Prospective study of serum γ-glutamyltransferase and risk of NIDDM
Prospective study of serum γ-glutamyltransferase and risk of NIDDM
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DOI：
10.2337/diacare.21.5.732
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发表时间：
1998-05-01
期刊：
影响因子：
16.2
通讯作者：
Shaper, AG
中科院分区：
文献类型：
--
作者：
Perry, IJ;Wannamethee, SG;Shaper, AG
目的-血清γ-谷氨酰转移酶（GGT）水平在肥胖个体中升高，并且已经描述了与中心性肥胖的特别强的关联。我们假设GGT水平升高是内脏脂肪的标志物，特别是脂肪肝，脂肪肝导致肝脏胰岛素抵抗。为了验证这一假设，我们研究了GGT水平和NIDDM.RESEARCH设计和方法的风险之间的关联-我们进行了一项前瞻性队列研究的事件病例的医生诊断的NIDDM 7, 458非糖尿病男性笼40-59岁），平均为12.8年（范围11.5-13.0）。这些人是从英国24个城镇的全科医生名单中随机挑选出来的。NIDDM的情况下，通过反复邮寄问卷调查的男性和定期系统审查的初级保健records.RESULTS -共194名男性发展NIDDM在后续。基线时NIDDM患者的平均血清GGT（几何平均值[95%CI]）显著高于队列的其他患者（20.9 [19.3-22.6] vs. 15.3 U/l [15.0-15.6]，P < 0.0001）。随着GGT水平的升高，年龄调整后的NIDDM风险呈平稳、分级的增加，相对于底部五分之一，顶部五分之一的相对风险为6.8（3.5-12.9）（趋势P < 0.0001）。这种关联独立于血糖和BMI以及其他与GGT相关的NIDDM预测因子，包括酒精摄入和体力活动水平（校正的上至下第五相对危险度：4.8 [2.0-11.8]，趋势P < 0.0001]）。结论：这些发现表明血清GGT水平升高是NIDDM的独立危险因素。血清GGT水平可能是内脏和肝脏脂肪的一个简单而可靠的标志物，并推断肝脏胰岛素抵抗。
OBJECTIVE - Serum gamma-glutamyltransferase (GGT) levels are raised in obese individuals, and a particularly strong association with central obesity has been described. We hypothesized that elevated GGT levels are a marker for visceral fat, and specifically for hepatic steatosis (fatty liver), and that hepatic steatosis leads to hepatic insulin resistance. To test this hypothesis, we examined the association between GGT levels and risk of NIDDM.RESEARCH DESIGN AND METHODS - We carried out a prospective cohort study of incident cases of doctor-diagnosed NIDDM in a group of 7,458 nondiabetic men caged 40-59 years) followed for a mean of 12.8 years (range 11.5-13.0). The men were randomly selected from general practice lists in 24 British towns. Cases of NIDDM were ascertained by repeated postal questionnaires to the men and by regular systematic review of primary care records.RESULTS - A total of 194 men developed NIDDM during follow-up. Mean serum GGT at baseline (geometric mean [95% CI]) was significantly higher in the NIDDM patients than in the rest of the cohort (20.9 [19.3-22.6] vs. 15.3 U/l [15.0-15.6], P < 0.0001). There was a smooth, graded increase in the age-adjusted risk of NIDDM with increasing GGT levels, with a relative risk in the top fifth of the distribution of 6.8 (3.5-12.9) relative to the bottom fifth (trend P < 0.0001). This association was independent of serum glucose and BMI and of other predictors of NIDDM with which GGT is associated, including alcohol intake and physical activity level (adjusted upper to lower fifth relative risk: 4.8 [2.0-11.8], trend P < 0.0001]).CONCLUSIONS - These findings suggest that a raised serum GGT level is an independent risk factor for NIDDM. Serum GGT level may be a simple and reliable marker of visceral and hepatic fat and, by inference, of hepatic insulin resistance.