Glutathione S-transferase Alpha 1-1 and aminotransferases in umbilical cord blood

Recent data suggest that levels of glutathione S-transferase Alpha 1-1 in u mbilical cord plasma may be a good indicator of neonatal hepatocellular int egrity. In order to fully understand the significance of this new marker we compared the values of glutathione S-transferase Alpha 1-1 (GSTA1-1) with that of the well known liver function markers alanine aminotransferase (ALT ) and aspartate aminotransferase (AST) in arterial and corresponding venous umbilical cord blood of 93 patients. In addition, in 49 of these patients maternal venous blood was also studied. Both arterial and venous umbilical cord GSTA1-1 and AST levels were significantly higher than corresponding ma ternal venous levels, whereas ALT levels were not. Arterial umbilical cord GSTA1-1 correlated significantly with the corresponding AST and ALT levels (R = 0.46, P < 0.0001 and R = 0.41, P < 0.0001, respectively). Arterial umb ilical cord AST correlated significantly with corresponding ALT levels (R = 0.58, P < 0.0001). Arterial umbilical cord plasma GSTA1-1 levels were sign ificantly lower in the cesarean delivery group as compared to the vaginal b irth group, whereas no difference was noted for AST or ALT. Arterial umbili cal cord AST and GSTA1-1 levels correlated significantly with base deficit (R = 0.29, P = 0.005; R = 0.29, P = 0.005, respectively), whereas ALT did n ot (R = 0.06, P = 0.54). Arterial umbilical cord AST, ALT, and GSTA1-1 leve ls correlated significantly with birthweight. In conclusion, GSTA1-1 levels as assessed in neonatal umbilical cord blood, being unrelated to maternal levels, seem to be a more sensitive marker for early neonatal hepatocellula r integrity as compared to ALT or AST and even might detect impaired hepato cellular integrity due to the vaginal birth process. Umbilical cord GSTA1-1 may provide a valuable indicator of neonatal condition immediately after b irth, the clinical relevance of which needs to be further established. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.