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Chang Y, Lee H, Song TJ. Association of gamma-glutamyl transferase variability with risk of venous thrombosis. Sci Rep 2023; 13:7402. [PMID: 37149666 PMCID: PMC10164162 DOI: 10.1038/s41598-023-34368-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/28/2023] [Indexed: 05/08/2023] Open
Abstract
Gamma-glutamyl transferase (GGT) is a biomarker of inflammation, and is known to be associated with stroke and atrial fibrillation. Venous thromboembolism (VT), a not uncommon thrombotic disorder, shares similar mechanisms with other thrombotic disorders including these stroke and atrial fibrillation. Given these associations, we intended to investigate the potential association between variability in GGT and VT. The study included data from the National Health Insurance Service-Health Screening Cohort, comprising 1,085,105 participants with health examinations 3 or more times from 2003 to 2008. Variability indexes were the coefficient of variation, standard deviation, and variability independent of the mean. The occurrence of venous thromboembolism (VT) was defined with more than one claim of the following ICD-10 codes: deep VT (I80.2-80.3), pulmonary thromboembolism (I26), intraabdominal venous thrombosis (I81, I82.2, I82.3), or other VT (I82.8, I82.9). To determine the relationship of quartiles of GGT with incident VT risk, Kaplan-Meier survival curve and logrank test were used. Cox's proportional hazard regression was used to investigate the risk of VT occurrence by GGT quartile (Q1-Q4). A total of 1,085,105 subjects were incorporated in the analysis, and the average follow-up was 12.4 years (interquartile range 12.2-12.6). VT occurred in 11,769 (1.08%) patients. The GGT level was measured 5,707,768 times in this stud. Multivariable analysis showed that GGT variability were positively associated with the occurrence of VT. Compared to the Q1, the Q4 showed an adjusted HR of 1.15 (95% CI 1.09-1.21, p < 0.001) when using coefficient of variation, 1.24 (95% CI 1.17-1.31, p < 0.001) when using standard deviation, and 1.10 (95% CI 1.05-1.16, p < 0.001) when using variability independent of the mean. Increased variability of GGT may be related to an increased risk of VT. Maintaining a stable GGT level would be beneficial in reducing the risk of VT.
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Affiliation(s)
- Yoonkyung Chang
- Department of Neurology, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Heajung Lee
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, 260, Gonghang-Daero, Gangseo-Gu, Seoul, 07804, Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, 260, Gonghang-Daero, Gangseo-Gu, Seoul, 07804, Republic of Korea.
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Teng F, Ye Y, Wang L, Qin R, Liu X, Geng H, Xu W, Lai P, Liang J. Association between serum gamma glutamyl transferase and fasting blood glucose in Chinese people: A 6-year follow-up study. J Diabetes Investig 2022; 14:339-343. [PMID: 36412546 PMCID: PMC9889614 DOI: 10.1111/jdi.13947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 10/25/2022] [Accepted: 11/02/2022] [Indexed: 11/23/2022] Open
Abstract
AIMS/INTRODUCTION In this study, we aimed to investigate the relationships between gamma-glutamyl transferase (GGT) and fasting blood glucose (FBG) during a 6-year follow-up study of participants, and to determine whether GGT is a risk factor for FBG. MATERIALS AND METHODS A total of 1,369 individuals from the health examination survey in the urban area of Xuzhou, central China, were followed up for 6 years. The patients were divided into four groups based on their baseline GGT levels (in quartiles). The one-way analysis of variance (anova) method was used to compare the differences between the variables and baseline. The relationship between GGT and FBG levels was investigated using repeated measurements anova. RESULTS The grouping of baseline GGT levels affected the changes in blood glucose during the 6-year follow-up study. In the GGT quartile subgroups, the annual mean increase in FBG levels showed a positive relationship with baseline GGT levels. This trend was even more aggregated in the highest baseline GGT group. Interactions among time course, baseline FBG and GGT groups in different participants together affected the change of FBG levels during the follow-up period. The repeated measures anova suggested that different baseline GGT groups were still significantly associated with increased FBG levels. GGT is a risk factor that affects FBG levels(P < 0.001). CONCLUSIONS The annual mean increase in FBG levels showed a positive relationship with baseline GGT levels. Higher baseline GGT levels resulted in a faster annual mean increase in FBG. Thus, GGT can be used for the early detection of FBG-related disorders of glucose metabolism for clinical application.
