title: Gamma-glutamyl transferase and C-reactive protein as alternative markers of metabolic abnormalities and their associated comorbidites: a prospective cohort study.
abstract: BACKGROUND
  Recent studies suggested that gamma-glutamyl transferase (GGT) and C-reactive protein (CRP) are good markers of metabolic abnormalities. We assessed the link between GGT, CRP and common metabolic abnormalities, as well their link to related diseases, such as cancer and cardiovascular disease (CVD).
  
  
  METHODS
  We selected 333,313 subjects with baseline measurements of triglycerides (TG), total cholesterol (TC), glucose, GGT and CRP in the Swedish AMORIS study. Baseline measurement of BMI was available for 63,900 persons and 77,944 had baseline measurements of HDL. Pearson correlation coefficients between CRP, GGT, and metabolic components (TG, HDL, BMI and TC) were calculated. To investigate the combined effect of GGT and CRP we created a score ranging from 0 to 6 and used Cox proportional hazard models to evaluate its association with CVD and cancer.
  
  
  RESULTS
  21,216 individuals developed cancer and 47,939 CVD. GGT and TG had the strongest correlation (r=0.22). An increased risk of cancer was identified with elevated levels of GGT or CRP or both markers (GGT-CRP score ≥3); the greatest risk of cancer was found when GGT-CRP score = 6 (HR: 1.40 (95%CI: 1.31-1.48) and 1.60 (1.47-1.76) compared to GGT-CRP score = 0, respectively).
  
  
  CONCLUSIONS
  While GGT and CRP have been shown to be associated with metabolic abnormalities previously, their association to the components investigated in this study was limited. Results did demonstrate that these markers were predictive of associated diseases, such as cancer.
authors.affiliation: King's College London, School of Medicine, Division of Cancer Studies, Cancer Epidemiology Group London, UK ; Regional Oncologic Centre, Uppsala University Uppsala, Sweden.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Melvin
authors.forename: Crystal
authors.initials: C
authors.lastname: Rodrigues
authors.forename: Lars
authors.initials: L
authors.lastname: Holmberg
authors.forename: Hans
authors.initials: H
authors.lastname: Garmo
authors.forename: Niklas
authors.initials: N
authors.lastname: Hammar
authors.forename: Ingmar
authors.initials: I
authors.lastname: Jungner
authors.forename: Göran
authors.initials: G
authors.lastname: Walldius
authors.forename: Mats
authors.initials: M
authors.lastname: Lambe
authors.forename: Wayel
authors.initials: W
authors.lastname: Jassem
authors.forename: Mieke
authors.initials: M
authors.lastname: Van Hemelrijck