CoChat
Sign Up
Cited by 7Abdominal vascular conditions and treatmentsAortic Thrombus and EmbolismVascular anomalies and interventions

Plasma α-Glutathione S-Transferase in Patients with Chronic Mesenteric Ischemia and Median Arcuate Ligament Syndrome

Open access
Kazmi, Syed Sajid Hussain, Safi, Nathkai, Berge, Simen Tveten, Kazmi, Marryam, Sundhagen, Jon Otto, Julien, Kari, Thorsby, Per Medbøe, Ånonsen, Kim Vidar +2 more·2022·Vascular Health and Risk Management
DOI 10.2147/vhrm.s365625PMC PMC9315055
Open this paper in CoChat — free accountOpen PDF

Abstract

Background: Chronic mesenteric ischemia (CMI) due to either atherosclerosis of the mesenteric arteries or median arcuate ligament syndrome (MALS) is an underdiagnosed entity. The etiology of MALS and its existence have been debated and questioned. We aimed to identify plasma biomarkers indicating mesenteric ischemia in patients with CMI and MALS. Methods: Plasma α-glutathione S-transferase (α-GST), intestinal fatty acid-binding protein (I-FABP), citrulline, and ischemia modified albumin (IMA) were analyzed in fifty-eight patients with CMI (Group A, n=44) and MALS (Group B, n=14) before and after revascularization. The plasma levels of these potential biomarkers were compared with those of healthy individuals (Group C, n=16). Group comparison was performed with the Mann–Whitney U -test. Cross-tabulation and its derivatives were obtained. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were calculated. Results: Plasma levels of α-GST were significantly raised in the patients with CMI (7.8 ng/mL, p< 0.001) and MALS (8.4 ng/mL, p< 0.001), as compared with the control Group C (3.3 ng/mL). The threshold for normal median plasma α-GST levels of 4 ng/mL yielded a sensitivity of 93% and 86%, specificity of 86% and 88%, respectively, for the diagnosis of CMI due to atherosclerosis and MALS. AUC of ROC curves was 0.96 (p< 0.0001) for CMI and 0.85 (p< 0.002) for MALS. The patient groups did not differ from the healthy controls in any other biomarkers. Conclusion: Plasma α-GST levels are elevated in CMI and MALS patients. Elevated plasma levels of α-GST suggest ischemia as the etiology of MALS. Keywords: biomarker, chronic mesenteric ischemia, intestinal ischemia, median arcuate ligament syndrome, α-GST

