AST, ALT, platelets and albumin levels. Mild fibrosis group had a mean GGT level of 39.33±26.01 while severe fibrosis group had a mean GGT level of 66.19±67.69. The difference between groups in terms of GGT levels was significant (p=0.002). Conclusion: In chronic hepatitis B patients high serum GGT levels seem to be related to higher stages of fibrosis in liver biopsies. Elevetad GGT level in our patients is in parallel to older age, high ALT and AST, low platelets and albumin. GGT may be a non invasive marker of fibrosis in chronic hepatitis B patients.

Anahtar Kelimeler

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Kronik Viral Hepatit B Tanısı Olan Hastalarda Serum GGT Düzeyi İle Karaciğer Fibrozu İlişkisi

Öz

Amaç: Bu çalışmada Fırat Üniversitesi Tıp Fakültesi Gastroenteroloji Kliniği'nde takip edilmekte olan kronik hepatit B tanılı hastalarda serum GGT düzeyinin karaciğer biyopsisi sonucunda ortaya konulan fibrozis skoru ile olan ilişkisini değerlendirmek amaçlanmıştır. Gereç ve Yöntemler: Fırat Üniversitesi Tıp Fakültesi Gastroenteroloji Kliniği'nde 2006-2009 yılları arasında kronik viral hepatit B tanısı ile takip edilen ve karaciğer biyopsisi yapılan 140 hasta retrospektif olarak değerlendirildi. Tüm hastaların hepatit belirteçleri, HBV DNA düzeyi, tam kan sayımı, biyokimya tetkikleri, serum GGT düzeyleri gözden geçirildi. Karaciğer histolopatolojisine (Knodell sınıflaması ile) göre hastalar düşük (evre 0-2) ve yüksek (evre 3-4) fibrozis grubu olarak ikiye ayrıldı. Gruplar kendi aralarında serum GGT düzeyleri temel alınarak karşılaştırıldı. Bulgular: Düşük fibrozis skoru olan hasta grubu ile yüksek fibrozis skoru olan hasta grubu arasında AKŞ, T.Bil, ALP, Tprot, PTZ, Hb, HbsAg titresi, HBV DNA düzeyleri açısından istatistiksel olarak anlamlı fark saptanmadı. Bununla birlikte iki grup arasında yaş, AST, ALT, plt, alb düzeyleri açısında istatistiksel olarak anlamlı farklar görüldü. Düşük fibrozis skoru olan hasta grubunun ortalama serum GGT düzeyi 39.33±26.01 iken yüksek fibrozis skoru olan hasta grubunun ortalama serum GGT düzeyi 66.19±67.69 idi, aradaki fark istatistiksel olarak anlamlı bulundu (p=0.002). Sonuç: Kronik hepatit B hastalarımızda serum GGT düzeyinin artması ilerlemiş yaş, yüksek AST, yüksek ALT, düşük alb düzeyi ve yüksek fibrozis ile birliktelik göstermektedir. Kronik viral hepatit B tanısı olan hastalarda yüksek serum GGT düzeyi ileri evre fibrozisin bir göstergesi olabilir.

Anahtar Kelimeler

Kronik hepatit B, GGT, karaciğer fibrozu

Kaynakça

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