Authors
Etienne Rivière, Noémie Gensous, Benjamin de Sainte-Marie, Yann Nguyen, Nathalie Costedoat-Chalumeau, Marie-Lise Bats, Adèle Delamarre, Groupe Greenternist de la SNFMI
Published in
La Revue de medecine interne. Oct 07, 2026. Epub Oct 07, 2026.
Abstract
Gamma-glutamyl transferase (GGT) is a membrane-bound enzyme involved in extracellular glutathione metabolism and amino-acid transport, widely expressed in hepatobiliary epithelium and other tissues. In clinical practice, serum GGT is primarily used as a sensitive but non-specific marker of hepatobiliary injury and cholestasis, and as a companion test to alkaline phosphatase (ALP) to confirm hepatic origin. Beyond liver disease, elevated GGT reflects systemic oxidative stress and inflammation and has been associated with cardiometabolic disorders, some cancers, and drug-induced liver injury. This review summarizes the biology and function of GGT and proposes practical indications for ordering GGT in adult clinical practice based on PubMed-indexed literature. GGT measurement is most informative in: (1) evaluation of abnormal liver tests, particularly isolated or predominant ALP elevation; (2) suspected alcohol-related liver disease; (3) suspected cholestatic or pancreatic disease; (4) monitoring for drug-induced liver injury; and (5) selected contexts of cardiometabolic risk stratification and liver cancer risk assessment. Given its lack of specificity, GGT should always be interpreted alongside clinical context, other liver enzymes, imaging, and metabolic risk factors. It is imperative that clinicians address the issue of streamlining so-called "routine" laboratory tests, including gamma-GT, which ultimately proves to be of limited value in most cases.
PMID:
42844127
Bibliographic data and abstract were imported from PubMed on 08 Oct 2026.
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