title: Plasma gamma-glutamyltransferase is strongly determined by acylation stimulating protein levels independent of insulin resistance in patients with acute coronary syndrome.
abstract: BACKGROUND
  Steatosis is a manifestation of the metabolic syndrome often associated with release of liver enzymes and inflammatory adipocytokines linked to cardiovascular risk. Gamma-glutamyltransferase (GGT) is one sensitive liver marker recently identified as an independent cardiovascular risk factor. Mechanisms involved in enhanced hepatic lipogenesis causing steatosis are not yet identified and are usually linked to insulin resistance (IR). Acylation stimulating protein (ASP), a potent lipogenic factor, was recently shown to increase in patients with steatosis and was implicated in its pathogenesis.
  
  
  OBJECTIVE
  To investigate the association of plasma ASP levels with liver and metabolic risk markers in acute coronary syndrome (ACS) patients.
  
  
  METHODS
  28 patients and 30 healthy controls were recruited. Their anthropometrics, lipid profile, liver markers, insulin, and ASP levels were measured.
  
  
  RESULTS
  In the patients, ASP, liver, and metabolic risk markers were markedly higher than in the controls. ASP strongly predicted GGT levels (B = 0.75, P < 0.0001), followed by triglycerides (B = 0.403, P = 0.017), together determining 57.6% variation in GGT levels. Insulin and IR correlated with metabolic risk components but not with liver enzymes.
  
  
  CONCLUSIONS
  The strong association of ASP with GGT in ACS patients suggests that ASP, independent of IR, may contribute to a vicious cycle of hepatic lipogenic stimulation and GGT release promoting atherogenesis.
authors.affiliation: Biochemistry Department, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Muscat 123, Oman.
authors.forename: Jumana
authors.initials: J
authors.lastname: Saleh
authors.forename: Hatem
authors.initials: H
authors.lastname: Farhan
authors.forename: Ibtisam
authors.initials: I
authors.lastname: Al-Saqri
authors.forename: Bashair
authors.initials: B
authors.lastname: Al-Riyami
authors.forename: Katherine
authors.initials: K
authors.lastname: Cianflone
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000175:diagnosis; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003176:Complement C3; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D015415:Biomarkers; C038245:C3 protein, human; D003176:Complement C3; D036341:Intercellular Signaling Peptides and Proteins; D005723:gamma-Glutamyltransferase; C554782:gamma-glutamyltransferase, human