Prospective Assessment of the Predictive Value of α-Glutathione S-Transferase for Intestinal Ischemia
Abstract
Nonspecific investigations resulting in treatment delays contribute to the 30 per cent mortality associated with acute mesenteric ischemia (AMI). As preliminary studies indicate that α-glutathione S-transferase (α-GST) is elevated in AMI we compare the ability of a-GST against conventional biochemical tests to predict AMI. There were 58 patients prospectively evaluated for AMI. Samples for α-GST (Biotrin International, Dublin, Ireland), lactate, pH, amylase, base excess, and white blood cell count (WBC) were evaluated. Intestinal ischemia was confirmed by colonoscopy, angiography, or laparotomy. Ischemia was present in 35 (60%) patients: small bowel (n = 14), colonic (n = 17), and global (n = 4). Four patients without autopsy were excluded. α-GST was elevated in those with AMI [22.2 (7–126) ng/mL vs 2.2 (1–3) ( P = 0.001)]. α-GST was more accurate at predicting intestinal ischemia (74%) than conventional tests (47–69% accuracy). Accuracy was increased to 80 per cent by combination with lactate or WBC, which increased sensitivity to 97 to 100 per cent. α-GST monitoring is a useful tool for the diagnosis of intestinal ischemia. A normal α-GST and WBC may exclude the presence of AMI.
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Scores or combinations of biomarkers were assessed in only 5 studies, mainly combining laboratory biomarkers with radiological or clinical markers, and this did not permit meta-analysis.
“Scores/combinations of biomarkers were assessed in only 5 studies [23, 35, 42, 85, 94], mainly combining laboratory biomarkers with radiological or clinical markers and thus not permitting any meta-analysis.”
From Diagnostic accuracy of biomarkers to detect acute mesenteric ischaemia in adult patients: a systematic review and meta-analysis (2023) · cites this paper as [35]
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- Authors
- Gearhart, S. L., Delaney, C. P., Senagore, A. J., Banbury, M. K., Remzi, F. H., Kiran, R. P., & Fazio, V. W.
- Affiliations
- Cleveland Clinic (US)
- Venue
- The American Surgeon
- Publisher
- SAGE Publications
- Published
- 2003-04
- Volume
- 69
- Issue
- 4
- Pages
- 324-329
- ISSN
- 0003-1348 (ISSN-L)
- 1555-9823
- OpenAlex
- W4312318009
- Cited by
- 47
- References
- 15
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 2 · 2022: 4 · 2021: 1 · 2019: 1 · 2018: 1 · 2017: 4 · 2016: 3 · 2015: 2 · 2014: 4 · 2013: 1
- FWCI
- 1.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Surgeon (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Keywords
- alpha-glutathione S-transferase, acute mesenteric ischemia, intestinal ischemia, diagnostic biomarkers, lactate, white blood cell count, diagnostic accuracy, small bowel ischemia, ischemic colitis, treatment delay
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