title: Distribution, determinants, and prognostic value of gamma-glutamyltransferase for all-cause mortality in a cohort of construction workers from southern Germany.
abstract: BACKGROUND
  Serum gamma-glutamyltransferase (GGT) is commonly measured as a marker of hepatobiliary disorders in clinical practice, but little is known about its distribution and prognostic value for all-cause mortality.
  
  
  METHODS
  Distribution and determinants of serum GGT levels were assessed among 8,043 construction workers ages 25-64 who underwent occupational health examinations in six centers in Southern Germany from 1986 to 1988. Study participants were followed for all-cause mortality until 1994.
  
  
  RESULTS
  Serum GGT levels were considerably higher in this cohort than among male employees examined in a national survey conducted during the same period. The factors most strongly related to serum GGT were self-reported alcohol consumption, body mass index, diabetes, and hypertension, but relations of GGT levels were also found with nationality, occupation, and smoking. There was a strong dose-response relation between serum GGT levels and all-cause mortality (P value for trend < 0.001). Compared with men with GGT levels below 15 U/liter (measured at 25 degrees C), relative risks (95% CI) were 1.46 (0.86-2.49), 1.78 (1.08-2.94), 2.09 (1.26-3.45), and 3.44 (2.20-5.38) for men with GGT levels of 15-19, 20-29, 30-49, and > or = 50 U/liter, respectively. This relation was reduced but not eliminated by control for body mass index, diabetes, hypertension, alcohol consumption, and other covariates in multivariable analysis.
  
  
  CONCLUSIONS
  Serum GGT is a strong risk indicator of all-cause mortality.
authors.affiliation: Department of Epidemiology, University of Ulm, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Brenner
authors.forename: D
authors.initials: D
authors.lastname: Rothenbacher
authors.forename: V
authors.initials: V
authors.lastname: Arndt
authors.forename: S
authors.initials: S
authors.lastname: Schuberth
authors.forename: E
authors.initials: E
authors.lastname: Fraisse
authors.forename: T M
authors.initials: TM
authors.lastname: Fliedner
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D002423:Cause of Death; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005858:Germany / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D016272:Occupational Health / Q000706:statistics & numerical data*; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D016019:Survival Analysis; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D015415:Biomarkers; D005723:gamma-Glutamyltransferase