ENZIMSKE AKTIVNOSTI U HRONIČNOM ALKOHOLIZMU

Begić L 1, Arnautović A 2.
1Medicinski fakultet Univerziteta u Tuzli, Tuzla,Bosna i Hercegovina
2Klinika za unutrašnje bolesti UKC Tuzla, Tuzla, Bosna i Hercegovina

Alkoholizam predstavlja ozbiljan zdravstveni problem sa ogromnim socio-ekonomskim posljedicama. Smatra se da 10% evropske i američke populacije ima zdravstvene probleme koje su posljedica konzumiranja alkohola. Tri najčešća oblika alkoholne bolesti jetre (ABJ) su:steatoza, alkoholni hepatitis i ciroza. Ako se problemi sa alkoholom prepoznaju u ranom stadiju ljekar može prevenirati razvoj i progresiju bolesti.

CILJ: Cilj našeg rada je da se procijene enzimske aktivnosti ALAT, ASAT i GGT, u različitim oblicima ABJ i njihova eventualna primjena kao markera u hroničnom alkoholizmu.

ISPITANICI I METODE: Rad je obuhvatio 52 bolesnika sa sigurnim anamnestičkim podacima o hroničnom alkoholizmu. Pomoću ultrazvuka jetre i aspiracione biopsije ispitanici su podijeljeni u 5 skupina. Aktivnosti alanin aminotransferaze (ALAT), aspartat aminotransferaze (ASAT) i gama-glutamil transferaze (GGT) u serumu određene su spektrofotometrijski.

REZULTATI: U ukupnom uzorku najviše je bilo pacijenata sa cirozom (19), zatim hepatitisom (16), steatozom (12), hepatocelularnim karcinomom (6) i fibrozom (1). Od ukupnog broja pacijenata 75,9% imalo je povišene vrijednosti ASAT, 55,6% povišene vrijednosti ALAT, a 90.7% povišene vrijednosti GGT. Odnos ASAT/ALAT u naših pacijenata iznosio je 1,88.

ZAKLJUČAK: Od ispitivanih parametara GGT i odnos ASAT/ALAT su korisni indikatori hroničnog konzumiranja velikih količina alkohola. Nedostatak GGT kao markera je nedostatak specifičnosti i osjetljivosti, jer brojna druga oštećenja i lijekovi povisuju nivo GGT i daju lažno pozitivne rezultate. Odnos ASAT/ALAT bolji je pokazatelj oštećenja jetre izazvanih alkoholom od pojedinačnih određivanja ASAT i ALAT u serumu.

ENZYME ACTIVITIES IN CHRONIC ALCOHOL ABUSE

Begić L1, Arnautović A2.
1Medical Faculty University of Tuzla, Tuzla, Bosnia and Herzegovina
2Internal Clinic UKC Tuzla, Tuzla, Bosnia and Herzegovina

Alcoholism represents a serious health issue with major socio-economic consequences. It appears that 10% of European and American population have same health problems as a result of high alcohol consumption. Clinical features of alcoholic liver disease are fatty liver, alcoholic hepatitis and cirrhosis. If alcohol problems are recognised at an early stage, a physician may prevent further development and progression of disease.

OBJECTIVE: Aim of our work is evaluation of ALAT, ASAT and GGT assays in alcoholic liver diseases and their application as markers in chronic alcoholism.

SUBJECTS AND METHODS: The investigation included 52 patients with reliable medical history data about chronic alcoholism. Used needle biopsy and US of liver, examiners are classified into 5 groups. Alanine aminotransferase (ALAT), aspartate aminotransferase (ASAT) and gamma-glutamyl transferase (GGT) activities in serum are determined by spectroscopic methods.

RESULTS: In total sample, the biggest group was composed of patients suffering cirrhosis (19) followed by groups of patients suffering hepatitis (16), steatosis (12), hepatocellular carcinoma (6) and fibrosis (1). As many as 75.9% of all patients had increased levels ASAT, 55.6% had increased levels of ALAT, and 90.7% had increased GGT activity. The ratio ASAT/ALAT in our patient was 1.88.

CONCLUSION: On the basis of our investigation we can conclude that GGT level in serum and ASAT/ALAT ratio are valuable indicators of chronic excessive alcohol intake. The major shortcomings of GGT as a marker of excessive alcohol consumption are lack of sensitivity and specificity. Numerous other disorders and drugs can elevate GGT and produce false positive results. The ASAT/ALAT ratio is better marker of alcoholic liver disease than separate serum levels of ASAT and ALAT.

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