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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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Park JY, Han K, Kim HS, Cho JH, Yoon KH, Kim MK, Lee SH. Cumulative Exposure to High γ-Glutamyl Transferase Level and Risk of Diabetes: A Nationwide Population-Based Study. Endocrinol Metab (Seoul) 2022; 37:272-280. [PMID: 35413781 PMCID: PMC9081297 DOI: 10.3803/enm.2022.1416] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/01/2022] [Accepted: 03/07/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Elevated γ-glutamyl transferase (γ-GTP) level is associated with metabolic syndrome, impaired glucose tolerance, and insulin resistance, which are risk factors for type 2 diabetes. We aimed to investigate the association of cumulative exposure to high γ-GTP level with risk of diabetes. METHODS Using nationally representative data from the Korean National Health Insurance system, 346,206 people who were free of diabetes and who underwent 5 consecutive health examinations from 2005 to 2009 were followed to the end of 2018. High γ-GTP level was defined as those in the highest quartile, and the number of exposures to high γ-GTP level ranged from 0 to 5. Hazard ratio (HR) and 95% confidence interval (CI) for diabetes were analyzed using the multivariable Cox proportional-hazards model. RESULTS The mean follow-up duration was 9.2±1.0 years, during which 15,183 (4.4%) patients developed diabetes. There was a linear increase in the incidence rate and the risk of diabetes with cumulative exposure to high γ-GTP level. After adjusting for possible confounders, the HR of diabetes in subjects with five consecutive high γ-GTP levels were 2.60 (95% CI, 2.47 to 2.73) in men and 3.05 (95% CI, 2.73 to 3.41) in women compared with those who never had a high γ-GTP level. Similar results were observed in various subgroup and sensitivity analyses. CONCLUSION There was a linear relationship between cumulative exposure to high γ-GTP level and risk of diabetes. Monitoring and lowering γ-GTP level should be considered for prevention of diabetes in the general population.
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Affiliation(s)
- Ji-Yeon Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Hun-Sung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae-Hyoung Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kun-Ho Yoon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Mee Kyoung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung-Hwan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Bi Y, Yang S, Liu Y, Cao L, Gao M, Liu W, Li Y, Tian S, Sun C. To explore association between gamma-glutamyl transferase and type 2 diabetes using a real-world study and mendelian randomization analysis. Front Endocrinol (Lausanne) 2022; 13:899008. [PMID: 35957835 PMCID: PMC9359111 DOI: 10.3389/fendo.2022.899008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/01/2022] [Indexed: 01/09/2023] Open
Abstract
AIM The association between gamma-glutamyl transferase (GGT) and type 2 diabetes mellitus (T2DM) is controversial. In this study, we investigated the association between GGT and the risk of T2DM using real-world data, Mendelian randomization (MR) analysis, and literature mining. METHODS A cross-sectional study enrolled 3,048 participants (>40 years) from a community in Northeastern China was conducted. A generalized additive model was used to examine the relation between GGT and T2DM. A two-sample MR was performed to investigate the causal effect of GGT (61,089 individuals, mostly of European ancestry) on T2DM (29,193 cases and 182,573 controls of European ancestry). RESULTS GGT was related to glucose metabolism indicators, such as fasting plasma glucose and glycosylated hemoglobin (P < 0.05). The odds ratios (ORs) [95% confidence interval (95% CI), P] for T2DM across the GGT categories (14-16, 17-20, 21-25, 26-35, ≥36) were 1.14 [(0.88-1.47), P = 0.330], 1.55 [(1.22-1.98), P < 0.001], 1.87 [(1.47-2.28), P < 0.001], 1.97 [(1.55-2.52), P < 0.001], and 2.29 [(1.78-2.94), P < 0.001] versus GGT ≤ 13 category after adjusting for potential confounding factors. A generalized additive model identified a non-linear correlation between GGT and T2DM and indicated that the risk of T2DM almost levelled out when GGT exceeded 34 IU/L. The MR analysis showed that the odds of having T2DM for a one-time increase in genetically determined GGT was 0.998 [(0.995-1.002), P = 0.34]. CONCLUSIONS Our analysis of observational study suggested that GGT, its increment, within a certain range, is indicative of the development of T2DM. However, MR analysis provided no evidence that GGT is a linear causal factor of T2DM. Further investigation is required to determine if GGT exerts a non-linear causal effect on T2DM.
