Elevated gamma‐glutamyl transferase levels are associated with stroke recurrence after acute ischemic stroke or transient ischemic attack

Li, Siqi; Wang, Anxin; Tian, Xue; Zuo, Yingting; Meng, Xia; Zhang, Yumei

doi:10.1111/cns.13909

Cited by 12 publications

(7 citation statements)

References 56 publications

(111 reference statements)

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“…The study found that GGT elevation significantly increases the risk of gastrointestinal, lung, breast, gynecological, and hematological malignancies in cancer site-specific models (p<0.006). 26 A similar study involving men reported analogous results, linking elevated GGT levels to increased cancer risk, especially in men aged ≤65 years (p<0.001). 27 Furthermore, several studies have associated GGT elevation with poor prognosis in various malignancies, including pancreatic, cervical, prostate, and renal cancers.…”

Section: Discussionmentioning

confidence: 63%

Gamma-Glutamyl Transferase/Albumin Ratio and Alkaline Phosphatase/Albumin Ratio as Novel Prognostic Markers for Metastatic Pancreatic Cancer

YÜCE,

FİDAN

2023

J Oncol Sci

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Metastatic pancreatic cancer is a common condition and highly lethal condition, emphasizing the urgent need for novel prognostic markers. This study investigated the effect of the gamma-glutamyl transferase/albumin ratio (GAR) and alkaline phosphatase/albumin ratio (APAR) on prognosis. Material and Methods: We conducted a retrospective examination 287 patients diagnosed with metastatic pancreatic cancer between January 2008 2019. Results: The median age was 65 years, and obstructive jaundice was present in 58 (20.2%). Median overall-surviva (OS) was significantly longer in patients without jaundice (6.0 vs. 3.0 months, p=0.005). Furthermore, median OS and progression-free survival (PFS) were extended in the low-GAR-group (6.0 vs. 4.0 months, p=0.001; 5.0 vs. 3.0 months, p<0.01, respectively). Similarly, patients in the low APAR group exhibited longer median OS and PFS (6.0 vs. 3.0 months, p<0.01; 5.0 vs. 3.0 months, p<0.01, respectively). The low neutrophil-to-lymphocyte-ratio (NLR) group demonstrated prolonged median OS and PFS (8.0 vs. 3.0 months, p<0.01; 6.0 vs. 3.0 months, p<0.01, respectively). Additionally, patients in the high prognostic-nutritional-index (PNI) group experienced extended median OS and PFS (6.0 vs. 3.0 months, p<0.01; 5.0 vs. 2.0 months, p=0.02, respectively). Furthermore, members of the low-GARgroup were significantly more prevalent in the low-NLR and low platelet-to-lymphocyte-ratio-groups (79.4% vs. 20.6%, p=0.02 and 75.9% vs. 24.1%, p=0.04, respectively). By contrast, the low-APAR-group had significantly more members than the high-PNI-group (90% vs. 10%, p<0.01). Conclusion: In metastatic pancreatic cancer, both OS and PFS significantly extend in the low-GAR, APAR, and NLR groups, while the high-PNI-group also exhibits enhanced OS and PFS. These findings must be supported by further studies .

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Section: Discussionmentioning

confidence: 63%

Gamma-Glutamyl Transferase/Albumin Ratio and Alkaline Phosphatase/Albumin Ratio as Novel Prognostic Markers for Metastatic Pancreatic Cancer

YÜCE,

FİDAN

2023

J Oncol Sci

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“…Baseline GGT level is positively and strongly associated with the risk for metabolic syndrome in a nonlinear dose-response manner [26,27]. Several epidemiologic studies have also demonstrated important advances in the definition of the associations between serum GGT level and the risk of overall mortality, coronary heart disease, type 2 DM, stroke, and chronic kidney disease [12,[28][29][30]. The regulatory mechanism of GGT expression has been already been widely investigated.…”

