Lee Duk-Hee, Silventoinen Karri, Hu Gang, Jacobs David R, Jousilahti Pekka, Sundvall Jouko, Tuomilehto Jaakko
Department of Preventive Medicine, School of Medicine, Kyungpook National University, Jung-gu, Daegu, South Korea 700-422.
Eur Heart J. 2006 Sep;27(18):2170-6. doi: 10.1093/eurheartj/ehl086. Epub 2006 Jun 13.
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.
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).
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.
血清γ-谷氨酰转移酶（GGT）浓度可能与动脉粥样硬化有关。本研究调查了血清GGT是否能预测冠心病（CHD），尤其是在普通人群或2型糖尿病患者中区分非致命性心肌梗死（MI）和致命性CHD事件。
对28838名年龄在25 - 74岁的芬兰男女进行了一项前瞻性研究（1467例冠心病新发病例；中位随访时间为11.9年）。血清GGT切点为第25、50、75和90性别特异性百分位数。在调整已知心血管危险因素后，与最低GGT类别相比，其他四个GGT类别中男性的风险比（HR）分别为1.15、1.25、1.27和1.57，女性分别为1.03、1.22、1.32和1.44（趋势P值均<0.01）。然而，在年龄<60岁的受试者和饮酒者中观察到更强的关联。非致命性MI和致命性CHD的关联强度相似。在2型糖尿病患者中，相应的调整后HR分别为1.29、1.57、1.88和1.78（男性和女性合并的P趋势 = 0.03）。
本研究提示在普通人群中血清GGT与CHD之间存在独立的关联机制。尽管在所有受试者中关联强度似乎适中，但在年龄<60岁的受试者和饮酒者中观察到更强的关联。特别是，检测2型糖尿病患者的血清GGT可能有助于预测未来患CHD的风险。
