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Dose-response Relationship Between Gamma-Glutamyltransferase and the Risk of Atherosclerotic Cardiovascular Diseases in Korean Adults

 Jooeun Jeon  ;  Dae Hyun Kim  ;  Woojin Kim  ;  Dong-Woo Choi  ;  Keum Ji Jung  ;  Sung-In Jang 
 ATHEROSCLEROSIS, Vol.292 : 152-159, 2020-01 
Journal Title
Issue Date
Atherosclerotic cardiovascular disease ; Cohort ; Dose-response relationship ; Obesity ; γ-Glutamyltransferase
Background and aims: The value of gamma-glutamyltransferase (GGT) in the putative mechanisms underlying its association with cardiovascular disease is unclear. This study examined whether serum GGT value has an independent association and dose-response relationship with the risk of atherosclerotic cardiovascular disease (ASCVD).

Methods: This observational study included 419,433 subjects from the National Health Insurance Service database. Serum GGT levels were classified into sex-specific quartiles. We used Cox proportional hazard models to examine the effect of serum GGT values on the risk of ASCVD. We quantified associations of the serum GGT quartile groups with risk of ASCVD or each subtype through multivariate sub-distribution hazard models adjusted for covariates at baseline.

Results: During 4,572,993.8 person-years of follow-up for ASCVD, we documented 40,359 (9.6%) incident cases of ASCVD. The highest serum GGT group had a significant association with ASCVD in contrast to the lowest serum GGT quartile group (hazard ratio [HR] = 1.23, 95% confidence interval [CI] = 1.19-1.27). Serum GGT quartile groups 2, 3, and 4 had a significantly higher risk for incident hemorrhagic stroke than the serum GGT quartile group 1 (Q 2: HR = 0.92, 95% CI = 0.83-1.02; Q 3: HR = 1.03, 95% CI = 0.93-1.15; Q 4: HR = 1.29, 95% CI = 1.16-1.42; p for trend <0.001). For ischemic heart disease (IHD) and myocardial infarction, non-linear trends were shown according to increasing log-transformed GGT values. In the dose-response trends to assess the interaction effect of obese status, differences of trends were shown between serum GGT level and IHD or hemorrhagic stroke.

Conclusions: The serum GGT value, which is known as a factor linked to cardiovascular diseases, has a strong independent association and dose-response relationship with hemorrhagic stroke risk in contrast to that with ischemic stroke or IHD.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Kim, Woojin(김우진) ORCID logo https://orcid.org/0000-0001-5520-4228
Jang, Sung In(장성인) ORCID logo https://orcid.org/0000-0002-0760-2878
Jung, Keum Ji(정금지) ORCID logo https://orcid.org/0000-0003-4993-0666
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