scholarly journals Termination of Repeat Testing in Chemical Laboratories Based on Practice Guidelines: Examining the Effect of Rule-Based Repeat Testing in a Transplantation Center

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Neda Soleimani ◽  
Amir Azadi ◽  
Mohammad Javad Esmaeili ◽  
Fatemeh Ghodsi ◽  
Reza Ghahramani ◽  
...  
Keyword(s):  
Binding Capacity ◽  
Density Lipoprotein ◽  
Turnaround Time ◽  
Gamma Glutamyl Transferase ◽  
Repeated Testing ◽  
Subjective Test ◽  
Cross Sectional ◽  
Rule Based ◽  
Repeat Testing ◽  
Glutamyl Transferase

Background. Although the automation of instruments has reduced the variability of results and errors of analysis, in some laboratories, repeating a test to confirm its accuracy is still performed for critical and noncritical results. However, the importance of repeat testing is not well established yet, and there are no clear criteria for repeating a test. Materials and Methods. In this cross-sectional study, all repeated tests for 26 biochemical analytes (i.e., albumin, alkaline phosphatase (ALP), alanine aminotransferase (ALT), amylase, aspartate aminotransferase (AST), bilirubin total (BT), bilirubin direct (BD), blood urea nitrogen (BUN), calcium, chloride (Cl), cholesterol total (CholT), creatine kinase (CK), creatinine (Cr), glucose, gamma-glutamyl transferase (GGT), high-density lipoprotein-cholesterol (HDL-c), iron, lactate dehydrogenase (LDH), LDL-c, lipase, magnesium (Mg), phosphorus (Ph), protein total (ProtT), total iron binding capacity (TIBC), triglyceride (TG), and uric acid) were assessed in both critical and noncritical ranges over two consecutive months (routine subjective test repeats in the first month and rule-based repeats in the second month). To determine the usefulness of test repeats, differences between the initial and verified results were compared with the allowable bias, and repeat testing was considered necessary if it exceeded the allowable bias range. All causes of repeat testing, including linearity flags, delta checks, clinically significant values, and critical values, were also documented. All data, including the cause of repeats, initial and verified results, time, and costs in the two consecutive months, were transferred to Microsoft Excel for analysis. For comparison of data between the months, Student’s t-test was used. Results. A total of 7714 repeat tests were performed over two consecutive months. Although a significant decline (38%) was found in repeated tests in the second month ( P  < 0.001), there was no significant change in the percentage of unnecessary repeats (77% in the first month and 74% in the second month). In both consecutive months, AST and ALT were the most commonly repeated tests, and delta check was the most common cause of repeat testing. Mg, ALP, AST, and lipase showed the highest rates of necessary repeats, respectively (the least stable tests), while albumin, LDL, and CholT tests showed the highest rates of unnecessary repeats, respectively (the most stable tests). The total cost and delay in turnaround time (TAT) due to repeated testing decreased by 32% and 36%, respectively. Conclusion. Although repeat testing has been shown to be unnecessary in most cases, having a strict policy for repeat testing appears to be more valuable than avoiding it completely. Each laboratory is advised to establish its own protocol for repeat testing based on its own practice.

scholarly journals METABOLIC SYNDROME

2015 ◽  
Vol 22 (04) ◽  
pp. 414-419
Author(s):  
Tariq Zaffar Shaikh ◽  
Hamid Nawaz Ali Memon ◽  
Nisar Ahmed Shah ◽  
Syed Zulfiquar Ali Shah ◽  
Irfan Murtaza Shahwani
Keyword(s):  
Metabolic Syndrome ◽  
Density Lipoprotein ◽  
Gamma Glutamyl Transferase ◽  
Cross Sectional ◽  
Female Population ◽  
Gamma Glutamyltransferase ◽  
Gamma Glutamyl ◽  
The Mean ◽  
One Year ◽  
Glutamyl Transferase

Objective: To determine the role of gamma glutamyltransferase as a biochemicalmarker for the diagnosis of metabolic syndrome. Study Design: Cross sectional descriptivestudy. Period: One year. Setting: Department of Medicine, Liaquat University HospitalHyderabad / Jamshoro. Methods: All the patients with metabolic syndrome visited at OPD /admitted in the ward were further evaluated for serum gamma-glutamyltransferase level. Thedata was analyzed in SPSS 16 and the frequency and percentage was calculated. Results:During one year study period, total one hundred patients (23 males and 77 were females) withmetabolic syndrome were recruited and study for gamma glutamyl transferase level. The meanage ±SD for overall population was 56.84±6.52 whereas it was 48.92±5.82 and 58.61±7.73in male and female population respectively. The mean ± SD of systolic and diastolic bloodpressure (mmHg), triglycerides (mg/dl), high density lipoprotein pressure (mg/dl) and fastingblood sugar (mg/dl) in overall population was 161.20 ± 16.74 and 95.60 ± 8.34, 176.38 ±11.93, 29.44 ± 2.90 and 108.42± 6.25. The mean gamma glutamyl transferase level in overallpopulation was 86.75±7.74 while it was 84.83±5.32 and 89.52±6.84 in male and femalepopulation respectively. The gamma-glutamyltransferase was raised in 75 patients of which13 were males and 62 were females (p=0.02) and majority of patients were 50-59 year agegroup (p <0.01). Conclusions: It is concluded that GGT is a good diagnostic tool in metabolicsyndrome with statistical significant results.

