Gamma glutamyl transferase and metabolic syndrome, cardiovascular disease, and mortality risk - The Framingham Heart Study
Gamma glutamyl transferase and metabolic syndrome, cardiovascular disease, and mortality risk - The Framingham Heart Study
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DOI：
10.1161/01.atv.0000251993.20372.40
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发表时间：
2007-01-01
影响因子：
8.7
通讯作者：
Vasan, Ramachandran S.
中科院分区：
文献类型：
--
作者：
Lee, Douglas S.;Evans, Jane C.;Vasan, Ramachandran S.
目的-确定血清γ-谷氨酰转移酶（GGT）是否预测心血管疾病（CVD）的发病率和死亡率，解释已知CVD危险因素和C-反应蛋白（CRP）的时间变化。（平均年龄44岁，52%为女性），我们检查了GGT与CVD危险因素的关系，并前瞻性地确定了新发代谢综合征、CVD事件和死亡的风险。在横断面分析中，GGT与体重指数、血压、LDL胆固醇、甘油三酯和血糖呈正相关（P < 0.005）。在随访（平均19年）中，968名参与者发生代谢综合征，535名发生CVD，362名死亡。代谢综合征的风险随着GGT的升高而增加（多变量校正的风险比[HR]/SD增量log-GGT，1.26 [95% CI; 1.18 - 1.35]）。校正已确定的CVD风险因素（作为时间依赖性协变量，每四年更新一次）和基线CRP，log-GGT增加1-SD，CVD风险增加13%（P = 0.007），死亡风险增加26%（P < 0.001）。GGT最高四分位数的个体CVD发病率增加67%（多变量校正HR 1.67，95%CI; 1.25 - 2.22）。结论-血清GGT增加可预测代谢综合征的发生、CVD事件和死亡，表明GGT是代谢和心血管风险的标志物。
Objective - To determine whether serum gamma-glutamyl transferase (GGT) predicts cardiovascular disease (CVD) morbidity and mortality, accounting for temporal changes in known CVD risk factors and C-reactive protein (CRP).Methods and Results - In 3451 Framingham Study participants (mean age 44 years, 52% women) we examined the relations of GGT with CVD risk factors, and prospectively determined the risk of new-onset metabolic syndrome, incident CVD, and death. GGT was positively associated with body mass index, blood pressure, LDL cholesterol, triglycerides, and blood glucose in cross-sectional analysis (P < 0.005). On follow-up (mean 19 years), 968 participants developed metabolic syndrome, 535 developed incident CVD, and 362 died. The risk of metabolic syndrome increased with higher GGT (multivariable-adjusted hazard ratio [HR] per SD increment log-GGT, 1.26 [95% CI; 1.18 to 1.35]). Adjusting for established CVD risk factors (as time-dependent covariates updated quadriennially) and baseline CRP, a 1-SD increase in log-GGT conferred a 13% increase in CVD risk (P = 0.007) and 26% increased risk of death (P < 0.001). Individuals in the highest GGT quartile experienced a 67% increase in CVD incidence (multivariable-adjusted HR 1.67, 95% CI; 1.25 to 2.22).Conclusion - An increase in serum GGT predicts onset of metabolic syndrome, incident CVD, and death suggesting that GGT is a marker of metabolic and cardiovascular risk.