Generic placeholder image

Current Diabetes Reviews

Editor-in-Chief

ISSN (Print): 1573-3998
ISSN (Online): 1875-6417

Review Article

Serum Gamma Glutamyl Transferase: Understanding its Contribution as a Potential Predictor of the Occurrence of Type 2 Diabetes

In Press, (this is not the final "Version of Record"). Available online 24 January, 2024
Author(s): Sristi Anupam, Simran Goel, Karun Bhatti, Dinesh Kumar Mehta and Rina Das*
Published on: 24 January, 2024

Article ID: e240124226080

DOI: 10.2174/0115733998260996231122054907

Price: $95

Abstract

Introduction: The liver and kidneys are the primary locations of the glutathione metabolism enzyme gamma-glutamyl transferase (GGT). The two main factors contributing to an increase are hepatic illnesses and excessive alcohol use. This study set out to test a theory on the predictive importance of the association between GGT and Type 2 diabetes mellitus. (T2DM).

Methods: In order to do this, we combed through PubMed, Google Scholar, Medline, and Science Direct for a wide range of information from previous studies. Attributes were established at the outset and compared to GGT concentration.

Result: GGT, present in most cells, absorbs glutathione for intracellular antioxidant defences. This study links GGT to hepatic enzymes including HDL, LDL, and triglyceride. LDL, triglycerides, AST, and ALT increased with GGT concentration, but LDL decreased. Because of obesity, GGT production rises with BMI. We found that greater GGT levels were associated with more T2DM after analysing data from multiple sources.

Conclusion: This literature review concludes that GGT is related to other factors such as BMI, HDL, AST, and triglycerides in the development of diabetes mellitus. Serum GGT was found to be a potential predictor of metabolic syndrome and T2DM.

