Gamma-glutamyltransferase as a risk factor for cardiovascular disease mortality: an epidemiological investigation in a cohort of 163,944 Austrian adults.
Gamma-glutamyltransferase as a risk factor for cardiovascular disease mortality: an epidemiological investigation in a cohort of 163,944 Austrian adults.
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发表时间：
2005
期刊：
影响因子：
37.8
通讯作者：
E. Ruttmann;L. Brant;H. Concin;G. Diem;K. Rapp;H. Ulmer
中科院分区：
文献类型：
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作者：
E. Ruttmann;L. Brant;H. Concin;G. Diem;K. Rapp;H. Ulmer
背景：最近的研究表明γ-谷氨酰转移酶（GGT）可能与心血管疾病（CVD）有关。然而，到目前为止，很少有足够的样本量和随访研究GGT与CVD死亡率的关系。方法和结果在一个163，944名奥地利成年人的队列中检查了GGT与CVD死亡风险的关系，该队列被监测长达17年。为了评价GGT作为独立预测因子的作用，计算了考克斯比例风险模型，该模型对已确定的风险因素进行了调整。在男性和女性中，高GGT与CVD的总死亡率显著相关（P<0.001），显示出明确的剂量反应关系。男性和女性中每对数GGT增加的校正风险比（95% CI）分别为1.66（1.40 - 1.98）和1.64（1.36 - 1.97）。在男性中，亚组分析显示，高GGT与慢性冠心病（P=0.009）、充血性心力衰竭（P<0.001）、出血性（P=0.01）和缺血性卒中（P<0.001）等致死性事件呈正相关。未观察到与急性心肌梗死的显著相关性（P=0.16）。在女性中，风险比表明所有亚组均存在相关性;然而，出血性和缺血性卒中的风险比无统计学显著性（分别为P=0.09和P=0.07）。此外，按年龄分层的亚组分析显示，年轻参与者中GGT的相关性更强。60岁以下男性和女性总CVD的风险比分别为2.03（1.53至2.69）和2.60（1.53至4.42）。结论：本研究在一个大型前瞻性队列中证实GGT与心血管死亡率独立相关。
BACKGROUND There is evidence from recent studies that gamma-glutamyltransferase (GGT) is likely to be associated with cardiovascular disease (CVD). However, few studies to date with sufficient sample size and follow-up investigated the association of GGT with CVD mortality. METHODS AND RESULTS The relation of GGT to the risk of death from CVD was examined in a cohort of 163,944 Austrian adults that was monitored for up to 17 years. To evaluate GGT as an independent predictor, Cox proportional hazards models were calculated, which adjusted for established risk factors. In both men and women, high GGT was significantly (P<0.001) associated with total mortality from CVD, showing a clear dose-response relationship. Adjusted hazard ratios (95% CI) per log GGT increase were 1.66 (1.40 to 1.98) in men and 1.64 (1.36 to 1.97) in women. In men, subgroup analyses showed that high GGT was positively associated with incident fatal events of chronic forms of coronary heart disease (P=0.009), congestive heart failure (P<0.001), and hemorrhagic (P=0.01) and ischemic stroke (P<0.001). No significant associations were observed for acute myocardial infarction (P=0.16). In women, hazard ratios suggested associations in all subgroups; however, for hemorrhagic and ischemic stroke they were not statistically significant (P=0.09 and P=0.07, respectively). In addition, subgroup analyses stratified by age revealed a stronger relationship of GGT in younger participants. Hazard ratios for total CVD were 2.03 (1.53 to 2.69) in men and 2.60 (1.53 to 4.42) in women younger than 60 years. CONCLUSIONS This study demonstrates in a large, prospectively observed cohort that GGT is independently associated with cardiovascular mortality.