Published: 2019-07-25

Serum gamma-glutamyl transferase level in acute stroke

Lagendra Kumar Singh, Sourabh Pradhan, Laxmikanta Dash, Jagannath Pradhan, Umakanta Raul, Rajesh Kumar Meher


Background: Stroke is the second leading cause of death worldwide, causing 6.2 million deaths in 2011. Serum Gamma-Glutamyl Transferase (GGT) has been conventionally considered as a marker of excessive alcohol intake and/or liver dysfunction. There are accumulating evidences suggesting association of raised serum GGT level in stroke. So, this study was conducted to determine the association between the serum GGT level and stroke in population without history of alcohol consumption.

Methods: This cross-sectional comparative study was carried out at Department of General medicine, Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), Burla from November 2016 to October 2018. 100 cases and 100 controls were included in this study. Cases were the patients admitted to Department of General Medicine, VIMSAR, Burla, presenting within 24 hours of first episode of stroke. Controls were the age (+/-5 years) and sex matched healthy attendants of the patients. Alcoholics or patients suffering from hepatitis, cirrhosis of liver, cholestasis or patients taking drugs like Phenytoin, Valproic acid, Carbamazepine etc or patients with past episode of stroke were excluded from this study. Serum GGT level of both cases and controls were measured and compared.

Results: In stroke patients, the mean serum GGT level was 54.95 IU/L with standard deviation of 20.54. In controls, the mean serum GGT level was 32.14 IU/L with standard deviation of 5.07. The p-value was less than 0.0001 i.e. highly significant.

Conclusions: Serum GGT level is significantly increased in stroke patients than healthy persons without stroke.


Diabetes mellitus, Dyslipidemia, Gamma-Glutamyl transferase, Hypertension, Stroke

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Smith WS, Johnston SC, Hemphill JC. Cerebrovascular Diseases. In: Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J, eds. Harrison’s Principles of Internal Medicine. 19th ed. McGraw-Hill; 2015: 2559-2586.

Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol. 2009;8(4):355-69.

Kamalakannan S, Gudlavalleti AS, Gudlavalleti VS, Goenka S, Kuper H. Incidence & prevalence of stroke in India: a systematic review. Ind J Med Res. 2017;146(2):175.

Hatano S. Experience from a multicentre stroke register: a preliminary report. Bull World Heal Org. 1976;54(5):541.

Whittfield JB. Gamma glutamyl transferase. Crit. 2001;3798-804.

Rollason JG, Pincherle G, Robinson D. Serum gamma glutamyl transpeptidase in relation to alcohol consumption. Clin Chimica Acta. 1972;39(1):75-80.

Jousilahti P, Rastenyte D, Tuomilehto J. Serum gamma-glutamyl transferase, self-reported alcohol drinking, and the risk of stroke. Stroke. 2000;31(8):1851-5.

Bots ML, Salonen JT, Elwood PC, Nikitin Y, de Concalves AF, Inzitari D, et al. γ-Glutamyl transferase and risk of stroke: the eurostroke project. J Epidemiol Comm Heal. 2002;56(1):i25-9.

Shimizu Y, Imano H, Ohira T, Kitamura A, Kiyama M, Okada T, et al. γ-Glutamyltranspeptidase and incident stroke among japanese men and women: the circulatory risk in communities study (CIRCS). Stroke. 2010;41(2):385-8.

Emdin M, Pompella A, Paolicchi A. Gamma-glutamyl transferase, atherosclerosis, and cardiovascular disease: triggering oxidative stress within the plaque. Circulation. 2005;112:2078-80.

Demirkan B, Güray Y, Güray Ü, Turak O, Hajro E, Korkmaz Ş. The relationship between saphenous coronary bypass graft occlusion and serum gamma-glutamyltransferase activity. Arch Turk Soc Cardiol. 2010;38(5):321-6.

Dalal PM, Malik S, Bhattacharjee M, Trivedi ND, Vairale J, Bhat P, et al. Population-based stroke survey in Mumbai, India: incidence and 28-day case fatality. Neuroepidemiol. 2008;31(4):254.

Sridharan SE, Unnikrishnan JP, Sukumaran S, Sylaja PN, Nayak SD, Sarma PS, et al. Incidence, types, risk factors, and outcome of stroke in a developing country: the Trivandrum stroke registry. Stroke. 2009;40(4):1212-8.

Das SK, Banerjee TK, Biswas A, Roy T, Raut DK, Mukherjee CS, et al. A prospective community-based study of stroke in Kolkata, India. Stroke. 2007;38(3):906-10.

Zhang XW, Li M, Hou WS, Li K, Zhou JR, Tang ZY. Association between gamma-glutamyl transferase level and risk of stroke: a systematic review and meta-analysis of prospective studies. J Stroke Cerebrovascul Dis. 2015;24(12):2816-23.

Mijovic V, Patapiou H, Machin SJ, McVerry BA, Cleghorn TE. Serum gamma-glutamyl transferase activity in volunteer blood donors. J Clin Pathol. 197;30(8):779.

Gurbuzer N, Gozke E, Basturk ZA. Gamma-Glutamyl transferase levels in patients with acute ischemic stroke. Cardiovascular Psychiatry Neurology. 2014;4.