Association between serum gamma-glutamyltransferase and early-onset coronary artery disease: a retrospective case-control study

Gamma-glutamyl transferase to high-density lipoprotein cholesterol ratio: A valuable predictor of coronary heart disease incidence

BACKGROUND AND AIM

Existing studies have found that serological markers for predicting coronary heart disease (CHD) have relatively low predictive value for the severity of coronary arteries and the types of CHD. GGT to HDL-C ratio (GHR) has been shown to be associated with T2DM and non-alcoholic fatty liver disease. Therefore, we explore the relationship among GHR, CHD and its subgroups.

METHODS AND RESULTS

The study retrospectively analyzed 2703 participants from August 2022 to August 2023. The patients were divided into CHD group (N = 1911) and control group (N = 792) according to the diagnostic criteria of CHD. Adjustments for all covariates found that GHR was an independent risk factor for CHD (OR: 1.025, 95 % CI 1.016-1.033) and had the highest AUC of 0.767 (95 % CI 0.744-0.790) in identifying CHD. Additionally, GHR was significantly associated with multi-vessel CHD (OR: 1.018, 95 % CI 1.012-1.023) and showed excellent diagnostic capability for patients with multi-vessel CHD (AUC: 0.638). Moreover, compared with chronic coronary syndromes (CCS) and unstable angina (UA) groups, the level of GHR was significantly increased in acute myocardial infarction (AMI) (ST elevation myocardial infarction and Non-ST elevation myocardial infarction) group (P < 0.05). GHR had the higher AUC in STMETI [0.819 (95 % CI 0.796-0.854)] and NASTEMI [0.792 (95 % CI 0.766-0.816)] than the CCS and UA groups.

CONCLUSIONS

Our study analyses found that GHR is an independent risk factor for CHD and can predict the severity of coronary artery stenosis. Moreover, GHR has a high predictive value for AMI than CCS and UA in CHD patients.

The relationship between early-onset coronary artery disease and familial hypercholesterolemia: a cohort study based on the Hakka population in Meizhou, China

BACKGROUND

The low diagnosis and treatment rates of familial hypercholesterolemia (FH) have become a global issue. This study aims to explore the correlation between early-onset coronary artery disease (CAD) and FH in the Hakka population in Meizhou, Guangdong.

METHODS

Clinical data of Hakka patients with early-onset CAD, admitted to the Meizhou People's Hospital from January 2023 to January 2024 were retrospectively analyzed. The patients were categorized into an FH group and a non-FH group. Biochemical indicators, lipid levels, echocardiographic parameters, clinical phenotypes, and genetic typing of early-onset CAD patients in the Hakka population were analyzed for their correlation with FH.

RESULTS

A total of 167 Hakka patients with early-onset CAD were included, among whom 22 patients had FH. The FH group showed lower triglyceride (TG) level [1.785 (1.40, 2.10) vs. 2.090 (1.80, 2.30), P = 0.002] and higher levels of total cholesterol (TC) [6.635 (5.60, 7.10) vs. 4.830 (4.00, 5.40), P<0.001], low-density lipoprotein cholesterol (LDL-C) [4.440 (3.90, 5.20) vs. 2.820 (2.40, 3.30), P<0.001], and apolipoprotein B (Apo B) [1.600 (1.30, 1.80) vs. 0.910 (0.70, 1.10), P<0.001]. FH was correlated with TG, TC, LDL-C and Apo B levels (r1 = -0.235; r2 = 0.441; r3 = 0.483; r4 = 0.538). TG is a risk factor while TC, LDL-C and Apo B are protective factors for FH.

CONCLUSION

The incidence of FH is relatively high among early-onset CAD patients in the Hakka population in Meizhou. TG, TC, LDL-C, and Apo B levels are valuable in aiding clinical differential diagnosis of CAD patients with FH.

The importance of the enzyme Gamma-glutamyltransferase in the pathogenic cluster in type2 diabetic patient

Introduction. Gamma-glutamyltransferase (GGT) is a liver enzyme involved in inflammation and oxidative stress. It is already known that MCP-1 (Monocyte Chemoattractant Protein-1) and TNF-α (tumour necrosis factor) as inflammatory markers, ICAM-1 (Intercellular Adhesion Molecule-1) as an endothelial dysfunctional marker, and glutathione, as an antioxidant, have abnormal levels in type 2 diabetic patients. The aim of this study was to evaluate the specific biological picture of type 2 diabetic patients that also associate higher GGT activity. Methods. Eighty-five type 2 diabetes, aged 40-70 years with a duration of diabetes less than 6 years without infections, epilepsy, chronic liver or cardiac diseases, without alcohol consumption (>20 g/day) were divided in two subgroups, those with normal and those with high abnormal GGT. Results. The diabetic patients with high GGT (n=31) had dysglycaemia, dyslipidemia, higher inflammatory markers (CRP, TNF-α, MCP-1) and endothelial dysfunction (high leptin and sICAM). sICAM, serum MCP-1 and TNF-α levels had significant correlations with GGT activity (r= 0.38, r=0.30 and 0.26 respectively, p<0.05). Conclusion. This study underlines that in non-alcoholic diabetic patients, with a duration of the metabolic disease less than 6 years, sICAM, serum MCP-1 and TNF-α might play an important role in dysmetabolism, and higher level for GGT represents the "red flag" for this condition.