title: Association between serum gamma-glutamyltransferase and acute ischemic nonembolic stroke in elderly subjects.
abstract: OBJECTIVE
  Elevated serum gamma-glutamyltransferase (GGT) levels have been proposed as an independent predictor for cardiovascular morbidity and mortality. The aim of this study was to determine whether GGT levels are associated with acute ischemic/nonembolic stroke in a case-control study of elderly subjects.
  
  
  METHODS
  A total of 163 patients >70 years of age (88 men) admitted due to a first-ever acute ischemic/nonembolic stroke and 166 volunteers (87 men) without a history of cardiovascular disease were included. The association between GGT and stroke was determined by multivariate logistic regression modelling after adjusting for potential confounding factors.
  
  
  RESULTS
  GGT levels were higher in subjects with metabolic syndrome (MetS) and correlated with MetS individual components including insulin resistance. Stroke patients showed higher concentrations of GGT compared with controls. In univariate analysis, crude odds ratio (OR) for GGT was 1.06/1 IU/L increase (95% CI, 1.03-1.09; p<0.001). Compared to subjects with GGT levels in the lowest quartile, those within the highest quartile had a 4.7-times increase in the odds of experiencing an ischemic stroke (95% CI 2.39-9.11, p<0.001). This association remained significant after controlling for all potential confounders (adjusted OR, 2.90, 95% CI, 1.35-6.27; p=0.007). Analysis of interaction between MetS and GGT showed that subjects with MetS had a 1.08 higher odds/1 IU/L increase in GGT to experience an ischemic stroke [adjusted OR, 1.08 (95% CI, 1.04-1.12; p<0.001).
  
  
  CONCLUSIONS
  There are positive associations between serum GGT and first ischemic/nonembolic stroke in individuals >70 years of age independent of established risk factors for cardiovascular disease and concurrent metabolic abnormalities.
authors.affiliation: Department of Cardiology, University of Ioannina, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Korantzopoulos
authors.forename: Petros
authors.initials: P
authors.lastname: Tzimas
authors.forename: Kallirroi
authors.initials: K
authors.lastname: Kalantzi
authors.forename: Michael
authors.initials: M
authors.lastname: Kostapanos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Vemmos
authors.forename: John
authors.initials: J
authors.lastname: Goudevenos
authors.forename: Moses
authors.initials: M
authors.lastname: Elisaf
authors.forename: Haralampos
authors.initials: H
authors.lastname: Milionis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000097:blood / Q000201:enzymology; D016022:Case-Control Studies; D005260:Female; D006115:Greece; D006801:Humans; D008297:Male; D016017:Odds Ratio; D020521:Stroke / Q000097:blood / Q000201:enzymology; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D005723:gamma-Glutamyltransferase