[1]
Hanigan MH, Ricketts WA. Extracellular glutathione is a source of cysteine for cells that express. gamma.-glutamyl transpeptidase. Biochemistry 1993; 32(24): 6302-6.
[http://dx.doi.org/10.1021/bi00075a026] [PMID: 8099811]
[2]
Tate SS, Meister A. γ-Glutamyl transpeptidase: Catalytic, structural and functional aspects. Mol Cell Biochem 1981; 39(1): 357-68.
[http://dx.doi.org/10.1007/BF00232585] [PMID: 6118826]
[3]
Hanigan MH, Pitot HC. Gamma-glutamyl transpeptidase – its role in hepatocarcinogenesis. Carcinogenesis 1985; 6(2): 165-72.
[http://dx.doi.org/10.1093/carcin/6.2.165] [PMID: 2857599]
[4]
Whitfield JB. Gamma glutamyl transferase. Crit Rev Clin Lab Sci 2001; 38(4): 263-355.
[http://dx.doi.org/10.1080/20014091084227] [PMID: 11563810]
[5]
Finidori J, Laperche Y, Haguenauer-Tsapis R, Barouki R, Guellaen G, Hanoune J. In vitro biosynthesis and membrane insertion of gamma-glutamyl transpeptidase. J Biol Chem 1984; 259(8): 4687-90.
[http://dx.doi.org/10.1016/S0021-9258(17)42898-5] [PMID: 6143750]
[6]
Wickham S, West MB, Cook PF, Hanigan MH. Gamma-glutamyl compounds: Substrate specificity of gamma-glutamyl transpeptidase enzymes. Anal Biochem 2011; 414(2): 208-14.
[http://dx.doi.org/10.1016/j.ab.2011.03.026] [PMID: 21447318]
[7]
Brenner H, Rothenbacher D, Arndt V, Schuberth S, Fraisse E, Fliedner TM. Distribution, determinants, and prognostic value of gamma-glutamyltransferase for all-cause mortality in a cohort of construction workers from southern Germany. Prev Med 1997; 26(3): 305-10.
[http://dx.doi.org/10.1006/pmed.1997.0144] [PMID: 9144754]
[8]
Fischbach F. Manual of Laboratory & Diagnostic Tests. (7th ed.), New York, NY: Lippincott-Raven 2004.
[9]
Pagana KD, Pagana TJ, Pagana TN. Mosby’s Diagnostic & Laboratory Test Reference. (14th ed.), St. Louis, Mo: Elsevier 2019.
[10]
Sah KK, Gupta KK, Mehta DK, Joshi S, Das R. Prescription pattern of type-2 Diabetes management in the geriatric patients. J Young Pharm 2022; 14(4): 416-9.
[http://dx.doi.org/10.5530/jyp.2022.14.84]
[11]
Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol 2018; 14(2): 88-98.
[http://dx.doi.org/10.1038/nrendo.2017.151] [PMID: 29219149]
[12]
Chen L, Magliano DJ, Zimmet PZ. The worldwide epidemiology of type 2 diabetes mellitus: Present and future perspectives. Nat Rev Endocrinol 2011; 8(4): 228-36.
[http://dx.doi.org/10.1038/nrendo.2011.183]
[13]
Genetic basis of type 1 and type 2 diabetes, obesity, and their complications.. Advances and emerging opportunities in diabetes research. a Strategic Planning report of the DMICC
[14]
Chatterjee S, Khunti K, Davies MJ. Type 2 diabetes. Lancet 2017; 389(10085): 2239-51.
[http://dx.doi.org/10.1016/S0140-6736(17)30058-2] [PMID: 28190580]
[15]
Hu FB, Manson JE, Stampfer MJ, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med 2001; 345(11): 790-7.
[http://dx.doi.org/10.1056/NEJMoa010492] [PMID: 11556298]
[16]
Schellenberg ES, Dryden DM, Vandermeer B, Ha C, Korownyk C. Lifestyle interventions for patients with and at risk for type 2 diabetes: a systematic review and meta-analysis. Ann Intern Med 2013; 159(8): 543-51.
[http://dx.doi.org/10.7326/0003-4819-159-8-201310150-00007] [PMID: 24126648]
[17]
Zhou B, Lu Y, Hajifathalian K, et al. Worldwide trends in diabetes since 1980: A pooled analysis of 751 population-based studies with 4·4 million participants. Lancet 2016; 387(10027): 1513-30.
[http://dx.doi.org/10.1016/S0140-6736(16)00618-8] [PMID: 27061677]
[18]
Dhankhar S, Chauhan S, Mehta DK, et al. Novel targets for potential therapeutic use in Diabetes mellitus. Diabetol Metab Syndr 2023; 15(1): 17.
[http://dx.doi.org/10.1186/s13098-023-00983-5] [PMID: 36782201]
[19]
A public service on clinical lab testing from the laboratory professionals who do the testing, Internet description of GGT provided by Lab Tests Online. 2015. Available from: https://labtestsonline.org/understanding/analytes/ggt/tab/test/
[20]
Singh A, Ranjan V, Das R, Bhatti K, Mehta DK, Chidurala RM. Serum biomarkers for noninvasive diagnosis of liver diseases: How laudable are these tools? Curr Chem Biol 2021; 15(2): 128-38.
[http://dx.doi.org/10.2174/2212796814999201111204639]
[21]
Blaha M, Elasy TA. Clinical use of the metabolic syndrome: why the confusion? Clin Diabetes 2006; 24(3): 125-31.
[http://dx.doi.org/10.2337/diaclin.24.3.125]
[22]
Evans JL, Goldfine ID, Maddux BA, Grodsky GM. Are oxidative stress-activated signaling pathways mediators of insulin resistance and beta-cell dysfunction? Diabetes 2003; 52(1): 1-8.
