Association Between Serum γ-Glutamyltransferase and Acute Ischemic Nonembolic Stroke in Elderly Subjects

Korantzopoulos, Panagiotis; Τζίμας, Πέτρος; Kalantzi, Kallirroi I; Kostapanos, Michael S.; Vemmos, Konstantinos; Goudevenos, John; Elisaf, Moses; Milionis, Haralampos

doi:10.1016/j.arcmed.2009.07.012

Cited by 21 publications

(17 citation statements)

References 29 publications

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“…Interestingly, patients at the highest quartile for γGT activity had a 4.7-fold higher risk of ischemic stroke than those at the lowest quartile [30] . This association was relevant after adjustment for the presence of established CV risk factors [30] . In accordance with these findings, elevated ALT activity was associated with increased CV-and diabetes-related mortality in 37085 Korean subjects [31] .…”

Section: Introductionmentioning

confidence: 99%

“…In prospective studies, raised serum activity of liver enzymes independently predicted CV events and/or total and CV mortality [20] . For example, γGT activity was raised in 163 patients admitted with an acute ischemic/non-embolic stroke compared with 166 healthy individuals [30] . Interestingly, patients at the highest quartile for γGT activity had a 4.7-fold higher risk of ischemic stroke than those at the lowest quartile [30] .…”

Section: Introductionmentioning

confidence: 99%

“…For example, γGT activity was raised in 163 patients admitted with an acute ischemic/non-embolic stroke compared with 166 healthy individuals [30] . Interestingly, patients at the highest quartile for γGT activity had a 4.7-fold higher risk of ischemic stroke than those at the lowest quartile [30] . This association was relevant after adjustment for the presence of established CV risk factors [30] .…”

Section: Introductionmentioning

confidence: 99%

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Current role of fenofibrate in the prevention and management of non-alcoholic fatty liver disease

Kostapanos

Kei²,

Elisaf³

2013

WJH

131

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Non-alcoholic fatty liver disease (NAFLD) is a common health problem with a high mortality burden due to its liver-and vascular-specific complications. It is associated with obesity, high-fat diet as well as with type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS). Impaired hepatic fatty acid (FA) turnover together with insulin resistance are key players in NAFLD pathogenesis. Peroxisome proliferator-activated receptors (PPARs) are involved in lipid and glucose metabolic pathways. The novel concept is that the activation of the PPARα subunit may protect from liver steatosis. Fenofibrate, by activating PPARα, effectively improves the atherogenic lipid profile associated with T2DM and MetS. Experimental evidence suggested various protective effects of the drug against liver steatosis. Namely, fenofibraterelated PPARα activation may enhance the expression of genes promoting hepatic FA β-oxidation. Furthermore, fenofibrate reduces hepatic insulin resistance. It also inhibits the expression of inflammatory mediators involved in non-alcoholic steatohepatitis pathogenesis. These include tumor necrosis factor-α, intercellular cell adhesion molecule-1, vascular cell adhesion molecule-1 and monocyte chemoattractant protein-1. Consequently, fenofibrate can limit hepatic macrophage infiltration. Other liver-protective effects include decreased oxidative stress and improved liver microvasculature function. Experimental studies showed that fenofibrate can limit liver steatosis associated with high-fat diet, T2DM and obesity-related insulin resistance. Few studies showed that these benefits are also relevant even in the clinical setting. However, these have certain limitations. Namely, these were uncontrolled, their sample size was small, fenofibrate was used as a part of multifactorial approach, while histological data were absent. In this context, there is a need for large prospective studies, including proper control groups and full assessment of liver histology.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Current role of fenofibrate in the prevention and management of non-alcoholic fatty liver disease

Kostapanos

Kei²,

Elisaf³

2013

WJH

131

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“…Exclusion criteria were: (1) giving blood after intravenous fluid replacement or treatment by any means (resuscitation etc.) in emergency department, (2) presence of known chronic liver or kidney diseases, (3) presence of thyroid dysfunctions, (4) presence of active infections, (5) history of neoplasia, (6) previous high aspartate transaminase and alanine transaminase enzymes, (7) alcohol consumption (The patients with intermediate and severe alcohol use (2)), (8) presence of transient ischemic attack (TIA), (9) admission to the hospital 24 hours after the first symptom, (10) absence of laboratory results, (11) general cardiac evaluation (history, physical examination, electrocardiography, transthoracic and/or transasephageal echocradiography) and (12) absence of Doppler ultrasonography (13) Those patients for which CT and diffusion MR could not be performed (14) high levels of liver enzymes or functional impairment due to drug use.…”

Section: Methodsmentioning

confidence: 99%

“…[3][4][5][6] Risk factors for coronary artery diseases and stroke have also been indicated. 7,8 In addition, GGT has a prognostic role in CVD and stroke. 9 The aim of our study was to identify the differences in GGT levels in different types of stroke, and to evaluate the relationship between GGT and 30-day mortality.…”

Section: Introductionmentioning

confidence: 99%

Can We Use Serum Gamma-Glutamyl Transferase Levels to Predict Early Mortality in Stroke?

Akıncı¹,

Doğan

Gümüş³

et al. 2014

The Journal of Emergency Medicine

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Benefit–Risk Assessment of Rosuvastatin in the Treatment of Atherosclerosis and Related Diseases

2014

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Rosuvastatin has been marketed for approximately a decade. In this review we critically discuss available evidence on the benefits and risks from its use. In clinical trials using rosuvastatin, 'lowest is best' was relevant for on-treatment low-density lipoprotein cholesterol levels. Targeting levels <50 mg/dl was associated with the greatest decrease in vascular morbidity/mortality in the primary prevention setting. Also, such reduction can induce atherosclerosis regression without increasing the risk of adverse effects. Pooled data suggest that the safety profile of rosuvastatin is not different from that of other statins. It was estimated that rosuvastatin-associated absolute hazards of muscle-, liver- and renal-related adverse effects are lower than the corresponding vascular benefits in moderate vascular risk individuals. However, these data are subject to biases and need confirmation on a prospective basis. Significant liver enzyme elevations are rare. These often imply underlying non-alcoholic fatty liver disease (NAFLD), which is associated with increased vascular risk. Rosuvastatin can improve biochemical biomarkers and histological score of NAFLD. Whether this benefit is associated with vascular risk reduction should be assessed by prospective studies. Both chronic kidney disease and albuminuria independently predict vascular morbidity and mortality. Rosuvastatin improved the estimated glomerular filtration rate and decreased albuminuria in patients with moderately impaired kidney function. Also, vascular morbidity and mortality might be reduced in these patients. The same was not relevant in end-stage renal disease. Rosuvastatin-induced proteinuria appears to be of tubular origin, not relating to kidney injury. Rosuvastatin increases the risk of new-onset diabetes by dose-dependently impairing insulin sensitivity. Obese individuals with prediabetes appear to be predominantly affected. However, absolute vascular benefits of rosuvastatin may counterbalance this risk. Rosuvastatin is effective for the prevention and management of atherosclerotic vascular disease. Individualization of its use can maximize benefits and reduce the risk of adverse effects.

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Association Between Serum γ-Glutamyltransferase and Acute Ischemic Nonembolic Stroke in Elderly Subjects

Cited by 21 publications

References 29 publications

Current role of fenofibrate in the prevention and management of non-alcoholic fatty liver disease

Current role of fenofibrate in the prevention and management of non-alcoholic fatty liver disease

Can We Use Serum Gamma-Glutamyl Transferase Levels to Predict Early Mortality in Stroke?

Benefit–Risk Assessment of Rosuvastatin in the Treatment of Atherosclerosis and Related Diseases

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