J Korean Med Sci.  2011 Oct;26(10):1305-1309. 10.3346/jkms.2011.26.10.1305.

Serum Gamma-Glutamyltransferase Concentration Correlates with Framingham Risk Score in Koreans

• Kim KN
• Kim KM
• Lee DJ
• Joo NS

• KMID: 1785987
• DOI: http://doi.org/10.3346/jkms.2011.26.10.1305

Abstract

Gamma-glutamyltransferase (GGT) is a novel coronary artery disease (CAD) risk factor, but its use as an independent factor for CAD risk prediction remains unclear in Asian population. This study examined the association between serum GGT concentration and Framingham risk score (FRS) in the Korean population. This cross-sectional study was performed on 30,710 Koreans. Besides FRS, body mass index, fasting blood glucose, liver enzymes, lipid profile, uric acid and high sensitive C-reactive protein data were used. The study subjects were grouped into quartiles according to the levels of GGT. Analyses relating GGT to FRS > or = 20% utilized multiple confounders adjusted logistic regression. Positive correlations were established between log-transformed GGT concentration and FRS (r = 0.38; P < 0.001). Increasing the quartile of serum GGT concentration was significantly associated with linear increasing trends in FRS (P-trend < 0.001). Compared to the lowest baseline GGT category, age-gender adjusted odd ratios for FRS > or = 20% were significantly increased from the lowest to highest GGT quartiles; these results remained significantly after adjustments for multiple confounders. Increased GGT concentration is associated with the increase in FRS. Serum GGT may be helpful to predict the future risk of CAD.

Keyword

Gamma-Glutamyltransferase; Framingham Risk Score; Oxidative Stress

MeSH Terms

Adult
Aged
Aged, 80 and over
Blood Glucose/analysis
Body Mass Index
C-Reactive Protein/analysis
Coronary Artery Disease/enzymology/*epidemiology
Cross-Sectional Studies
Female
Humans
Lipids/blood
Liver/enzymology
Male
Middle Aged
Republic of Korea/epidemiology
Risk Factors
Uric Acid/blood
gamma-Glutamyltransferase/*blood

Figure

• 

  Fig. 1 The relationship between the 10-yr CAD risk and the quartile of serum GGT concentration. Increasing quartiles of serum GGT concentration are significantly associated with linear increasing trends in 10-yr CAD risk (P trend < 0.001). Vertical bar indicates 95% confidence interval. White circle indicates the mean.

Reference

1. Mackay J, Mensah GA, Mendis S, Greenlund K. World Health Organization. The atlas of heart disease and stroke. 2004. Geneva: World Health Organization;46–49.

2. Roberts CK, Barnard RJ, Sindhu RK, Jurczak M, Ehdaie A, Vaziri ND. Oxidative stress and dysregulation of NAD(P)H oxidase and antioxidant enzymes in diet-induced metabolic syndrome. Metabolism. 2006. 55:928–934.

3. Bo S, Gambino R, Durazzo M, Guidi S, Tiozzo E, Ghione F, Gentile L, Cassader M, Pagano GF. Associations between gamma-glutamyltransferase, metabolic abnormalities and inflammation in healthy subjects from a population-based cohort: a possible implication for oxidative stress. World J Gastroenterol. 2005. 11:7109–7117.

4. Lee DH, Blomhoff R, Jacobs DR Jr. Is serum gamma glutamyltransferase a marker of oxidative stress? Free Radic Res. 2004. 38:535–539.

5. Lee DH, Jacobs DR Jr. Association between serum concentrations of persistent organic pollutants and gamma glutamyltransferase: results from the National Health and Examination Survey 1999-2002. Clin Chem. 2006. 52:1825–1827.

6. Rantala AO, Lilja M, Kauma H, Savolainen MJ, Reunanen A, Kesäniemi YA. Gamma-glutamyl transpeptidase and the metabolic syndrome. J Intern Med. 2000. 248:230–238.

7. Lee DH, Ha MH, Kim JR, Gross M, Jacobs DR Jr. Gamma-glutamyltransferase, alcohol, and blood pressure. A four year follow-up study. Ann Epidemiol. 2002. 12:90–96.

8. Lee DH, Ha MH, Kim JH, Christiani DC, Gross MD, Steffes M, Blomhoff R, Jacobs DR Jr. Gamma-glutamyltransferase and diabetes: a 4 year follow-up study. Diabetologia. 2003. 46:359–364.

9. Perry IJ, Wannamethee SG, Shaper AG. Prospective study of serum gamma-glutamyltransferase and risk of NIDDM. Diabetes Care. 1998. 21:732–737.