scholarly journals Association of Two Indices of Insulin Resistance Marker with Abnormal Liver Function Tests: A Cross-Sectional Population Study in Taiwanese Adults

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 4
Author(s):  
Adi Lukas Kurniawan ◽  
Chien-Yeh Hsu ◽  
Jane C.-J. Chao ◽  
Rathi Paramastri ◽  
Hsiu-An Lee ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Liver Function ◽  
Early Stage ◽  
Abnormal Liver Function ◽  
Low Grade ◽  
Positive Trend ◽  
Gamma Glutamyl Transferase ◽  
Cross Sectional ◽  
Tyg Index ◽  
Glutamyl Transferase

Background and objectives: Insulin resistance (IR) is frequently associated with chronic low-grade inflammation and has an important role as a mediator in the development of liver disease. Thus, this study aimed to explore the relationship between two indexes of IR and abnormal liver function parameters. Materials and Methods: This cross-sectional study obtained data of 41,510 men and 92,357 women aged ≥30 years from a private health screening institute in Taiwan. Two IR indexes namely triglyceride-glucose (TyG) index and triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio were used to examine their relationship to predict abnormal liver function parameters (aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP)). Results: Positive trend was shown for the association of TyG index in the highest quintile (Q5) and risk of high AST (OR = 1.45, 95% CI: 1.33–1.57), high ALT (OR = 1.85, 95% CI: 1.73–1.97), high GGT (OR = 2.04, 95% CI: 1.93–2.15), and high ALP (OR = 1.13, 95% CI: 1.07–1.19) compared with the median quintile (Q3) in the fully adjusted model. Similarly, participants in the Q5 of the TG/HDL-C ratio were associated with 1.38 (95% CI: 1.27–1.49), 1.71 (95% CI: 1.61–1.82), 1.75 (95% CI: 1.66–1.84), and 1.21 (1.16–1.27) odds for having high AST, ALT, GGT, and ALP respectively. The AUC (95% CI) value of the TyG index for predicting high AST, high ALT, and high GGT was 0.699 (0.692–0.705), 0.738 (0.734–0.742), and 0.752 (0.749–0.755), respectively. Meanwhile, the AUC (95% CI) of the TG/HDL-C ratio for predicting high AST, high ALT, and high GGT was 0.680 (0.673–0.686), 0.738 (0.734–0.742), 0.734 (0.731–0.738), respectively. Conclusions: Our study supported that the TyG index and TG/HDL-C ratio may be useful as non-invasive methods to predict the existence of impaired liver function in the early stage.

STUDY ON EVALUATION OF SERUM GAMMA-GLUTAMYL TRANSFERASE (GGT) LEVELS IN ACUTE CORONARY SYNDROME

2021 ◽  
pp. 39-40
Author(s):  
Avtar Singh Dhanju ◽  
Deepshikha Singla ◽  
Pashaura Singh ◽  
Ajay Chhabra ◽  
Sukhraj Kaur
Keyword(s):  
Acute Coronary Syndrome ◽  
Cross Sectional Study ◽  
Gamma Glutamyl Transferase ◽  
Cross Sectional ◽  
Gamma Glutamyl ◽  
Coronary Syndrome ◽  
Healthy Control ◽  
Group A ◽  
Group B ◽  
Glutamyl Transferase

Aim: The present study was undertaken with the aim to evaluate serum Gamma Glutamyl Transferase (GGT) levels in patients of acute coronary syndrome. Methodology: This cross-sectional study was conducted on 50 cases with acute coronary syndrome (Group A) and 50 healthy control subjects (Group B) meeting inclusion and exclusion criteria. Results: There is signicant rise in serum GGT levels in patients presenting with ACS in Group A as compared to Group B. Conclusion: Higher levels of GGT in ACS patients with risk factors such as hypertension, dyslipidemia and smoking may serve as biomarker to predict the occurrence of ACS.