[http://dx.doi.org/10.2337/diabetes.52.1.1] [PMID: 12502486]
[23]
Harrison’s Principles of Internal Medicine. New York: McGraw-Hill, Health Professions Division 1998.
[24]
Islam S, Rahman S, Haque T, Sumon AH, Ahmed AZM, Ali N. Prevalence of elevated liver enzymes and its association with type 2 diabetes: A cross‐sectional study in Bangladeshi adults. Endocrinol Diabetes Metab 2020; 3(2): e00116.
[http://dx.doi.org/10.1002/edm2.116] [PMID: 32318634]
[25]
Sharmin F, Roy MN, Junaed MT. Association of serum gamma glutamyl transferase and uric acid levels with impaired fasting glucose in adults at a tertiary level hospital of bangladesh. Mymensingh Med J 2021; 30(4): 973-9.
[PMID: 34605465]
[26]
Nakanishi N, Nishina K, Li W, Sato M, Suzuki K, Tatara K. Serum γ‐glutamyltransferase and development of impaired fasting glucose or type 2 diabetes in middle‐aged Japanese men. J Intern Med 2003; 254(3): 287-95.
[http://dx.doi.org/10.1046/j.1365-2796.2003.01198.x] [PMID: 12930239]
[27]
Nakanishi N, Suzuki K, Tatara K. Serum γ-glutamyltransferase and risk of metabolic syndrome and type 2 diabetes in middle-aged Japanese men. Diabetes Care 2004; 27(6): 1427-32.
[http://dx.doi.org/10.2337/diacare.27.6.1427] [PMID: 15161799]
[28]
Doi Y, Kubo M, Yonemoto K, et al. Liver enzymes as a predictor for incident diabetes in a Japanese population: The Hisayama study. Obesity (Silver Spring) 2007; 15(7): 1841-50.
[http://dx.doi.org/10.1038/oby.2007.218] [PMID: 17636103]
[29]
Kaneko K, Yatsuya H, Li Y, et al. Association of gamma‐glutamyl transferase and alanine aminotransferase with type 2 diabetes mellitus incidence in middle‐aged Japanese men: 12‐year follow up. J Diabetes Investig 2019; 10(3): 837-45.
[http://dx.doi.org/10.1111/jdi.12930] [PMID: 30204299]
[30]
Miyamori D, Tanaka M, Furuhashi M, et al. Prediction of new onset of diabetes mellitus during a 10-year period by using a combination of levels of alanine aminotransferase and γ-glutamyl transferase. Endocr J 2021; 68(12): 1391-402.
[http://dx.doi.org/10.1507/endocrj.EJ20-0823] [PMID: 34234055]
[31]
Itabashi F, Hirata T, Kogure M, et al. Combined associations of liver enzymes and obesity with diabetes mellitus prevalence: the tohoku medical megabank community-based cohort study. J Epidemiol 2022; 32(5): 221-7.
[http://dx.doi.org/10.2188/jea.JE20200384] [PMID: 33390464]
[32]
Hu H, Han Y, Guan M, Wei L, Wan Q, Hu Y. Elevated gamma‐glutamyl transferase to high‐density lipoprotein cholesterol ratio has a non‐linear association with incident diabetes mellitus: A second analysis of a cohort study. J Diabetes Investig 2022; 13(12): 2027-37.
[http://dx.doi.org/10.1111/jdi.13900] [PMID: 36056709]
[33]
Kim CH, Park JY, Lee KU, Kim JH, Kim HK. Association of serum γ-glutamyltransferase and alanine aminotransferase activities with risk of type 2 diabetes mellitus independent of fatty liver. Diabetes Metab Res Rev 2009; 25(1): 64-9.
[http://dx.doi.org/10.1002/dmrr.890] [PMID: 19065605]
[34]
Ahn HR, Shin MH, Nam HS, et al. The association between liver enzymes and risk of type 2 diabetes: The Namwon study. Diabetol Metab Syndr 2014; 6(1): 14.
[http://dx.doi.org/10.1186/1758-5996-6-14] [PMID: 24502834]
[35]
Lee SH, Kim KM, Kim KN. Combined effect of serum gamma-glutamyltransferase and uric acid on incidence of diabetes mellitus. Medicine 2017; 96(19): e6901.
[http://dx.doi.org/10.1097/MD.0000000000006901] [PMID: 28489802]
[36]
Choi SH, Kim BT, Shin J, Kim KN. Combined effect of serum alanine aminotransferase and gamma-glutamyltransferase on incidence of diabetes mellitus. Medicine 2020; 99(11): e18963.
[http://dx.doi.org/10.1097/MD.0000000000018963] [PMID: 32176028]
[37]
Xu L, Jiang CQ, Schooling CM, Zhang WS, Cheng KK, Lam TH. Liver enzymes and incident diabetes in China: a prospective analysis of 10 764 participants in the Guangzhou Biobank Cohort Study. J Epidemiol Community Health 2015; 69(11): 1040-4.
[http://dx.doi.org/10.1136/jech-2015-205518] [PMID: 26139641]
[38]
Wang YL, Koh WP, Yuan JM, Pan A. Association between liver enzymes and incident type 2 diabetes in Singapore Chinese men and women. BMJ Open Diabetes Res Care 2016; 4(1): e000296.
[http://dx.doi.org/10.1136/bmjdrc-2016-000296] [PMID: 27738514]
[39]
Wang X, Guo B, Yang X, et al. Role of liver enzymes in the relationship between particulate matter exposure and diabetes risk: A longitudinal cohort study. J Clin Endocrinol Metab 2022; 107(10): e4086-97.
