title: Serum gamma-glutamyltransferase predicts non-fatal myocardial infarction and fatal coronary heart disease among 28,838 middle-aged men and women.
abstract: OBJECTIVE
  Serum gamma-glutamyltransferase (GGT) concentration may be involved in atherosclerosis. This study examined if serum GGT predicted coronary heart disease (CHD), especially differentiating non-fatal myocardial infarction (MI) and fatal CHD event, among the general population or participants with type-2 diabetes.
  
  
  RESULTS
  A prospective study of 28,838 Finnish men and women aged 25-74 years was performed (1467 incident CHD cases; a median follow-up time of 11.9 years). Serum GGT cutpoints were the 25th, 50th, 75th, and 90th sex-specific percentiles. After adjustment for known cardiovascular risk factors, compared with the lowest GGT category, hazard ratios (HR) were 1.15, 1.25, 1.27, and 1.57 among men and 1.03, 1.22, 1.32, and 1.44 among women in other four GGT categories (P for trend <0.01, respectively). However, stronger associations were observed among subjects aged <60 and among alcohol drinkers. The strength of association was similar for non-fatal MI and for fatal CHD. Among subjects with type-2 diabetes, the corresponding adjusted HRs were 1.29, 1.57, 1.88, and 1.78 (P trend=0.03, men and women combined).
  
  
  CONCLUSIONS
  This study suggests an independent mechanism linking serum GGT to CHD among general population. Even though the strength of association appeared to be modest among all subjects, stronger associations were observed among subjects aged <60 and among alcohol drinkers. Especially, measurement of serum GGT among type-2 diabetics may be helpful to predict the future risk of CHD.
authors.affiliation: Department of Preventive Medicine, School of Medicine, Kyungpook National University, Jung-gu, Daegu, South Korea 700-422. lee_dh@knu.ac.kr
authors.forename: Duk-Hee
authors.initials: DH
authors.lastname: Lee
authors.forename: Karri
authors.initials: K
authors.lastname: Silventoinen
authors.forename: Gang
authors.initials: G
authors.lastname: Hu
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
authors.forename: Pekka
authors.initials: P
authors.lastname: Jousilahti
authors.forename: Jouko
authors.initials: J
authors.lastname: Sundvall
authors.forename: Jaakko
authors.initials: J
authors.lastname: Tuomilehto
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000401:mortality; D003327:Coronary Disease / Q000201:enzymology* / Q000401:mortality; D003925:Diabetic Angiopathies / Q000201:enzymology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000201:enzymology* / Q000401:mortality; D016016:Proportional Hazards Models; D012307:Risk Factors; D005723:gamma-Glutamyltransferase / Q000378:metabolism*
chemical_list: D005723:gamma-Glutamyltransferase