Gamma glutamyltransferase as a novel marker of coronary artery calcification in women

aDepartment of Pneumoconiosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine bDepartment of Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China cTransplantation Research Center, Samsung Biomedical Research Institute dDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea eDepartment of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China fCenter for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea *These two authors contributed equally to this work.
Journal of Cardiovascular Medicine (Impact Factor: 1.51). 07/2012; 13(11). DOI: 10.2459/JCM.0b013e328356a432
Source: PubMed


Gamma glutamyltransferase (GGT) has attracted great interest as a potential novel marker of cardiovascular risk. However, its association with coronary artery calcification (CAC) score-determined coronary artery atherosclerosis is unknown. This study was designed to assess the association of GGT with CAC score.

Participants, 311 asymptomatic men and 220 asymptomatic women who underwent evaluation of CAC by cardiac computed tomography, were retrospectively investigated. Correlation and logistic regression analysis were used to assess the association of GGT with CAC score and other variables.

Women but not men with higher GGT had a higher incidence of CAC score above 100 and a higher prevalence of metabolic syndrome (P = 0.012 and 0.007, respectively). GGT was positively correlated with C-reactive protein (CRP) in women (r = 0.336, P < 0.001). GGT was independently associated with the incidence of CAC score above 100 in women [odds ratio (OR) 1.228, 95% confidence interval (CI) 1.206-1.252, P = 0.001] but not in men.

In asymptomatic women, GGT is independently and positively associated with CAC score and it can be useful as a provisional new risk factor for CAC. Additionally, metabolic syndrome and CRP may be the mediators of the mechanisms by which GGT increases CAC in asymptomatic women.

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    • "Only a few studies to date have shown that serum GGT activity is independently and positively associated with CAC score [13] [14]. However, these studies mostly included Western populations and were cross-sectionally designed [13] [14], so the temporal relationship between exposure and outcomes could not be assessed [15]. In light of these findings, we designed our current study to investigate the association between serum GGT activity and CAC progression in an asymptomatic, middle-aged, Korean population. "
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    ABSTRACT: Background: Elevated serum gamma-glutamyltransferase (GGT) has been demonstrated to be associated with coronary artery calcification (CAC). CAC progression is an important marker of atherosclerosis and correlates with future cardiovascular risk. However, there is a lack of research that directly examines the association between serum GGT and CAC progression. The aim of this study was to elucidate the association between serum GGT activity and CAC progression. Methods: We enrolled 1246 asymptomatic participants who underwent repeated CAC score measurement during routine health examinations. To eliminate the dependence of the inter scan variability on the baseline CAC scores, square root-transformed CAC scores were used to analyze CAC progression. In addition, the annualized rate of change in CAC scores was computed. Results: Serum GGT activities were significantly higher in "progressors" than "nonprogressors". The prevalence of progression increased with the GGT tertile (11.9%, 20.1% and 27.9% in the 1st, 2nd, and 3rd GGT tertiles, respectively; p < 0.001). In the multivariate logistic regression analysis, the odds ratio (95% confidence interval) for CAC score progression was 1.85 (1.14-3.00) in the highest GGT tertile group. By multivariate linear regression analysis, baseline serum GGT activity demonstrated a positive association with the annualized change in CAC score (β = 0.002; p = 0.006) after adjusting for cardiovascular risk factors. Conclusion: Elevated serum GGT levels are independently associated with CAC progression. Serum GGT levels may be a potential biomarker of future coronary atherosclerosis and prognosis.
    Atherosclerosis 11/2015; 243(1):300-306. DOI:10.1016/j.atherosclerosis.2015.09.027 · 3.99 Impact Factor
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    ABSTRACT: Background Elevated gamma-glutamyl transferase (GGT) levels have been demonstrated to be associated with poor prognoses in patients with coronary artery disease. Coronary computed tomography angiography (CCTA) is a noninvasive imaging modality that may differentiate the structure of coronary plaques. Elevated plaque burdens and noncalcified plaques, detected by CCTA, are important predictors of atherosclerosis in young adults.HypothesisThe present study investigated the possible relationship between GGT levels and coronary plaque burdens/structures in young adults with coronary atherosclerosis.MethodsCCTA images of 259 subjects were retrospectively examined, and GGT levels were compared between patients with coronary plaques and individuals with normal coronary arteries. Coronary plaques, detected by CCTA, were categorized as noncalcified, calcified, and mixed, according to their structures. The significant independent predictors of coronary atherosclerosis were also analyzed using multivariate logistic regression analysis.ResultsGGT levels were significantly higher in patients with coronary plaque formation than in controls (35.7 ± 14.7 vs 19.6 ± 10.0 U/L; P < 0.001). GGT levels were also positively correlated with the number of plaques; presence of noncalcified plaques; and levels of high-sensitivity C-reactive protein (hs-CRP), hemoglobin A1c, uric acid, and triglycerides. Moreover, smoking and levels of GGT, hs-CRP, uric acid, and low high-density lipoprotein cholesterol were independent predictors of coronary atherosclerosis.ConclusionsGGT is an inexpensive and readily available marker that provides additional risk stratification beyond that provided by conventional risk factors for predicting coronary plaque burdens and plaque structures in young adults.
    Clinical Cardiology 08/2014; 37(9). DOI:10.1002/clc.22307 · 2.59 Impact Factor
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    ABSTRACT: Progression of coronary artery calcification (CAC) may be more predictive of future coronary heart disease events than a baseline CAC score. We determined whether serum gamma-glutamyltransferase (GGT) activity can independently predict the progression of CAC in adults with type 2 diabetes mellitus (T2DM). Patients (n = 326) without symptomatic cardiovascular (CV) disease were evaluated by CAC imaging. The CAC scores were assessed at baseline and after 20 ± 4 months. Serum GGT activities were significantly higher in progressors compared with nonprogressors (39 ± 16 vs 27 ± 11 U/L, P < .001). Multivariable analyses demonstrated that GGT activity retained a strong association with CAC progression after adjustment for CV risk factors. Additionally, there was a graded association between GGT activity quartile and annualized CAC progression. In asymptomatic patients with T2DM, we prospectively found that serum GGT activity may be an independent predictor of CAC progression but not a predictor of CAC incidence.
    Angiology 08/2014; 66(7). DOI:10.1177/0003319714548566 · 2.97 Impact Factor
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