Lee Chang-Hoon, Han Kyungdo, Kim Da Hye, Kwak Min-Sun
Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, South Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, South Korea.
World J Gastroenterol. 2021 Jan 14;27(2):176-188. doi: 10.3748/wjg.v27.i2.176.
The association between elevated γ-glutamyltransferase (GGT) at a certain point and incident cancer has been suggested; however, no study has evaluated the association between repeatedly elevated GGT and cancer incidence.
To investigate the effects of repeatedly elevated GGT on the incidence of digestive cancers.
Participants who had undergone health screening from 2009 to 2012 and 4 consecutive previous examinations were enrolled. GGT points were calculated as the number of times participants met the criteria of quartile 4 of GGT in four serial measurements (0-4 points). Multivariable Cox proportional hazard regression models were applied.
In total, 3559109 participants were included; among them, 43574 digestive cancers developed during a median of 6.8 years of follow-up. The incidence of total digestive cancers increased in a dose-response manner in men [adjusted hazard ratio (aHR) compared with those with 0 GGT points = 1.28 and 95% confidence interval (CI) = 1.24-1.33 in those with 1 point; aHR = 1.40 and 95%CI = 1.35-1.46 in those with 2 points; aHR = 1.52 and 95%CI = 1.46-1.58 in those with 3 points; aHR = 1.88 and 95%CI = 1.83-1.94 in those with 4 points; for trend < 0.001]. This trend was more prominent in men than in women and those with healthy habits (no smoking, no alcohol consumption, and a low body mass index) than in those with unhealthy habits.
Repeatedly elevated GGT levels were associated with an increased risk of incident digestive cancer in a dose-responsive manner, particularly in men and those with healthy habits. Repeated GGT measurements may be a good biomarker of incident digestive cancer and could help physicians identify high-risk populations.
已有研究表明某一时刻γ-谷氨酰转移酶（GGT）升高与新发癌症之间存在关联；然而，尚无研究评估反复升高的GGT与癌症发病率之间的关联。
探讨反复升高的GGT对消化系统癌症发病率的影响。
纳入2009年至2012年接受健康筛查且此前连续进行过4次检查的参与者。GGT积分计算为参与者在4次连续测量中达到GGT四分位数4标准的次数（0 - 4分）。应用多变量Cox比例风险回归模型。
共纳入3559109名参与者；其中，在中位6.8年的随访期间发生了43574例消化系统癌症。男性中，消化系统癌症的总发病率呈剂量反应关系增加[与GGT积分为0分者相比，积分为1分者的调整后风险比（aHR）= 1.28，95%置信区间（CI）= 1.24 - 1.33；积分为2分者aHR = 1.40，95%CI = 1.35 - 1.46；积分为3分者aHR = 1.52，95%CI = 1.46 - 1.58；积分为4分者aHR = 1.88，95%CI = 1.83 - 1.94；趋势P < 0.001]。这种趋势在男性中比在女性中更显著，在有健康习惯（不吸烟、不饮酒且体重指数低）的人群中比在有不健康习惯的人群中更显著。
反复升高的GGT水平与新发消化系统癌症风险增加呈剂量反应关系，尤其是在男性和有健康习惯的人群中。重复测量GGT可能是新发消化系统癌症的良好生物标志物，有助于医生识别高危人群。
