Serum gamma-glutamyl transferase levels in acute stroke: a hospital-based case–control study from India

Background & objectives: Gamma-glutamyl transferase (GGT), an enzyme involved in oxidative stress and glutathione metabolism, is increasingly recognized as a cardiovascular risk biomarker. Limited data are available on its association with stroke in the Indian population. This study aimed to evaluate serum GGT levels in acute stroke patients and analyze variations across stroke subtypes and established vascular risk factors. Methods: This hospital-based case–control study included 50 consecutive patients aged ≥18 years presenting within 24 hours of their first acute stroke and 50 age- and sex-matched healthy controls. Patients with liver/kidney disease, alcohol use, or prior stroke were excluded. Serum GGT was measured enzymatically and compared between groups and across subgroups (smokers vs non-smokers, diabetics vs non-diabetics, hypertensives vs normotensives, haemorrhagic vs non-haemorrhagic strokes). Statistical analysis used unpaired t-test, chi-square test, and Pearson’s correlation. Results: Mean GGT levels were significantly higher in stroke patients than controls (50.46 ± 23.57 vs 33.52 ± 18.77 U/L; p = 0.0001). Elevated GGT correlated significantly with smoking (p = 0.03), diabetes mellitus (p = 0.01), and hypertension (p = 0.03). No significant difference was observed between haemorrhagic and non-haemorrhagic stroke subtypes (p = 0.6). Age showed a positive correlation with GGT, while gender did not. Interpretation & conclusions: Elevated GGT levels in acute stroke patients support its potential role as a biomarker reflecting oxidative stress and vascular risk. Larger longitudinal studies are warranted to explore its prognostic value in stroke.