Medical expert of the article
New publications
Causes of gamma glutamyl transpeptidase increase and decrease
Last reviewed: 06.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Increased activity of gamma-glutamyl transpeptidase in blood serum may be due to the following reasons.
- Increased synthesis as a result of activation of enzymes that ensure this process, alcohol and drugs.
- Damage to cell membranes due to toxic agents, ischemia and infectious liver damage.
- Release of the enzyme from its connection with cell membranes as a result of the detergent action of surface-active bile acids in all types of cholestasis.
Changes in the activity of gamma-glutamyl transpeptidase in the blood serum are of great diagnostic importance in diseases of the liver and hepatobiliary tract. This enzyme is more sensitive to disturbances in liver cells than ALT, AST, alkaline phosphatase, glutamate dehydrogenase (GlDH), etc. Normal activity of this enzyme in bone diseases allows us to establish the source of increased alkaline phosphatase activity.
Gamma glutamyl transpeptidase is particularly sensitive to the effects of long-term alcohol consumption on the liver. In individuals who abuse alcohol, serum gamma glutamyl transpeptidase activity correlates with the amount of alcohol consumed. The test is especially valuable for monitoring the treatment of alcoholism. Stopping alcohol consumption reduces enzyme activity by approximately 50% within 10 days.
Determination of gamma-glutamyl transpeptidase activity is used to establish hepatotoxicity; it increases in 90% of cases of liver diseases. In most cases, such patients have simultaneously increased activity of transaminases in the blood. Isolated increase in gamma-glutamyl transpeptidase activity is observed in 6-20% of patients with hepatobiliary pathology. Anticonvulsants, fatty liver disease, and heart failure cause an increase in gamma-glutamyl transpeptidase activity more than 3 times.
In acute hepatitis, the activity of gamma glutamyl transpeptidase increases earlier than the activity of AST and ALT. At the height of the disease, the activity of gamma glutamyl transpeptidase is lower (increased by 2-5 times) than the activity of aminotransferases, and normalizes much more slowly. This allows the use of gamma glutamyl transpeptidase to monitor the patient's recovery.
The highest activity of gamma glutamyl transpeptidase (5-30 times higher than the reference interval) is observed in intra- and extrahepatic cholestasis. Somewhat lower values of enzyme activity are recorded in primary liver tumors. In malignant tumors of other localizations, a gradual increase in gamma glutamyl transpeptidase activity indicates the presence of metastases to the liver. Gamma glutamyl transpeptidase activity can be used as a marker of pancreatic and prostate cancer, since it reflects remissions and relapses.
It should be noted once again that gamma glutamyl transpeptidase has many diagnostic values. At least 5 processes increase its activity: cytolysis, cholestasis, alcohol intoxication, tumor growth in the liver, drug intoxication. The etiological diversity of mechanisms for increasing gamma glutamyl transpeptidase requires a very careful and thorough assessment of the causes of hyperfermentemia. Detection of high gamma glutamyl transpeptidase activity forces us to look for the cause of this increase. As a "screening" test and a method for monitoring the course of a known pathological process, the study of gamma glutamyl transpeptidase is literally irreplaceable in clinical significance.
No significant increase in gamma glutamyl transpeptidase activity was found in myocardial infarction, but it increases in pancreatic diseases and, in particular, in diabetes mellitus. Increased gamma glutamyl transpeptidase activity is also noted in infectious mononucleosis.