Association of gamma‐glutamyl transferase concentrations with all‐cause and cause‐specific mortality in Chinese adults with type 2 diabetes

Abstract

Background Evidence links gamma‐glutamyl transferase (GGT) to mortality in the general population. However, the relationship of GGT with all‐cause and cause‐specific mortality risk has been little explored in type 2 diabetes mellitus (T2DM) patients. Methods We recruited 20 340 community‐dwelling T2DM patients between 2013 and 2014 in Jiangsu, China. Cox regression models were used to assess associations of GGT with all‐cause and specific‐cause mortality. Restricted cubic splines were used to analyze dose–response relationships between GGT and mortality. Stratified analysis was conducted to examine potential interaction effects by age, sex, smoking status, body mass index (BMI), diabetes duration, and dyslipidemia. Results During a median follow‐up period of 7.04 years (interquartile range: 6.98–7.08), 2728 deaths occurred, including 902 (33.09%) due to cardiovascular disease (CVD), and 754 (27.58%) due to cancer. GGT concentrations were positively associated with all‐cause, CVD, and cancer mortality. Multivariable hazard ratios (HRs) for the highest (Q5) vs. the lowest quintile (Q1) were 1.63 (95% confidence intervals [CI]: 1.44–1.84) for all‐cause mortality, 1.87 (95% CI: 1.49–2.35) for CVD mortality, and 1.43 (95% CI: 1.13–1.81) for cancer mortality. Effect modification by BMI and dyslipidemia was observed for all‐cause mortality (both p for interaction <.05), and HRs were stronger in the BMI <25 kg/m2 group and those without dyslipidemia. Conclusions Our findings suggest that, in Chinese T2DM patients, elevated serum GGT concentrations were associated with mortality for all‐cause, CVD, and cancer, and further research is needed to elucidate the role of obesity, nonalcoholic fatty liver disease, and lipids in this association.

The Prognosis of Pediatric Intensive Care Unit Patients Can Be Affected by Gamma Glutamyl transferase and Uric Acid Levels: A systematic review with Meta-Analysis.

“…De nitions of elevated biomarker levels varied across studies from 1-1.5 times the upper limit of normal [5,6] to tertiles [7] or study-speci c cutoffs [8]. For transparency, we accepted the study authors' de nitions without standardizing thresholds post hoc.…”

“…Measuring hyperuricemia in the serum re ects renal in ammation and is a diagnostic agent. Gout, kidney stones, and hypertension may develop due to elevated urinary hyperuricemia over a prolonged period [5]. Additionally, uric acids could be lethal for critically ill PICU patients.…”

“…In adult intensive care populations, studies have found elevated levels of GGT and U.A. to be associated with increased mortality risk [4,5]. However, their prognostic value, speci cally in PICU patients, is less certain.…”

“…Literature/Theoretical framework Gamma Glutamyl transferases (GGTs) are cell surface enzymes are cells that are found throughout the body [5]. GGT cleaves glutathione and other extracellular gamma-glutamyl molecules to produce glutathione in cells.…”