背景:γ-谷氨酰转移酶(γ-GTP)水平升高与代谢综合征相关。我们调查了大规模人群中高γ-GTP累积暴露与心血管疾病(CVD)风险的关系。
方法:使用韩国国民健康保险制度的全国代表性数据,纳入了1,640,127人,从2009年至2012年连续4年进行了γ-GTP测量,并随访至2019年底。对于研究期间的每一年,参与者按最高γ-GTP四分位数(0-4)的暴露次数分组,四分位数之和(0-12)定义为累积γ-GTP暴露。使用Cox比例风险模型评估CVD的风险比。
结果:在6.4年的随访中,心肌梗死(MI)15980例(0.97%),中风14,563(0.89%),29,717(1.81%)的CVD,和25,916(1.58%)的死亡。持续暴露于高γ-GTP水平与较高的MI风险相关。中风,CVD,和死亡比那些没有这种暴露的人。MI的风险,中风,CVD,根据总累积γ-GTP,死亡率以剂量依赖性方式增加(所有趋势P<0.0001)。受试者年龄小于65岁,体重指数<25kg/m2,无高血压或脂肪肝的情况下,累积γ-GTP与MI发病率之间的关系更强,CVD,和死亡。
结论:累积γ-GTP升高与CVD相关。γ-GTP可以更广泛地用作CVD风险的早期标志物,特别是在没有传统CVD危险因素的个体中。
BACKGROUND: Elevated γ-glutamyl transferase (γ-GTP) levels are associated with metabolic syndrome. We investigated the association of cumulative exposure to high γ-GTP with the risk of cardiovascular disease (CVD) in a large-scale population.
METHODS: Using nationally representative data from the Korean National Health Insurance system, 1,640,127 people with 4 years of consecutive γ-GTP measurements from 2009 to 2012 were included and followed up until the end of 2019. For each year of the
study period, participants were grouped by the number of exposures to the highest γ-GTP quartile (0-4), and the sum of quartiles (0-12) was defined as cumulative γ-GTP exposure. The hazard ratio for CVD was evaluated using the Cox proportional hazards model.
RESULTS: During the 6.4 years of follow-up, there were 15,980 cases (0.97%) of myocardial infarction (MI), 14,563 (0.89%) of stroke, 29,717 (1.81%) of CVD, and 25,916 (1.58%) of death. Persistent exposure to high γ-GTP levels was associated with higher risks of MI, stroke, CVD, and death than those without such exposure. The risks of MI, stroke, CVD, and mortality increased in a dose-dependent manner according to total cumulative γ-GTP (all P for trend <0.0001). Subjects younger than 65 years, with a body mass index <25 kg/m2, and without hypertension or fatty liver showed a stronger relationship between cumulative γ-GTP and the incidence of MI, CVD, and death.
CONCLUSIONS: Cumulative γ-GTP elevation is associated with CVD. γ-GTP could be more widely used as an early marker of CVD risk, especially in individuals without traditional CVD risk factors.