Department of Family Medicine, Yongin Severance Hospital, Yongin-si, Republic of Korea.
Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Front Endocrinol (Lausanne). 2023 Aug 15;14:1231502. doi: 10.3389/fendo.2023.1231502. eCollection 2023.
The combination of gamma-glutamyl transferase (GGT) and high-density lipoprotein cholesterol (HDL-C) (GGT/HDL-C) is a novel noninsulin-based marker for assessing the risk of nonalcoholic fatty liver disease and type 2 diabetes mellitus. However, whether the GGT/HDL-C ratio is related to the risk of incident cardiovascular disease (CVD) risk is not well known. Therefore, we aimed to investigate the longitudinal effect of GGT/HDL-C ratio on incident CVD risk in three large cohorts of Korean men and women.
Data were assessed from 27,643 participants without CVD from the Korean Genome and Epidemiology Study (KoGES), Health Risk Assessment Study (HERAS), and Korea Health Insurance Review and Assessment (HIRA) (HERAS-HIRA) datasets. The participants were divided into four groups according to the GGT/HDL-C quartiles. We prospectively assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for CVD using multivariate Cox proportional-hazard regression models over a 50-month period following the baseline survey.
During the follow-up period, 949 patients (3.4%; 529 men and 420 women) developed CVD. The HRs of CVD for GGT/HDL-C quartiles 2-4 were 1.36 (95% CI, 0.91-2.02), 1.54 (95% CI, 1.05-2.26), and 1.66 (95% CI, 1.12-2.47) after adjusting for metabolic parameters in women, but GGT/HDL-C did not show a trend toward increases in incident CVD in men. Regional discrepancies were evident in the results; the increase in HR in the metropolitan hospital cohort was more pronounced than that in the urban cohort, and the risk was not increased in the rural cohort.
GGT/HDL-C ratio may be a useful predictive marker for CVD in women. Furthermore, the prevalence of CVD was strongly correlated with the GGT/HDL-C ratio in metropolitan areas, and this correlation was more significant than that observed with GGT or HDL-C in isolation.
γ-谷氨酰转移酶（GGT）与高密度脂蛋白胆固醇（HDL-C）的联合（GGT/HDL-C）是一种新型的非胰岛素基础标志物，可用于评估非酒精性脂肪性肝病和 2 型糖尿病的风险。然而，GGT/HDL-C 比值与心血管疾病（CVD）风险的关系尚不清楚。因此，我们旨在研究三个大型韩国男女队列中 GGT/HDL-C 比值对 CVD 发病风险的纵向影响。
本研究的数据来自韩国基因组与流行病学研究（KoGES）、健康风险评估研究（HERAS）和韩国健康保险审查与评估服务（HIRA）（HERAS-HIRA）数据集的 27643 名无 CVD 的参与者。根据 GGT/HDL-C 四分位组将参与者分为四组。我们使用多变量 Cox 比例风险回归模型，在基线调查后 50 个月的时间内，前瞻性评估 CVD 的风险比（HR）和 95%置信区间（CI）。
在随访期间，949 名患者（3.4%；529 名男性和 420 名女性）发生 CVD。在校正代谢参数后，女性 GGT/HDL-C 四分位组 2-4 的 CVD HR 分别为 1.36（95%CI，0.91-2.02）、1.54（95%CI，1.05-2.26）和 1.66（95%CI，1.12-2.47），但 GGT/HDL-C 并没有显示出男性 CVD 发病风险的趋势增加。结果存在地域差异；大都市医院队列的 HR 增加更为明显，而城市队列和农村队列的风险并未增加。
GGT/HDL-C 比值可能是女性 CVD 的有用预测标志物。此外，在大都市地区，CVD 的患病率与 GGT/HDL-C 比值密切相关，且与 GGT 或 HDL-C 单独相比，该相关性更为显著。
