Meisinger C, Döring A, Schneider A, Löwel H
Central Hospital of Augsburg, MONICA/KORA Myocardial Infarction Registry, Stenglinstr. 2, D-86156 Augsburg, Germany.
Atherosclerosis. 2006 Dec;189(2):297-302. doi: 10.1016/j.atherosclerosis.2006.01.010. Epub 2006 Feb 17.
To investigate whether serum gamma-glutamyltransferase (GGT) is an independent predictor for incident coronary events in initially healthy men from the general population.
The study was based on 1878 men (aged 25-64 years) who participated in the first MONICA Augsburg survey 1984/1985, and who were free of coronary heart disease at baseline. Up to 2002 a total of 150 incident acute coronary events occurred. Baseline levels of GGT were higher in men who experienced an event than in event-free men (28.4+/-2.0 units/l versus 22.4+/-2.1 units/l, p 0.0002). GGT was highly correlated with other cardiovascular risk factors. In a Cox proportional hazards model after age adjustment hazard ratios (HR) for incident myocardial infarction across GGT quartiles (<13, 13 to <20, 20 to <35, and >/=35 units/l) were 1.0, 1.84, 2.02, and 3.08 (p for trend 0.0001). Further adjustment for hypertension, TC/HDL ratio, diabetes, smoking, physical activity, alcohol intake, education years and BMI attenuated the association; comparing the highest versus lowest quartile of GGT the HR for a first-ever coronary event was then 2.34 (95% CI, 1.23-4.44).
Serum GGT is a strong predictor of acute coronary events in apparently healthy men from the general population, independent of other risk factors for cardiovascular disease.
探讨血清γ-谷氨酰转移酶(GGT)是否为一般人群中初发健康男性发生冠状动脉事件的独立预测指标。
本研究基于1878名男性(年龄25 - 64岁),他们参与了1984/1985年奥格斯堡的首次莫尼卡(MONICA)调查,且基线时无冠心病。至2002年共发生150例急性冠状动脉事件。发生事件的男性GGT基线水平高于未发生事件的男性(分别为28.4±2.0单位/升和22.4±2.1单位/升,p = 0.0002)。GGT与其他心血管危险因素高度相关。在年龄调整后的Cox比例风险模型中,GGT四分位数(<13、13至<20、20至<35以及≥35单位/升)发生心肌梗死的风险比(HR)分别为1.0、1.84、2.02和3.08(趋势p = 0.0001)。进一步对高血压、总胆固醇/高密度脂蛋白比值、糖尿病、吸烟、体力活动、饮酒量、受教育年限和体重指数进行调整后,这种关联减弱;比较GGT最高与最低四分位数,首次发生冠状动脉事件的HR为2.34(95%可信区间,1.23 - 4.44)。
血清GGT是一般人群中看似健康男性急性冠状动脉事件的强有力预测指标,独立于其他心血管疾病危险因素。