Effects of Smoking and Body Mass Index on Serum Liver Enzyme Levels in Chronic Kidney Disease Patients on Hemodialysis

Abstract Background and objective: A markedly elevated liver enzyme levels (GGT, AST, and ALT) are commonly associated with liver disease but recently has also been linked to an increased risk of chronic kidney disease (CKD). Therefore, this study was carried out to measure the serum levels of GGT, AST, and ALT in Iraqi adult patients with CKD. Materials and Methods: The levels of GGT, AST, and ALT were measured in 30 controls and 30 CKD patients before the hemodialysis session. The effects of age, gender, smoking status, and body mass index (BMI) on the levels of liver enzymes were investigated. Results: Compared with the controls, CKD patients had a significantly higher level of GGT (P<0.05), whereas, no significant associations between the levels of ALT or AST and risk of CKD were observed. There were no significant differences between male and female with regard to GGT, ALT, and AST levels in patients or the controls. The GGT levels were significantly reduced with age in patients and the controls (P<0.05). The GGT levels were significantly higher in smokers than in non-smokers for patients and the controls. For patients and the controls, the GGT levels were significantly higher in overweight and obesity subjects than in normal BMI subjects (P<0.05). By contrast, the age, cigarette smoking, BMI did not significantly affect the ALT and AST levels in patients or the controls. Conclusions: The GGT level was elevated in CKD patients on hemodialysis without the elevation of other liver enzymes in the middle-aged and elderly in Iraq. Smoking and BMI were positively associated with elevated levels of GGT in CKD patients. Therefore, these findings suggested that maintaining a healthy weight and smoking cessation might reduce the GGT level, and may also prevent or delay the onset of CKD and improve health overall.