عنوان الإطروحه
Assessment of the Serum levels of Aspartate Aminotransferase Alanine Aminotransferase and Gamma Glutamyl Transferase in Patients with Chronic Kidney Disease
تاريخ مناقشة الاطروحه
2017-08-15
اسم الطالب
احمد سعد عبود سعيد
المشرف
فوزي ارشيد يعقوب ارشيد
المشرف المشارك
اعضاء لجنة المناقشة
يعقوب حسن عيد يعقوب
عبدالله طراد شوفان الفواز
عبد الرحيم الحنيطي
الكلية
كلية العلوم
القسم
العلوم الحياتية
الملخص بالعربية
مرض الكلوي المزمن يعرف هذا المرض بأنه البدء في فقدان الوظائف الحيوية للكلى تدريجياً ولفترات طويلة ، ومن الجدير بالذكر أنّ هذا المرض المزمن لا يمكن حصر الأعراض المتعلّقة به ولكن من الممكن وجود مجموعة من الأعراض العامة. المصابين بامراض الكلى المزمن أكثر عرضة للإصابة بأمراض الكبد أثناء غسيل الكلى. وان معدل للإصابة بامراض الكلى المزمن في البلدان العربية عالي. الهدف من هذه الدراسة هو تقيم مستويات انزيمات Gamma-Glutamyl (GGT) transferase و(ALT)Alanine aminotransferase و(AST) Aspartate aminotransferase في الاشخاص المصابين بامراض الكلى المزمن . وقد شملت هذه الدراسة ثلاثين مريضا مصاب بامراض الكلى المزمن من العراقيين الخاضعين بشكل دوري لغسيل الكلى وثلاثين اخرين اصحاء من اعمار متقاربة . تم اخذ عينات الدم من الاصحاء والمصابين بامراض الكلى وتم اجراء تقيم مستويات انزيمات الكبد ليديهم . وقد أشارت نتائج هذه الدراسة إلى أن معظم مرضى الكلى كان لديهم ارتفاع ملحوض وله دلالة احصائية في مستوى انزيمGGT في مصل الدم مقارنة مع الاصحاء. واشارت النتائج ايضا على ارتفاع ملحوض لانزيم GGT في مصل الدم مع الاشخاص الذين لديهم زيادة بالوزن , ولوحظ من خلال نتائج هذه الدراسة انخفاض في مستوى انزيم GGT في مصل الدم مع التقدم في السن. اما بالنسبة لانزيمات AST و ALTلوحظ من خلال النتائج انه وجود انخفاض طفيف في مستوياتهم في مصل الدم عند الاشخاص المصابين بامراض الكلى المزمن ولكن بدون دلالة احصائية. ومن الممكن أن غسيل الكلى قد يكون له صله في الأنخفاض في مستوى انزيمات AST و ALTفي المرضى الكلى. وبالإضافة إلى ذلك، من الممكن أن نستنتج بأن ارتفاع مستوى GGT في مصل الدم بمثابة مؤشر لامراض الكلى . ويمكن استنتاج ايضاً أن مرض الكلى المزمن له تأثير على انزيمات الكبد. ولذلك، ينصح تقدير مستويات انزيمات الكبد في الدم، وخاصة عند المصابين بأمراض الكلى . لا تزال هناك حاجة إلى مزيد من الدراسات لتحديد سبب التغيرات في مستويات انزيمات الكبد في مصل الدم عند الاشخاص المصابين بالمرضى الكلى المزمن.
الملخص بالانجليزي
 This current study was carried out to measure liver enzymes serum levels of Gamma Glutamyl Transferase (GGT), Aspartate amino transferase (AST) and Alanine aminotransferase (ALT) in adult patients with chronic kidney disease. The influence of several variable factors such as age, gender and lifestyle factor such as smoking status and health related factor such as BMI on levels of these three liver enzymes were also investigated. During this study, 30 patients with chronic kidney disease and 30 age-matched health subjects as control group were recruited. The serum levels of GGT, AST and ALT levels were measured in all patients with chronic kidney disease and controls. Data on demographic characteristics and history of the any diseases were collected for the 60 all participants. The age of chronic kidney disease patient range between 17 and 72 years of ages (mean 47.6 ? 14.1). For control group, the age ranged from 24 to 75 years of age and the average age was 41.9 ? 14.1. The average age of chronic kidney disease patients was slightly higher than the control group. The average serum GGT concentration in the control group was 19.1 U/L, whereas average GGT concentration in patients with Chronic kidney disease was 50.9 U/L. Statistically, patients had a significantly higher GGT level than the controls (P?0.05). On other hand, the average values of serum ALT concentration in control group and patients with Chronic kidney disease were 11.3 U/L and 15.5. Similarly, the mean values of serum AST concentrations were 18.1 in the control and 19.7 in patients with chronic kidney disease. Statistically analyses revealed no significant associations between level of ALT or AST and risk of chronic kidney disease. The gender did not significantly affect the serum concentrations of GG, ALT and AST in both control and chronic kidney disease patient groups. The concentration of GGT in the serum appeared to significantly decrease with age (P?0.05). No significant differences in ALT levels were found between the three subgroups of both controls and patients. For AST, there was a tendency for decrease in the serum mean levels of this enzyme in control group with increasing age. The mean GGT levels in smoker of both controls and CKD patients were significantly different from those observed in non-smoker group (P < 0.05). On the other hand, smoking cigarettes showed no significant effect on the mean serum ALT concentrations in both patients with CKD and control group. For AST, there was no significant difference in the mean serum levels of this enzyme between smoker patients and non-smoker patients. By contrast, a significant increase in the mean serum AST levels was noted in smoker control participants as compared to non-smoker control participants (P?0.05). High BMI values were consistently characterized by significantly higher GGT and ALT levels than normal BMI in both CKD patients and controls (P?0.05). Also, a significant positive correlation was found between the serum level of ALT and BMI in chronic kidney disease patients, but not in control group (P?0.05). With respect to the serum levels of AST, only obese controls showed significantly higher serum levels of AST compared to obese patients with chronic kidney disease (P?0.05). However, obese chronic kidney disease patients had closely similar levels of the serum AST compared with overweight chronic kidney disease control. Similarly, the association between AST and BMI was also reduced in control group and no longer significant (P>0.05). By contrast, Based on the current results, it can be concluded that BMI and smoking status are important factors which are involved on association between GGT level and risk of chronic kidney disease. These two factors appear to be more important than age and gender among chronic kidney disease patients and normal individuals. Therefore, estimation of the serum liver enzyme levels is highly recommended, particularly for chronic kidney disease patients. Further studies are still required to establish the cause of alterations in serum liver enzyme levels in patients with CKD. Also, further studies with a large sample size must be carried to clarify the relationship between the serum GGT levels and BMI and smoking
رقم ISN
331
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