10. Lee DH, Jacobs DR Jr, Gross M, Kiefe CI, Roseman J, Lewis CE, Steffes M. Gamma-glutamyltransferase is a predictor of incident diabetes and hypertension: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Clin Chem. 2003. 49:1358–1366.

11. Lee DH, Gross MD, Jacobs DR Jr. Cardiovascular Risk Development in Young Adults (CARDIA) Study. Association of serum carotenoids and tocopherols with gamma-glutamyltransferase: the Cardiovascular Risk Development in Young Adults (CARDIA) study. Clin Chem. 2004. 50:582–588.

12. Wannamethee G, Ebrahim S, Shaper AG. Gamma-glutamyltransferase: determinants and association with mortality from ischemic heart disease and all causes. Am J Epidemiol. 1995. 142:699–708.

13. Jousilahti P, Rastenyte D, Tuomilehto J. Serum gamma-glutamyl transferase, self-reported alcohol drinking, and the risk of stroke. Stroke. 2000. 31:1851–1855.

14. Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998. 97:1837–1847.

15. D'Agostino RB, Russell MW, Huse DM, Ellison RC, Silbershatz H, Wilson PW, Hartz SC. Primary and subsequent coronary risk appraisal: new results from the Framingham study. Am Heart J. 2000. 139:272–281.

16. Greenfield TK. Ways of measuring drinking patterns and the difference they make: experience with graduated frequencies. J Subst Abuse. 2000. 12:33–49.

17. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002. 106:3143–3421.

18. Whitfield JB. Gamma glutamyl transferase. Crit Rev Clin Lab Sci. 2001. 38:263–355.

19. Teschke R, Brand A, Strohmeyer G. Induction of hepatic microsomal gamma-glutamyltransferase activity following chronic alcohol consumption. Biochem Biophys Res Commun. 1977. 75:718–724.

20. Lim JS, Yang JH, Chun BY, Kam S, Jacobs DR Jr, Lee DH. Is serum gamma-glutamyltransferase inversely associated with serum antioxidants as a marker of oxidative stress? Free Radic Biol Med. 2004. 37:1018–1023.

21. Lee MY, Koh SB, Koh JH, Nam SM, Shin JY, Shin YG, Kong ID, Ryu SY, Lee TY, Park JK, Chung CH. Relationship between gamma-glutamyltransferase and metabolic syndrome in a Korean population. Diabet Med. 2008. 25:469–475.

22. Ikai E, Honda R, Yamada Y. Serum gamma-glutamyl transpeptidase level and blood pressure in nondrinkers: a possible pathogenetic role of fatty liver in obesity-related hypertension. J Hum Hypertens. 1994. 8:95–100.

23. Nilssen O, Førde OH, Brenn T. The Tromsø Study. Distribution and population determinants of gamma-glutamyltransferase. Am J Epidemiol. 1990. 132:318–326.

24. Nakanishi N, Suzuki K, Tatara K. Serum gamma-glutamyltransferase and risk of metabolic syndrome and type 2 diabetes in middle-aged Japanese men. Diabetes Care. 2004. 27:1427–1432.

25. Stranges S, Trevisan M, Dorn JM, Dmochowski J, Donahue RP. Body fat distribution, liver enzymes, and risk of hypertension: evidence from the Western New York Study. Hypertension. 2005. 46:1186–1193.

26. Paolicchi A, Minotti G, Tonarelli P, Tongiani R, De Cesare D, Mezzetti A, Dominici S, Comporti M, Pompella A. Gamma-glutamyl transpeptidase-dependent iron reduction and LDL oxidation: a potential mechanism in atherosclerosis. J Investig Med. 1999. 47:151–160.

27. Dominici S, Paolicchi A, Lorenzini E, Maellaro E, Comporti M, Pieri L, Minotti G, Pompella A. Gamma-glutamyltransferase-dependent prooxidant reactions: a factor in multiple processes. Biofactors. 2003. 17:187–198.

28. Emdin M, Passino C, Donato L, Paolicchi A, Pompella A. Serum gamma-glutamyltransferase as a risk factor of ischemic stroke might be independent of alcohol consumption. Stroke. 2002. 33:1163–1164.

29. Jean JC, Liu Y, Brown LA, Marc RE, Klings E, Joyce-Brady M. Gamma-glutamyl transferase deficiency results in lung oxidant stress in normoxia. Am J Physiol Lung Cell Mol Physiol. 2002. 283:L766–L776.

30. Joyce-Brady M, Takahashi Y, Oakes SM, Rishi AK, Levine RA, Kinlough CL, Hughey RP. Synthesis and release of amphipathic gamma-glutamyl transferase by the pulmonary alveolar type 2 cell. Its redistribution throughout the gas exchange portion of the lung indicates a new role for surfactant. J Biol Chem. 1994. 269:14219–14226.