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Affiliation(s)
- Yaru Bi
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, Changchun, China
| | - Shuo Yang
- Department of Clinical Nutrition, First Hospital of Jilin University, Changchun, China
| | - Yanjing Liu
- Department of Internal Medicine, Lvyuan People's Hospital, Changchun, China
| | - Lingxia Cao
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, Changchun, China
| | - Menghan Gao
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, Changchun, China
| | - Weixia Liu
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, Changchun, China
| | - Yuting Li
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, Changchun, China
| | - Suyan Tian
- Division of Clinical Research, First Hospital of Jilin University, Changchun, China
- *Correspondence: Suyan Tian, ; Chenglin Sun,
| | - Chenglin Sun
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, Changchun, China
- Department of Clinical Nutrition, First Hospital of Jilin University, Changchun, China
- *Correspondence: Suyan Tian, ; Chenglin Sun,
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Xie W, Liu B, Tang Y, Yang T, Song Z. Gamma-glutamyl transferase to high-density lipoprotein cholesterol ratio: A valuable predictor of type 2 diabetes mellitus incidence. Front Endocrinol (Lausanne) 2022; 13:1026791. [PMID: 36246883 PMCID: PMC9557082 DOI: 10.3389/fendo.2022.1026791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/15/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Gamma-glutamyl transferase (GGT) and high-density lipoprotein cholesterol (HDL-C) have been proven to be valuable predictors of type 2 diabetes mellitus (T2DM). The aim of this study was to investigate the association between GGT/HDL-C ratio and incident T2DM. METHODS The study retrospectively analyzed 15453 participants from 2004 to 2015. Cox proportional hazards regression models and Kaplan-Meier curves were used to elucidate the effect of GGT/HDL-C ratio on T2DM. Restricted cubic spline (RCS) analysis was performed to explore any non-linear correlation between GGT/HDL-C ratio and the risk of T2DM. The predictive performance of GGT, HDL-C and GGT/HDL-C ratio for T2DM was evaluated utilizing receiver-operating-characteristic (ROC) curves. RESULTS During a median follow-up of 5.39 years, 373 cases of incident T2DM were observed. Kaplan-Meier curves showed that the cumulative probabilities of T2DM increased in the participants with higher GGT/HDL-C ratio significantly (P < 0.001). Cox models further clarified that high GGT/HDL-C ratio was an independent risk factor for T2DM (HR = 1.01, 95% CI = 1.00-1.01, P = 0.011). Linear positive correlation between GGT/HDL-C ratio and the risk of T2DM was demonstrated through RCS analysis. In the ROC analysis, GGT/HDL-C ratio (AUC = 0.75, 95% CI = 0.73-0.77) showed competitive role in the prediction of T2DM compared with single GGT and HDL-C. CONCLUSIONS The GGT/HDL-C ratio could serve as a valuable predictor of T2DM, and the risk of T2DM increases in the condition of higher GGT/HDL-C ratio.
