Study of Serum Magnesium, Sodium, Calcium, Phosphorus and Liver Enzyme Gamma-Glutamyl Transferase (GGT) Levels in Chronic Alcoholic Liver Disease

Abstract

Background: Chronic alcoholic liver disease (CALD) is associated with progressive hepatic injury, impaired synthetic and metabolic functions, and disturbances in mineral homeostasis. Alterations in serum magnesium, sodium, calcium, and phosphorus may occur during chronic alcohol consumption and liver disease, while elevated gamma-glutamyl transferase (GGT) is commonly associated with hepatobiliary injury and chronic alcohol exposure. The present study was undertaken to assess serum magnesium, sodium, calcium, phosphorus, and GGT levels in patients with chronic alcoholic liver disease and to compare them with healthy individuals.

Materials and Methods: This hospital-based comparative study was conducted in the Departments of Biochemistry and Medicine at Tezpur Medical College and Hospital, Tezpur, over a period of one year from December 2022 to December 2023. A total of 100 subjects were included, comprising 50 patients diagnosed with chronic alcoholic liver disease and 50 age- and sex-matched healthy controls. Patients aged 18–60 years with chronic liver disease associated with fatty liver or cirrhosis were included, while patients with non-alcoholic liver disease, autoimmune cirrhosis, malignancy, pregnancy, or those receiving mineral supplementation were excluded. Venous blood samples were collected under aseptic precautions, and serum was analyzed for magnesium, sodium, calcium, phosphorus, GGT, liver enzymes, bilirubin, total protein, albumin, creatinine, and glucose. Statistical comparison between the groups was performed using appropriate statistical tests.

Results: The mean serum magnesium level was significantly lower in cases than in controls (1.016 ± 0.286 vs. 1.946 ± 0.167 mg/dL; p < 0.001). Serum sodium was also significantly reduced in cases (129.54 ± 2.51 vs. 139.72 ± 3.05 mmol/L; p < 0.001). Similarly, serum calcium (7.274 ± 0.524 vs. 9.182 ± 0.654 mg/dL) and phosphorus (1.518 ± 0.479 vs. 3.60 ± 0.489) were significantly lower among cases than controls (p < 0.001). In contrast, serum GGT was markedly elevated in patients with CALD (585.06 ± 182.56 vs. 18.32 ± 6.59 U/L; p < 0.001). Cases also demonstrated significantly increased ALT, AST, ALP, bilirubin, creatinine, and glucose levels, along with significantly decreased total protein and albumin levels, compared with controls.

Conclusion: Patients with chronic alcoholic liver disease demonstrated significant disturbances in serum mineral homeostasis, characterized by hypomagnesemia, hyponatremia, hypocalcemia, and hypophosphatemia, along with markedly elevated GGT and other biochemical indicators of hepatic dysfunction. Assessment of serum mineral levels together with GGT and routine liver-function parameters may provide useful information regarding metabolic disturbances and hepatic dysfunction in patients with chronic alcoholic liver disease.