title: Gamma-glutamyltransferase, cardiovascular disease and mortality in individuals with diabetes mellitus.
abstract: BACKGROUND
  Increased plasma activity of gamma-glutamyltransferase (GGT) is associated with cardiovascular diseases (CVD) and mortality in the general population. We investigated the association between GGT, CVD and mortality in individuals with diabetes mellitus.
  
  
  METHODS
  Data used were from 1280 participants, aged 35-70 years, with a confirmed diagnosis of diabetes mellitus in the European Prospective Investigation into Cancer and Nutrition in Potsdam (Germany), Bilthoven and Utrecht (the Netherlands). Multivariate hazard ratios (HR) and 95% confidence intervals (CI) for CVD (non-fatal and fatal events) and overall mortality were estimated using sex-specific quartiles of GGT.
  
  
  RESULTS
  After 8.2 years follow-up, 108 incident CVD cases and 84 deaths were observed. Participants with high GGT activity had an increased mortality risk: HR in the highest quartile was 3.96 (95% CI 1.74, 9.00). This association was in particular present in former and current smokers, younger persons and those with a higher waist-height ratio and alcohol consumption. No associations were observed for non-fatal CVD and non-fatal and fatal CVD events combined.
  
  
  CONCLUSIONS
  Higher GGT plasma activity is associated with increased all-cause mortality in individuals with diabetes.
authors.affiliation: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. Diewertje.Sluik@dife.de
authors.forename: Diewertje
authors.initials: D
authors.lastname: Sluik
authors.forename: Joline W J
authors.initials: JW
authors.lastname: Beulens
authors.forename: Cornelia
authors.initials: C
authors.lastname: Weikert
authors.forename: Susan
authors.initials: S
authors.lastname: van Dieren
authors.forename: Annemieke M W
authors.initials: AM
authors.lastname: Spijkerman
authors.forename: Daphne L
authors.initials: DL
authors.lastname: van der A
authors.forename: Andreas
authors.initials: A
authors.lastname: Fritsche
authors.forename: Hans-Georg
authors.initials: HG
authors.lastname: Joost
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
authors.forename: Ute
authors.initials: U
authors.lastname: Nöthlings
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000401:mortality*; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012307:Risk Factors; D012907:Smoking / Q000401:mortality; D055105:Waist Circumference; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D005723:gamma-Glutamyltransferase