Γ-glutamyltransferase, hepatic enzymes, and risk of incident heart failure in older men.
OBJECTIVE
The relationship between γ-glutamyl transferase (GGT) and heart failure (HF) in older adults is unknown. We have examined the relationship between GGT, other markers of hepatic function (alanine aminotransferase, aspartate transaminase, and alkaline phosphatase), and incident HF in older men.


RESULTS
This was a prospective study of 3494 men aged 60 to 79 years with no diagnosed HF or myocardial infarction followed up for a mean period of 9 years, in whom there were 168 incident HF cases. Elevated GGT (top quartile, ≥38 U/L) was associated with significantly increased risk of incident HF in men aged<70 years but not in men aged≥70 years (test for age-GGT interaction, P<0.0001). The increased risk of HF associated with elevated GGT persisted after adjustment for a wide range of established and novel risk factors for HF, including diabetes, stroke, obesity, systolic blood pressure, atrial fibrillation, lung function, inflammation (C-reactive protein), endothelial dysfunction (von Willebrand factor), leptin, and N terminal pro brain natriuretic peptide (adjusted hazard ratio [95% CI], 1.91 [1.07, 3.42]). Other liver function markers showed no significant associations with HF after similar adjustments.


CONCLUSIONS
Elevated GGT was associated with increased risk of HF in men aged<70 years. Additional studies are now needed to determine the mechanisms responsible.
Department of Primary Care and Population Health, University College London Medical School, Royal Free Campus, Rowland Hill St, London NW3 2PF, United Kingdom. g.wannamethee@ucl.ac.uk
S Goya
SG
Wannamethee
Peter H
PH
Whincup
A Gerald
AG
Shaper
Lucy
L
Lennon
Naveed
N
Sattar
D000367:Age Factors; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D000469:Alkaline Phosphatase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D006333:Heart Failure / Q000097:blood / Q000201:enzymology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008099:Liver / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology; D015854:Up-Regulation; D005723:gamma-Glutamyltransferase / Q000097:blood*
D015415:Biomarkers; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase