Clinical Application of Combined Detection of Serum Carbohydrate Antigen 199, Alanine Aminotransferase, and Gamma-glutamyl Transferase in the Diagnosis of Hyperthyroid Liver Damage_West China Medical Journal

Authors：

 YANGLi-wei ¹ , CAIXue-mei ¹ , HUANGJian ²

1. Clinical Laboratory, the Fifth People's Hospital of Zigong City, Zigong, Sichuan 643000, P. R. China;
2. Department of Acupuncture and Massage of Traditional Chinese Medicine, the Second People's Hospital of Zigong City, Zigong, Sichuan 643000, P. R. China;

Corresponding?author：

Keywords：

Carbohydrate antigen 199; Alanine aminotransferase; Gamma-glutamyl transferase; Hyperthyroidism liver damage; Combined detection

DOI：

10.7507/1002-0179.20150472

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Objective To investigate the significance of carbohydrate antigen 199 (CA199), alanine aminotransferase (ALT), gamma-glutamyl transferase (_γ-GT) levels in the diagnosis of liver damage caused by hyperthyroidism. Method A total of 106 patients confirmed to have hyperthyroid liver damage between February 2012 and February 2014 were selected to form the hyperthyroidism liver injury group (group A). Ninety-five hyperthyroidism patients without liver damage were regarded as the hyperthyroidism without liver injury group (group B). In the same period, 72 healthy subjects were designated to form the control group (group C). Automatic chemiluminescence detector was used to determine free triiodothyronine, free thyroid hormone and CA199, and automatic biochemical analyzer was adopted to measure the levels of _γ-GT and ALT. Then we performed the statistical analysis. Results The levels of serum CA199, _γ-GT and ALT in group A were significantly higher than those in group B and group C, and the differences were statistically significant (P<0.05). CA199 and _γ-GT levels in group B were significantly higher than those in group C (P<0.05). The area under the receiver operating characteristic curve for CA199, _γ-GT, ALT was respectively 0.840, 0.895, and 0.818, the maximum Youden indexes were 0.593, 0.703, and 0.578, with the corresponding critical values 37.25 U/mL, 60.81 U/L, and 43.14 U/L, respectively. The parallel dectection of the three indexes improved Youden index to 0.763. Conclusions CA199, _γ-GT and ALT as diagnosis indexes of hyperthyroidism liver damage have good diagnostic value, and combined detection of the three indexes is more favorable for early diagnosis and prediction.

Citation： YANGLi-wei, CAIXue-mei, HUANGJian. Clinical Application of Combined Detection of Serum Carbohydrate Antigen 199, Alanine Aminotransferase, and Gamma-glutamyl Transferase in the Diagnosis of Hyperthyroid Liver Damage. West China Medical Journal, 2015, 30(9): 1654-1657. doi: 10.7507/1002-0179.20150472 Copy

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10.	陳光美. 甲亢患者血清酶測定的臨床意義[J]. 中國廠礦醫學, 2001, 14(3):184-185.
11.	Videla LA, Smok G, Troncoso P, et al. Influence of hyperthyroidism on lindane-induced hepatotoxicity in the rat[J]. Biochem Pharmacol, 1995, 50(10):1557-1565.
12.	楊愛青. CA-199與肝損害程度的相關性研究[J]. 贛南醫學院學報, 2013, 6(6):865-866.
13.	石艷芬, 蘇文芳, 李耿祥. 3項指標檢測在肝臟病患者中的臨床意義[J]. 國際檢驗醫學雜志, 2011, 32(1):141-142.
14.	熊會玲, 范彥, 胡美, 等. 血清CA199對良惡性膽道疾病的意義[J]. 臨床消化病雜志, 2013, 25(6):327-329.
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16.	周玉萍. 龍游縣2006-2013年15417例高校體檢學生ALT檢測結果分析[J]. 中國衛生檢驗雜志, 2014, 24(2):300-301.
17.	宋婕, 李官成. 肝癌相關腫瘤標志物研究新進展[J]. 國際病理科學與臨床雜志, 2011, 31(1):54-58.

1. 胡在林. 谷胱甘肽治療甲亢性肝損傷的臨床療效觀察[J]. 現代醫藥衛生, 2011, 27(4):525-526.
2. 高巧燕, 雷雅玲. 慢性乙型肝炎血清谷氨酰轉肽酶含量測定的臨床意義[J]. 現代中西醫結合雜志, 2010, 19(10):1266-1267.
3. 劉秀煥, 柏立欣. 糖尿病患者血清CA 199水平與疾病進展關系研究[J]. 內蒙古醫學雜志, 2013, 45(12):1455-1458.
4. 中華醫學會內分泌學分會, 《中國甲狀腺疾病診治指南》編寫組. 中國甲狀腺疾病診治指南:甲狀腺炎[J]. 中華內科學雜志, 2008, 47(9):784.
5. 陳灝珠. 實用內科學[M]. 10版. 北京:人民衛生出版社, 1997:1016-1023.
6. 巫曉強. 甲亢性肝損害116例臨床分析[J]. 蛇志, 2013, 25(4):378-379, 382.
7. 徐寶榮. 雙環醇片治療甲亢性肝損害臨床療效分析[J]. 中國肝臟病雜志:電子版, 2011, 3(3):5-7.
8. 肖宏, 周樸. Graves甲狀腺功能亢進合并肝損傷與甲狀腺自身抗體相關性研究[J]. 醫學綜述, 2012, 18(23):4090-4092.
9. 李建寧, 曹龍翎, 陳小曼. 甲亢性肝功能損害的相關因素分析[J]. 中國醫藥指南, 2012, 10(16):54.
10. 陳光美. 甲亢患者血清酶測定的臨床意義[J]. 中國廠礦醫學, 2001, 14(3):184-185.
11. Videla LA, Smok G, Troncoso P, et al. Influence of hyperthyroidism on lindane-induced hepatotoxicity in the rat[J]. Biochem Pharmacol, 1995, 50(10):1557-1565.
12. 楊愛青. CA-199與肝損害程度的相關性研究[J]. 贛南醫學院學報, 2013, 6(6):865-866.
13. 石艷芬, 蘇文芳, 李耿祥. 3項指標檢測在肝臟病患者中的臨床意義[J]. 國際檢驗醫學雜志, 2011, 32(1):141-142.
14. 熊會玲, 范彥, 胡美, 等. 血清CA199對良惡性膽道疾病的意義[J]. 臨床消化病雜志, 2013, 25(6):327-329.
15. Ruckert IM, Heier M, Rathmann W, et al. Association between markers of fatty liver disease and impaired glucose regulation in men and women from the general population:the KORA-F4-study[J]. PLoS One, 2011, 6(8):E22932.
16. 周玉萍. 龍游縣2006-2013年15417例高校體檢學生ALT檢測結果分析[J]. 中國衛生檢驗雜志, 2014, 24(2):300-301.
17. 宋婕, 李官成. 肝癌相關腫瘤標志物研究新進展[J]. 國際病理科學與臨床雜志, 2011, 31(1):54-58.

West China Medical Journal

Clinical Application of Combined Detection of Serum Carbohydrate Antigen 199, Alanine Aminotransferase, and Gamma-glutamyl Transferase in the Diagnosis of Hyperthyroid Liver Damage

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