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.2147/vhrm.s365625

Cites

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

The citation lists haven’t been fetched yet

References 36 · Cited by 7

Research works printed but not linked: 29

  1. [1]Terlouw LG, Moelker A, Abrahamsen J, et al. European guidelines on chronic mesenteric ischemia – joint United European Gastroenterology, European association for gastroenterology, endoscopy and nutrition, European society of gastrointestinal and abdominal radiology, Netherlands Association of hepatogastroenterologists, Hellenic society of gastroenterology, cardiovascular and interventional radiological society of Europe, and Dutch mesenteric ischemia study group clinical guidelines on the diagnosis and treatment of patients with chronic mesenteric ischaemia. United Eur gastroenterol j. 2020; 8(4): 371– 395. PMC7226699 32297566
  2. [3]Ter Steege RW, Sloterdijk HS, Geelkerken RH, Huisman AB, van der Palen J, Kolkman JJ. Splanchnic artery stenosis and abdominal complaints: clinical history is of limited value in detection of gastrointestinal ischemia. World J Surg. 2012; 36(4): 793– 799. 22354487 PMC3299959
  3. [6]Weber JM, Boules M, Fong K, et al. Median arcuate ligament syndrome is not a vascular disease. Ann Vasc Surg. 2016; 30: 22– 27. 26365109
  4. [7]Mensink PB, van Pettersen AS, Kolkman JJ, et al. Gastric exercise tonometry: the key investigation in patients with suspected celiac artery compression syndrome. J Vasc Surg. 2006; 44: 277– 281. 16890853
  5. [8]Berge ST, Safi N, Sundhagen JO, Hisdal J, Kazmi SSH. Perioperative microcirculatory changes detected with gastroscopy assisted laser Doppler flowmetry and visible light spectroscopy in patients with median arcuate ligament syndrome. VHRM. 2020; 16: 331– 341. PMC7493022 32982262
  6. [10]Delaney CP, O’Neill S, Manning F, Fitzpatrick JM, Gorey TF. Plasma concentrations of glutathione S-transferase are raised in patients with intestinal ischemia. BJS. 1999; 86: 1349– 1353. 10540149
  7. [11]Kanda T, Fujii H, Fujita M, Sakai Y, Ono T, Hatakeyama K. Intestinal fatty acid binding protein is available for diagnosis of intestinal ischemia: immunochemical analysis of two patients with ischemic intestinal diseases. Gut. 1995; 36: 788– 791. 7797132 PMC1382688
  8. [12]Peters JHC, Nicolette JW, Beishuizen A, Teerlink T, Van Bodegraven AA. Intravenous citrulline generation test to assess intestinal function in intensive care unit patients. Clin Exp Gastroenterol. 2017; 10: 75– 81. 28496350 PMC5417678
  9. [13]Kuiken NSS, Rings EHHM, Blijlevens NMA, Tissing WJE. Biomarkers and non-invasive tests for gastrointestinal mucositis. Support Care Cancer. 2017; 25: 2933– 2941. 28536886 PMC5527064
  10. [14]Obulkasim M, Zhang L, Shen J. Serological biomarkers for acute mesenteric ischemia. Ann Transl Med. 2019; 7(16): 394. 31555708 PMC6736808
  11. [15]Fedrico A, Tuccillo C, Crafa E, Loguercio C. The significance of alpha glutathione S-transferase determination in patients with chronic liver disease. Minerva Gastro-Enterologica e Dietologica. 1999; 45(3): 181– 185. 16498328
  12. [16]Iwanaga Y, Komatsu H, Yokono S, Ogli K. Serum glutathione S-transferase alpha as a measure of hepatocellular function following prolonged anaesthesia with sevoflurane and halothane in paediatric patients. Pediatric Anesthesia. 2000; 10(4): 395– 398. 10886696
  13. [17]Czuczejko J, Mila-Lierzenkowska C, Szewczyk-Golec K. Plasma α-Glutathione S-Transferase evaluation in patients with acute and chronic liver injury. Cand J Gastrenter Hep. 2019; 1: 1– 6. PMC6854929 31772928
  14. [18]Evennett NJ, Petrov MS, Mittal A, Windsor JA. Systemic review and pooled estimates for the diagnostic accuracy of serological markers for intestinal ischemia. World J Surg. 2009; 33: 1374– 1383. 19424744
  15. [19]Mensink PBF, Hol L, Borghuis-Koertshuis N, et al. Transient postprandial ischemia is associated with increased intestinal fatty acid binding protein in patients with chronic gastrointestinal ischemia. Eur J Gastroenterol Hepatol. 2009; 21: 278– 282. 19279473
  16. [20]Gunduz A, Turedi S, Mentese A, et al. Ischemia-modified albumin in the diagnosis of acute mesenteric ischemia: a preliminary study. Am J Emerg Med. 2008; 26: 202– 205. 18272103
  17. [21]Treskes N, Persoon AM, van Zanten ARH. Diagnostic accuracy of novel serological biomarkers to detect acute mesenteric ischemia: a systemic review and meta-analysis. Intern Emerg Med. 2017; 12: 821– 836. 28478489 PMC5559578
  18. [23]Montagnana M, Danese E, Lippi G. Biochemical markers of acute intestinal ischemia: possibilities and limitations. Ann Transl Med. 2018; 6(17): 341. 30306080 PMC6174180
  19. [24]Acosta S, Nilsson T. Current status on plasma biomarkers for acute mesenteric ischemia. J Thromb Thrombolysis. 2012; 33: 355– 361. 22081293
  20. [25]Heijkant TCVD, Aerts BAC, Teijink JA, Buurman WA, Luyer MDP. Challenges in diagnosing mesenteric ischemia. World J Gastroenterol. 2013; 19(9): 1338– 1341. 23538325 PMC3602491
  21. [26]Moneta GL, Yeager RA, Dalman R, Antonovic R, Hall LD, Porter JM. Duplex ultrasound criteria for diagnosis of splanchnic artery stenosis or occlusion. J Vasc Surg. 1991; 14(4): 511– 520. 1920649
  22. [28]Hanley JA, McNeil BJ. The meaning and use of the area under a receiver operating characteristics (ROC) curve. Radiology. 1982; 143: 29– 36. 7063747
  23. [29]Metz CE. Basic principles of ROC analysis. Semin Nucl Med. 1978; 8(4): 283– 298. 112681
  24. [30]Polo TCF, et al. Use of ROC curves in clinical and experimental studies. J Vasc Bras. 2020; 19: 1– 4. PMC8218006 34211533
  25. [31]Gloviczki P, Ducan AA. Treatment of celiac artery compression syndrome: does it really exist? Perspect Vasc Surg Endovasc Ther. 2007; 19(3): 259– 263. 17911551
  26. [32]Kim EN, Lamb K, Relles D, et al. Median arcuate ligament syndrome- review of this rare disease. JAMA. 2016; 15(5): 471– 477. 26934394
  27. [34]Björck M, Koelemay M, Acosta S, et al. Editor’s choice – management of the diseases of mesenteric arteries and veins: clinical practice guidelines of the European Society of Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2017; 53(4): 460– 510. 28359440
  28. [35]McCord JM. Oxygen-derived free radicals in postischemic tissue injury. N Engl J Med. 1985; 312: 159– 163. 2981404
  29. [36]Grootjans J, Lenaerts K, Derikx JP, et al. Human intestinal ischemia-reperfusion induced inflammation characterized: experiences from a new translational model. Am J Pathol. 2010; 176: 2283– 2291. 20348235 PMC2861093

