Cho Yun Kyung, Kang Yu Mi, Hwang Jenie Yoonoo, Kim Eun Hee, Yang Dong Hyun, Kang Joon-Won, Park Joong-Yeol, Lee Woo Je, Kim Hong-Kyu, Jung Chang Hee
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Atherosclerosis. 2015 Nov;243(1):300-6. doi: 10.1016/j.atherosclerosis.2015.09.027. Epub 2015 Sep 25.
Elevated serum gamma-glutamyltransferase (GGT) has been demonstrated to be associated with coronary artery calcification (CAC). CAC progression is an important marker of atherosclerosis and correlates with future cardiovascular risk. However, there is a lack of research that directly examines the association between serum GGT and CAC progression. The aim of this study was to elucidate the association between serum GGT activity and CAC progression.
We enrolled 1246 asymptomatic participants who underwent repeated CAC score measurement during routine health examinations. To eliminate the dependence of the inter scan variability on the baseline CAC scores, square root-transformed CAC scores were used to analyze CAC progression. In addition, the annualized rate of change in CAC scores was computed.
Serum GGT activities were significantly higher in "progressors" than "nonprogressors". The prevalence of progression increased with the GGT tertile (11.9%, 20.1% and 27.9% in the 1st, 2nd, and 3rd GGT tertiles, respectively; p < 0.001). In the multivariate logistic regression analysis, the odds ratio (95% confidence interval) for CAC score progression was 1.85 (1.14-3.00) in the highest GGT tertile group. By multivariate linear regression analysis, baseline serum GGT activity demonstrated a positive association with the annualized change in CAC score (β = 0.002; p = 0.006) after adjusting for cardiovascular risk factors.
Elevated serum GGT levels are independently associated with CAC progression. Serum GGT levels may be a potential biomarker of future coronary atherosclerosis and prognosis.
血清γ-谷氨酰转移酶（GGT）升高已被证明与冠状动脉钙化（CAC）有关。CAC进展是动脉粥样硬化的一个重要标志物，并且与未来心血管风险相关。然而，缺乏直接研究血清GGT与CAC进展之间关联的研究。本研究的目的是阐明血清GGT活性与CAC进展之间的关联。
我们纳入了1246名在常规健康检查期间接受重复CAC评分测量的无症状参与者。为了消除扫描间变异性对基线CAC评分的依赖性，采用平方根转换后的CAC评分来分析CAC进展。此外，计算了CAC评分的年化变化率。
“进展者”的血清GGT活性显著高于“非进展者”。进展的患病率随着GGT三分位数的增加而升高（在第1、第2和第3 GGT三分位数中分别为11.9%、20.1%和27.9%；p<0.001）。在多变量逻辑回归分析中，最高GGT三分位数组中CAC评分进展的比值比（95%置信区间）为1.85（1.14 - 3.00）。通过多变量线性回归分析，在调整心血管危险因素后，基线血清GGT活性与CAC评分的年化变化呈正相关（β = 0.002；p = 0.006）。
血清GGT水平升高与CAC进展独立相关。血清GGT水平可能是未来冠状动脉粥样硬化和预后的潜在生物标志物。