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Affiliation(s)
- Fei Teng
- Present address:
Department of EndocrinologyXuzhou Central HospitalXuzhou, JiangsuChina,Xuzhou Institute of Medical SciencesXuzhou, JiangsuChina
| | - Yan Ye
- Present address:
Department of EndocrinologyXuzhou Central HospitalXuzhou, JiangsuChina,The Xuzhou Clinical College of Xuzhou Medical UniversityXuzhou, JiangsuChina
| | - Liying Wang
- Present address:
Department of EndocrinologyXuzhou Central HospitalXuzhou, JiangsuChina
| | - Ruihao Qin
- Present address:
Department of EndocrinologyXuzhou Central HospitalXuzhou, JiangsuChina,Department of General SurgeryXuzhou Central HospitalXuzhou, JiangsuChina
| | - Xuekui Liu
- Present address:
Department of EndocrinologyXuzhou Central HospitalXuzhou, JiangsuChina,Xuzhou Institute of Medical SciencesXuzhou, JiangsuChina
| | - Houfa Geng
- Present address:
Department of EndocrinologyXuzhou Central HospitalXuzhou, JiangsuChina
| | - Wei Xu
- Present address:
Department of EndocrinologyXuzhou Central HospitalXuzhou, JiangsuChina
| | - Peng Lai
- The Xuzhou Clinical College of Xuzhou Medical UniversityXuzhou, JiangsuChina
| | - Jun Liang
- The Xuzhou Clinical College of Xuzhou Medical UniversityXuzhou, JiangsuChina
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Li S, Wang A, Tian X, Zuo Y, Meng X, Zhang Y. Elevated gamma‐glutamyl transferase levels are associated with stroke recurrence after acute ischemic stroke or transient ischemic attack. CNS Neurosci Ther 2022; 28:1637-1647. [PMID: 35789538 PMCID: PMC9437228 DOI: 10.1111/cns.13909] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 11/28/2022] Open
Abstract
Aims Methods Results Conclusion
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Affiliation(s)
- Siqi Li
- Department of Neurology, Beijing Tiantan Hospital Capital Medical University Beijing China
- China National Clinical Research Center for Neurological Diseases Capital Medical University Beijing China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital Capital Medical University Beijing China
- China National Clinical Research Center for Neurological Diseases Capital Medical University Beijing China
| | - Xue Tian
- Department of Neurology, Beijing Tiantan Hospital Capital Medical University Beijing China
- China National Clinical Research Center for Neurological Diseases Capital Medical University Beijing China
| | - Yingting Zuo
- Department of Neurology, Beijing Tiantan Hospital Capital Medical University Beijing China
- China National Clinical Research Center for Neurological Diseases Capital Medical University Beijing China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital Capital Medical University Beijing China
- China National Clinical Research Center for Neurological Diseases Capital Medical University Beijing China
| | - Yumei Zhang
- Department of Neurology, Beijing Tiantan Hospital Capital Medical University Beijing China
- China National Clinical Research Center for Neurological Diseases Capital Medical University Beijing China
- Department of Rehabilitation medicine, Beijing Tiantan Hospital Capital Medical University Beijing China
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G K, Shankar SM, Nagesh U, Gururaj SB, Chidambar CK, Bhushan K. Assessment of gingival crevicular fluid levels of gamma glutamyl transferase in chronic periodontitis patients before and after non-surgical periodontal therapy: A clinico-biochemical study. J Oral Biol Craniofac Res 2022; 12:481-485. [PMID: 35747166 PMCID: PMC9210469 DOI: 10.1016/j.jobcr.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 03/14/2022] [Indexed: 11/21/2022] Open
Abstract
Objectives Gamma-glutamyl transferase (GGT) enzyme is a routinely used diagnostic marker to detect various systemic diseases, elevation of which indicates destructive activity. Elevated GGT levels in GCF of destructive periodontal diseases hence can be expected. Hence, the aim of this study was to investigate if gamma glutamyl transferase would be a good indicator of on-going disease activity and to also assess the effect of non-surgical therapy on Gamma glutamyl transferase in gingival crevicular fluid of clinically healthy and chronic periodontitis patients. Methods GCF samples from 20 chronic periodontitis patients and 20 clinically healthy individuals of age group 35-45 years were collected. Clinical parameters were recorded and GGT levels in GCF assessed using semi-autoanalyser before and after appropriate non-surgical periodontal therapy in both the groups. Results GGT levels were higher in chronic periodontitis group compared to healthy group at baseline. There was a significant reduction in the GGT levels and clinical parameters at 30th and 90th day post treatment. Conclusion The significant reduction in the GGT levels after Non Surgical Periodontal Therapy at every recall interval may indicate that GGT can be used as a potential diagnostic marker of periodontitis.