[http://dx.doi.org/10.1210/clinem/dgac438] [PMID: 35861878]
[40]
Bi Y, Yang S, Liu Y, et al. To explore association between gamma-glutamyl transferase and type 2 diabetes using a real-world study and mendelian randomization analysis. Front Endocrinol 2022; 13: 899008.
[http://dx.doi.org/10.3389/fendo.2022.899008] [PMID: 35957835]
[41]
Wang Y, Wu T, Zang X, et al. Relationship between serum gamma-glutamyl transferase level and impaired fasting glucose among chinese community-dwelling adults: A follow-up observation of 6 years. Metab Syndr Relat Disord 2021; 19(2): 100-6.
[http://dx.doi.org/10.1089/met.2020.0032] [PMID: 33170087]
[42]
Tohidi M, Harati H, Hadaegh F, Mehrabi Y, Azizi F. Association of liver enzymes with incident type 2 diabetes: A nested case control study in an Iranian population. BMC Endocr Disord 2008; 8(1): 5.
[http://dx.doi.org/10.1186/1472-6823-8-5] [PMID: 18533046]
[43]
Valizadeh N, Mohammadi R, Mehdizadeh A, Motarjemizadeh Q, Khalkhali HR. Evaluation of serum gamma glutamyl transferase levels in diabetic patients with and without retinopathy. Shiraz E Med J 2018; In Press(In Press): e64073.
[http://dx.doi.org/10.5812/semj.64073]
[44]
Gaeini Z, Bahadoran Z, Mirmiran P, Azizi F. The association between liver function tests and some metabolic outcomes: Tehran lipid and glucose study. Hepat Mon 2020; 20(5): e98535.
[http://dx.doi.org/10.5812/hepatmon.98535]
[45]
Noroozi Karimabad M, Khalili P, Ayoobi F, Esmaeili-Nadimi A, La Vecchia C, Jamali Z. Serum liver enzymes and diabetes from the Rafsanjan cohort study. BMC Endocr Disord 2022; 22(1): 127.
[PMID: 35549705]
[46]
Philip R, Mathias M, Kumari SN, Gowda DK, Shetty JK. Evaluation of relationship between markers of liver function and the onset of type 2 diabetes. Nitte Univ J Health Sci 2014; 4(2): 90.
[http://dx.doi.org/10.1055/s-0040-1703770]
[47]
Devi1 KM, Patil2 RK, Mandeep Malhi. Evaluation of serum gamma-glutamyl transferase activity and serum uric acid level in type ii diabetes mellitus patients. Int J Health Sci Res 2021.
[http://dx.doi.org/10.52403/ijhsr.20210929]
[48]
Agarwal H, Jha OP, Meena P. Role of serum γ-glutamyl transpeptidase (ggt) level as a marker for the detection of type-2 diabetes mellitus. Int J Sci Res (IJSR) ISSN: 2319-7064 ResearchGate Impact Factor 2018.
[49]
Aggarwal J, Singh N, Kumar M. Analysis of serumgamma glutamyl transpeptidase (GGT) level as a marker for thedetection of type 2 diabetes mellitus in Okhla industrial area. Int J Clin Biochem Research 2019; 6(3): 336-9.
[http://dx.doi.org/10.18231/j.ijcbr.2019.073]
[50]
Bandara D, Thennakoon S, Dias P, Withanage N. Association of serum gamma glutamyltransferase with diabetes mellitus, random blood sugar and body mass index in selected Sri Lankan subjects. Ceylon Journal of Medical Science 2022; 57(1): 36-42.
[http://dx.doi.org/10.4038/cjms.v57i1.4970]
[51]
Lsb D, Ma H, Ns M. am D, Ma B. Elevated liver enzymes and its association with type two diabetes mellitus: The occurrence in yemeni population. Int J Endocrinol Metab Disord 2021; 7(1)
[http://dx.doi.org/10.16966/2380-548X.175]
[52]
André P, Balkau B, Born C, et al. Hepatic markers and development of type 2 diabetes in middle aged men and women: A three-year follow-up study. Diabetes Metab 2005; 31(6): 542-50.
[http://dx.doi.org/10.1016/S1262-3636(07)70229-X] [PMID: 16357802]
[53]
Forlani G, Di Bonito P, Mannucci E, et al. Prevalence of elevated liver enzymes in type 2 diabetes mellitus and its association with the metabolic syndrome. J Endocrinol Invest 2008; 31(2): 146-52.
[http://dx.doi.org/10.1007/BF03345581] [PMID: 18362506]
[54]
Abbasi A, Bakker SJL, Corpeleijn E, et al. Liver function tests and risk prediction of incident type 2 diabetes: Evaluation in two independent cohorts. PLoS One 2012; 7(12): e51496.
[http://dx.doi.org/10.1371/journal.pone.0051496] [PMID: 23284703]
[55]
Nannipieri M, Gonzales C, Baldi S, et al. Liver enzymes, the metabolic syndrome, and incident diabetes: The Mexico City diabetes study. Diabetes Care 2005; 28(7): 1757-62.
[http://dx.doi.org/10.2337/diacare.28.7.1757] [PMID: 15983331]
[56]
Belkacemi L, Belalia M. Cross-sectional pilot study about the liver enzymes profile in type 2 diabetic patients from an Algerian west region: Wilaya of Mostaganem. Diabetes Metab Syndr 2016; 10(1) (Suppl. 1): S147-50.
[http://dx.doi.org/10.1016/j.dsx.2015.10.013] [PMID: 26711007]

Rights & Permissions Print Cite
© 2025 Bentham Science Publishers | Privacy Policy