title: Gamma glutamyl transferase and metabolic syndrome, cardiovascular disease, and mortality risk: the Framingham Heart Study.
abstract: OBJECTIVE
  To determine whether serum gamma-glutamyl transferase (GGT) predicts cardiovascular disease (CVD) morbidity and mortality, accounting for temporal changes in known CVD risk factors and C-reactive protein (CRP).
  
  
  RESULTS
  In 3451 Framingham Study participants (mean age 44 years, 52% women) we examined the relations of GGT with CVD risk factors, and prospectively determined the risk of new-onset metabolic syndrome, incident CVD, and death. GGT was positively associated with body mass index, blood pressure, LDL cholesterol, triglycerides, and blood glucose in cross-sectional analysis (P<0.005). On follow-up (mean 19 years), 968 participants developed metabolic syndrome, 535 developed incident CVD, and 362 died. The risk of metabolic syndrome increased with higher GGT (multivariable-adjusted hazard ratio [HR] per SD increment log-GGT, 1.26 [95%CI; 1.18 to 1.35]). Adjusting for established CVD risk factors (as time-dependent covariates updated quadriennially) and baseline CRP, a 1-SD increase in log-GGT conferred a 13% increase in CVD risk (P=0.007) and 26% increased risk of death (P<0.001). Individuals in the highest GGT quartile experienced a 67% increase in CVD incidence (multivariable-adjusted HR 1.67, 95%CI; 1.25 to 2.22).
  
  
  CONCLUSIONS
  An increase in serum GGT predicts onset of metabolic syndrome, incident CVD, and death suggesting that GGT is a marker of metabolic and cardiovascular risk.
authors.affiliation: Institute for Clinical Evaluative Sciences, Division of Cardiology, University Health Network, University of Toronto, Rm G-106, 2075 Bayview Ave, Toronto, Ontario, M4N 3M5 Canada. dlee@ices.on.ca
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Lee
authors.forename: Jane C
authors.initials: JC
authors.lastname: Evans
authors.forename: Sander J
authors.initials: SJ
authors.lastname: Robins
authors.forename: Peter W
authors.initials: PW
authors.lastname: Wilson
authors.forename: Irene
authors.initials: I
authors.lastname: Albano
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Fox
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Wang
authors.forename: Emelia J
authors.initials: EJ
authors.lastname: Benjamin
authors.forename: Ralph B
authors.initials: RB
authors.lastname: D'Agostino
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate; D005723:gamma-Glutamyltransferase / Q000097:blood* / Q000502:physiology
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D005723:gamma-Glutamyltransferase