Gamma-glutamyltransferase and disability pension: A cohort study of construction workers in Germany

Abstract

Given the accumulating evidence that gamma-glutamyltransferase (␥-GT) is not merely a sensitive marker for liver and bile disorders but also a risk marker for a multiplicity of other chronic diseases, ␥-GT may represent a promising risk indicator for occupational disability, which has emerged as an important public health problem. The association between ␥-GT and disability pension was examined in a cohort of 16,520 male construction workers in Württemberg, Germany, who participated in routine occupational health examinations from 1986 to 1992 and who were followed until 2005. Using the Cox proportional hazards model, hazard ratios were calculated with ␥-GT concentrations in the lowest quartile (1 to 24 U/L) as reference category after adjustment for age and further adjustment for potential confounding factors such as nationality, type of occupation, smoking, alcohol consumption, cholesterol, and body mass index (BMI). Overall, a monotonically increasing association of ␥-GT with all-cause disability pension (total number: n ‫؍‬ 2,998 cases) was observed, with the steepest increase at lower levels of ␥-GT. Particularly strong associations were observed for participants in the highest quartile (>67 U/L) and disability pension due to musculoskeletal disorders, diseases of the digestive system, and cardiovascular as well as mental diseases (age-adjusted hazard ratios with 95% confidence intervals: 1.53, 1.27-1.85; 9.68, 3.10-30.21; 1.76, 1.28-2.42; and 1.83, 1.23-2.72, respectively). Conclusion: ␥-GT is a strong risk indicator of all-cause occupational disability even at levels of ␥-GT in the "normal range" and is in particular associated with disability pension due to diseases of the digestive system, musculoskeletal disorders, cardiovascular, and mental diseases. (HEPATOLOGY 2010; 51:482-490.)

Gamma-glutamyltransferase, general and cause-specific mortality in 19,000 construction workers followed over 20 years

“…Corroborating recent analyses identifying the same marker as an important predictor of allcause and cause-specific occupational disability [7], our findings imply that c-GT measurements in screening settings could justifiably serve as arguments for and arguments in individual risk factor modification. Largely independent from only partially understood causal relationships between this apparently powerful predictor and adverse health outcomes, occupational health professionals and other clinicians might one day use these results as an additional tool to help motivate subjects with high c-GT to attempt and maintain lifestyle changes by pointing to the strong association of this screening parameter with serious disorders for which a fair number of modifiable risk factors are known and preventive action is possible albeit not easy.…”

A novel hypothesis for atherosclerosis as a cholesterol sulfate deficiency syndrome

“…This relates to the observation, now thoroughly confirmed, that elevated γ-glutamyl transferase (GGT), an enzyme that breaks GSH down into its component amino acids, is an outstanding serum marker for a host of modern diseases, including liver dysfunction, cardiovascular disease [ 122 , 123 ], digestive disorders, Alzheimer’s disease, metabolic syndrome, obesity, diabetes, musculoskeletal disorders, cancer and death [ 124 – 127 ], with high significance. Ischemia depletes glutathione in both liver [ 128 ] and brain [ 129 ].…”

Smoking and γ-Glutamyltransferase: Opposite Interactions with Alcohol Consumption and Body Mass Index

“…The virtual absence of definite knowledge pertaining to an absolutely routine laboratory parameter and its interaction with some of the most classical epidemiological exposures should strongly stipulate additional research efforts in this area, preferably encompassing not only large-scale epidemiological, but also biomolecular approaches on the cellular level. Regardless of these future efforts, the apparent confirmation of a detrimental interaction of smoking and alcohol consumption with respect to γ-GT, an important predictor of morbidity, mortality, and disability [32], should motivate occupational health practitioners to rigorously address tobacco/alcohol co-use in their clientele, who depend on their physical integrity even more than the general population.…”