Rathor Eeshaan, Arasada Chinmayee, Kulkarni Ashwin, Shaikh Mohammed Aslam
Internal Medicine, Ramaiah Medical College, Bengaluru, IND.
Cureus. 2024 Jul 25;16(7):e65336. doi: 10.7759/cureus.65336. eCollection 2024 Jul.
Background Gamma-glutamyl transferase (GGT) mediates intracellular uptake of glutathione which is a known antioxidant. GGT levels are found to be elevated in conditions of oxidative stress. Ischemic stroke results in anoxic injury, which liberates free radicals, causing glutathione to rise, which may be accompanied by a rise in serum GGT levels. This study aimed to compare serum GGT levels in acute ischemic stroke patients with normal controls and to ascertain the relation of serum GGT levels with National Institute of Health Stroke Scale (NIHSS) scores. Materials and methods This cross-sectional study was carried out in a tertiary care hospital in South India from August 2023 to February 2024. The study included 57 patients who presented with acute ischemic stroke within 24 hours of onset and 57 age- and sex-matched controls. The serum GGT levels of the cases were compared with age- and sex-matched controls using an independent t-test. Mean serum GGT levels were compared among groups with varying NIHSS scores and different locations of infarction using the ANOVA test. Serum GGT levels were also compared based on age, gender, and various comorbidities. Results The mean serum GGT levels were significantly increased (p < 0.0001) in acute ischemic stroke patients, 43.96 ± 28.02 (mean ± SD), when compared to controls, 26.14 ± 5.93 (mean ± SD). The difference in serum GGT levels with NIHSS scores of 5-15 (moderate strokes) with 34.17 ± 18.39 (mean ± SD), 16-20 (moderate-severe strokes) with 46.64 ± 21.95 (mean ± SD), and >21 (severe stroke) with 84.62 ± 39.35 (mean ± SD) was significant (p < 0.00001). Serum GGT levels were not significant while comparing age, gender, location of infarction, type 2 diabetes mellitus, and hypertension. Conclusion Serum GGT levels were significantly elevated in acute ischemic stroke patients within 24 hours of presentation. Serum GGT levels were significantly elevated with increasing severity of stroke as calculated by NIHSS scores at the time of presentation. Serum GGT levels are a potential marker of ischemic stroke and its severity.
γ-谷氨酰转移酶（GGT）介导细胞内谷胱甘肽的摄取，而谷胱甘肽是一种已知的抗氧化剂。在氧化应激条件下，GGT水平会升高。缺血性中风会导致缺氧损伤，释放自由基，使谷胱甘肽升高，这可能伴随着血清GGT水平的升高。本研究旨在比较急性缺血性中风患者与正常对照组的血清GGT水平，并确定血清GGT水平与美国国立卫生研究院卒中量表（NIHSS）评分的关系。
本横断面研究于2023年8月至2024年2月在印度南部的一家三级护理医院进行。该研究纳入了57例发病24小时内出现急性缺血性中风的患者以及57例年龄和性别匹配的对照组。使用独立t检验比较病例组与年龄和性别匹配的对照组的血清GGT水平。使用方差分析（ANOVA）检验比较不同NIHSS评分组和不同梗死部位组的平均血清GGT水平。还根据年龄、性别和各种合并症比较血清GGT水平。
与对照组（26.14±5.93，均值±标准差）相比，急性缺血性中风患者的平均血清GGT水平显著升高（p<0.0001），为43.96±28.02（均值±标准差）。NIHSS评分为5 - 15（中度中风）时血清GGT水平为34.17±18.39（均值±标准差）、16 - 20（中重度中风）时为46.64±21.95（均值±标准差）、>21（重度中风）时为84.62±39.35（均值±标准差），差异有统计学意义（p<0.00001）。在比较年龄、性别、梗死部位、2型糖尿病和高血压时，血清GGT水平无显著差异。
急性缺血性中风患者在发病24小时内血清GGT水平显著升高。根据发病时NIHSS评分计算，中风严重程度增加时血清GGT水平显著升高。血清GGT水平是缺血性中风及其严重程度的潜在标志物。