scholarly journals Lifetime duration of lactation and chronic inflammation among middle-aged women with a history of gestational diabetes

2020 ◽  
Vol 8 (2) ◽  
pp. e001229
Author(s):  
Sylvia H Ley ◽  
Jorge E Chavarro ◽  
Stefanie N Hinkle ◽  
Mengying Li ◽  
Michael Y Tsai ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Chronic Inflammation ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Health Study ◽  
Gamma Glutamyl Transferase ◽  
Middle Aged ◽  
History Of ◽  
Glutamyl Transferase

IntroductionLonger duration of lactation is associated with lower cardiometabolic disease risk, but pathogenic pathways involved in the disease progression are unclear, especially among high-risk women. We aimed to examine the associations of lifetime lactation duration with cardiometabolic biomarkers among middle-aged women with a history of gestational diabetes (GDM).Research design and methodsWomen with a history of GDM participating in the Nurses’ Health Study II, a prospective cohort study, were identified and followed through biennial questionnaires beginning in 1991. Lactation history was asked in three follow-up questionnaires to calculate lifetime duration. In 2012–2014, fasting blood samples were collected through the Diabetes & Women’s Health Study to measure inflammatory (C-reactive protein (CRP), interleukin (IL) 6), liver enzyme (alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase), and lipid biomarkers (total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol).ResultsAt follow-up blood collection, women were at median age 58.2 (95% CI 51 to 65) years and 26.3 (95% CI 15.7 to 34.1) years since GDM index pregnancy. After multiple adjustment including prepregnancy body mass index (BMI), longer duration of lactation was significantly associated with lower CRP (least squares (LS) mean 1.90 mg/L (95% CI 1.47 to 2.45) for 0-month lactation, 1.98 mg/L (95% CI 1.68 to 2.32) for up to 12-month lactation, 1.67 mg/L (95% CI 1.42 to 1.97) for 12–24 month lactation, and 1.39 mg/L (95% CI 1.19 to 1.62) for >24-month lactation; p trend=0.003) and IL-6 (1.25 pg/L (95% CI 0.94 to 1.68), 1.19 pg/L (95% CI 0.99 to 1.42), 1.04 pg/L (95% CI 0.87 to 1.25), and 0.93 pg/L (95% CI 0.78 to 1.11); p trend=0.04). Longer duration of lactation was associated with lower risk for chronic inflammation using CRP 3 mg/L cut-off in middle-aged women (OR 0.81 (95% CI 0.69 to 0.940 per 1-year increase) with multiple adjustment.ConclusionsLonger lifetime duration of lactation was associated with favorable inflammatory biomarker concentrations in middle-aged women with a history of GDM. Chronic inflammatory pathways may be responsible for previously reported associations between lactation and long-term risk for cardiometabolic diseases.

scholarly journals Biochemical Scoring System For Diagnosing Nonalcoholic steatohepatitis

2019 ◽  
Vol 30 (2) ◽  
pp. 58-62
Author(s):  
Sheikh Mohammad Noor E Alam ◽  
Shahinul Alam ◽  
Dulal Chandra Das ◽  
Mamun Al Mahtab
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Scoring System ◽  
Fatty Liver Disease ◽  
Serum Triglyceride ◽  
Gamma Glutamyl Transferase ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
Nonalcoholic Fatty Liver ◽  
Glutamyl Transferase

Background: Nonalcoholic fatty liver disease (NAFLD) encompasses a spectrum of conditions ranging from simple steatosis to steatohepatitis, advanced fibrosis, and end stage liver disease. Despite the high prevalence and severity of hepatic illness, NAFLD remains underdiagnosed, because of few symptoms, lack of accurate laboratory markers. Objective: To evaluate a biochemical score for diagnosing non-alcoholic steatohepatitis. Methods: An observational, cross sectional study was carried out for a period of two years in the Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. 43 patients of Non-alcoholic fatty liver disease (NAFLD) attending at department of Hepatology were selected and underwent for biochemical investigations and liver biopsy with NAFLD Activity Score (NAS). Results: A biochemical score (TAAG score) assigned 1 point for each parameter (fasting serum triglyceride >ULN, alanine aminotransferase >ULN, AST/ALT ratio (AAR) ≤1 and gamma-glutamyl transferase >ULN) was evaluated. TAAG score ≥3 was present in 32.5% of study population and 40% of NASH patients. It had a sensitivity of 40%, specificity 26% and AUROC 0.54. Conclusion: Biochemical scoring system comprising traditional biomarkers did not significantly predict NASH. Biopsy is the only way to estimate steatohepatitis and/or fibrosis. Bangladesh J Medicine July 2019; 30(2) : 58-62

scholarly journals Economic insecurity during the Great Recession and metabolic, inflammatory and liver function biomarkers: analysis of the UK Household Longitudinal Study

