Nakanishi N, Nishina K, Li W, Sato M, Suzuki K, Tatara K
Department of Social and Environmental Medicine, Course of Social Medicine, Osaka University Graduate School of Medicine, Yamada-oka, Suita-shi, Osaka, Japan.
J Intern Med. 2003 Sep;254(3):287-95. doi: 10.1046/j.1365-2796.2003.01198.x.
To investigate the association between serum gamma-glutamyltransferase (GGT) and risk for development of diabetes.
Longitudinal study (followed from 1994 to 2001).
A work site in Japan.
A total of 2918 Japanese male office workers aged 35-59 years who did not have impaired fasting glucose (IFG) (a fasting plasma glucose concentration of 6.1-6.9 mmol L-1), type 2 diabetes (a fasting plasma glucose concentration of >/=7.0 mmol L-1 or receipt of hypoglycaemic medication), medication for hypertension or hepatitis, alanine aminotransferase concentrations higher than three times the upper limit of the reference range or a history of cardiovascular disease at study entry.
Incidence of IFG or type 2 diabetes over a 7-year period.
With adjustment for potential risk factors for diabetes, the relative risk for IFG compared with serum GGT <16 U L-1 was 1.23 (95% CI, 0.79-1.90), 1.50 (CI, 0.97-2.32) and 1.70 (CI, 1.07-2.71) with serum GGT of 16-24, 25-43 and >/=44 U L-1, respectively (P for trend = 0.014). The respective relative risks for type 2 diabetes compared with serum GGT <16 U L-1 were 2.54 (CI, 1.29-5.01), 2.64 (CI, 1.33-5.23) and 3.44 (CI, 1.69-6.70) (P for trend = 0.002). From stratified analyses by body mass index (BMI) and alcohol intake, a stronger linear association between serum GGT and development of IFG or type 2 diabetes was found in men with a BMI >/=23.2 kg m-2 in both those who drank <46 and >/=46 g day-1 of ethanol.
The risk for development of IFG or type 2 diabetes increased in a dose-dependent manner as serum GGT increased in middle-aged Japanese men. The increased relative risk for IFG or type 2 diabetes associated with serum GGT was more pronounced in obese men.
研究血清γ-谷氨酰转移酶（GGT）与糖尿病发生风险之间的关联。
纵向研究（1994年至2001年随访）。
日本的一个工作场所。
总共2918名年龄在35 - 59岁之间的日本男性上班族，他们在研究开始时没有空腹血糖受损（IFG）（空腹血糖浓度为6.1 - 6.9 mmol/L）、2型糖尿病（空腹血糖浓度≥7.0 mmol/L或接受降糖药物治疗）、高血压或肝炎用药、丙氨酸氨基转移酶浓度高于参考范围上限的三倍或心血管疾病史。
7年内IFG或2型糖尿病的发病率。
在对糖尿病潜在危险因素进行调整后，与血清GGT<16 U/L相比，血清GGT为16 - 24、25 - 43和≥44 U/L时，IFG的相对风险分别为1.23（95%CI，0.79 - 1.90）、1.50（CI，0.97 - 2.32）和1.70（CI，1.07 - 2.71）（趋势P值 = 0.014）。与血清GGT<16 U/L相比，2型糖尿病的相应相对风险分别为2.54（CI，1.29 - 5.01）、2.64（CI，1.33 - 5.23）和3.44（CI，1.69 - 6.70）（趋势P值 = 0.002）。通过体重指数（BMI）和酒精摄入量进行分层分析发现，在BMI≥23.2 kg/m²且每日乙醇摄入量<46 g和≥46 g的男性中，血清GGT与IFG或2型糖尿病发生之间的线性关联更强。
在中年日本男性中，随着血清GGT升高，IFG或2型糖尿病的发生风险呈剂量依赖性增加。与血清GGT相关的IFG或2型糖尿病相对风险增加在肥胖男性中更为明显。