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Affiliation(s)
- Wangcheng Xie
- Department of General Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bin Liu
- Department of Gastrointestinal Surgery, Anqing First People’s Hospital, Anhui Medical University, Anqing, China
| | - Yansong Tang
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Tingsong Yang
- Department of General Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- *Correspondence: Zhenshun Song, ; Tingsong Yang,
| | - Zhenshun Song
- Department of General Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- *Correspondence: Zhenshun Song, ; Tingsong Yang,
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Falbová D, Vorobeľová L, Siváková D, Beňuš R. Association between FTO (rs17817449) genetic variant, gamma-glutamyl transferase, and hypertension in Slovak midlife women. Am J Hum Biol 2021; 34:e23672. [PMID: 34436809 DOI: 10.1002/ajhb.23672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/11/2021] [Accepted: 08/13/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES This cross-sectional study investigates associations between the FTO rs 17817449 genetic variant, liver enzymes, and hypertension in Slovak midlife women. METHODS We assessed 576 Slovak women aged 39 to 65 years. The women were interviewed and examined during their medical examination at local Health Centers and then divided into subgroups according to their blood pressure status; 255 women with hypertension and 321 normotensive. The FTO genetic variant was detected by polymerase chain reaction-restriction fragment length polymorphism. Resultant data was analyzed by linear regression analysis and general linear models to adjust for risk factors associated with gamma-glutamyl transferase levels (GGT), including waist to hip ratio (WHR) and uric acid (UA). RESULTS A significant association between the FTO variant and GGT levels was observed in the hypertensive group after control for confounding covariates, including WHR and UA (p = .004). The predicted GGT level for GT/TT hypertensive carriers is 0.158 μkat/L higher than for GG carriers. Moreover, the two-way analysis of covariance revealed significant interaction between FTO effects and hypertension on logGGT levels (p = .042). Finally, hypertensive women with the T-allele had the highest estimated marginal mean value of logGGT at -0.39 μkat/L while the GG-genotype in both hypertensive and normotensive women had the lowest value at -0.54 μkat/L. CONCLUSIONS This study suggests that the FTO (rs17817449) variant is associated with higher serum GGT levels in hypertensive midlife women.
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Affiliation(s)
- Darina Falbová
- Department of Anthropology, Faculty of Natural Sciences, Comenius University in Bratislava, Bratislava, Slovakia
| | - Lenka Vorobeľová
- Department of Anthropology, Faculty of Natural Sciences, Comenius University in Bratislava, Bratislava, Slovakia
| | - Daniela Siváková
- Department of Anthropology, Faculty of Natural Sciences, Comenius University in Bratislava, Bratislava, Slovakia
| | - Radoslav Beňuš
- Department of Anthropology, Faculty of Natural Sciences, Comenius University in Bratislava, Bratislava, Slovakia
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Lin V, Hamby T, Das S, Chatrath A, Basha R, Fulda KG, Habiba N. Prevalence of elevated liver enzymes and their association with type 2 diabetes risk factors in children. J Pediatr Endocrinol Metab 2021; 34:707-711. [PMID: 33819416 DOI: 10.1515/jpem-2020-0512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 02/22/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Given their established role in hepatic function and insulin resistance for adults, early screening of type 2 diabetes mellitus (T2DM) in the pediatric population may potentially be improved by the assessment of elevated liver enzymes. METHODS Our study enrolled 151 nondiabetic children aged 10-14 years. Patients were assessed for demographics and five risk factors for T2DM. The levels of γ-glutamyl transpeptidase (GGT), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) levels were determined in serum samples. The effects of demographics and risk factors on abnormal liver enzyme levels were assessed with univariate chi-square analyses and also with multivariate logistic regression analyses, which were controlled for gender. RESULTS Frequencies for abnormal liver enzyme values were as follows: 13 (9%) for GGT, 5 (3%) for ALT, and 20 (13%) for ALP. Across analyses, two results were consistently statistically significant. Females were more likely to have abnormal ALP levels, and patients with BMI percentile ≥95% and with acanthosis nigricans were more likely to have abnormal GGT levels. CONCLUSIONS Our study suggests GGT as potential marker for T2DM discovery in children. Subsequent long-term longitudinal studies would help to more clearly delineate GGT's association with T2DM. Additionally, future studies that elucidate the molecular contribution of GGT elevation to T2DM pathogenesis are needed.
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Affiliation(s)
- Victor Lin
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Tyler Hamby
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
- Cook Children's Medical Center, Fort Worth, TX, USA
| | - Siddharth Das
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Amritpaul Chatrath
- University of Texas Health Science Center at San Antonio, Fort Worth, TX, USA
| | - Riyaz Basha
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Kimberly G Fulda
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
- The North Texas Primary Care Practice-Based Research Network (NorTex), Fort Worth, TX, USA
| | - Nusrath Habiba
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
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