Section: Discussionmentioning

confidence: 99%

Significance of Fib4 index as an indicator of alcoholic hepatotoxicity in health examinations among Japanese male workers: a cross-sectional and retrospectively longitudinal study

et al. 2023

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Background Fib4 index (Fib4) is clinically used as a noninvasive marker of liver fibrosis. In this study, we aimed to preliminarily investigate whether Fib4 can be used to detect individuals who need assessment for alcoholic liver disease (ALD) in the general population by clarifying the detailed association of Fib4 with alcohol consumption and gamma-glutamyl transferase (GGT) among male workers. Methods We analyzed data sets on the comprehensive medical examinations of male workers as cross-sectional and retrospectively longitudinal studies. We enrolled 10 782 males (mean age: 52.2 ± 10.2 years) in FY2019 and 7845 males (mean follow-up: 12.6 ± 6.7 years) who could be consecutively followed up for 20 years from FY2000 to FY2019. Data were evaluated using logistic regression and COX proportional analysis. Results In the cross-sectional setting, the rate of Fib4 ≥ 2.67 in heavy drinkers (≥ 40 g of ethanol/day) was increased dose dependently in those over 65 years old, and that of body mass index ≥ 30 kg/m2 was increased in those over 60 years old, but not in those with fatty liver. The odds ratio (OR) (95% confidence interval [CI]) for heavy drinking was 4.30 (95% CI = 1.90–9.72), and GGT ≥ 200 IU/L was considerably high (OR = 29.05 [95% CI = 17.03–49.56]). In the longitudinal setting, heavy drinkers and those with GGT ≥ 200 IU/L at 10 years after the baseline showed an increased risk for Fib4 ≥ 2.67 (hazard ratio = 2.17 [95% CI = 1.58–2.98] and 7.65 [95% CI 5.26–11.12], respectively). Conclusions The development of Fib4 ≥ 2.67 after 10 years was associated with heavy alcohol drinking and GGT level ≥ 200 IU/L. Therefore, Fib4 combined with GGT could indicate high risk of ALD. However, clinical examinations and course observations are essentially needed.

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“…According to previous studies, GGT level is associated with a CVD diagnosis [9][10][11]. After a period of observation, researchers found that individuals with a higher GGT level were more likely than those with a lower GGT level to experience stroke [12,13]. Researchers also investigated the relationship between GGT level and adverse CVD clinical outcomes in stroke patients [14,15].…”

Section: Introductionmentioning

confidence: 99%

“…Researchers also investigated the relationship between GGT level and adverse CVD clinical outcomes in stroke patients [14,15]. In addition, a previous study reported that an elevated GGT level is related to stroke recurrence and transient ischemic attack [13]. However, after adjusting for multiple factors, a previous study found that the association between GGT activity and stroke was no longer significant, suggesting that GGT activity might not be a good predictor of the severity of cardio-cerebrovascular diseases [16].…”

Section: Introductionmentioning

confidence: 99%

Potential Causal Association between Elevated Gamma-Glutamyl Transferase Level and Stroke: A Two-Sample Mendelian Randomization Study

Lee,

Seo

2023

Biomolecules

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Researchers have suggested a potential relationship between gamma-glutamyl transferase (GGT) level and stroke. We investigated a potential causal relationship between GGT level as exposures and stroke and stroke subtypes (cardioembolic, small vessel, and large artery) in a European population. We performed a two-sample Mendelian randomization (MR) study using the genome-wide association study (GWAS) data from the UK Biobank as the exposure set. For the outcome set, we used stroke in the GWAS data from the GIGASTROKE Consortium. We considered alcohol consumption, atrial fibrillation, and body mass index as confounders. We used PhenoScanner searches for removal of SNPs and multivariable MR analysis for assessing confounders. We observed significant causal associations between GGT level and stroke (odds ratio [OR] = 1.23, 95% CI = [1.05–1.44], and p = 0.012 with IVW; OR = 1.19, 95% CI= [1.02–1.39], and p = 0.031 with MR-PRESSO). These results were consistent after removing SNPs related to confounding factors. Similarly, in multivariable MR, GGT was associated with stroke after adjusting for confounding factors (OR = 1.30, 95% CI 1.07–1.60), p = 0.010). Because GGT level has a causal relationship with stroke, researchers should test its significance as a potential risk factor for stroke. Additional research is required to validate these results.

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Elevated gamma‐glutamyl transferase levels are associated with stroke recurrence after acute ischemic stroke or transient ischemic attack

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 12 publications

References 56 publications

Gamma-Glutamyl Transferase/Albumin Ratio and Alkaline Phosphatase/Albumin Ratio as Novel Prognostic Markers for Metastatic Pancreatic Cancer

Gamma-Glutamyl Transferase/Albumin Ratio and Alkaline Phosphatase/Albumin Ratio as Novel Prognostic Markers for Metastatic Pancreatic Cancer

Significance of Fib4 index as an indicator of alcoholic hepatotoxicity in health examinations among Japanese male workers: a cross-sectional and retrospectively longitudinal study

Potential Causal Association between Elevated Gamma-Glutamyl Transferase Level and Stroke: A Two-Sample Mendelian Randomization Study

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