European Heart Journal Advance Access originally published online on June 13, 2006
European Heart Journal 2006 27(18):2170-2176; doi:10.1093/eurheartj/ehl086
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Serum gamma-glutamyltransferase predicts non-fatal myocardial infarction and fatal coronary heart disease among 28 838 middle-aged men and women
1 Department of Preventive Medicine, School of Medicine, Kyungpook National University, 1, 01 Dongin-dong, Jung-gu, Daegu, South Korea 700-422
2 Department of Public Health, University of Helsinki, Finland
3 Department of Epidemiology and Health Promotion, National Public Health Institute, Finland
4 Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN, USA
5 Department of Nutrition, University of Oslo, Oslo, Norway
6 School of Public Health, University of Tampere, Finland
7 Department of Health and Functional Capacity, National Public Health Institute, Finland
8 South Ostrobothnia Central Hospital, Seinäjoki, Finland
Received 22 March 2006; revised 15 May 2006; accepted 19 May 2006; online publish-ahead-of-print 13 June 2006.
* Corresponding author. Tel: +82 53 420 6960; fax: +82 53 425 2447. E-mail address: lee_dh{at}knu.ac.kr
See page 2145 for the editorial comment on this article (doi:10.1093/eurheartj/ehl151)
Aims Serum gamma-glutamyltransferase (GGT) concentration may be involved in atherosclerosis. This study examined if serum GGT predicted coronary heart disease (CHD), especially differentiating non-fatal myocardial infarction (MI) and fatal CHD event, among the general population or participants with type-2 diabetes.
Methods and results A prospective study of 28 838 Finnish men and women aged 25–74 years was performed (1467 incident CHD cases; a median follow-up time of 11.9 years). Serum GGT cutpoints were the 25th, 50th, 75th, and 90th sex-specific percentiles. After adjustment for known cardiovascular risk factors, compared with the lowest GGT category, hazard ratios (HR) were 1.15, 1.25, 1.27, and 1.57 among men and 1.03, 1.22, 1.32, and 1.44 among women in other four GGT categories (P for trend <0.01, respectively). However, stronger associations were observed among subjects aged <60 and among alcohol drinkers. The strength of association was similar for non-fatal MI and for fatal CHD. Among subjects with type-2 diabetes, the corresponding adjusted HRs were 1.29, 1.57, 1.88, and 1.78 (P trend=0.03, men and women combined).
Conclusion This study suggests an independent mechanism linking serum GGT to CHD among general population. Even though the strength of association appeared to be modest among all subjects, stronger associations were observed among subjects aged <60 and among alcohol drinkers. Especially, measurement of serum GGT among type-2 diabetics may be helpful to predict the future risk of CHD.
Key Words: Gamma-glutamyltransferase • Myocardial infarction • Coronary heart disease • Diabetes • Oxidative stress
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