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Affiliation(s)
- Kavyashree G
- Department of Periodontics, Sri Siddhartha Dental College and Hospital, Agalakote, BH Road, Tumakuru, Karnataka, 572107, India
| | - Shrinidhi Maji Shankar
- Department of Periodontics, Sharavathi Dental College and Hospital, Shimoga, NH 206, Alkola, T.H Road, Shivamogga, Karnataka, 577204, India
| | - Umesh Nagesh
- Department of Pediatrics, Sri Siddhartha Medical College and Hospital, Sri Siddhartha Medical College and Hospital, Agalakote, BH Road, Tumakuru, Karnataka, 572107, India
| | - Soumya Bardvalli Gururaj
- Department of Periodontics, Sharavathi Dental College and Hospital, Shimoga, NH 206, Alkola, T.H Road, Shivamogga, Karnataka, 577204, India
| | - Chethana Kunthur Chidambar
- Department of Periodontics, Sharavathi Dental College and Hospital, Shimoga, NH 206, Alkola, T.H Road, Shivamogga, Karnataka, 577204, India
| | - Kala Bhushan
- Department of Periodontics, Sharavathi Dental College and Hospital, Shimoga, NH 206, Alkola, T.H Road, Shivamogga, Karnataka, 577204, India
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Martínez-Quintana E, Pardo-Maiza J, Déniz-Alvarado B, Riaño-Ruiz M, González-Martín JM, Rodríguez-González F. Gamma-glutamyl transferase and cardiovascular events in patients with congenital heart disease. Eur J Clin Invest 2022; 52:e13720. [PMID: 34817878 DOI: 10.1111/eci.13720] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/16/2021] [Accepted: 11/16/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Serum gamma-glutamyl transferase activity (GGT) seems to predict cardiovascular events in different populations. However, no data exist on patients with congenital heart disease (CHD). METHODS Observational, analytic, prospective cohort study design involving CHD patients and a control population to determine the effect of GGT levels on survival. RESULTS A total of 589 CHD patients (58% males, 29 ± 14 years old) and 2745 matched control patients were followed up. A total of 69 (12%) CHD patients had a major acute cardiovascular event (MACE) during the follow-up time (6.1 [0.7-10.4] years). Patients with CHD and a GGT >60 U/L were significantly older, more hypertensive and dyslipidemic, had a worse NYHA functional class and a greater anatomical complexity than CHD patients with a GGT ≤60 U/L. The binary logistic regression analysis showed that age, a great CHD anatomical complexity, and having atrial fibrillation/flutter were the predictive factors of higher GGT levels (>60 U/L). The Kaplan-Meier analysis showed that patients with CHD and a GGT concentration above 60 UL showed the lowest probability of survival compared to that of CHD with GGT ≤60 U/L and controls irrespective of their GGT concentrations (p < .001). Similarly, the multivariable Cox regression analysis found an independent association between higher GGT levels (>60 U/L) and a worse prognosis (HR 2.44 [1.34-4.44], p = .003) among patients with CHD. CONCLUSION Patients with CHD showed significant higher GGT levels than patients in the control group having those with higher GGT concentrations (>60 U/L) the worst survival.
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Affiliation(s)
- Efrén Martínez-Quintana
- Cardiology Department, Complejo Hospitalario Universitario Insular-Materno Infantil, Las Palmas de Gran Canaria, Spain.,Medical and Surgical Sciences Department, Facultad de Ciencias de la Salud, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Javier Pardo-Maiza
- Medical and Surgical Sciences Department, Facultad de Ciencias de la Salud, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Beatriz Déniz-Alvarado
- Medical and Surgical Sciences Department, Facultad de Ciencias de la Salud, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Marta Riaño-Ruiz
- Department of Biochemistry and Clinical Analyses, Complejo Hospitalario Universitario Insular-Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Jesús María González-Martín
- Research Unit, Complejo Hospitalario Universitario Insular-Materno Infantil, Las Palmas de Gran Canaria, Spain
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Affiliation(s)
- Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Corresponding author: Hye Jin Yoo https://orcid.org/0000-0003-0600-0266 Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Korea E-mail:
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Park MJ, Choi KM. Association between Variability of Metabolic Risk Factors and Cardiometabolic Outcomes. Diabetes Metab J 2022; 46:49-62. [PMID: 35135078 PMCID: PMC8831817 DOI: 10.4093/dmj.2021.0316] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/07/2021] [Indexed: 11/10/2022] Open
Abstract
Despite strenuous efforts to reduce cardiovascular disease (CVD) risk by improving cardiometabolic risk factors, such as glucose and cholesterol levels, and blood pressure, there is still residual risk even in patients reaching treatment targets. Recently, researchers have begun to focus on the variability of metabolic variables to remove residual risks. Several clinical trials and cohort studies have reported a relationship between the variability of metabolic parameters and CVDs. Herein, we review the literature regarding the effect of metabolic factor variability and CVD risk, and describe possible mechanisms and potential treatment perspectives for reducing cardiometabolic risk factor variability.
