{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:42:54Z","timestamp":1788514974981,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T00:00:00Z","timestamp":1720569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100012319","name":"National Center for Global Health and Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>In patients with Fontan\u2010associated liver disease (FALD), gamma\u2010glutamyl transferase (GGT) levels are often elevated, however, its clinical importance is unclear. We investigated the relationship between the clinical course of FALD and GGT levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We enrolled 145 patients with FALD who underwent right\u2010heart catheterization (RHC) and visited our department. Ursodeoxycholic acid (UDCA) was administered to 62 of the patients. Patients with GGT levels &lt;50 and \u226550\u00a0U\/L were compared. Follow\u2010up RHC was undertaken in 76 patients. Cases in which GGT levels decreased by \u226510% or &lt;50\u00a0U\/L were defined as improved (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a033).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with GGT levels \u226550\u00a0U\/L had significantly lower levels of albumin and higher levels of alanine transaminase (ALT) but no significant differences in RHC factors. Over a 4.6\u2010year period, 43.4% showed improvement in GGT levels. Improved cases had significantly lower total bilirubin (1.1 vs. 1.6\u00a0mg\/dL), AST (22 vs. 28\u00a0U\/L), and ALT (18 vs. 27\u00a0U\/L) levels than nonimproved cases (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a029,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05), and the change in platelet count (\u22120.5 vs. \u22123.0\u00a0\u00d7\u00a010\n                      <jats:sup>\u22124<\/jats:sup>\n                      \/\u03bcL) was significantly lower in the latter (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.03). The improvement rate was significantly higher in UDCA\u2010treated cases (55.2%) with GGT levels \u226550\u00a0U\/L compared to cases not treated with UDCA (18.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.04).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In cases of FALD with no improvement in GGT level, the platelet count decreased over time, suggesting progression of fibrosis. Physicians should be aware of the importance of a high GGT level in patients with FALD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hepr.14093","type":"journal-article","created":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T11:03:59Z","timestamp":1720609439000},"page":"1205-1214","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Importance of gamma\u2010glutamyl transferase elevation in patients with Fontan\u2010associated liver disease"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1248-4324","authenticated-orcid":false,"given":"Tomomi","family":"Kogiso","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Institute of Gastroenterology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuri","family":"Ogasawara","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Institute of Gastroenterology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makiko","family":"Taniai","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Institute of Gastroenterology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eriko","family":"Shimada","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology and Adult Congenital Cardiology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Inai","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology and Adult Congenital Cardiology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsutoshi","family":"Tokushige","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Institute of Gastroenterology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousuke","family":"Nakai","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Institute of Gastroenterology Tokyo Women's Medical University  Tokyo 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