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Research ArticleArticle

γ-Glutamyl Transferase Is Associated with Mortality Outcomes Independently of Fatty Liver

Ki-Chul Sung, Seungho Ryu, Bum-Soo Kim, Eun Sun Cheong, Dong-il Park, Byung Ik Kim, Min-Jung Kwon, Sarah H. Wild, Christopher D. Byrne
DOI: 10.1373/clinchem.2015.240424 Published August 2015
Ki-Chul Sung
Division of Cardiology, Department of Medicine,
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  • For correspondence: kcmd.sung@samsung.com c.d.byrne@soton.ac.uk
Seungho Ryu
Department of Occupational and Environmental Medicine,
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Bum-Soo Kim
Division of Cardiology, Department of Medicine,
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Eun Sun Cheong
Division of Cardiology, Department of Medicine,
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Dong-il Park
Division of Gastroenterology, Department of Medicine,
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Byung Ik Kim
Division of Gastroenterology, Department of Medicine,
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Min-Jung Kwon
Center for Cohort Studies, Total Healthcare Center, and Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea;
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Sarah H. Wild
Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK;
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Christopher D. Byrne
Nutrition and Metabolism Unit and Southampton National Institute for Health Research Biomedical Research Centre, Southampton General Hospital, University of Southampton, Southampton, UK.
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  • For correspondence: kcmd.sung@samsung.com c.d.byrne@soton.ac.uk
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Abstract

BACKGROUND: High serum enzyme activity levels of γ-glutamyl transferase (GGT) are associated with increased risk of mortality, but whether this is mediated by fatty liver, as a common cause of high GGT levels, is uncertain. Our aim was to test whether GGT levels are associated with all-cause, cancer, and cardiovascular (CVD) mortality, independently of fatty liver.

METHODS: In an occupational cohort (n = 278 419), causes of death (International Statistical Classification of Diseases and Related Health Problems, 10th revision) were recorded over 7 years. Liver function tests and liver fat [measured by ultrasonographic standard criteria or fatty liver index (FLI)] were assessed at baseline. We used Cox proportional hazards models to estimate adjusted hazard ratios (HRs) and 95% CIs of all-cause, cancer, and CVD mortality for GGT quartiles (with lowest GGT quartile as reference).

RESULTS: There were 136, 167, 265, and 342 deaths across increasing GGT quartiles. After adjusting for liver fat (by ultrasound diagnosis) in the fully adjusted model, all-cause and cancer mortality were increased in the highest GGT quartile [HR 1.50 (95% CI 1.15–1.96) and 1.57 (1.05–2.35), respectively]. For CVD mortality, the hazard was attenuated: HR 1.35 (95% CI 0.72–2.56). After adjusting for FLI in the fully adjusted model, HRs for all-cause, cancer, and CVD mortality were 1.46 (0.72–2.56), 2.03 (1.02–4.03), and 1.16 (0.41,3.24), respectively.

CONCLUSIONS: There were similar hazards for all-cause and cancer mortality and attenuated hazards for CVD mortality for people in the highest GGT quartile, adjusting for fatty liver assessed by either ultrasound or FLI.

  • Received for publication February 27, 2015.
  • Accepted for publication June 18, 2015.
  • © 2015 American Association for Clinical Chemistry
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Clinical Chemistry: 61 (9)
Vol. 61, Issue 9
September 2015
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γ-Glutamyl Transferase Is Associated with Mortality Outcomes Independently of Fatty Liver
Ki-Chul Sung, Seungho Ryu, Bum-Soo Kim, Eun Sun Cheong, Dong-il Park, Byung Ik Kim, Min-Jung Kwon, Sarah H. Wild, Christopher D. Byrne
Clinical Chemistry Sep 2015, 61 (9) 1173-1181; DOI: 10.1373/clinchem.2015.240424
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γ-Glutamyl Transferase Is Associated with Mortality Outcomes Independently of Fatty Liver
Ki-Chul Sung, Seungho Ryu, Bum-Soo Kim, Eun Sun Cheong, Dong-il Park, Byung Ik Kim, Min-Jung Kwon, Sarah H. Wild, Christopher D. Byrne
Clinical Chemistry Sep 2015, 61 (9) 1173-1181; DOI: 10.1373/clinchem.2015.240424

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