Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge Biomedical Campus, University of Cambridge School of Clinical Medicine, Cambridge, UK; Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Ann Epidemiol. 2014 Nov;24(11):809-16. doi: 10.1016/j.annepidem.2014.09.001. Epub 2014 Sep 8.
We assessed the nature of the dose-response relationship between gamma-glutamyl transferase (GGT) levels and risk of incident type II diabetes mellitus (T2DM) in the general population.
Systematic review and dose-response meta-analysis of published prospective studies. Relevant studies were identified in a literature search of MEDLINE, EMBASE, and Web of Science databases up to June 2014. We examined a potential nonlinear relationship using restricted cubic splines.
Of the 300 titles reviewed, we included 24 cohort studies with data on 177,307 participants and 11,155 T2DM cases. In pooled analysis of 16 studies with relevant data, there was evidence of a nonlinear association between GGT and T2DM risk in both males (P for nonlinearity = .02) and females (P for nonlinearity = .0005). In a comparison of extreme thirds of baseline levels of GGT, relative risk for T2DM in pooled analysis of all 24 studies was 1.34 (95% confidence interval, 1.27-1.42). There was heterogeneity among the studies (P < .001), which was to a large part explained by blood sample used, study size, degree of confounder adjustment, and quality of studies.
Circulating level of GGT contributes to an increased risk of T2DM in the general population in a nonlinear dose-response pattern.
我们评估了γ-谷氨酰转移酶（GGT）水平与普通人群中 2 型糖尿病（T2DM）发病风险之间的剂量-反应关系的性质。
对已发表的前瞻性研究进行系统评价和剂量-反应荟萃分析。在截至 2014 年 6 月的 MEDLINE、EMBASE 和 Web of Science 数据库中进行文献检索，以确定相关研究。我们使用限制性立方样条检查了潜在的非线性关系。
在审查的 300 个标题中，我们纳入了 24 项具有 177307 名参与者和 11155 例 T2DM 病例数据的队列研究。在具有相关数据的 16 项研究的汇总分析中，GGT 与 T2DM 风险之间存在非线性关联，无论是男性（非线性检验 P =.02）还是女性（非线性检验 P =.0005）。在对 GGT 基线水平的极端三分之一进行比较时，24 项研究的汇总分析中 T2DM 的相对风险为 1.34（95%置信区间，1.27-1.42）。研究之间存在异质性（P <.001），这在很大程度上可以用所使用的血液样本、研究规模、混杂因素调整程度和研究质量来解释。
在普通人群中，循环 GGT 水平呈非线性剂量-反应模式，与 T2DM 风险增加有关。