Authors
Kazmi, S. S. H., Safi, N., Berge, S. T., Kazmi, M., Sundhagen, J. O., Julien, K., Thorsby, P. M., Ånonsen, K. V., Medhus, A. W., & Hisdal, J.
Affiliations
  • Oslo University Hospital (NO)
  • Poznan University of Medical Sciences (PL)
Corresponding author
Kazmi, Syed Sajid Hussain
ORCID
Venue
Vascular Health and Risk Management
Publisher
Informa UK Limited
Published
2022-07
Volume
Volume 18
Pages
567-574
ISSN
  • 1176-6344 (ISSN-L)
  • 1178-2048
DOI
10.2147/vhrm.s365625
PMC
PMC9315055
OpenAlex
W4286268861
Cited by
7
References
36
Citations by year
2026: 1 · 2025: 5 · 2024: 1
FWCI
1.43
Type
journal article
Language
en
Open access
Licence
Locations
  • Vascular Health and Risk Management (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
  • NORA - Norwegian Open Research Archives (submittedVersion, cc-by-nc)
Topics
  • Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Aortic Thrombus and Embolism
  • Health Sciences › Medicine › Surgery › Vascular anomalies and interventions
Keywords
chronic mesenteric ischemia, median arcuate ligament syndrome, alpha-glutathione S-transferase, plasma biomarkers, intestinal ischemia, intestinal fatty acid binding protein, citrulline, ischemia-modified albumin, mesenteric revascularization, sensitivity and specificity
MeSH terms
Median Arcuate Ligament Syndrome, Celiac Artery, Chronic Disease, Glutathione Transferase, Humans, Ischemia, Serum Albumin, Biomarkers, Atherosclerosis, Mesenteric Ischemia

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review