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Home :: Gamma Glutamyl Transpeptidase

Gamma Glutamyl Transpeptidase (GGT)

Also called gamma glutamyl transpeptidase, gamma glutamyl transferase (GGT) participates in the transfer of amino acids across cellular membranes and, possibly, in glutathione metabolism. The highest concentrations of GGT exist in the renal tubules, but the enzyme also appears in the liver, biliary tract epithelium, pancreas, lymphocytes, brain, and testes. This test is used to measure serum GGT levels.

Purpose

  • To provide information about hepatobiliary diseases, to assess liver function, and to detect alcohol ingestion.
  • To distinguish between skeletal disease and hepatic disease when serum alkaline phosphatase level is elevated (a normal GGT level suggests that such elevation stems from skeletal disease).

Patient preparation

  • Explain to the patient that this test is used to evaluate liver function.
  • Tell him that the test requires a blood sample. Explain who will perform the venipuncture and when.
  • Explain that he may experience slight discomfort from the needle puncture and the tourniquet but that collecting the sample usually takes less than 3 minutes.
  • Inform him that he needn't restrict food or fluids before the test.

Procedure and posttest care

  • Perform a venipuncture, and collect the sample in a 7-ml red-top tube.
  • If a hematoma develops, apply warm soaks
Precautions
  • Handle the sample gently to prevent hemolysis.
  • GGT activity is stable in serum at room temperature for 2 days.
Reference values

Serum GGT values vary with the assay method used (kinetic or end-point method). Normal levels range from 7 to 48 UIL in males and from 6 to 29 U/L in females

Abnormal findings

Serum GGT levels rise in any acute hepatic disease because enzyme production increases in response to hepatocellular injury. Moderate increases occur in acute pancreatitis, renal disease, and prostatic metastases; postoperatively; and in some patients with epilepsy or brain tumors. Levels also increase after alcohol ingestion because of enzyme induction. The sharpest elevations occur in patients with obstructive jaundice and hepatic metastatic infiltrations.

GGT levels may also increase 5 to 10 days after acute myocardial infarction, either as a result of tissue granulation and healing or as an indication of the effects of cardiac insufficiency on the liver.

Interfering factors

  • Hemolysis due to rough handling of the sample.
  • Clofibrate, oral contraceptives, and late pregnancy (decrease).
  • Aminoglycosides, barbiturates, and phenytoin (increase).
  • Moderate intake of alcohol (increase for at least 60 hours).

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