Association Between Serum Gamma-Glutamyl Transferase and Alkaline Phosphatase with Presence of Premature Coronary Artery Disease: Findings from Khuzestan Comprehensive Health Study (KCHS)

Abstract

Background Coronary artery disease has remained the leading cause of death worldwide. Premature coronary artery disease (PCAD) is defined as the incidence of coronary artery disease in males ≤ 45 and females ≤ 55. This study aimed to investigate the association between the concentrations of gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP) with the presence of PCAD for the first time in a large general population in a developing country. Methods A total of 20,542 from the Khuzestan Comprehensive Health Study participants were entered into the study based on the inclusion and exclusion criteria. The association of the GGT and ALP levels with the presence of PCAD was analyzed with multiple logistic regression models adjusted for gender, dyslipidemia, triglyceride concentration, cigarette smoking, opium consumption, hypertension, diabetes mellitus, and age. Moreover, the receiver operating characteristic (ROC) was used to assess the predictive power of GGT and ALP for PCAD. Results While in univariate analyses both ALP and GGT were significantly associated with the presence of PCAD [GGT: odds ratio (OR), 1.008; 95% confidence interval (CI), 1.005–1.011; p-value < 0.0001; ALP: OR, 1.003; CI, 1.002–1.004; p-value < 0.0001], after adjusting for confounders, the associations were no longer significant (GGT p-value = 0.177; ALP p-value = 0.963). However, the addition of the GGT to the conventional cardiovascular risk factors improved the predictive value of the model for the presence of PCAD in females (p-value < 0.05). Conclusions In conclusion, although ALP showed no independent association with PCAD, adding GGT to conventional cardiovascular risk factors could significantly improve the prediction of PCAD in female participants.