Serum γ‐Glutamyltransferase: Independent Predictor of Risk of Diabetes, Hypertension, Metabolic Syndrome, and Coronary Disease

Abstract

Serum γ‐glutamyltransferase (GGT) is associated with oxidative stress and hepatic steatosis. The extent to which its value in determining incident cardiometabolic risk (coronary heart disease (CHD), metabolic syndrome (MetS), hypertension and type 2 diabetes) is independent of obesity needs to be further explored in ethnicities. After appropriate exclusions, a cohort of 1,667 adults of a general population (age 52 ±11 years) was evaluated prospectively at 4 year's follow‐up using partly Cox proportional hazard regressions. GGT activity was measured kinetically, and values were log‐transformed for analyses. MetS was identified by Adult Treatment Panel‐III criteria modified for male abdominal obesity. Median (interquartile range) GGT activity was 24.9 (17.0; 35.05) U/l in men, 17.0 (12.3; 24.0) U/l in women. In linear regression analysis, while smoking status was not associated, (male) sex, sex‐dependent age, alcohol usage, BMI, fasting triglycerides and C‐reactive protein (CRP) were significant independent determinants of circulating GGT. Each 1‐s.d. increment in (= 0.53 ln GGT) GGT activity significantly predicted in each sex incident hypertension (hazard ratio (HR) 1.20 (95% confidence interval (CI) 1.10; 1.31)), and similarly MetS, after adjustment for age, alcohol usage, smoking status, BMI and menopause. Strongest independent association existed with diabetes (HR 1.3 (95% CI 1.1; 1.5)) whereas GGT activity tended to marginally predict CHD independent of total bilirubin but not of BMI. Higher serum total bilirubin levels were protective against CHD risk in women. We conclude that elevated serum GGT confers, additively to BMI, risk of hypertension, MetS, and type 2 diabetes but only mediates adiposity against CHD risk.

Is there any relationship between serum γ-glutamyltransferase levels and premature coronary artery disease?

“…Oxidative stress was shown to play important roles in many phases of atherosclerosis [3]. Elevated serum GGT levels have been shown to be associated with development of diabetes mellitus (DM), hypertension (HT) and metabolic syndrome [5][6][7]. The relationship between GGT levels and CAD is established in many studies [8][9][10].…”

Increased gamma-glutamyl transferase level is associated with absence of coronary collateral vessels in patients with acute coronary syndrome: an observational study

“…Previous reports showed that there was a close relationship between increased serum GGT levels and other prognostic factors, such as hypertension, metabolic syndrome, diabetes, dyslipidemia (6,36). But we do not have clearly information about an association between GGT and known ischemic heart disease risk factors.…”

“…The GGT activity has been observed in coronary atherosclerotic plaques (4). Several studies demonstrated that an elevated serum GGT activity can be used as a marker for increased oxidative stress in humans (5,6). In addition, serum GGT was an independent risk factor for the diabetes mellitus, stroke and hypertension (7,8).…”

Increased apolipoprotein A-I levels mediate the development of prehypertension among Turks

“…Present findings and those of others discussed indicate that any relevant degree of pro-inflammatory state/oxidative stress offsetting the balance of anti-inflammatory processes may be prominently involved in the development of prehypertension or hypertension, be it low levels or dysfunctional high levels of apoA-I, HDL particles or adiponectin, or elevated concentrations of CRP, apoB or gamma-glutamyltransferase (32). High levels of pro-inflammatory apoA-I may thereby be accounted for a prospective association with diabetes, CHD and prehypertension.…”