Étude de l'impact de cholestase hépatique sur les biomarqueurs enzymatique hépatique : analyse de l'élévation des niveaux de GGt/ PAL et la bilirubine

Abstract

This study looked at changes in liver biochemical parameters, including GGT, PAL, ASAT, and ALAT enzymes, as well as bilirubin, in healthy individuals and those with cholestasis, taking gender into account. The results show a significant elevation of GGT in patients compared to healthy subjects, with averages reaching 356.4 U/L versus 115.3 U/L in women and 403.8 U/L versus 112.0 U/L in men. This increase reflects marked biliary stress, aggravated by pre-existing liver damage. Overall, GGT values are higher in men, which could be related to hormonal differences, such as the protective effect of oestrogen in women, or to the increased prevalence of certain female cholestatic conditions, such as primary biliary cholangitis. Alkaline phosphatase (ALP) levels are also higher in male patients: 684.8 U/L compared to 375.2 U/L in women, and 651.0 U/L compared to 284.4 U/L in men. This difference could be partly explained by hormonal influences, particularly in situations such as intrahepatic cholestasis of pregnancy. Transaminases (AST and ALT) show a marked increase in sick patients, reflecting active hepatic cytolysis. AST rises from 85.3 to 417.8 U/L in women and from 300.9 to 725.9 U/L in men. In women, ALAT levels rose from 62.5 to 345.5 U/L, and from 215.8 to 454.5 U/L in men. These differences could be linked to biological factors such as muscle mass, androgen levels, or certain health behaviours that differ between the sexes. With regard to bilirubin, a slight increase is observed in female patients (44.4 mg/L compared to 39.8 mg/L), while a decrease is noted in male patients (27.4 mg/L compared to 34.5 mg/L). This difference could reflect an increased susceptibility of women to autoimmune cholestatic diseases that disrupt bile excretion. In conclusion, this study highlights significant hepatic enzyme alterations in individuals with cholestasis, with notable differences between the sexes. These results underscore the importance of an individualised and integrative approach when interpreting liver function tests, taking into account hormonal and biological factors in the diagnosis and management of liver diseases.