Background: Elevated gamma-glutamyl transferase (GGT) is a biomarker associated with alcohol-related hepatic stress and oxidative imbalance. Although alcohol abstinence is the primary determinant of GGT normalization, adjunctive strategies may support biochemical improvement in real-world settings. Methods: This non-randomized cohort study included 197 of 1957 screened participants (10.1%), stratified according to baseline GGT into 55–99 U/L (n = 95) and ≥100 U/L (n = 102). Participants in the higher baseline subgroup underwent a multimodal intervention consisting of nutraceutical supplementation (silymarin, essential phospholipids, and a polyherbal antioxidant formulation) combined with structured psychological support aimed at promoting alcohol abstinence. The primary outcome was the change in GGT between baseline (T1) and follow-up (T2). Secondary outcomes included the proportion of participants achieving GGT reduction and the magnitude of change according to baseline severity. Clinical trial registration: ClinicalTrials.gov Identifier: NCT07603726. Results: Among participants with baseline GGT ≥ 100 U/L, GGT levels decreased from a median of 133.73 to 97.41 U/L (p < 0.001), whereas in the 55–99 U/L subgroup, median GGT changed from 67.49 to 66.51 U/L without reaching statistical significance (p = 0.072). Participants in the higher baseline subgroup demonstrated greater GGT reductions (median ΔGGT: −35.25 vs. −2.58 U/L), a higher proportion achieving GGT reduction (91.2% vs. 70.5%), and higher odds of GGT reduction at follow-up in exploratory analysis (OR = 4.32, 95% CI: 1.91–9.75). Conclusions: In this real-world cohort, reductions in GGT levels were observed, particularly among individuals with elevated baseline values (≥100 U/L) who underwent the multimodal intervention. These findings support monitoring GGT dynamics in routine clinical practice, where GGT remains a practical and accessible biomarker due to its widespread availability, low cost, and sensitivity to oxidative and alcohol-related hepatic stress.
Diana et al. (Sat,) studied this question.