title: Gamma-glutamyl transferase: a novel cardiovascular risk biomarker.
abstract: Gamma-glutamyl transferase (GGT) is a second-generation enzymatic liver function test available for several decades, initially used as a sensitive indicator of alcohol ingestion, hepatic inflammation, fatty liver disease, and hepatitis. Longitudinal and cross-sectional investigational studies since 1990 have associated GGT with an increase in all-cause mortality, as well as chronic heart disease events such as congestive heart failure and components of the metabolic syndrome (abnormal body mass index and levels of high-density lipoprotein cholesterol, glucose, triglycerides, and systolic and diastolic blood pressure). In the upper reference range, GGT was found to be an independent biomarker of the metabolic syndrome, with a 20% per GGT quartile trend rise. Additionally, GGT was positively correlated with an 18% per quartile risk of cardiovascular events and a 26% per quartile increased risk of all-cause mortality. Furthermore, it may be considered a biomarker for "oxidative stress" associated with glutathione metabolism and possibly a "proatherogenic" marker because of its indirect relationship in the biochemical steps to low-density lipoprotein cholesterol oxidation. GGT is becoming an important addition to the multimarker approach to cardiovascular risk evaluation. It should be considered a valuable adjunct in stratifying patient risk and in assessing the aggressiveness of appropriate treatment, with hopes of preventing unnecessary cardiac events and deaths in future years.
authors.affiliation: Berkeley HeartLab, Inc, Burlingame, CA, USA. Jennifer_Mason@msn.com
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Mason
authors.forename: Rodman D
authors.initials: RD
authors.lastname: Starke
authors.forename: John E
authors.initials: JE
authors.lastname: Van Kirk
mesh_terms: D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000201:enzymology* / Q000401:mortality; D006801:Humans; D008111:Liver Function Tests; D024821:Metabolic Syndrome / Q000378:metabolism; D018384:Oxidative Stress; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D015415:Biomarkers; D005723:gamma-Glutamyltransferase