γ-谷氨酰转移酶与新发血管事件相关，独立于酒精摄入量：英国女性心脏与健康研究及荟萃分析

Gamma-glutamyltransferase is associated with incident vascular events independently of alcohol intake: analysis of the British Women's Heart and Health Study and Meta-Analysis.

作者信息

Fraser Abigail, Harris Ross, Sattar Naveed, Ebrahim Shah, Smith George Davey, Lawlor D A

机构信息

Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Rd, Bristol BS8 2PR, UK.

出版信息

Arterioscler Thromb Vasc Biol. 2007 Dec;27(12):2729-35. doi: 10.1161/ATVBAHA.107.152298. Epub 2007 Oct 11.

DOI:10.1161/ATVBAHA.107.152298

PMID:17932318

Abstract

OBJECTIVE

To investigate the association of gamma-glutamyltransferase (GGT) with incident CHD and stroke [corrected] GGT [corrected] is a marker of alcohol intake but may also reflect oxidative stress and nonalcoholic fatty liver disease. Alanine aminotransferase (ALT) is the enzyme most closely associated with liver fat content.

METHODS AND RESULTS

Associations of GGT and ALT with incident CHD, stroke, and a combined outcome of CHD or stroke were examined in the British Women's Heart and Health study (n=2961), and a meta-analysis of population based studies examining these associations was performed. In pooled analyses of fully adjusted results of 10 prospective studies, a change of 1 U/L of GGT was associated with a HR=1.20 (95% CI: 1.02, 1.40) for CHD; a HR=1.54 (95% CI: 1.20, 2.00) for stroke; and HR=1.34 (95% CI: 1.22, 1.48) for CHD or stroke. Heterogeneity was substantially decreased when 2 studies in Asian populations were excluded. In a subgroup of nondrinkers results were similar to the main analysis. Meta analyses of the only 2 studies that examined the association of ALT with incident cardiovascular events found a HR=1.18, 95% CI: 0.99, 1.41) for CHD and a HR=1.10 (95% CI: 0.89, 1.36) for CHD or stroke (combined).

CONCLUSIONS

GGT is associated with incident vascular events independently of alcohol intake. The mechanisms underlying this association remain unclear and require future study.

摘要

目的

探讨γ-谷氨酰转移酶（GGT）与冠心病及卒中发病的相关性[校正后]GGT[校正后]是酒精摄入的标志物，但也可能反映氧化应激和非酒精性脂肪性肝病。丙氨酸氨基转移酶（ALT）是与肝脏脂肪含量最密切相关的酶。

方法与结果

在英国女性心脏与健康研究（n = 2961）中，研究了GGT和ALT与冠心病、卒中和冠心病或卒中联合结局的相关性，并对基于人群的研究中这些相关性进行了荟萃分析。在对10项前瞻性研究的完全调整结果进行的汇总分析中，GGT每升高1 U/L，冠心病的风险比（HR）=1.20（95%置信区间：1.02, 1.40）；卒中的HR = 1.54（95%置信区间：1.20, 2.00）；冠心病或卒中的HR = 1.34（95%置信区间：1.22, 1.48）。排除2项亚洲人群研究后，异质性显著降低。在不饮酒者亚组中，结果与主要分析相似。对仅有的2项研究进行的荟萃分析，这些研究检测了ALT与心血管事件发病的相关性，发现冠心病的HR = 1.18（95%置信区间：0.99, 1.41），冠心病或卒中联合结局的HR = 1.10（95%置信区间：0.89, 1.36）。