γ-Glutamyltransferase as a Risk Factor for Cardiovascular Disease Mortality

Abstract

the Vorarlberg Health Monitoring and Promotion Program Study GroupBackground-There is evidence from recent studies that ␥-glutamyltransferase (GGT) is likely to be associated with cardiovascular disease (CVD). However, few studies to date with sufficient sample size and follow-up investigated the association of GGT with CVD mortality. Methods and Results-The relation of GGT to the risk of death from CVD was examined in a cohort of 163 944 Austrian adults that was monitored for up to 17 years. To evaluate GGT as an independent predictor, Cox proportional hazards models were calculated, which adjusted for established risk factors. In both men and women, high GGT was significantly (PϽ0.001) associated with total mortality from CVD, showing a clear dose-response relationship. Adjusted hazard ratios (95% CI) per log GGT increase were 1.66 (1.40 to 1.98) in men and 1.64 (1.36 to 1.97) in women. In men, subgroup analyses showed that high GGT was positively associated with incident fatal events of chronic forms of coronary heart disease (Pϭ0.009), congestive heart failure (PϽ0.001), and hemorrhagic (Pϭ0.01) and ischemic stroke (PϽ0.001). No significant associations were observed for acute myocardial infarction (Pϭ0.16). In women, hazard ratios suggested associations in all subgroups; however, for hemorrhagic and ischemic stroke they were not statistically significant (Pϭ0.09 and Pϭ0.07, respectively). In addition, subgroup analyses stratified by age revealed a stronger relationship of GGT in younger participants. Hazard ratios for total CVD were 2.

Ultrasonographic hepatic steatosis increases prediction of mortality risk from elevated serum gamma-glutamyl transpeptidase levels

“…The latter is supported by studies linking elevated GGT levels directly to increased risk of CVD and all-cause mortality. [1][2][3]36,37 Parallel evidence for indirect effects emerges from studies Fig. 1.…”

Can aspirin resistance be clinically predicted in stroke patients?

“…This finding clearly indicated that subjects with a high-normal ALT might be susceptible to carotid atherosclerosis. There are many cross-sectional [13][14][15][16] and prospective [9,17,18] studies on the association between NAFLD and intermediate markers of cardiovascular disease or clinical outcomes. These studies have reported that ultrasounddiagnosed liver steatosis or raised serum concentrations of liver enzymes predict an increased risk of cardiovascular disease, independent of several established risk factors.…”

Can persistent organic pollutants explain the association between serum γ-glutamyltransferase and type 2 diabetes?

“…However, POPs may have increased potency at a lower body burden in an obesity epidemic, because the toxicity of POPs appears to increase among obese persons [29]. Additionally, other POPs, such as brominated flame retardants and perfluorinated compounds, which are still widely used today, may be as important as the POPs we studied in the pathogenesis of type 2 diabetes [49].…”

“…However, serum GGT activity within its normal range has also been shown to prospectively predict other clinical outcomes [29][30][31][32][33]. Similarly, in the NHANES dataset, serum POP concentrations were positively associated with the prevalence of the metabolic syndrome, insulin resistance, hypertension, and cardiovascular diseases [34,36].…”