Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No.109, Xueyuanxi Road, Wenzhou, 325000, Zhejiang, China.
Department of Rehabilitation, Zhejiang Chinese Medical University Affiliated Wenzhou Hospital of Traditional Chinese Medicine, No.9 Jiaowei Road, Wenzhou, 325000, Zhejiang, China.
Clin Exp Med. 2023 Nov;23(7):3619-3630. doi: 10.1007/s10238-023-00991-9. Epub 2023 Jan 11.
The relationship between serum γ-glutamyltransferase (GGT) and renal dysfunction is controversial. In this study, we examined the relationship of serum GGT to diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM). A total of 577 patients with T2DM were enrolled and their basic information and laboratory data were collected and analyzed. The prevalence of DN increased with the elevated serum GGT tertiles. The level of serum GGT in the DN group was higher than in the non-DN groups. Multivariate logistic analysis showed that high GGT was independent risks for DN (OR = 1.041, 95% CIs 1.023-1.059). And the OR of log-transformed serum GGT for DN was 6.190 (95% CIs 4.248-9.021). The OR of DN across increasing tertiles of serum GGT were 1.00, 3.288 (1.851-5.840), and 5.059 (2.620-9.769) (P for trend < 0.001). Stratified receiver operating characteristic (ROC) analysis by gender showed that the area under ROC curve (AUC) value for GGT was 0.781 (0.732-0.825, P < 0.05) in male and was 0.817 (0.761-0.864, P < 0.05) in female. Compared with female, GGT in male showed lower sensitivity (52.86% vs. 82.05%) and higher specificity (90.32% vs. 55.26%). And the AUC value for GGT was greater than creatinine (Cr) and estimated glomerular filtration rate (eGFR) in male and smaller than Cr and eGFR in female, respectively. In Conclusion, there was an independently positive relationship between serum GGT levels and DN, which suggested that elevated GGT was a potential indicator for risk of DN. There were gender differences in the predictive property of GGT for DN.
血清 γ-谷氨酰转移酶(GGT)与肾功能障碍之间的关系存在争议。本研究旨在探讨 2 型糖尿病(T2DM)患者血清 GGT 与糖尿病肾病(DN)的关系。共纳入 577 例 T2DM 患者,收集并分析其基本信息和实验室数据。随着血清 GGT 三分位升高,DN 的患病率增加。DN 组的血清 GGT 水平高于非 DN 组。多变量 logistic 分析显示,高 GGT 是 DN 的独立危险因素(OR=1.041,95%CI 1.023-1.059)。血清 GGT 的对数值与 DN 的 OR 为 6.190(95%CI 4.248-9.021)。血清 GGT 三分位升高与 DN 的 OR 分别为 1.00、3.288(1.851-5.840)和 5.059(2.620-9.769)(P 趋势<0.001)。按性别分层的受试者工作特征(ROC)分析显示,GGT 的 ROC 曲线下面积(AUC)值在男性为 0.781(0.732-0.825,P<0.05),在女性为 0.817(0.761-0.864,P<0.05)。与女性相比,男性 GGT 的敏感性较低(52.86%比 82.05%),特异性较高(90.32%比 55.26%)。在男性中,GGT 的 AUC 值大于肌酐(Cr)和估算肾小球滤过率(eGFR),而在女性中,GGT 的 AUC 值小于 Cr 和 eGFR。总之,血清 GGT 水平与 DN 呈独立正相关,提示升高的 GGT 可能是 DN 风险的潜在指标。GGT 预测 DN 的性别差异。