Department of Neurology, Seoul National University Hospital.
Korean Cerebrovascular Research Institute.
Ann Neurol. 2018 Feb;83(2):375-386. doi: 10.1002/ana.25158. Epub 2018 Feb 10.
Although gamma-glutamyl transferase (GGT) is generally regarded as an alternative biomarker for alcohol consumption, its independent role in vascular diseases emerged recently. However, its role in stroke remains unknown. The aim of this study is to clarify the impact of GGT on stroke in a large-sized, national, standardized population cohort in Korea.
In Korea, the National Health Insurance Service (NHIS) provides full-coverage health insurance service for all citizens. Using data from the NHIS, the NHIS-National Sample Cohort was designed by randomly selecting 2% of Koreans, carefully considering demographic characteristics. We analyzed eligible individuals from this standardized cohort. The Cox proportional hazards model was used for the study investigating the relationship between GGT and stroke.
Among the 456,100 eligible participants, 7,459 patients (1.64%) developed stroke as follows: 5,789 ischemic strokes, 1,046 intracerebral hemorrhages (ICHs), and 624 subarachnoid hemorrhages. GGT was independently correlated with increased risk of stroke after adjustment for alcohol consumption and stroke risk factors (hazard ratio [HR] = 1.39, 95% confidence interval [CI] = 1.29-1.51). The risks of both ischemic stroke (HR = 1.45, 95% CI = 1.32-1.58) and ICH (HR = 1.46, 95% CI = 1.18-1.80) were significantly elevated with increasing GGT. Despite some effect modifications by sex, age, and alcohol, the risk of total stroke and ischemic stroke in association with GGT remained significant in all subgroups.
In a standard Korean population, GGT was a novel biomarker predicting stroke risk, independently from alcohol consumption and other risk factors. Ann Neurol 2018;83:375-386.
尽管 γ-谷氨酰转移酶（GGT）通常被视为酒精摄入的替代生物标志物，但它在血管疾病中的独立作用最近才显现出来。然而，其在中风中的作用仍不清楚。本研究旨在阐明 GGT 在韩国大型全国标准化人群队列中对中风的影响。
在韩国，国民健康保险服务（NHIS）为所有公民提供全面的健康保险服务。利用 NHIS 的数据，通过随机选择 2%的韩国人，仔细考虑人口特征，设计了 NHIS-国家样本队列。我们对该标准化队列中的合格个体进行了分析。使用 Cox 比例风险模型研究 GGT 与中风之间的关系。
在 456,100 名合格参与者中，7,459 名患者（1.64%）发生了中风，包括 5,789 例缺血性中风、1,046 例脑出血（ICH）和 624 例蛛网膜下腔出血。在调整了酒精摄入量和中风危险因素后，GGT 与中风风险的增加独立相关（风险比 [HR] = 1.39，95%置信区间 [CI] = 1.29-1.51）。GGT 水平升高与缺血性中风（HR = 1.45，95% CI = 1.32-1.58）和 ICH（HR = 1.46，95% CI = 1.18-1.80）的风险显著增加相关。尽管性别、年龄和酒精存在一定的交互作用，但 GGT 与总中风和缺血性中风的相关性在所有亚组中仍然显著。
在标准的韩国人群中，GGT 是一种预测中风风险的新型生物标志物，独立于酒精摄入和其他危险因素。