2017 ◽  
Vol 71 (10) ◽  
pp. 1005-1013 ◽  
Author(s):  
Claire L Niedzwiedz ◽  
Srinivasa Vittal Katikireddi ◽  
Aaron Reeves ◽  
Martin McKee ◽  
David Stuckler
Keyword(s):  
Liver Function ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Glycated Haemoglobin ◽  
Financial Strain ◽  
Gamma Glutamyl Transferase ◽  
Economic Insecurity ◽  
Linear Regression Models ◽  
The Uk ◽  
Glutamyl Transferase

BackgroundEconomic insecurity correlates with adverse health outcomes, but the biological pathways involved are not well understood. We examine how changes in economic insecurity relate to metabolic, inflammatory and liver function biomarkers.MethodsBlood analyte data were taken from 6520 individuals (aged 25–59 years) participating in Understanding Society. Economic insecurity was measured using an indicator of subjective financial strain and by asking participants whether they had missed any bill, council tax, rent or mortgage payments in the past year. We investigated longitudinal changes in economic insecurity (remained secure, increase in economic insecurity, decrease in economic insecurity, remained insecure) and the accumulation of economic insecurity. Linear regression models were calculated for nine (logged) biomarker outcomes related to metabolic, inflammatory, liver and kidney function (as falsification tests), adjusting for potential confounders.ResultsCompared with those who remained economically stable, people who experienced consistent economic insecurity (using both measures) had worsened levels of high-density lipoprotein (HDL)-cholesterol, triglycerides, C reactive protein (CRP), fibrinogen and glycated haemoglobin. Increased economic insecurity was associated with adverse levels of HDL-cholesterol (0.955, 95% CI 0.929 to 0.982), triglycerides (1.077, 95% CI 1.018 to 1.139) and CRP (1.114, 95% CI 1.012 to 1.227), using the measure of financial strain. Results for the other measure were generally consistent, apart from the higher levels of gamma-glutamyl transferase observed among those experiencing persistent insecurity (1.200, 95% CI 1.110 to 1.297).ConclusionEconomic insecurity is associated with adverse metabolic and inflammatory biomarkers (particularly HDL-cholesterol, triglycerides and CRP), heightening risk for a range of health conditions.

Sildenafil, a phosphodiesterase-5 inhibitor, offers protection against carbon tetrachloride-induced hepatotoxicity in rat

2018 ◽  
Vol 29 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Olorunfemi R. Molehin ◽  
Anne A. Adeyanju ◽  
Stephen A. Adefegha ◽  
Oluwasanmi O. Aina ◽  
Blessing A. Afolabi ◽  
...  
Keyword(s):  
Carbon Tetrachloride ◽  
Density Lipoprotein ◽  
Serum Levels ◽  
Selective Inhibition ◽  
Guanosine Monophosphate ◽  
Control Group ◽  
Gamma Glutamyl Transferase ◽  
Protective Agent ◽  
Glutamyl Transferase ◽  
Phosphodiesterase 5

AbstractBackground:Elevation of phosphodiesterase-5 (PDE5) activity converts cyclic guanosine monophosphate (cGMP) to 5′-GMP, a mechanism that could be associated with drug-mediated hepatotoxicity. This study investigated whether selective inhibition of PDE5 by sildenafil could offer protection against hepatotoxicity induced by carbon tetrachloride (CCl4).Methods:CCl4(0.5 mL/kg) was administered intraperitoneally to induce hepatotoxicity. The control group received normal saline. Sildenafil (5 mg, 10 mg, and 20 mg/kg, p.o.) was administered to CCl4-treated rats.Results:CCl4significantly increased the serum levels of gamma glutamyl transferase (γ-GT), alkaline phosphatase (ALP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) and reduced total protein (TP) (p<0.05). Pretreatment with sildenafil moderately reduced ALP, AST, and ALT activities with modest increase in TP level. CCl4-induced changes in the antioxidant status of the liver were significantly improved by sildenafil, especially at the lowest dose of 5 mg/kg by elevating the levels of reduced glutathione (GSH), glutathione peroxidase (GPx), catalase (CAT), superoxide dismutase (SOD), and glutathione-S-transferase (GST) and preventing lipid peroxidation (p<0.05). Sildenafil did not significantly alter the total cholesterol and triglyceride levels. However, high-density lipoprotein (HDL) level was significantly increased by sildenafil (p<0.05).Conclusions:The results from this study suggest that sildenafil, when used at low doses, may be a useful pharmacological protective agent against CCl4-induced hepatotoxicity.

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