Sang-Wook Yi1, Sang-Hun Lee2, Hee-Jin Hwang3, Jee-Jeon Yi4. 1. Department of Preventive Medicine and Public Health, Catholic Kwandong University, College of Medicine, Gangneung, 25601, Republic of Korea; Institute for Clinical and Translational Research, Catholic Kwandong University International St. Mary's Hospital, Incheon, 22711, Republic of Korea. Electronic address: flyhigh@cku.ac.kr. 2. Department of Internal Medicine, Catholic Kwandong University International St. Mary's Hospital, Incheon, 22711, Republic of Korea. 3. Institute for Clinical and Translational Research, Catholic Kwandong University International St. Mary's Hospital, Incheon, 22711, Republic of Korea; Department of Family Medicine, Catholic Kwandong University International St. Mary's Hospital, Incheon, 22711, Republic of Korea. 4. Institute for Occupational and Environmental Health, Catholic Kwandong University, Gangneung, 25601, Republic of Korea.
Abstract
BACKGROUND AND AIMS: Insufficient evidence has been reported on the associations between gamma-glutamyltransferase (GGT) and cardiovascular disease (CVD) mortality from studies with an adequate number of participants. METHODS: 512,990 Korean adults who participated in routine health examinations during the period 2002-2003 were followed up until 2013. Hazard ratios (HRs) were calculated after adjusting for potential confounders. RESULTS: Each 1-unit higher natural-log-transformed GGT (LogeGGT) level was associated with approximately 30-50% higher mortality risk of CVD (HR = 1.31): hypertensive diseases (HR = 1.31), ischemic heart diseases (IHD, HR = 1.29), total stroke (HR = 1.29), acute myocardial infarction (HR = 1.30), chronic IHD (HR = 1.27), heart failure (HR = 1.48), hemorrhagic stroke (HR = 1.42), and ischemic stroke (HR = 1.27). The associations with CVD mortality did not vary by sex, or alcohol use, whereas they were stronger in younger (<60 years), non-hypertensive (systolic blood pressure [SBP] <140 mmHg), physically more active, normal-weight (body mass index<25 kg/m2), and normocholesterolemic (total cholesterol <200 mg/dL) adults than in their respective counterparts. Adding LogeGGT to prediction models for CVD mortality increased AUC value (0.0020, p < 0.001), especially in persons aged <60 years (0.0055), with SBP <140 mmHg (0.0030), and with both age <60 years and SBP <140 mmHg (0.0086). CONCLUSIONS: Higher GGT significantly increased the risk of mortality due to CVD and its subtypes. The relative risks were greater in subjects with younger age, no hypertension, more physical activity, normal weight, and normocholesterolemia than in their respective counterparts. In the general population, adding GGT to conventional CVD risk factors may improve the prediction of CVD mortality, especially in subjects younger than 60 years and in those without hypertension.
BACKGROUND AND AIMS: Insufficient evidence has been reported on the associations between gamma-glutamyltransferase (GGT) and cardiovascular disease (CVD) mortality from studies with an adequate number of participants. METHODS: 512,990 Korean adults who participated in routine health examinations during the period 2002-2003 were followed up until 2013. Hazard ratios (HRs) were calculated after adjusting for potential confounders. RESULTS: Each 1-unit higher natural-log-transformed GGT (LogeGGT) level was associated with approximately 30-50% higher mortality risk of CVD (HR = 1.31): hypertensive diseases (HR = 1.31), ischemic heart diseases (IHD, HR = 1.29), total stroke (HR = 1.29), acute myocardial infarction (HR = 1.30), chronic IHD (HR = 1.27), heart failure (HR = 1.48), hemorrhagic stroke (HR = 1.42), and ischemic stroke (HR = 1.27). The associations with CVD mortality did not vary by sex, or alcohol use, whereas they were stronger in younger (<60 years), non-hypertensive (systolic blood pressure [SBP] <140 mmHg), physically more active, normal-weight (body mass index<25 kg/m2), and normocholesterolemic (total cholesterol <200 mg/dL) adults than in their respective counterparts. Adding LogeGGT to prediction models for CVD mortality increased AUC value (0.0020, p < 0.001), especially in persons aged <60 years (0.0055), with SBP <140 mmHg (0.0030), and with both age <60 years and SBP <140 mmHg (0.0086). CONCLUSIONS: Higher GGT significantly increased the risk of mortality due to CVD and its subtypes. The relative risks were greater in subjects with younger age, no hypertension, more physical activity, normal weight, and normocholesterolemia than in their respective counterparts. In the general population, adding GGT to conventional CVD risk factors may improve the prediction of CVD mortality, especially in subjects younger than 60 years and in those without hypertension.