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Affiliation(s)
- Min Jeong Park
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyung Mook Choi
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Corresponding author: Kyung Mook Choi https://orcid.org/0000-0001-6175-0225 Division of Endocrinology & Metabolism, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Korea E-mail:
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Hong SH, Lee JS, Kim JA, Lee YB, Roh E, Hee Yu J, Kim NH, Yoo HJ, Seo JA, Kim SG, Kim NH, Baik SH, Choi KM. Glycemic variability and the risk of nonalcoholic fatty liver disease : A nationwide population-based cohort study. Diabetes Res Clin Pract 2021; 177:108922. [PMID: 34146602 DOI: 10.1016/j.diabres.2021.108922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/01/2021] [Accepted: 06/14/2021] [Indexed: 12/15/2022]
Abstract
AIM Although few recent studies have reported the association between the glycemic variability and the development of type 2 diabetes mellitus and cardiovascular disease in individuals without diabetes mellitus, the impact of the long-term variability in fasting plasma glucose (FPG) levels on the incident nonalcoholic fatty liver disease (NAFLD) has not been evaluated. METHODS The study included 57,636 Korean men and women without NAFLD and diabetes mellitus from the Korean National Health Insurance System cohort. FPG variability was calculated using the coefficient of variation (FPG-CV), standard deviation (FPG-SD), variability independent of the mean (FPG-VIM), and average successive variability (FPG-ASV). RESULTS The cumulative incidence of NAFLD demonstrated progressively increasing trends according to the higher quartiles of FPG variability in Kaplan-Meier curves. A multivariable Cox proportional hazard analysis revealed that the hazard ratio for incident NAFLD was 1.15 (95% confidence interval, 1.06-1.24) in the highest quartile of FPG-CV compared with the lowest quartile of FPG-CV after adjusting for various confounding factors, including mean FPG levels. When using FPG-SD, FPG-VIM, and FPG-ASV, the results were similar. The 10-unit increase in FPG variability was associated with a 14% increased risk of NAFLD in the fully adjusted model. Moreover, this effect remained consistent in the subgroup and sensitivity analyses. CONCLUSION Increased long-term FPG variability is associated with the development of NAFLD, independent of confounding risk variables including mean FPG levels.
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Affiliation(s)
- So-Hyeon Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Ji Sung Lee
- Clinical Research Center, Asan Medical Center, College of Medicine, Seoul, Republic of Korea
| | - Jung A Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
| | - Eun Roh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Ji Hee Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Ji A Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea.
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Potassium variability during hospitalization and outcomes after discharge in patients with acute myocardial infarction. J Geriatr Cardiol 2021; 18:10-19. [PMID: 33613655 PMCID: PMC7868917 DOI: 10.11909/j.issn.1671-5411.2021.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The variability of metabolic biomarkers has been determined to provide incremental prognosis information, but the implications of electrolyte variability remained unclear. METHODS We investigate the relationships between electrolyte fluctuation and outcomes in survivors of acute myocardial infarction (n = 4386). Ion variability was calculated as the coefficient of variation, standard deviation, variability independent of the mean (VIM) and range. Hazard ratios (HR) were estimated using the multivariable-adjusted Cox proportional regression method. RESULTS During a median follow-up of 12 months, 161 (3.7%) patients died, and heart failure occurred in 550 (12.5%) participants after discharge, respectively. Compared with the bottom quartile, the highest quartile potassium VIM was associated with increased risks of all-cause mortality (HR = 2.35, 95% CI: 1.36-4.06) and heart failure (HR = 1.32, 95% CI: 1.01-1.72) independent of cardiac troponin I (cTnI), N terminal pro B type natriuretic peptide (NT-proBNP), infarction site, mean potassium and other traditional factors, while those associations across sodium VIM quartiles were insignificant. Similar trend remains across the strata of variability by other three indices. These associations were consistent after excluding patients with any extreme electrolyte value and diuretic use. CONCLUSIONS Higher potassium variability but not sodium variability was associated with adverse outcomes post-infarction. Our findings highlight that potassium variability remains a robust risk factor for mortality regardless of clinical dysnatraemia and dyskalaemia.
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Affiliation(s)
- Thomas Senoner
- University Hospital for Internal Medicine III (Cardiology and Angiology), Medical University Innsbruck, Innsbruck, Austria
| | - Wolfgang Dichtl
- University Hospital for Internal Medicine III (Cardiology and Angiology), Medical University Innsbruck, Innsbruck, Austria
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