King's College London, School of Medicine, Division of Cancer Studies, Cancer Epidemiology Unit, London, UK.
Eur J Cancer. 2011 Sep;47(13):2033-41. doi: 10.1016/j.ejca.2011.03.010. Epub 2011 Apr 11.
Apart from using gamma-glutamyltransferase (GGT) as a predictor of diabetes, cardiovascular and chronic kidney disease, some evidence suggests GGT as an indicator of cancer risk. We aimed to study the association between GGT and cancer in a large Swedish cohort with 37,809 primary cancers.
In a cohort of 545,460 persons (aged >20 years) who had a measurement of GGT in the Apolipoprotein Mortality Risk (AMORIS) study, multivariate Cox proportional hazards regression was used to investigate categories of GGT (<18, 18-36,36-72, ≥72 U/L) in relation to cancer risk. Stratified analyses were conducted by gender, levels of alanine aminotransferase (ALT) (</≥ 50 U/L), glucose (</≥ 6.11 mmol/L) and triglycerides (</≥1.71 mmol/L).
A positive association was found between categories of GGT and overall cancer risk (HR: 1.07 (95%CI: 1.04-1.09,), 1.18 (1.14-1.22), 1.32 (1.26-1.38) for the 2nd, 3rd and 4th categories compared to the 1st). Stratified analyses showed that for those with glucose ≥6.11 mmol/L, the association between GGT and risk of prostate, breast and liver cancer became stronger (e.g. HR for GGT ≥72 U/L and prostate cancer: 1.11 (0.98-1.26) and 1.35 (1.00-1.81) for glucose <6.11 and ≥6.11 mmol/L, respectively). With pancreatic cancer, the association with GGT was weaker for those with elevated glucose levels compared to those with normal levels. No effects of ALT or triglyceride levels on risk were found.
We found evidence of associations between elevated GGT and risk of developing different cancers. The strength of this association may vary by glucose levels because hyperglycaemia can result in oxidative stress initiating damaging pathways of carcinogenesis.
除了将γ-谷氨酰转移酶（GGT）用作糖尿病、心血管疾病和慢性肾病的预测指标外，一些证据表明 GGT 可作为癌症风险的指标。我们旨在对一个大型瑞典队列中 37,809 例原发性癌症进行研究，以探讨 GGT 与癌症之间的关系。
在 Apolipoprotein Mortality Risk（AMORIS）研究中，我们对 545,460 名（年龄>20 岁）接受 GGT 测量的人群进行了队列研究，使用多变量 Cox 比例风险回归分析来研究 GGT（<18、18-36、36-72、≥72 U/L）与癌症风险的关系。通过性别、丙氨酸氨基转移酶（ALT）水平（</≥50 U/L）、血糖（</≥6.11 mmol/L）和甘油三酯（</≥1.71 mmol/L）进行分层分析。
发现 GGT 类别与总体癌症风险之间存在正相关关系（HR：1.07（95%CI：1.04-1.09）、1.18（1.14-1.22）、1.32（1.26-1.38），第 2、3 和 4 类与第 1 类相比）。分层分析表明，对于血糖≥6.11 mmol/L 的人群，GGT 与前列腺癌、乳腺癌和肝癌风险之间的关系更强（例如，GGT≥72 U/L 与前列腺癌的 HR：1.11（0.98-1.26）和 1.35（1.00-1.81），血糖<6.11 和≥6.11 mmol/L 分别）。对于胰腺癌，与 GGT 相关的风险对于血糖升高的人群比血糖正常的人群要弱。未发现 ALT 或甘油三酯水平对风险的影响。
我们发现，升高的 GGT 与不同癌症的发生风险之间存在关联。这种关联的强度可能因血糖水平而异，因为高血糖会导致氧化应激，从而引发致癌的损伤途径。
