Assessment of Serum -glutamyl Transferase and High Sensitivity C-reactive Protein and Insulin Levels in Metabolic Syndrome Patients: A Cross-sectional Observational Study

Abstract

Aim: Evaluation of serum γ-glutamyl transferase and its association with high sensitivity C -
reactive protein and insulin levels in the patients with metabolic syndrome.
Material and methods: This cross sectional observational study was carried out in the
Department of Medicine Nalanda Medical College and Hospital, Patna, Bihar, India for 1 year.
5 ml of blood was collected from median cubital vein. The collected blood was allowed to clot
for 30 minutes in a clean dry test tube and was subjected to centrifugation to separate the serum.
The serum samples were stored in a Deep freezer at -800C till they were studied.
Results: The mean±SD of the cases and controls were 51.4±9. 7 years old and 50.2±9 years
old respectively, which suggested that metabolic syndrome was prevalent in late middle ages.
Waist circumference (WC) and body mass index (BMI) are the two important anthropometric
measurements among the various definitions of metabolic syndrome. The study proved the
mean±SD for WC in that case as 104±9.5 cm and in the controls as 82.5±10.3 cm. And the
mean BMI in that case was 29.58±3.96 kg/m2 and in the controls – 23.14±2.52 kg/m2. Both
these parameters were significantly higher in the cases with p≤0.001.The biochemical
characteristics of the study population are presented in Table 2. The mean concentration of
fasting blood glucose in the controls was 4.1±0.93 mmol/L; in that case it was 6.5±2.1 mmol/L,
which was significantly increased in the subjects with MS. Increased triacylglycerol’s and
decreased HDL-cholesterol were potential markers of CVD In this study, mean Triglycerides
in metabolic syndrome cases was 1.86±0.96 mmol/L and in the controls, it was 1.41±0.8
mmol/L, which was significantly higher. HDL-cholesterol levels in cases were found to be
0.73±0.2mmol/L and 0.96±0.3mmol/L in the controls. The lower HDL- cholesterol levels in
that case was found to be significant with p<0.005. The mean±SD of γGT in that case was
60.96±45.64 U/L and in the controls 29.78±18.01U/L with a P value <0.001**. The mean±SD  of serum insulin in that case was 29.34±26.94 μIU/ml and in the controls 11.97±5.98 μIU/ml
with P value ≤0.01**. The mean±SD of hs-CRP in that case was 76.2±47.6 mmol/L and in the
controls 27.6± 11.4 mmol/L with P value ≤0.001**. The mean±SD of HOMA- IR in that case
was 9.44±4.39 and in the controls 2.32±1.48 with P value ≤0.001**.
Conclusion: This study suggests that increased gamma-glutamyl transferase activity could be
considered as harbinger of low-grade systematic inflammation and oxidative stress through
mediation of glutathione transport.