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血清γ-谷氨酰转肽酶可预测老年人的全因死亡率、心血管死亡率和肝脏死亡率。

Serum γ-glutamyltranspeptidase predicts all-cause, cardiovascular and liver mortality in older adults.

作者信息

Loomba Rohit, Doycheva Iliana, Bettencourt Ricki, Cohen Benjamin, Wassel Christina L, Brenner David, Barrett-Connor Elizabeth

机构信息

Division of Gastroenterology, University of California, San Diego, La Jolla, CA 92093-0607 ; Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA 92093-0607.

出版信息

J Clin Exp Hepatol. 2013 Mar 1;3(1):4-11. doi: 10.1016/j.jceh.2012.10.004.

Abstract

BACKGROUND

Serum γ-glutamyltranspeptidase (GGT), a marker of fatty liver disease (FLD), predicts mortality in young adults. However, the association between serum GGT and mortality in older adults is unclear.

OBJECTIVES

To examine if elevated serum GGT predicts all-cause, cardiovascular (CVD), and liver mortality in community-dwelling older adults.

DESIGN AND SETTING

A prospective cohort study including 2364 participants (mean-age 70 yr, BMI-24.5 kg/m, 54% women) from the Rancho Bernardo Study who attended a research visit in 1984-87 when multiple metabolic covariates were ascertained including serum GGT. They were followed for a mean (± standard deviation) of 13.7 (±6.2) years.

MEASUREMENT

Multivariable-adjusted Cox-proportional hazards analyses were conducted to examine the association between elevated serum GGT (>51 U/L in men and > 33 U/L in women) and all-cause, CVD, and liver mortality.

RESULTS

In these older men and women, cumulative mortality was 56.2% (n=1329) with CVD and liver mortality accounting for 49.4% and 2.3% of all deaths, respectively, over 32,387 person-years of follow-up. In multivariate analyses (adjusted for age, sex, alcohol use, body-mass-index, total cholesterol, HDL cholesterol, serum triglyceride, smoking status, systolic blood pressure, diabetes mellitus, serum interleukin-6, and c-reactive protein), serum GGT elevation was significantly associated with all-cause (HR, 1.55, 95% CI, 1.21-1.98), CVD (HR, 1.51, 95% CI, 1.04-2.17), and liver mortality (HR, 9.10, 95% CI, 3.42-24.26).

CONCLUSIONS

In community-dwelling older adults, serum GGT is an independent predictor of all-cause, CVD, and liver mortality.

摘要

背景

血清γ-谷氨酰转肽酶(GGT)是脂肪肝疾病(FLD)的一个标志物,可预测年轻人的死亡率。然而,血清GGT与老年人死亡率之间的关联尚不清楚。

目的

探讨血清GGT升高是否可预测社区居住老年人的全因死亡率、心血管疾病(CVD)死亡率和肝脏死亡率。

设计与背景

一项前瞻性队列研究,纳入了2364名来自兰乔贝纳多研究的参与者(平均年龄70岁,体重指数24.5kg/m²,54%为女性),他们在1984 - 1987年参加了一次研究访视,当时确定了多个代谢协变量,包括血清GGT。对他们进行了平均(±标准差)13.7(±6.2)年的随访。

测量

进行多变量调整的Cox比例风险分析,以检验血清GGT升高(男性>51 U/L,女性>33 U/L)与全因死亡率、CVD死亡率和肝脏死亡率之间的关联。

结果

在这些老年男性和女性中,在32387人年的随访期间,累积死亡率为56.2%(n = 1329),CVD死亡率和肝脏死亡率分别占所有死亡的49.4%和2.3%。在多变量分析中(调整了年龄、性别、饮酒、体重指数、总胆固醇、高密度脂蛋白胆固醇、血清甘油三酯、吸烟状况、收缩压、糖尿病、血清白细胞介素-6和C反应蛋白),血清GGT升高与全因死亡率(风险比[HR],1.55,95%置信区间[CI],1.21 - 1.98)、CVD死亡率(HR,1.51,95% CI,1.04 - 2.17)和肝脏死亡率(HR,9.10,95% CI,3.42 - 24.26)显著相关。

结论

在社区居住的老年人中,血清GGT是全因死亡率、CVD死亡率和肝脏死亡率的独立预测因子。

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